bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between Stenting and Stentless Technique in Biliary Anastomosis after Living Donor Liver Transplantation
Authors: Abdelaal A A , Hassan M A M , Aboelnaga M A M , Rayan M T 
Published: May 2020

Abstract

Background
billiary complications is the most common complication after LDLT. Biliary complications include stricture, leakage, cholangitis, biliary stones, hemobilia and ductopenia. Risk factors of complications include advanced donor age multiple anastomoses, long cold and warm ischemia times, hepatic artery thrombosis and duct-to-duct reconstruction.

Aim of the Work
it is a combined retrospective and prospective analytical study to compare between using stent and stentless technique in biliary anastomosis in living donor liver transplantation.

Patients and Methods
in this observational study we did comparative study between stented and stentless technique. We compared the main complications; leakage, stricture and cholangitis. Diagnosis of each complications is built up by follow up serum liver profile, and Ultrasonography. We did MRCP to diagnose stricture and follow up drains or aspiration of any collection to confirm leakage. All cases of cholangitis was admitted to our hepatobiliary unit to control the condition and to exclude any concomitant stricture or leakage.

Results
there is a significant decrease in the previously mentioned postoperative biliary complication using stentless technique by decreasing biliary infection rate and, thus, decreasing stricture and leakage. Managment of complicated case was initially done by hospital admission. ERCP was done for all cases of sticture.

Conclusion
biliary complications after living donor liver transplant can significantly be reduced by using stentless techinque.
Role of Laparoscopy in Treatment of Diaphragmatic Hernia in Adult
Authors: Almenawy A A , Almaraghy A M , Farahat M S , Nageeb R M 
Published: May 2020

Abstract

Background
congenital diaphragmatic hernia in adult is a rare condition, most of cases are asymptomatic and discovered accidental. We reported 10 cases of diaphragmatic hernia repaired successfully via the laparoscopic approach.

Objectives
to describe the role of laparoscopy in treatment of congenital and traumatic diaphragmatic hernia in adult.

Methods
prospective study was conducted on 10 adult patients suffering from diaphragmatic hernia to evaluate the role of laparoscopy in treatment of diaphragmatic hernia in adult. The study was conducted at general surgery department of Ain shams university hospitals and Kafr ash Shaykh general hospital including all symptomatic types of diaphragmatic hernia on both adult male and female patients with age more than 18 years.

Results
We achieved satisfactory intracorporeal repair of these diaphragmatic defects. The patients had excellent recovery and started on oral diet one to two days postoperative except one patient (10%) started on the 5th day due to resection anastomoses, and then were discharged with symptomatic relieve after surgery.

Conclusion
The minimally invasive advantage of laparoscopic approach offers a secure, reliable and satisfactory way to confirm the diagnosis and achieve the repair of diaphragmatic hernia.
A Comparative Study between Traditional Care Program and Enhanced Recovery after Surgery (ERAS) Program in General Surgery
Authors: Abadir A F , Benjamine F M , Aziz A H F 
Published: May 2020

Abstract

Background
Enhanced Recovery after Surgery (ERAS) programs have been very important to surgeons who are keen to decrease postoperative morbidity, reducing variability in postoperative care and minimizing hospital costs

Aim of the Work
This study aims to assess the safety and efficacy of enhanced recovery after surgery programs in general surgery in comparison with traditional care.

Patients and Methods
The present prospective study was conducted at the General Surgery Department, Ain Shams University Hospitals in Cairo, Egypt from September 2017 to June 2018 on 80 patients undergoing general surgical interventions. Patients were randomly distributed into 2 groups: Group A (n = 40) for conventional protocol (control group) and Group B (n = 40) for enhanced recovery protocol (ERAS group).

Results
Patients of both groups passed the procedure efficiently without any intraoperative complications. The mean operative time was 155 minutes in control group and 160 minutes in ERAS group, this wasn’t statistically significant (P &gt; 0.05). The mean amount of blood loss was 150 ml in control group and 175 ml in ERAS group which was also insignificant (P &gt; 0.05). Mean length of hospital stay (LOS) was 3.05 in group A versus 1.2 in group B which was highly significant (P &lt; 0.001).

Conclusion
ERAS pathway was shown to be feasible for application in general surgery as it shortened postoperative hospital stay and showed no increased risk to patients in terms of morbidity or mortality.
Care of Breast in Pregnant and Lactating Females
Authors: Soliman Al-shaimaa G , Abdelrahman S A , Darweesh A A , Gerges W B , Tantawy H S 
Published: May 2020

Abstract

Background
Brest feeding is an important process that’s not only important for baby nutrition but also it strengthens the relation between the mother and her baby. Female breast undergoes multiple physiological changes during pregnancy and lactation.if the female not well educated about them and how to deal with them it will be a source of great horror to the female and her family as they consider any pain or unknown change in the breast as cancer until proved otherwise.

Objective
To assess breast care during pregnancy and its preparation for lactation and the value of this care in preventing breast infection.

Patients and Methods
This is a prospective study included 85 female patients coming to breast clinic and obstetric clinic of El Demerdash Hospital from September 2017 to August 2018. 40 of them presented during the third trimester of their pregnancy and the remaining 45 presented during lactation period. Sixty –three of them were multipara, the others were primigravida. Thirty of them gave a history of problems with previous lactation.

Results
In our research, females who came and were followed during pregnancy were educated about the importance of breast feeding to the baby and to the mother during their visits to the obstetric clinic. They were taught how to take care of their breast preparing it for safe and comfortable nursing. 35% of them were previously suffered from breast engorgement in previous lactation but when they followed our instructions about 27% of them developed breast engorgement which relieved rapidly without progressing to further complications. Also 5% previously developed breast abscess which was avoided in current study. We had also two of our participants that had retracted nipple one of them had previous experience of lactation that stopped shortly after birth but when we reassure her and learn her how to prepare her nipples by gentle massage, lubricants and use of plastic shells after delivery she could overcome her problem and continue breast feeding. Females who came during lactation were not prepared properly during pregnancy and 44% of them suffered from breast engorgement which was relieved with proper management but one of them developed breast abscess.

Conclusion
Every female have to learn about the right position of nursing and how to make proper care of her breasts and when she has to seek medical advice. This will help her to adapt the act of nursing and overcome any annoying problem that she may face during this period.
Comparative Study between Mass Closure and Hughes Repair in Emergency Laparotomy
Authors: Ebied E F , Khalil A A , Soliman A M 
Published: May 2020

Abstract

Background
Exploratory laparotomy remains one of the common operations across the surgical disciplines. As such, the systematic and safe closure of such a laparotomy wound is the key to reduce the postoperative morbidity like wound pain, wound infection and incisional hernia.

Objective
To compare mass closure & Hughes repair in emergency laparotomy as regard intraoperative technique, operation time, incidence of complication as wound infection, dehiscence, burst abdomen and incisional hernia.

Patients and Methods
This is a prospective comparative study between two types of closure, mass closure and hughes repair in emergency laparotomies. This study was conducted at Ain-Shams University Emergency Hospitals. Patients who underwent emergency laprotomy from September 2017 to March 2018 and the patients were followed up postoperatively for six months. All patients who underwent emergency laparotomy at Ain-Shams University Emergency Hospitals from September 2017 to March 2018 were chosen according to inclusion and exclusion criteria.

Results
In this study we used the same suture and materials” Polydioxanone PDS loop 1”. The comparative study included several items to discuss starting from the time of the technique in our study it ranged from 12 -19 minutes in the conventional method “Mass closure” and it ranged from 24-31 minutes in the huge repair group. It was observed that the length of the laprotomy incision determine the time of the technique. The overall operative time of mass closure group was shorter than the hughe repair technique

Conclusion
It was observed that there were major factors that affected the results such as the reason for the laparotomy and the general condition of the patient especially the chest condition, diabetes mellitus, serum albumin, anemia and the body mass index.
Role of Single Anastomosis Gastric Bypass Surgery in Class-I Obese Diabetic Patients
Authors: Sabry A A , Abdel-Samee K S , Kamel K A 
Published: May 2020

Abstarct

Background
bariatric surgery was originally designed to induce weight-reduction in morbidly obese patients. Benefits of bariatric surgery, however, extend well beyond weight loss and include dramatic improvement of type 2 diabetes, hypertension, dyslipidemia and reduction of overall mortality.

Aim of the Work
to evaluate the metabolic and weight loss effect of single anastomosis gastric bypass surgery in Class-1 obese diabetic patients type-2 in the first year postoperative follow up.

Patients and Methods
this study included 40 mild-obese patients (Class-I) with T2DM with one or both of the following (hypertension and hyperlipidemia) treated by laparoscopic Mini-Gastric Bypass.

Results
the mean BMI loss after one year from MGB surgery was (6.8 ± 1.1 kg/m2). Complete resolution of diabetes occurred was in 82.5% at 12 months and cases with no remission in DM was 0%. Regarding the Hypertension, resolution of Hypertension was 63.6%. improvement was 23% and no change in Hypertension status was 13.6%. Regarding Hyperlipidemia; resolution of Hyperlipidemia was 62.5%, improvement was 21% and no change in Hypertension status was 16.5%.

Conclusion
bariatric surgeries (MGB) is not only a weight-reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and it is considered the most effective long term treatment modality for type 2 diabetes in mild-obese patients, our study suggests that MGB is highly effective in controlling diabetes, hypertension and hyperlipidemia.
Comparison between Immediate and Delayed Prosthetic Breast Reconstruction Following Mastectomy
Authors: Wassef B A , Hassan W H , Ahmed R M , Shebl E S 
Published: May 2020

Abstract

Purpose
to compare the outcomes of Immediate versus Delayed prosthetic breast reconstruction. Together with highlighting the importance of immediate reconstruction when it is feasible.

Materials and methods
This was a prospective study that was held at ain shams university hospitals and Helwan university hospital. The study included 20 patients who were planned to undergo a mastectomy either unilateral or bilateral, patients were divided equally in to 2 groups, (Group A) had an immediate breast reconstruction using mammary implants, while (Group B) had a delayed breast reconstruction using tissue expander then replacing it after a few months with a mammary implant, and the post operative complications were compared against each other.

Results
Although the number of complications were more in (Group A), but statistically it was found that the rate of complications after immediate reconstruction was non significant from after delayed reconstruction.

Conclusion
both immediate and delayed mastectomy reconstruction provide substantial safety and quality of life benefits for women choosing these procedures. Furthermore, patients who postpone reconstruction after mastectomy due to personal preference or by medical necessity can be reassured that this approach is a safe alternative to immediate reconstruction and can provide equivalent quality of life and body image benefits.
Outcome of Anticoagulant Therapy Following Bariatric Surgery
Authors: Yousef A M , Mohamed A F , Elshayeb B H , Abdelmalak G M 
Published: May 2020

Abstract

Background
Bariatric surgery remains the most effective means of treating severe obesity. The number of severely obese patients is increasing and, consequently, more people are seeking bariatric surgery.

Aim of the Work
The Aim of This Study is to Outcome of Anticoagulant during Bariatric Surgery and Relation of Bariatric Surgery to Coagulopathy Disease.

Patients and Methods
This prospective study was conducted on 50 morbidly obese patients admitted to Hospital (Ahmed Maher Teaching Hospital and Ain Shams University Hospitals), for a primary one-stage laparoscopic bariatric surgery procedure over a 6-month period. The study is performed on 50 Patients, Who met all Inclusion criteria and none of Exclusion criteria.

Results
The study revealed no statistically significant difference between Enoxaparin and Rivaroxaban according to outcome of anti-coagulation therapy following bariatric surgery.

Conclusion
a high protective value of Chemical Thromboprophylaxis combined to Mechanical Thromboprophylaxis in preventing DVT safely. New Oral Anticoagulant drugs showed equal and may be superimposed the other traditional anticoagulant, but it needs more studies regarding its prophylactic dose, number of patient and its cost benefit in comparison with other Anticoagulant drugs were used in our study or other studies we mentioned above.
Comparative Study on Effect of Mesenchymal Stem Cells and Endothelial Progenitor Cells on Treatment of Experimental CCL4 Induced Liver Fibrosis
Authors: Sabry D , Khalifa W A , Abdelgwad M M , Alhelf M , Altaib Z M 
Published: May 2020

Abstract

Background
Bone marrow mesenchymal stem cells (BM-MSCs) and human umbilical cord endothelial progenitor cells (UC-EPCs) have several benefits for liver regeneration. We speculate huge impacts of rat BM-MSCs and UC-EPCs on reversal of hepatic injury and improvement of liver function in liver fibrosis induced by carbon tetrachloride (CCl4).

Methods
Forty adult rats were divided into 4 groups; control group, CCl4 group, CCl4/BM-MSCs group and CCl4/UCEPCs group. Blood samples were driven from rats at 1, 2 and 3months to measure serum concentration of albumin and alanine aminotransferase (ALT). Quantitative expression of HGF,TGF-β, MMP-2, and VEGF were assessed by polymerase chain reaction. Histological examination of the liver tissue was performed. α-SMA immunohistochemistry to identify the myoepithelial cells (MECs) and Ki-67 to identify cell prolifration immunohistochemistry are detected in groups injected with cells to confirm cells regeneration.

Results
Regarding liver function, there was elevating albumin (P &lt; 0.05) and reducing ALT (P &lt; 0.05) concentrations in groups treated with BM-MSCs and UC-EPCs effect compared to untreated CCL4 group. Concerning gene expression, UC-EPCs treated group have significantly higher MMP-2 and VEGF (P &lt; 0.01) genes expression than BM-MSCs treated group. Furthermore, UC-EPCs were more valuable than BM-MSCs in increasing gene expression of HGF (P &lt; 0.05) and immunohistochemistry of α-SMA and Ki-67 (P &lt; 0.01). BM-MSCs have significantly lower TGF- β (P &lt; 0.00) compared to UC-EPCs.

Conclusion
This study highlighted on liver regeneration role of both human UC-EPCs and BM-MSCs in liver fibrosis by different signaling mechanistic.
Comparing different risk factors associated with delisting of hepatocellular carcinoma patients candidates for liver transplantation
Authors: Elkarmouty K Z , Ahmed M M B , ElKilany H H , Rasmy H S , Mohamed R S , Iskandar E E E 
Published: May 2020

Abstract

Background
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide, with more than 1 million new cases diagnosed every year. Liver transplantation (LT) has been used as a curative treatment for patients with HCC. In countries where the liver allograft allocation is based on the Model for End-Stage Liver Disease (MELD) system, patients with HCC within the Milan criteria (MC) receive exception points, preventing dropout from the list.

Objective
The aim of this study is to analyse the different risk factors leading to delisting in liver transplant patients with hepatocellular carcinoma.

Methods
This study was a retrospective cohort study which had been carried out during the period between January 2017 to June 2018. During it, 48 patients were listed for LDLT at Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams Specialized Hospital till liver transplantation. By the end of this period 29 patients were delisted due to several reasons while 12 got transplanted and 7 were still on the waiting list. The study protocol was approved by the medical ethics committee of Ain Shams University.

Results
Regarding this study’s results, 25% were transplanted, 60.42% were delisted and 14.58% remained on the waiting list. 51.72% of patients in this study were delisted due to unavailability of related donor. In this center only related donors were allowed to donate as it follows Egypt’s organ donation policies, there are no organ allocation systems and deceased donor liver transplantation is illegal limiting availability of donors.

Conclusion
At the end of this study we can conclude that, age and tumour classification were independent predictors of delisting HCC patients candidates for liver transplantation.
Study of interlukin 6 (IL -6) in chronic lymphocytic leukemia patients
Authors: Hassan E A , Abdelhady E A , Hamza M T M , Abdelsamee H F , Elrazzaz M K , Hafez G H F 
Published: May 2020

Abstract

Background
Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. These malignant B-CLL cells represent over 99% of peripheral blood mononuclear cells (PBMCs) in CLL patients. In case of an aggressive form, the cell number may quickly double and, as a result, the disease may be fatal within a relatively short period of time .Currently several biomarkers are being used as CLL prognosticators, including: elevated protein levels (e.g. TCL-1, ZAP-70, CD38), elevated RNA levels (e.g. CLLU1, LPL, miRNAs), gene mutations (e.g.TP53, SF3B1, BIRC3, NOTCH1) and epigenetic changes. Early reports implicated IL-6 as pro-tumorigenic factor in various human tumors. IL-6 levels increased significantly in serum of CLL patients and correlated with adverse clinical features and short survival.

Aim of the work
Is to evaluate IL 6 level in patients with CLL at time of presentation and 6 months after chemotherapy and to study its relevance to disease prognosis.

Patients and Methods
This Study is a cross sectional study that was conducted on 55 patients newly diagnosed with chronic lymphocytic leukemia (CLL) in Clinical Hematology Unit in Ain-Shams University Hospitals in Cairo, Egypt. The control group included 50 healthy control subjects.

Result
The initial serum IL 6 level in the patient group (pre-treatment) ranged from 36-91pg/mL (median 57), and in the control group it ranged from 1-2 pg/mL (median 1).The initial serum IL 6 level in patient group (pre-treatment) range from 36-91 pg/mL (median 57), and in patient group (post treatment) range from 1-32 pg/mL (median 2).There are positive correlations between IL6 level and with WBC, B2 microglobulin, LDH, ESR, B symptoms, Uric Acid, BM Aspirate (% of lymphocytes)and Binet and Rai staging system.

Conclusion
Serum IL 6 is a useful poor prognostic marker in newly diagnosed CLL patients, its prognostic value goes with the other known prognostic markers as the lymphocytic count, ESR and LDH.
Abbreviations: CLL (chronic lymphocytic leukaemia); IL-6 (interleukin 6).
Caudal block versus penile block for postoperative analgesia in children undergoing hypospadias repair
Authors: Salama H G , Elsersi M H , Shabana T S , Mahanna J M 
Published: May 2020

Abstract

Background
Hypospadias repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery.

Aim of the Work
The aim of this work is to evaluate the success rate and the effectiveness of penile block for hypospadias repair in pediatric patients in comparison with caudal block.

Patients and Methods
This prospective randomized study was conducted in Ain Shams University Hospitals; Pediatric Surgery Unit. It included 80 ASA I or II patients undergoing hypospadias (distal penile and mid penile) repair. They were divided into two groups: Group P: Group P penile block (n = 40) received dorsal penile nerve block by using the subpubic approach technique. Group C: Group C caudal block (n = 40) received caudal epidural block using a 22-G needle in the lateral decubitus position.

Results
There was no statistically significant difference between two groups regarding haemodynamics including MBP (P &lt; 0.05) and HR (P &lt; 0.05). FLACC pain scores were significantly lower in group C compared with group P (P&lt; 0.01). Also, the time to first need for analgesia was significantly lower in group C compared with group P (P&lt; 0.001) .The total rescue analgesic requirement was also significantly lower (P&lt; 0.001) in group C compared with group P.Postoperative time of ambulation was also significantly lower (P&lt; 0.05) in group P compared with group C.

Conclusion
the current study revealed that caudal block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and prolonged time of ambulation as compared with penile block in pediatric patients undergoing hypospadias repair.
Non-alcoholic Fatty Liver Disease and ECG changes in Egyptian Patients
Authors: Alsawaby A S , Elfeky R A , Mohamed A E , Abdelaziz H , Saleh S A , Mohammed H G , Montasser I F , Abdelbary M H 
Published: May 2020

Abstract

Background
interactions between the heart and the liver have been described. The presence and severity of non-alcoholic fatty liver disease (NAFLD) was found to be associated with increased QTc interval and subclinical cardiac abnormalities.
Aim of the work is to evaluate the electrocardiographic (ECG) and echocardiographic changes in patients with NAFLD and its correlation with disease severity.

Patients and Methods
this study was conducted on 50 NAFLD patients and 50 controls. Clinical, laboratory, ultrasonographic examinations were done for all included subjects together with liver biopsies. ECG and ECHO were also performed.

Results
longer corrected QT was found in the NAFLD group in comparison to controls (406.6±26.8 msec and 380.0±24.5 msec respectively). Significant correlation between QTc and liver size, grade of steatosis and NAFLD activity score (NAS) was found. 16% and 8% of NAFLD patients had diastolic and valvular dysfunctions respectively.

Conclusion
NAFLD is associated with significant QTc prolongation and structural heart changes with significant correlation between QTc and disease severity.