bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Sinus Laser Assisted Closure (SiLaC) for Pilonidal Disease: Technique and Short Term Outcomes
Authors: Masoud Amr Shahat , Ahmed Tarek Youssef , Abdel-Maksoud Ibrahim Magid , Khalil Ahmed Aly 
Published: November 2024

Abstract

Background
Pilonidal disease (PD) is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal (inter-gluteal) cleft the term ―pilonidal‖ means ―nest of hair. Different Modalities were described to treat PD however, there is no consensus on the best method to eradicate this disease without recurrence.

Aim of the Work
To describe the technique for Sinus laser assisted closure (SiLaC) in the treatment of pilonidal disease and evaluate the short term outcomes regarding pain, wound infection, rate of wound healing and early recurrence.

Patients and Methods
A prospective clinical study, this study was conducted at the General surgery department, Ain Shams University Hospitals on 25 patients with PD. Approval of the Ethical Committee and written informed consents from all participants were obtained.

Results
The study included 25 patients with 18 males and 7 females. Their age ranged between 19 and 24. Pain score dropped from 4 on the first post operative day to 0 on the seventh day on VAS. Notably, there was no postoperative bleeding in all patients. Recurrence rate was 11.1% in non branched cases and 57.1% in single branched cases.

Conclusion
SiLaC is a feasible technique for the treatment of Pilonidal disease, It is proved to be safe, reproducible with early resumption of normal activities and return to social life. However, it gives best results in simple non branched cases. Further studies with larger number of patients and long-term follow-up will provide more precise data about the procedure with clearer understanding of its effectiveness and durability.
Evaluation of the Role of Intraoperative Cervical Lymph Node Frozen Section in Detection of Cervical Lymph Node Metastasis in Differentiated Thyroid Carcinoma Surgeries
Authors: Shehata Amr Maher Mohamed , El-Shafei Mahmoud Ahmed Mohamed , Hanna Hanna Habib , Ibrahim Eman Abdel-Salam , Ghaly Ayman Magdy Boutros 
Published: November 2024

Abstract

Background
Lymphatic metastases at the time of diagnosis are common in differentiated thyroid cancer. There is still continuing controversy regarding the role of prophylactic cervical lymph node dissection in patients with differentiated thyroid cancer, it is widely accepted that in the presence of cervical lymphadenopathy, cervical lymph node dissection is indicated at the time of initial thyroidectomy. Occasionally, skip metastases can occur, but in general lymphatic dissemination occurs in a stepwise fashion.

Objective
To evaluate the role of intraoperative frozen lymph node biopsy in detection of cervical lymph nodes metastasis to reduce incidence of unnecessary cervical lymph node neck dissection in differentiated thyroid carcinoma surgeries to avoid complications of neck dissection.

Patients and Methods
This is a prospective cross-sectional study to evaluate the role of intra- operative frozen lymph node biopsy in detection of cervical lymph nodes metastasis to reduce incidence of unnecessary cervical lymph node neck dissection in differentiated thyroid carcinoma surgeries to avoid complications of neck dissection. This study wasbe conducted at (the General surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Diagnosis and staging examinations were carried out according to the standard protocol being conducted at Ain Shams University Hospitals

Results
In our study about 50 patients with negative FNAC from lymph nodes underwent frozen section intra-operative. About 27 patients were positive malignant lymph nodes with percent 54% and underwent neck dissection and 23 patients with percent 46% were negative for malignant lymph node and aborted neck dissection with sensitivity 87% and specificity 98%. Paraffin section postoperative revealed about 30 patients were positive for malignant lymph nodes and 20 patients were negative for malignant lymph nodes with sensitivity 90% and specificity 97.4% Thus, the main role of the intra-operative Frozen section of the lymph nodes is the triage of patients who require surgery, thus reducing the number of unnecessary neck dissection and possible complications.

Conclusion
To sum up, the main role of the intra-operative Frozen section of the lymph nodes is the triage of patients who require surgery, thus reducing the number of unnecessary neck dissection and possible complications. Besides, frozen section has a high sensitivity and specificity percent that makes if effective to avoid overtreatment. The main drawback of the study is the low number of patients. A study with a bigger sample would throw more light on this comparison.
Laparoscopic Cholecystectomy with or without Abdominal Drain in Benign Non Complicated Gall Bladder Disease
Authors: eldin Hisham Adel Alaa , Omran Hisham Mohamed , Rayan Mahmoud Talaat , Moamen El Zohery Yasmine Hany Abdel , Khaliel Ebtsam Ragab Awees 
Published: November 2024

Abstract

Background
Gallstone disease is the pathologic state of stones or calculi within the gallbladder lumen and biliary tree. This is a common digestive disorder worldwide, with occurrence varying from 6-20%.

Patients and Methods
This study was done on 60 patients from Ain Shams University Hospitals and El- Sahel teaching hospital, who were provisional diagnosed with chronic calcular cholecystitis. Patients were randomly allocated into 2 groups, 30 patients for each group. Group (A) Lap cholecystectomy with a drain and Group (B) Lap cholecystectomy without a drain, then the two groups were compared according to operative time, length of hospital stay, postoperative pain and post-operative complications as wound infection, fever and bile leakage.

Results
The collected data showed that the operative time was significantly longer in the drain group, also post-operative pain showed significant difference between the two groups being more in the drain group. This study showed significant difference in length of hospital stay which is more in drain type. However no significant difference in post-operative complications between both groups. The benefits of not inserting a drain include a reduction in hospital stay, post-operative pain. a higher incidence of longer hospital stay and post-operative pain associated with drainage.

Conclusion
This randomized controlled trial concludes that the routine use of a drain in uncomplicated elective laparoscopic cholecystectomy has no benefit; in contrast, it is associated with longer hospital stay and more post-operative pain, however beginner or under training surgeons prefer to leave a drain if they are worry about post-operative complication hemorrhage or bile leak.
Meta-Analysis of Long Term Prognosis of Non-Operative Active Surveillance vs Completion Thyroidectomy after Hemithyroidectomy for Pathologically Proven Low Risk Papillary Thyroid Carcinoma
Authors: Abd El Mageed Shaaban Mohamed , Ahmed Dina Hany , Raslan Ibrahim Khaled , Morshed Kerlos Gamal Israel Salem 
Published: November 2024

Abstract

Background
Differentiated thyroid cancer (DTC) includes papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC) and encompasses approximately 94% of all thyroid cancers. The majority of DTC carries an excellent prognosis, with 10-year survival rates of over 90% and when examining the subset of low risk DTC (approximately 48% of all thyroid cancers), 10-year survival rates are in the order of 98%, irrespective of management algorithms.

Aim of the Work
The goal of the current study was to evaluate active surveillance versus total thyroidectomy in patients with low papillary thyroid carcinoma.

Patients and Methods
These studies included 35579 cases who were divided into 2 group: 15929 cases in hemithyroidectomy group and 19650 cases in thyroidectomy completion group. About 1265 articles were identified and after exclusion of article which did not fulfill the inclusion criteria, 18 research articles were enrolled in the current study.

Results
The patients' age range was between 40 and 50 years, with a higher incidence of PTC reported in the 3rd and 4th decades of life. Most patients were females, with no significant differences between the two groups. The mean tumor size was approximately 0.5 cm, and most tumors were smaller than 3 mm. Only two studies reported a significant difference in tumor size between the two groups, with larger tumors found in the TT group. Other studies reported no significant difference between the two groups.

Conclusion
Hemithyroidectomy with active surveillance is a good option for treatment low risk papillary thyroid cancers with lower postoperative complications rate, comparable recurrence rate and overall mortality rate. In spite that, 10- year DFS rates were lower with hemithyroidectomy.
Evaluation of the Outcomes of Primary Closure after Open Common Bile Duct Exploration for Common Bile Duct Stones
Authors: Mohamed Magdy H , Alsaeid Ashraf Elzoghby , Abdelhamid Mohamed Abdel Sattar , Elsaid Kamal M 
Published: November 2024

Abstract

Background
The incidence of CBD stone develops in about 10–15% of patients with gall bladder stones and encountered in approximately 7–15% of patients undergoing cholecystectomy. It is common to be treated by endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST), however in cases who has large or multiple CBD stone or difficult to be cleared by ERCP.

Aim of the Work
To evaluate of the outcomes of primary closure after open common bile duct exploration for removal of common bile duct stones.

Methods
This descriptive prospective randomized clinical controlled trial was conducted on 30 patients at Hepatobiliary Pancreatic Department (HBP) - Faculty of Medicine – Ain Shams University from January 2022 until March 2023. Primary closure was performed after removal of CBD stones with follow up for 6 months.

Results
Operative time ranged from 1.3 to 3 hours with mean 2.03 and ± SD 0.48 hours. Biliary leakage was estimated 13.3% of the candidates (4 cases). One of the 30 patients developed CBD stricture. Total and direct bilirubin levels were statistically significant decrease in T and direct bilirubin in follow up “1st 5 days and post-operative 10th day”.

Conclusion
The primary closure after open common bile duct exploration for removal of common bile duct stones is a safe, effective and time saving procedure.
Robotic versus Laparoscopic Inguinal Hernia Repair; A Prospective Study
Authors: Sayed Mohamed Mohamed Hatem , Wagdy Hesham Hasan , Abdelhamid Mohamed Abdelsattar , Emad Moustafa M 
Published: November 2024

Abstract

Background
Robotic inguinal hernia repair has certain advantages over laparoscopic repair including less pain and earlier return to normal activity. Robotic surgery adds high definition visualization and articulating instruments. This enhanced dexterity can make laparoscopic hernia repair more refined while obtaining a critical view of the myopectineal orifice that should lead to fewer recurrences and complications.

Aim of the Work
To compare early postoperative outcomes and surgical ergonomics between robotic and laparoscopic inguinal hernia repair.

Patients and Methods
This study is a prospective study, conducted in Ain Shams specialized Hospital during one year (March 2022 - March 2023). Patients above 16 year old who had inguinal hernia.

Results
The RULA was used to assess the ergonomic status of surgeons involved in this trial. RULA is a survey method originally developed for use in workplaces where risk exists for work-related upper limb injuries, often related to poor ergonomics combined with repetitive motion. It provides an assessment of the postures of the neck, trunk, and upper limb along with muscle function and the external loads experienced. The NASA-TLX validated instrument was used to determine the mental workload of surgeons, and has precedent as a tool to evaluate the mental workload of surgeons in minimally invasive surgery. The NASA-TLX provides an overall index of mental workload as well as the relative contribution of 6 subscales: mental, physical, and temporal task demands, effort, frustration, and perceived performance. Mental demand determines the level of intellectual and perceptual work required for completion of a task and physical demand determines the level of physical work required for completion of a task. Temporal demand is the measure for time pressure during the completion of the task. The effort component assesses mental and physical work required to perform at a certain proficiency level.

Conclusion
The benefits provided by the robotic platform include better visualization, improved ergonomics and wristed movements allowing for easier dissection.
Evaluation of Targetive Axillary Dissection in Node Positive Locally Advanced Breast Cancer Patients with Complete Pathological Response to Neoadjuvant Chemotherapy
Authors: Sedky Mostafa K , Abdelmoghny Mostafa Ashraf , AboElazm Hossam Attia , Zaid Mohamed H 
Published: November 2024

Abstract

Background
This study aimed to evaluate targeted axillary dissection (TAD) in node locally advanced node positive breast cancer patients with complete pathological response to neoadjuvant chemotherapy.

Methods
This is a prospective cohort study including twenty-five females diagnosed with locally advanced breast cancer with proven lymph node involvement who had complete pathological response to the neoadjuvant chemotherapy regarding the clipped previously involved lymph node. Lymph node biopsy and frozen section of the clipped lymph node after wire localization and the sentinel lymph node after patent blue dye injection was done. This is followed by paraffin section examination of the lymph node biopsy and 6 months follow-up for the patients.

Results
Twenty-four patients out of twenty-five patients had successful localization of the clipped and sentinel lymph node with no macro-metastasis detected in frozen section. Twenty-two out of the twenty-four patients had no micro-metastasis in paraffin section. Two of the twenty-four patients had micro-metastasis on paraffin section and required axillary radiotherapy. One of the twenty-five patients failed localization of the clipped lymph node and received conventional axillary lymph node dissection. Two patients developed lymphoedema, one of them after axillary radiotherapy and the other one after axillary lymph node dissection.

Conclusion
The combination of TAD and SLNB can replace Axillary clearance in patients with node positive Locally advanced breast cancer with complete pathological response to neoadjuvant chemotherapy.
The Role of Hybrid Revascularization Procedures for Symptomatic Chronic Peripheral Arterial Disease
Authors: Salib Wafy Fouad , Wahba Ramez Mounir , Zekri Mina Gamil , Issa Hafez Ahmed Amr 
Published: November 2024

Abstract

Background
Peripheral arterial disease (PAD) is a chronic vascular disease characterized by impaired circulation to the lower extremities. While early stages of PAD may be asymptomatic, the hallmarks of its most severe stage, known as chronic limb threatening ischemia (CLTI). It is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration &gt;2 weeks duration.

Aim of the Work
The aim of this study is to assess the clinical and hemodynamic outcome of CLTI treated by hybrid revascularization procedures and the possible risk of postoperative amputation.

Patients and Methods
The following electronic databases were searched up to 2022: PubMed, Google Scholar search engine, Cochrane database of systematic reviews, EMBASE, Science Direct, Wiley Online Library, ELSEVIER, Scopus and the European journal of vascular society searching keywords and terms listed below: “Critical limb threatening ischemia, management of peripheral arterial disease, multi-level occlusive arterial disease, hybrid revascularization, outcome of hybrid procedures”.

Results
In our meta-analysis, risk factors of PAD included gender, smoking, HTN, DM, coronary artery disease, CVS, CKD, Hyperlipidemia and COPD. Success rate of hybrid revascularization technique showed a significant effect than other techniques.

Conclusion
The results of this meta-analysis showed that Diabetes Mellitus and hypertension are two major risk factors that worsen the outcome of hybrid procedures. Hybrid procedures have added to the armamentarium for treatment of patients with multilevel arterial disease and offer a less risky option for elderly patients with multiple comorbid conditions. Hybrid procedures are effective to treat patients with either CLI or claudication.
Tumescent Technique for Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) versus Conventional TAPP
Authors: Abd El-Hamed El-Ashry Alaa El-Din , Mostafa El-Maleh Haitham , Taha Zaazoa Mohamed Moustafa , El-Aziz El- Shayeb Basem Helmy Abd , Mohammed Taha Yomna Medhat 
Published: November 2024

Abstract

Background
Laparoscopic hernia repair is more difficult technically than open surgery and there is evidence of learning curve in its performance and many complications reported from laparoscopic procedure. But also, laparoscopic approach has its benefits as rapid recovery, quicker return to work, less acute pain complication, better quality of life outcomes.

Objective
To compare between the conventional and tumescent technique in TAPP inguinal hernia repair as regards operative technique, intra & post-operative complications, early post-operative pain, hospital stay, restriction of physical activity, incidence of recurrence and post-operative chronic groin pain.

Methods
This was a prospective, randomized, comparative study, that was conducted at El-Demerdash hospital over one and a half years (October/2021 - March/2023). The 60 patients who were included divided into two groups, 30 for each. Group A; tumescent technique, Group B; conventional technique.

Results
Follow up started from the first day after operation and then visits at surgery outpatient clinic were arranged as follows, two weeks postoperative, then after one month. Interpretation of results revealed that there was significant difference between the two groups in operative time and early post-operative pain which decreased in tumescent group. There was no significant difference between the two groups as regards postoperative complications, the most reported complications were post- operative urinary retention and seroma formation. No reported cases of hernia recurrence and chronic groin pain in both groups.

Conclusion
Tumescent TAPP inguinal hernia repair appears to offer technical and clinical improvements to conventional TAPP, with small learning curve makes it easy procedure for unexperienced surgeons to use it for hernia repair and to learn it quickly. In general, TAPP inguinal hernia repair is considered both safe and effective for surgeons skilled in laparoscopic surgery; as all perioperative complications are well tolerated by patients and mostly there was no need for a second operative intervention, also the short-term treatment results were satisfactory.
Common Organic Acidemias in a Tertiary Hospital in Egypt
Authors: Mohamed Amany Hosny , Fattah Nada Hammad Abdel , Khalifa Ola Ali 
Published: November 2024

Abstract

Background
Organic acidemias (OAs) are a heritable group of heterogeneous metabolic disorders characterized by the accumulation of organic acids in body fluids and tissues. They are rare disorders and infrequently reported worldwide. Methylmalonic acidemia (MMA), propionic acidemia (PA), isovaleric acidemia (IVA), 3-methylglutaconic aciduria (3-MGA), and glutaric acidemia type 1(GA1), are considered the more common OAs, their prevalence is higher in Arab populations due to the high consanguinity rate.

Aim
This study aimed to: • Evaluate the spectrum of common organic acidemias among pediatric patients who followed up at the metabolic clinic of a tertiary hospital in Egypt. • Present different clinical and biochemical characterizations and the time of onset of these disorders, so that helps in raising the high index of suspicion among pediatricians and health care practitioners to make an early diagnosis.

Method
We conducted a descriptive retrospective study by reviewing the medical records of pediatric aged group patients diagnosed with common forms of OAs, followed up in Metabolic Clinic, Ain Shams University Hospitals, Egypt, over a 4-year period, between January 2017 and January 2021. All patients were investigated by metabolic work up, including the acylcarnitine profile and urinary organic acid analysis.

Results
A total of 76 patients with common OAs were included in the study. There were (56.6%) males and (43.4%) females. Most patients presented after the first year of life (58.7%); whereas the median age at diagnosis was 15 months. GA-1 was the most frequent disorder (39.5%), followed by MMA (36.8%). There were relatively high rates of consanguinity (80%) and affected siblings (23%). The most frequent presenting symptoms were developmental delay (69.3%), poor feeding (65.7%), and vomiting (50.7%). The main observed complications among studied patients were delayed motor development (67.1%), delayed speech (22.4%) and faltering growth (15.8%). Regarding the disease course and patientś outcome; 55.3% of patients exhibited regressive course, whereas 84.2% of patients were alive and well.

Conclusion
GA-1 is the commonest organic acidemias in Egypt and is more evident due to high rate of consanguinity. This urges the need to enhance awareness among pediatricians, primary healthcare providers and devise a governmental newborn screening program for the early detection and prevention of such disorders.