bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Anatomic Reconstruction of the Middle Hepatic Vein in Right Lobe Graft Living Donor Liver Transplantation Using Natural Portal Vein Graft and Synthetic Graft
Authors: Ibrahim Mahmoud Mohamed Elsayed , Abdo Mostafa , Abdelaal Amr , Rayan Mahmoud Talaat 
Published: November 2024

Abstract

Background
LDLT using the right lobe is now a standard method for adults to alleviate the problem of graft size insufficiency. Without including MHV into RLG may cause sever congestion in the segment V and VIII which leads to graft dysfunction and septic complications.

Objective
This study was conducted to evaluate the efficacy of reconstructing the MHV in RLG LDLT with native portal vein graft versus synthetic graft. Methodology: This study involved 40 patients eligible for LDLT and was divided into, group A had synthetic graft reconstruction and group B had native PV graft reconstruction, while controlling for patient characteristics.

Results
In our study, 13 cases (32.5%) of postoperative venous graft thrombosis were recorded, with a higher incidence in the synthetic graft group (45.0%) compared to the native PV graft group (20.0%). However, the trend was not statistically significant. Timing-wise, thrombosis was observed earlier in the synthetic graft group. The existence of reconstructed veins V5 and V8 was associated with a higher incidence of thrombosis in the synthetic graft group. Sepsis was also found to be a potential risk factor, but with no statistical significance.

Conclusion
In adult LDLT with right lobe graft, the native PV graft should be the first choice for MHV reconstruction. The patency rate of the native PV graft was higher than synthetic graft, especially in cases with multiple veins requiring multiple venous anastomosis, which led to a decreased incidence of thrombosis.
Comparison between Balloon & Savary Dilatation in Management of Benign Esophageal Strictures in Pediatrics
Authors: Abd El Hamid Sameh Abd El-Hay , Farouk Abadeer Ashraf , Abd El Hamid Hazem Samir , Kostangy Sos Marco Rady 
Published: November 2024

Abstract

Background
Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children.

Aim and Objectives
The aim of this study was to perform a systematic review and a meta-analysis about literature published in the period from 2010-2020 comparing between balloon & savary dilatation in benign esophageal strictures in pediatric age group.

Subjects and Methods
This systematic review and meta-analysis included 5 retrospective studies fulfilled eligibility criteria, with a total of 353 cases were included with mean age 8 years and m\f was 200\153.

Results
5 studies compare success between ballon and savary dilatation showed that there were insignificant differences between two group p-value 0.052

Conclusion
The efficacy and complication rates of bougie and dilation are similar. Considering this level of evidence 1A study, we can state that there is no significant difference between methods to recommend one over the other. However, all the confounding factors and limitations should be considered.
Utility of Intraoperative Frozen Section in Making the Decision of Lobectomy vs Total Thyroidectomy in Selected Cases of Solitary Thyroid Nodules
Authors: Ahmed Abdallah Mohamad Ahmed Mohamad , Ahmed El-Shafie Mahmoud , Omran Hesham Mohamad , Ibrahim Eman Abdel-Salam , Halim George Magdy 
Published: November 2024

Abstract

Background
Intraoperative frozen section (IFS) had been, historically, the main tool to determine the initial histologic diagnosis of a thyroid nodule and therefore to guide the treatment strategy. Surgery could be limited to a hemi-thyroidectomy in case of a benign nodule, while a malignant IFS diagnosis indicates a total thyroidectomy. Since the advent of preoperative fine needle aspiration (FNA), and its establishment as a mainstay in the preoperative exploration of thyroid nodules, the role of IFS in this setting has been widely questioned. The introduction in 2007 of the Bethesda system for reporting thyroid cytopathology (BSRTC) has improved FNA reporting standards and became a standard of practice.

Aim of the Work
To determine accuracy and intertest agreement of preoperative fine-needle aspiration cytology (FNAC) and intraoperative frozen-section analysis (IFS) findings in thyroid surgery, and to assess the influence of intraoperative FS findings on decision making and the utility of IFS in solitary thyroid nodules.

Patients and Methods
This study is a retrospective and prospective cohort comparative clinical study. This study was conducted at (General surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. The period of the study between November 2020 and November 2023.

Results
The current study results Group A (n = 20) and Group B (n = 20) were assessed for demographic, baseline, hematological, biochemical, and preoperative characteristics to ensure equivalence prior to interventions. Results revealed no statistically significant differences in age distribution (p = 0.868) or gender composition (p = 0.327), indicating matched groups. Thyroid function tests (T3, T4, TSH) showed no significant variations (p = 0.820, p = 0.081, p = 0.567). Hematological and biochemical parameters (hemoglobin, creatinine, ALT, AST, INR) exhibited no significant disparities (p = 0.420, p = 0.811, p = 0.752, p = 0.571, p = 0.862). Preoperative characteristics (family history, TIRADS, nodule size, site) were well-balanced (p = 0.519, p = 0.752, p = 0.625, p = 0.321).

Conclusion
The comprehensive analysis of the clinical and pathological data comparing two groups reveals several key insights into the management and diagnostic evaluation of thyroid nodules. Firstly, there are no significant differences in baseline characteristics such as family history, TIRADS classification, nodule size, and site between the groups, ensuring a balanced comparison.
Early vs Delayed Temporal Ileostomy Closure after Low Anterior Resection (LAR) in Patients with Rectal Cancer, A Cohort Study
Authors: El-Din Abd El-Mageed Ahmed Alaa , Abd El-Maksoud Ibrahim Magid , Abd El-Gwad Mohamed Mohamed 
Published: November 2024

Abstract

Background
The optimal timing for ileostomy closure remains controversial, most of the surgeons are closing ileostomy after 6-8 weeks, although ileostomy closure considered a simple procedure, it can cause significant morbidity; this study aims to clarify any relation between the post-closure complications rate and the time from its creation to the repair.

Objective
To compare between early ileostomy closure within 2 weeks and delayed ileostomy closure after 6 weeks regarding post closure complications (anastmotic leak – intra abdominal collection – intestinal obstruction –SSI),operative time, post operative hospital stay and quality of life improvement.

Patients and Methods
This is a A cohort study. Data was collected from departments of Ain Shams university hospitals as colorectal department and oncology department.

Results
The overall post-closure complications in our study was 37.5%, there was no significant difference between the overall complications rate for both early and late closure groups (35% and 40%) respectively (P value 0.534), The majority of the complications were intestinal obstruction, and superficial surgical site infection, there was significant association between the interval to ileostomy reversal and the intestinal obstruction, it was higher in the late closure group, in the other hand the surgical site infection complication found to be not significantly higher in the early closure group than the late closure group (25% Vs 15%) with (P value 0.428).

Conclusion
Our study revealed that the duration between the creation of protective ileostomy and its reversal was not a significant independent predictor of post-closure complications rate. Depending on whether a patient has mild pre-closure complications and appears tolerant of the psychological effect of his stoma, the ileostomy closure can be deferred safely for a real indication such as completing adjuvant chemotherapy without concern that the longer duration to closure will increase the postoperative complications rate. We sincerely hope that our effort adds to the body of evidence until a consensus regarding the ileostomy closure timing is reached.
Vertical Axillary Incision for Treatment of Breast Outer Quadrants Tumors
Authors: Amer Hazem Abdelsalam Mohamed , Abdelmoty Kareem Fahmi , Shahrour Mohamed Ala'a Said , Elshiemy Mohamed Ahmed Fouad 
Published: November 2024

Abstract

Background
Breast cancer is the most common cancer among women. There is continuous annual improvement of the overall survival of breast cancer patients, with 5- year overall survival estimates increasing from 84.6% to 90.9% over the previous two decades. The upper outer quadrant of the breast is the most frequent site for breast cancer occurrence.

Aim of the Work
Is to evaluate the aesthetic satisfaction and oncological outcome of patients with breast outer quadrant tumors using single vertical axillary incision.

Patients and Methods
This prospective cohort study was carried out on 30 Patients who were histopathologically diagnosed with breast cancer in the upper lateral quadrant of the breast less than 5m and are eligible for breast conserving surgery between 18 and 45 years old - conducted at the breast cancer unit at Ain Shams University Hospitals.

Results
This study analyzed patients who underwent surgery for breast cancer. Most patients had no family history or co-morbidities. The mean age of patients was 38.8, with 86.7% having invasive ductal carcinoma. There was a moderate correlation between blood loss and drainage days. Patient and surgeon satisfaction with cosmetic outcome, recurrence, and other complaints was high, with 43.3%, 36.7%, and 20.0% rating the outcome as very good, excellent, and good, respectively.

Conclusion
The use of single vertical axillary incision in breast conserving surgery for upper lateral quadrant tumors was associated with high levels of patient and surgeon satisfaction with cosmetic outcome, recurrence, and other complaints. This technique can be a good option for eligible patients with breast cancer in the upper lateral quadrant of the breast less than 5cm. However, further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.
Systemic Review and Meta-Analysis on the Surgical Complications in Breast Cancer Patients following Immediate Breast Reconstruction in Patients Received Neoadjuvant Therapy
Authors: Saied Ashraf El Zoghby El , Helmy Mohamed Ahmed , Abou El Naga Mohamed Ahmed , Rayan Mahmoud Talaat , Abd Allah Mohamed Hussein Makhlouf 
Published: November 2024

Abstract

Background
Breast reconstruction (BR) is a unique surgical procedure that provides patients undergoing mastectomy with significant psychosocial and aesthetic benefits and has also become a crucial part of the treatment pathway for women with breast cancer.

Aim and Objectives
The main aim of this study was to determine the surgical complications in breast cancer patients following immediate breast reconstruction and the effect of neoadjuvant therapy on the surgical complications.

Subjects and Methods
In this systematic review; we obtained 1,840 citations from the previously mentioned databases. We examined the titles and Abstracts of these references and excluded all the studies that were clearly ineligible for the analysis. For the remaining articles, we obtained full text copies for further evaluation. In the databases that we searched, we obtained 14 potentially eligible studies that examined the influence of NAC on immediate breast reconstruction. Twenty eligible studies addressed the influence of NAC on immediate breast reconstruction, and these studies also included extractable data; they were included in the review and meta-analysis

Results
A total of 149 donor site complications were founded among included studies and was in form of herniation, infection, hematoma, seroma, fat necrosis, bulging, wound problem, mastectomy skin flap necrosis, capsulectomy

Conclusion
Immediate breast reconstruction after NACT is a safe procedure with an acceptable post- operative complication profile. It may result in a slight increase in implant loss rates, but it does not delay commencing adjuvant therapy.
Evaluation of the Axillary Reverse Mapping Technique in Preventing Breast Cancer-Related Post Operative Lymphedema, Ain Shams University Initial Experience
Authors: Qayed Mohamed Fathi Ali Ali , Elshekh Rania ALAhmadi , Ayoub Bishoy Refaat Ragheb , Maher Amira , Fahmy Karim 
Published: November 2024

Abstract

Background
Management of breast cancer patients with clinically positive nodes is a field of research and axillary lymph nodes dissection is still an acceptable option for them. However it affects the patient quality of life in the form of breast cancer related lymphedema. Axillary reversed mapping technique is used to spare the arm lymph nodes during Axillary surgery aiming to reduce the rate of breast cancer related lymphedema.

Objective
To study the feasibility of using patent blue dye to perform axillary reverse mapping procedure in breast cancer patients with positive axillary lymph nodes scheduled for axillary lymph node dissection.

Patients and Methods
A prospective study including 20 patient with clinically positive axillary lymph nodes planed by MDT Committee at Ain Shams university hospital to perform axillary lymph nodes dissection.

Results
Identification rate of lymphatics and lymph nodes was 75% and 80% respectively and 60% of the stained LNS were seen below the axillary vein and lateral to the thoracodorsal bundle. Correlation between identification rate of the lymphatics and the lymph nodes with regard to N-staging and Neoadjuvant therapy wasn't statistically significant. BMI and number of lymph nodes removed were a confounding variables related to lymphedema.

Conclusion
Axillary Reverse mapping procedure using patent blue dye is simple idea to preserve arm lymph nodes and so, decreases the incidence of lymphedema, however there are a lot of variables related to lymphedema development which needs to be investigated well on larger group of patients and further multicentrs studies with long term follow up. The operative technique is quite challenging and need longer learning curve with well orientation to the axillary anatomy.
Bone Health Assessment in Patients with Methylmalonic Acidemia
Authors: Emam Mohmed , Sedafy Heba El , Hussain Omar Omar , Hammad Nada , Elnabi Marawa Hasab , Elsayed Solaf M 
Published: November 2024

Abstract

Background
Methylmalonic acidemia (MMA) is a genetically heterogeneous disorder of methylmalonate and cobalamin metabolism. Isolated MMA is a rare inherited disorder of organic acid metabolism associated with elevated methylmalonic acid concentration in the blood and urine without elevation of homocysteine level or malonic acid. Nutritional intervention for MMA patients includes dietary restriction of proteins along with medical food and dietary supplements. Decreased bone mineral density (BMD) is a widely accepted complication of the life-long protein restricted diet in addition to accumulation of acids and toxic metabolites in those patients.

Aim of the Study
To investigate the effect of restricted and modified diet on bone health in a sample of patients with MMA.

Subject and Methods
Clinical, nutritional, selected laboratory parameters of bone health and bone mineral density (BMD) assessment by Dual-energy X-ray absorptiometry (DXA) scan of bones were carried out on Egyptian MMA patients from Genetics Clinic, Medical Genetic Department, Ain Shams University. Bone formation was assessed by measurement of serum osteocalcin level while bone resorption was evaluated by serum carboxy terminal telopeptide of collagen type 1 (S-CTX).

Results
The study included 24 patients from 14 families (13 males and 11 females). Their ages ranged between 5.2 to 26 years with median age of 10 years (IQR: 6.5-14). Consanguineous marriage was present in 91.67 of families. Median age of symptoms was 140 days (IQR: 3.5-332.5) while median age of diagnosis was 12 months (IQR (2.5-40). History of fractures was present in 5 patients (20.83%). Decreased total body BMD was detected in 14 patients (54.5 %) with mean Z score of -1.31 ± 1.38 SD. Decreased spine BMD was present in 21 patients (79.16%) with mean Z score of -1.9 ± 1.1 SD. This decrease was significantly related to non-compliance, chronic acidosis, low serum copper. There was no significant relation between BMD and creatinine, calcium, vitamin D, zinc, selenium, osteocalcin or S-CTX levels.

Conclusion
MMA patients have decreased BMD related to copper deficiency, poor compliance and chronic acidosis. This resulted in defective bone formation and increased bone resorption.
Impact of Androgen deprivation therapy on cognitive function of elderly men with Prostate Cancer
Authors: Bassyouny Nourhan M , Gouda Mohamed M , El Din Mai M Ezz , Sweed Hala S , El Akkad Rania M 
Published: November 2024

Abstract

Background
Prostate cancer affects millions of men worldwide. Androgen deprivation therapy (ADT) is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. ADT works on decreasing testosterone level and that can cause multiple side effects including potential cognitive affection, in the form of accelerating cognitive aging, and potentially increasing risk of dementia. Which in our elderly population requires careful consideration.

Aim
evaluation of the effect of androgen-deprivation therapy (ADT) on the cognitive function of elderly men recently diagnosed with prostate cancer (PC).

Methods and Results
The current research is a prospective cohort study conducted on 85 elderly recently diagnosed with prostate cancer and are about to start ADT within 2 weeks of the diagnosis. These patients were recruited from the Oncology and Geriatrics outpatient clinics of Ain Shams University hospitals and are expected to be followed up on ADT for at least 6 months. Cognitive and depression assessments were done using the Montreal cognitive assessment test (MoCA) and MoCA-basic according to their education and Geriatric Depression Scale (GDS) and the Patient Health Questionnaire-9 (PHQ-9). The cases were assessed at the start, after 2 months and after 6 months of ADT use. Cognitively impaired or depressed patients were excluded at the start of the study. This study showed that 57.6% of the studied participants had a lower MoCA score average after 6 months and indicating Mild cognitive impairment. Cognitive domains such as visuospatial, language, recall and attention were affected, 27.0 % were diagnosed with depression after 6 months of the ADT therapy. All of the depressed participants had cognitive impairment.

Conclusion
The use of androgen deprivation therapy caused cognitive decline, regression of some of the cognitive domains and depression in elderly patients with prostate cancer who received androgen deprivation therapy for a period of 6 months. It is recommended that the cognitive function and depression screening is to be assessed regularly to all cancer prostate patients receiving ADT and cognitive training must be advised and prescribed to preserve or improve the patients' cognitive abilities.

Key words
Prostate cancer, Androgen Deprivation Therapy, Cognitive decline, Elderly.
Same Day Elective Surgery Cancellation at El-Demerdash University Hospital: A Cross Sectional Study
Authors: Nasr Eman Mohamed , Al Tehewy Mahi Mahmoud , Ahmed Tarek Youssef , Ibrahim Dalia Ahmed , Mohamed El-Bokl Shaymaa 
Published: November 2024

Abstract

Background
Same day Elective surgery cancellation is a quality issue in the healthcare system that affects the financial aspect of healthcare system due to repeated pre-operative preparations and prolonged hospital stay, leading to increased costs. Aside from its economic impact, it is also associated with considerable psychological and social impact on patients and their families.

Objectives
To measure the prevalence of same day elective surgery cancellation at El-Demerdash University Hospital in Egypt and to identify causes of cancellation in the hospital. Methodology: A cross-sectional study included 993 elective surgical procedures in the operating department at El-Demerdash Hospital which consists of 21 operating rooms (ORs) for elective surgeries.

Results
The prevalence of same day elective surgical cancellation is 12.59%. the vital few causes of cancellation are: Unavailable OR time (24.03%), Unavailable ICU bed (21.71%), Change in patient’s medical condition (14.73%), Prolonged previous operation (10.85%) and Unavailable/failed equipment (7.75%). Vascular surgery department shows the highest cancellation rate (25.40%) followed by Plastic surgery (16%). This study shows that 20.0% of cancellations occur after patient’s arrival to operating department.

Conclusions and Recommendations
Same day elective surgery cancellation at El-Demerdash University Hospital is mainly due to hospital related causes. Managerial strategies and efforts towards vital few causes of cancellation for better utilization of the operating rooms is highly recommended.
The Effect of Aging on the Structure of the Colon of Rat with Reference to Interstitial Cells of Cajal
Authors: EL Morsy Dina Mohamed Rashad EL Saied , Mohamed Soliman Nevine Bahaa El Din , Shaker Safaa Mohammed , Kamel EL Ebiary Faika Hassan 
Published: November 2024

Abstract

Introduction
Aging process is a driving force behind the age associated diseases. The gastrointestinal tract (GIT), including the colon, is affected by the aging process. Constipation, fecal incontinence, and fecal impaction are common complaints of geriatric patients, probably reflecting colonic dysmotility. Interstitial cells of Cajal might be involved in this process, however, there is little known about changes in these cells and gastrointestinal tract with aging.

Aim
The objective of this work was to study the effect of aging on the structure of the colon of male albino rats. Age associated changes of the Interstitial Cells of Cajal (ICC) was also investigated.

Materials and Methods
Thirty male albino rats were equally divided into three groups: Group I (young): included rats aged six weeks. Group II (adult): included rats aged 16 weeks. Group III (senile): included rats aged two years. The specimens from the colon (one cm above the ileo- ceacal valve) of all rats were obtained and processed for light and electron microscopic examinations. Specimens were subjected to hematoxylin and eosin, toluidine blue, Alcian blue-PAS technique, Masson’s trichome, c-kit, and CD 34 immunohistochemical stain as well as transmission electron microscopic examination. Morphometric and statistical studies were also done.

Results
Aging altered the microscopic structure of the different layers of the colon. Focal mucosal corrugation or disruption, epithelial discontinuity, mononuclear cellular infiltration and alteration in the mucous content of goblet cells were found in aged rats. Increased collagen deposition in all colonic layers was also observed. Significant decrease of Nissls’ granules in the neurons of myenteric plexus and the number of goblet cells were also detected. Colonocytes of senile rats showed focal loss of microvilli, vacuolated cytoplasm, swollen mitochondria with irregular cristea and irregular nuclei. Change in nuclear shape and chromatin distribution, mitochondrial swelling and endoplasmic reticulum dilatation were also detected in ICCs in senile rats. Moreover, there was a significant decrease in area percentage of ICCs and telocytes (Tcs).

Conclusions
Aging caused profound alteration in the histological structure of the colon of senile rats. Moreover, ICC showed age related ultrastructural changes. These changes might contribute to age associated gastrointestinal diseases.