bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study the Role of Loose versus cutting of Seton in Treatment of High Perianal fistula in a District Hospital of Health Insurance
Authors: Abdelhameed M S , Elghazawy I M H , Elsayed E A 
Published: May 2020

Abstract

When the track reaches the skin or another epithelialized surface then a fistula is formed. Anal fistula were classified on the basis of its relationship to the sphincters. The definition of high or low describes the height of the track as it traverses the sphincter muscles and not the position of the internal opening which is almost without exception at the dentate line. More accurately according to parks classification fistula in ano can result in an abscess between the internal and external sphincters, which in turn can spread to other parts of the perianal region. Infection can then track in many directions from this focus in the intersphincteric plane.

Background
Anal fistula is an abnormal communicative small channel that has an internal opening and an external opening and connected by the primary track. Our study evaluate the effectiveness of seton in high variety anal fistula.

Objectives
Evaluation the efficacy and safety of seton as surgical management of high anal fistula. Methods: This is a prospective study done on 30 patients in ELNile hospital in one Year period with high variety of anal fistula which is above the dentate line and were treated with seton .Outcome measured during follow up period were- successfully healed, recurrence, incontinence, percentage of complications and patients satisfaction.

Result
Among 30 patients mean age was 42.2+_6.8 years. Overall outcome of the patients showed-fistula completely healed in 27 patients, incontinence occurred in 3 patients and recurrence occurred in 3 patients.

Conclusion
Seton is relatively safe, effective and low cost for the management of high anal fistula with low rate of incontinence. It can therefore, be recommended as the standard of treatment for high variety fistula in ano.
Skin Sparing Mastectomy as an Oncoplastic Surgery Technique for Breast Cancer treatment
Authors: Alanwar A M , Osman A G , Abdelhamed M A , Ebrahim A N E 
Published: May 2020

Abstract

Background
The goal of modern breast surgery is to cure patients with preservation of breast tissue as much as possible with satisfactory physical and psychological outcome. This goal has led to introduction of a new scope of surgery into our clinical practice called oncoplastic breast surgery, with the advantage of combining oncological safety and satisfactory cosmetic outcome.

Objective
To focus on skin sparing mastectomy as a surgical procedure for treatment of breast cancer and to assess outcomes and benefits versus complications.

Patients and Methods
It was a retrospective analytical study that included 30 patients aiming to clinically assess the skin sparing mastectomy as an oncoplastic technique regarding oncological safety and patient satisfaction. This study was conducted at Ain-Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained.

Results
In our study 6 patients underwent SSM and 24 Patients underwent NSM owing to high tumor/breast volume ratio. In our study we were able to conduct an very good cosmetic outcome for a relatively large tumor excisions with 66.7% of the cases (20 patients) falling in excellent and very good score. In our study only one of the patients had malignant recurrence as confirmed by the pathologist in our multidisciplinary team proving that we had performed skin sparring mastectomy technique safely from oncological point of view. The follow up of the malignant recurrence was for the first year as this was the time limitation of our study.

Conclusion
Skin sparing mastectomy has been proven as an alternate to traditional radical mastectomy with the same oncological safety and better cosmetic outcome.
Role of Neoadjuvant Chemotherapy in Stage 1, 2a Breast Cancer in Female Patients Breast Cup (A-C)
Authors: Elilan W A , Osman A G , Abdelaziz M O , Adly K B 
Published: May 2020

Abstract

Background
breast cancer is considered the most common cancer diagnosed in women worldwide with an incidence of 1.7 million new cancer cases in 2012. It is the fifth most common cause for cancer related mortality worldwide with a trend for increased mortality rates despite recent advances in breast cancer management. Currently, breast cancer is the most common cancer and one of the major health burdens for both developing and developed countries.

Purpose
to evaluate the impact of neoadjuvant chemotherapy in female patients stage 1, 2a breast cancer with breast cup (A-C)

Patients and Methods
we collected data from the records of female patients with breast cancer of stage 1,2a who had undergone documented preoperative biopsy and underwent chemotherapy neoadjuvant therapy at Ain Shams University Hospitals from September 2017 to June 2018. An informed consent was taken from all the patients sharing in the study.

Results
this study favors the idea of Neoadjuvant chemotherapy usage prior to any surgical intervention in early stage breast cancer. However, there were other studies that questions its role and demand a reconsideration about the oncological and clinical outcome which require further investigation.

Conclusion
it is clinically important to evaluate the value of the neoadjuvant chemotherapy in early stage breast cancer as it directs the future therapy. Although there is no obvious opinion with or against the neoadjuvant chemotherapy but through our studies the result support its significant role in downsizing and downgrading the tumor.
Assessment of Effect of Preoperative Vitamin D Deficiency on Postoperative Hypocalcemia after Total Thyroidectomy, A Prospective Study
Authors: Farahat M S , Omran H M , Abbas R F , Ghida A A A 
Published: May 2020

Abstract

Background
One-day surgeries are routinely performed for hemithyroidectomy, but hospital stay duration is more controversial after total thyroidectomy due to postoperative, potentially life-threatening complications.

Aim of the Work
The aim of this study is to assess the effect of pre-operative vitamin D3 deficiency on post thyroidectomy hypocalcemia.

Patients and Methods
Type of Study: This was a prospective cohort study which included 60 Egyptian patients for whom total thyroidectomy had been performed. Study Setting: Patients were recruited from general surgery department at Kafr Elshiekh University Hospital and Ain Shams University Hospital. Study Period: The study duration was form April 2018 to October 2018.

Results
The main findings of the current study as regards to calcium was that the mean preoperative level of calcium was 9.61 ± 0.48 mg/dl, the lowest level of postoperative calcium was detected after 48 hours (9.03 ± 0.73) and the highest postoperative level was measured 12 hours after the operation. With respect to relation between calcium and preoperative vitamin D, the results showed that no patients with normal preoperative vitamin D had a postoperative hypocalcaemia 12, 24, 48 or 72 hours after the operation. After one month, however, 2 patients with normal preoperative vitamin D level, had hypocalcaemia. It worth mention that these two patients had border line normal preoperative vitamin D level. The percentage of patients with low preoperative vitamin D level who had postoperative hypocalcaemia was 5%, 5%, 25% and 15% after the operation by 12, 24, 48 and 72 hours respectively while after one month, the percentage was 10%. The differences between hypocalcaemia incidence between patients with normal and below normal vitamin D levels was statistically significant although it was a borderline significance. The sensitivity and specificity of preoperative vitamin D level in prediction of postoperative hypocalcaemia was 87.50% and 40.91% respectively.

Conclusion
After investigating the postoperative calcium level in patients with and without preoperative vitamin D deficiency, the study had the following conclusions: Vitamin D deficiency is significantly common among Egyptian population, postoperative hypocalcaemia is closely related to the preoperative vitamin D level and patients with hypovitaminosis D are more labile to hypocalcaemia and females are more likely to have postoperative hypocalcemia.
Management of Post-operative Leakage after Sleeve Gastrectomy (A Systematic Review)
Authors: Khalil A I , Lasheen M A , Elzayyat I M , Hammad O R K 
Published: May 2020

Abstract

Background
the prevalence of obesity and overweight have reached epidemic proportions in the last decades, with estimates by the World Health Organization (WHO) pointing that about 2 billion people are at least overweight worldwide.

Aim of the Work
to establish, through the available literature, what is the current management of leakage after sleeve gastrectomy in relation to each patient’s condition through the range of interventions available and their effectiveness.

Materials and Methods
the search is carried out using the electronic national library of medicine’s PubMed database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications focusing on post-operative leakage. Electronic results were screened by title to exclude duplicate studies. Articles were identified by keywords: “laparoscopic sleeve gastrectomy” “leakage after sleeve” “gastric leak” and “management of leakage” and will be limited to research papers of all designed on human patients in English languish. Articles with no focus on leakage after sleeve gastrectomy were excluded from eligibility in this review.

Results
through this study, it is found that: 1- Early detection and management are very important to control the leak. 2- The early unstable patient should be operated for lavage and drainage and re-suturing of leak site if the tissue still healthy. 3- Management of the leakage after LSG still non-standardized and there are multiple treatment options, so it is important to carefully choose the best treatment options for each patient.

Conclusion
early diagnosis and deciding the best treatment option is important to reach a complete resolution of the leak. From this study, we concluded that treatment of gastric leak after LSG mainly depend on three factors; time of the leak, clinical presentation of the patient and site of the leak.
Early results of negative pressure wound therapy in treatment of chronic wounds
Authors: Maaty S A , Gerges S M , El-desoki A A , Khalil M M 
Published: May 2020

Abstract

Background
Chronic wounds may affect only the epidermis and dermis, or they may affect tissues all the way to the fascia. Chronic wounds seem to be detained in one or more of the phases of wound healing. For example, chronic wounds often remain in the inflammatory stage for too long.

Aim of the work
to assess the effect of negative pressure wound therapy in management of chronic wound.

Patients and Methods
This is prospective study was conducted on 30 Egyptian volunteers participated; they were 20 males and 10 females, between the age of 18 and 70 years. This study was conducted from July 2017 to July 2018 at Ain shams university specialized hospitals and Alexandria armed forces hospital.

Results
VAC therapy, together with periodical surgical wound debridement and specific antibiotic therapy, could be helpful to promote and accelerate wound healing of foot lesions after restoration of an adequate distal blood flow through surgical revascularization or angioplasty.

Conclusion
Negative-pressure wound therapy (NPWT) devices are designed to apply controlled suction to a wound bed at continuous or intermittent pressure settings to stimulate wound closure. Negative pressure can result in numerous alterations in the wound environment, including removal of excess exudate containing high concentrations of proteases and inflammatory cytokines, stimulation of senescent cells, mobilization of macrophages, and stimulation of angiogenesis.
The Role of Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Sciatic Nerve Injury in Rats
Authors: Saba C R , Abdeltawab S M , Omar S M , AboZeid A A 
Published: May 2020

Abstract

Background and Objectives
experimentally, peripheral nerve repair can be enhanced by Schwann cell (SC) transplantation but the clinical application is limited by donor site morbidity and the inability to generate a sufficient number of cells. We have investigated whether stem cells, isolated from adipose tissue, can enhance the regeneration of crushed sciatic nerves in adult male albino rats.

Materials and Methods
we divided our rats into 3 groups of 10 rats each. Group I was the control group. Group II underwent crushing of their left sciatic nerves and were left for spontaneous recovery. Group III underwent crushing of their left sciatic nerves with local transplantation of ASCs around the injured nerve. We then compared the effect of spontaneous recovery versus local injection of ASCs in the regeneration of the nerves.

Results
The results were evaluated 4 weeks postoperative; sciatic nerves were stained by H&E, and immunohistochemically using S-100. The results showed a significant increase in axonal regeneration with the ASCs treated group compared to the spontaneous recovery one.

Conclusion
Our results suggested that ASCs have a beneficial role in treatment of peripheral nerve injuries.

Keywords
ASCs, Sciatic nerve crush injury, S-100
Histological study on the effect of single prolonged stress model on the hippocampus of adult male albino rat
Authors: Moussa N , Elshakaa N , Kalleny N , Elwaseef D 
Published: May 2020

Abstract

Introduction: Post- traumatic stress disorder (PTSD) is a psychiatric disorder which occurs after the experience of life threatening events as natural disasters, military combat, serious accidents, or violent sexual assaults. It has a severe impact on quality of life.

Aim of the work
to study the effect of single prolonged stress on the structure of hippocampus in adult male albino rats.

Materials and Methods
20 adult male albino rats were randomly divided into four groups control group (group I) and single prolonged stress group examined at day 1(group II), day 7 (group III) and day 14 (groupIV). Rats were restrained by placing them in plastic restrainers, immediately followed by 20 minutes of forced swimming in 20–24°C water. Rats were exposed to ether until general anesthesia then they were placed in their home cages. At the end of the experiment, the hippocampi were taken and processed for light microscopic study.

Results
pyramidal cells of the CA3 region of the hippocampus showed progressive degeneration with passage of time from day 1 to day 14 with decrease in thickness. Transient increase in glial fibrillary acidic protein (GFAP) expression in the astrocytes of the hippocampus was detected at day 1 followed by reduction in GFAP expression started at day seven and continued to day 14.

Conclusion
post-traumatic stress PTSD causes significant structural hippocampal neuronal damage affecting the CA3 hippocampal subfield.
Taurolidine citrate and unfractionated heparin combination versus unfractionated heparin alone in prevention of inflammation in hemodialysis catheters
Authors: Elsharkawy M , Ezzat H , Rezk K , Emara A , Mohsen R , Mansour A M 
Published: May 2020

Abstract

Introduction and Aims
Patients on hemodialysis (HD) using dialysis catheters have significantly higher rates of morbidity and mortality which has been associated with chronic inflammatory state. In Egypt 6.6% of HD patients use catheters, of which short term catheters represent 59.6% and 40.4% with long-term catheters. In this study we aim to assess the possible effect of using Taurolidine citrate and unfractionated heparin (Taurolock-hep500™) in comparison to unfractionated heparin, as a lock solution for temporary hemodialysis catheters, on inflammatory status in HD patients.

Methods
a randomized controlled clinical trial that included 60 stable HD patients recruited from Ain Shams University hospitals at the time of catheter insertion. They were divided into two groups, Group 1: 30 Patients received taurolidine and citrate (4%) and 500 i.u of heparin as a catheter lock solution after hemodialysis sessions, Group 2: 30 patients received unfractionated heparin (5000i.u) as a catheter lock solution after hemodialysis sessions.
Standard aseptic techniques were used in handling catheters. High sensitive C-reactive protein (hsCRP) and interleukin 6 (IL-6) were measured in serum for both groups and samples were obtained at baseline and after 1 month of using the lock solutions.

Results
Group 1 (mean age 39.5 ± 14, 46.7% males), Group 2 (mean of age 39.3 ±14,60% males). At base line, there was no significant difference between both groups regarding hsCRP (P = 0.366) and IL-6 (p = 0.900). While after 1 month of using the lock solution there was significant difference as regard levels of hsCRP (p = 0.001) and IL-6 (p = 0.018),with the higher levels of inflammatory markers showed in group 2.

Conclusions
we may conclude that the use of Taurolidine citrate and unfractionated heparin combination as a lock solution for HD catheters reduces the inflammatory markers, and the inflammatory status in HD patients when compared to the standard unfractionated heparin lock as demonstrated by reducing the levels of inflammatory markers (hsCRP and IL-6). This may have good clinical consequences regarding the quality of life in HD patients.
Assessment of Vitamin D Status in Egyption Boys Aged 2-10 Years
Authors: Botros R M , Elbarbary N M , Bahaaeldin A M , Abdelshakour H F 
Published: May 2020

Abstract

Background
Vitamin D plays an essential role in calcium homeostasis and bone metabolism. Recent evidence suggests that vitamin D may also be important for a variety of non-skeletal outcomes including neuromuscular function, immunomodulation, and control of other hormonal system. It is well known that exposure of skin to direct sunlight is the most important source of vitamin D, so that according to many causes like fear of skin cancer, traditional clothing and spending most of the time indoors many Egyptian girls are exposed to vitamin D deficiency. Hypovitaminosis D is a widespread disorder in developing countries across all age groups, regardless of their latitude.

Objective
The aim of this study was to evaluate the magnitude of vitamin D deficiency/sufficiency in a sample of Egyptian boys children.

Subjects and Methods
The present study was conducted on 80 boys age from (2-10) years old randomly selected from outpatient clinic of Ain Shams University and their healthy relative. We excluded girls, boys whose age&lt;2 years or &gt; 10 years, boys suffering from chronic illness or on drugs as corticosteroid and anti-epileptic drugs.

Results
The results demonstrate that all boys studied have vitamin D deficiency with (36.25%of them with mild vitamin D deficiency, 46.25%of them have moderate vitamin D deficiency, and 17.50% of them have severe vitamin D deficiency. There was positive correlation between vitamin D and sun exposure.
A Comparative Study of the Diagnostic and Prognostic Value of Macrophage Activation Marker Soluble CD163 and Alpha Fetoprotein in Cirrhotic Patients with Hepatitis C Virus-related Hepatocellular Carcinoma treated by Loco-Regional Therapy
Authors: Mohamed K A , Mohamed E S , Hussein A M , Fouad M H A , Allam A S , Sakr M A M M 
Published: May 2020

Abstract

Background
hepatocellular carcinoma (HCC) shows an increasing incidence and represents the third most common cause of cancer-related death.

Aim of the Work
is to evaluate the diagnostic value of serum level of Macrophage activation marker soluble CD163 as a tumor marker for HCC and its prognostic value after transarterial chemo-embolization (TACE) or radiofrequency ablation (RFA), in comparison to alpha-feto protein (AFP).

Patients and Methods
this study was performed on 60 subjects from the outpatient Hepatology clinic and inpatient Gastroenterology and Hepatology Department at Ain Shams University Hospital.

Group I
includes 40 randomly selected cirrhotic patients with hepatitis C virus-related hepatocellular carcinoma (excluding BCLC class D) who underwent either RFA or TACE.

Group II
includes 20 patients with liver cirrhosis without hepatocellular carcinoma considered as control.

Results
soluble CD163 expression did not differ significantly between HCC group and liver cirrhosis group. This proves that soluble CD163 is not suitable for diagnostic use. On the other hand, soluble CD163 was associated with the severity of liver disease. Baseline soluble CD163 was significantly associated with disease progression independent of other risk factors known to be associated with an unfavorable course in HCC. Also the marked significant reduction of serum soluble CD163 levels in HCC patients subjected to either RF ablation or TACE proved that soluble CD163 may play a prognostic marker in HCC monitoring.

Conclusion
soluble CD163 is not suitable as a diagnostic marker for HCC but can be used as a prognostic marker for HCC.
Effect of hemodiafiltration on sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis
Authors: Elsayed H M , Elsharkawy M M , Kamel C R , Hussein H S , Abdelgawad M A , Abdelsamea M S 
Published: May 2020

Abstract

Background
sclerostin, an osteocyte-derived glycoprotein acts as a soluble inhibitor of the Wnt signaling pathway and its physiological role is to reduce bone formation. The serum sclerostin levels increase with the progression of CKD.

Aim of the work
in the present study, we investigated the effect of three months thrice weekly hemodiafiltration on serum sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis in stable HD patients.

Methods
prospective study was concluded upon 32 randomly selected ESRD patients from Dialysis Department in Ain Shams University Hospitals and Maadi Military Hospital. Serum sclerostin and bone specific alkaline phosphatase were measured at the start of the study (Zero months) and after 3 months of HDF dialysis between September 2017 and December 2017.

Results
32 test subjects were randomly selected had mean age 47.38 (± 18.68 years) in HDF group and 55.31 (± 7.40 years) in high flux group. 56.3% were male in HDF group, 81.3% male in high flux group. Patients in HDF group had serum sclerostin reduction ratio with mean 24.72 ± 10.34 pre-3 months and mean 30.34 ± 12.22 in post-3 months. While, serum sclerostin reduction ratio mean was 18.97 ± 7.87 in high flux group. There was a statistically significant difference between HDF group post-3months and high flux group as regard sclerostin reduction ratio (P-value: 0.015). There was no statistically significant difference between group HDF post-3 months and group high flux as regard BS-AP reduction ratio (P-value: 0.212).

Conclusion
Sclerostin decreased by HDF. Yet, HDF has no effect on bone specific alkaline phosphatase in comparison to high flux hemodialysis.