bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of combined MUC5A, S100P, and von Hippel-Lindau in differentiating intrahepatic cholangiocarcinoma from metastatic pancreaticobiliary carcinomas presented as hepatic focal lesions
Authors: Shakweer Marwa M. , Elgohary Shimaa A. , Hafez Fatma S. 
Published: August 2023

Background
Sometimes differentiation between intrahepatic cholangiocarcinoma (ICC) and metastatic pancreaticobiliary carcinoma (mPBC) could be challenging, and it is of great importance owing to different treatment modalities. We aimed to measure the diagnostic accuracy of MUC5A, von Hippel-Lindau (VHL), and S100p in differentiating ICC from mPBC in hepatic focal lesions.

Patients and methods
The study included 70 cases of liver biopsies presented as hepatic focal lesions divided into two groups: group 1: 40 cases of mPBC and group 2: 30 cases of ICC.

Results
There was a highly statistically significant difference regarding MUC5A, S100P, and VHL expression between both groups (P<0.001). mPBC showed MUC5A in 87.5%, S100P in 95%, and VHL in 5%. However, cases of ICC showed positive MUC5A in 10%, S100P in 29.6%, and VHL in 80%. Regarding the validity of diagnosing mPBC, S100P had the highest sensitivity (95%), whereas both panels of (MUC5A−/S100P+/VHL−) and (MUC5A+/S100P+/VHL−) showed the highest specificity and positive predictive values (100%). Regarding the validity for diagnosing ICC, VHL had the highest sensitivity (80%), whereas (MUC5A−/S100P−/VHL+) showed the highest specificity and positive predictive value (100%).

Conclusion
These results indicate the validity of combined MUC5A, S100P, and VHL as a highly sensitive and specific panel for differentiating ICC from mPBC.
A comparative study of laparoscopic versus laparotomy repair of perforated peptic ulcer: A prospective study
Authors: Saleem Abd-El-Aal A. , Arafa Mohamed W. , Galal Abdelrahman M. 
Published: August 2023

Background
Laparoscopic surgery is still gaining popularity in conditions associated with peritonitis, such as a perforated peptic ulcer.

Aim of the work
This study aimed to compare laparoscopic and laparotomy repair of perforated peptic ulcers regarding intraoperative parameters, postoperative pain, time of the start of oral feeding, postoperative complication, hospital stay, resuming normal activity, and outcomes.

Patients and methods
This is a prospective study of 50 patients (males and females), of any age with perforated peptic ulcer. Those patients will be divided by the random serial number method into two groups: the
laparoscopic group
and the
open (laparotomy) group.
In a period from 15th April 2022 to 15th February 2023 data related to patients were recorded and subjected to analysis.

Results
All patients were divided into two groups:
Laparoscopic group
with 25 patients (23 of them underwent successful laparoscopic repair and two patients were converted to open) and the
open (laparotomy) group
with 25 patients underwent laparotomy repair (of which 23 patients were living, and two patients died on the third and tenth postoperative days). There were no significant differences in baseline characteristics between both groups in terms of age, gender, special habits, preoperative risk factors, comorbidities, laboratory, and radiological findings; also both groups showed insignificant differences regarding the American Society of Anesthesiologists (ASA) scores (P=0.83), total Boey’s score (P=0.77), shock on admission (P= 1.00), and the duration of symptoms > 24 hours (P= 0.77). Operative time was significantly increased in the laparoscopic versus open group (P=0.0001). While, first-day pain score (VAS), opioid requirements, time of starting oral feeding, length of hospital stay, and return to normal activity were highly significantly decreased in laparoscopic repair compared with open repair (P= <0.0001 for each). Total postoperative complications showed insignificant difference between the studied groups (P=0.16), but they were more prevalent between the open group (14 patients, 56%) versus the laparoscopic group (9 patients, 36%). Good cosmetic results of wounds were more prevalent in the laparoscopic group [20 patients (80.00%)] than the open group [13 patients (56.52%)], but insignificant, P=0.17.

Conclusion
Laparoscopic repair had an upper hand over open repair regarding less intraoperative blood loss, less postoperative pain, requiring less postoperative analgesia, early starting of oral feeding, less postoperative complications, shorter hospital stay, early return to normal activity, and good cosmetic results of wounds.
Conversion of open varicose veins surgery unit into a modern one-stop shop endo-venous unit: strategies and cost-effectiveness
Authors: Elkassaby Mohammed , Hassanin Ahmed , Elmallah Ahmed 
Published: August 2023

Purpose
to provide a road map for converting varicose veins service to endovenous ablation and assess its process and outcome on patients with varicose veins.

Patients and methods
Retrospective assessment of prospectively recorded data for converting vein unit which exclusively did open varicose veins surgery (OS) (39 patients from September 2019 to February 2020) to endovenous radiofrequency ablation (ERFA) service (44 patients from March 2020 to January 2021).

Results
There was no statistical difference in theatre time between both interventions despite dealing with more complex cases in the ERFA group with more truncal veins (χ2
=11.950*, P<0.001*) and a higher number of stab avulsions (V number) (χ2
=217.889, P<0.001*). On the other hand, the overall cost was significantly lower in open group compared to ERFA (Mean±SD 1261±386 US$ and 1519.2±392 US$ respectively, P<0.001*. This statistical difference was reduced to P=0.041 when subgroup analysis only included cases with higher number of avulsions. In multivariate analysis, cost was associated with surgical duration and using ERFA however, less complications were recorded in ERFA group (χ2=4.419* P=0.036*) and recovery time was significantly longer in open group (8.90±2.44) than in ERFA group (6.0±1.06), P<0.001*

Conclusion
Converting varicose veins service to a modern ERFA is safe and effective when properly planned. ERFA is associated with shorter recovery and less theatre time and complications despite higher cost which becomes more cost-effective in cases with more truncal veins and avulsion sites.
Comparative study between anterior and posterior approach in emergent femoral hernia
Authors: Alabassy Mahmoud M. , Elsisy Alaa A. E. , Alhanafy Saad S. 
Published: August 2023

Objectives/aims
Emergency surgery is necessary for incarcerated and/or strangulated femoral hernias. With regard to emergency femoral hernia repair, this study attempted to compare between open anterior and open posterior (preperitoneal) techniques.

Methods
Patients who underwent emergency femoral hernia repair between October 2020 and October 2022 were included in this single centre retrospective cohort research. They were divided into two groups based on the surgical incisions: the anterior approach group (19 cases) and the posterior approach group (14 cases). Open anterior and posterior methods were compared using patient demographic information, intraoperative findings, operating time, and postoperative outcomes.

Results
33 patients in total were included in the current study. 19 patients (57.6%) underwent open anterior approach, whereas 14 patients (42.4%) underwent open preperitoneal approach. Patient features indicated a similarity between the two groups. The posterior approach group experienced considerably shorter mean operative time (53.624 7 min vs 77.936 5 min, P = 0.039) and recovery time (9.24 1days vs 13.36 6days, P = 0.049) before returning to full activity. The posterior approach group had a decreased (7.14%) rate of postoperative complications, such as wound infection, seroma/hematomas, persistent discomfort, and hernia recurrence.

Conclusion
While it can increase the rate of first-stage tension-free repair of incarcerated femoral hernia and with a lower risk of postoperative complications, the open preperitoneal approach for emergency femoral hernia may be preferable to other procedures.
Predictive value of biological markers in loco-regional recurrence of breast cancer after mastectomy and radiotherapy
Authors: Mahmoud Mahmoud Abdelbaky , Ouf Tarek Ismail Ahmed , Kamal Tarek Hussein , El Aziz Heba Tharwat Abd 
Published: August 2023

Objective
To assess the prognostic usefulness of the human epidermal growth factor receptor-2 (Her 2), the progestin receptor (PR), and the oestrogen receptor (ER) in locoregional recurrence following mastectomy radiotherapy in Egyptian breast cancer patients.

Patients and methods
This retrospective analysis comprised 432 female patients who had received radiation and had a mastectomy and immunohistochemistry reports. The Ethics Committee’s clearance was required before this study could be carried out at the Ain-Shams University hospitals.

Results
A total of 24 individuals developed LRR after a median follow-up period of 68.9 months. Although lymph nodes with more than three exhibited a statistically significant risk for LLR, tumour grade and pT were not significant risk factors. LRR risk rose for those who were HER2-positive and those with TNBC, but Luminal B had a non-significantly greater risk than Luminal A.

Conclusion
For breast cancer patients receiving PMRT, the biological subtype based on the categorization standard from the St. Gallen International Breast Cancer Conference (2013) Expert Panel acts as an accurate prognostic predictor. In HER2-positive and hormonal receptor-positive individuals, trastuzumab treatment significantly reduced the risk of LRR.
The safest power to be applied in relation to diameter of the vein to give maximal benefit with least complications in endovenous laser ablation of varicose veins
Authors: Mostafa Mohamed Hassan Albanna , Mohamed Ahmed Farouk , Mohamed Mohamed Ismail , AboElNeel Hamdy AbdelAzeem 
Published: August 2023

Background
Over the years, there have been significant advancements in the treatment of varicose veins. In most surgical settings, the open procedure is still the primary approach. Yet, the popularity of less invasive procedures like EVLA and RFA has produced fantastic outcomes.

Objective
to assess the safest power of laser which gives maximal effect and least complications in ablation of varicose veins.

Methodology
A prospective observational study inducing EVLA of different laser power settings (7W & 10W) with preoperative assessment then follow up by CEAP & VCSS and duplex ultrasound measuring great saphenous vein (GSV) diameter and also post-operative complications and time to return to work.

Results
This study included 50 patients (52 limbs). The Patients were distributed as regard laser power used into two groups (7W, 10W) of 26 limbs for each one. As regard GSV measures changes, there was highly statistically significant decrease in GSV diameter after 1 m and after 3 m compared to preoperative, with P value P<0.001, among patients group. Also, there is higher number of cases with GSV>10 mm in power of laser ‘10w’ group compared to ‘7w; group, with P value (P<0.001); while there is no statistically significant difference between power of laser 7w versus 10w, because all patients ≤10 mm after 1 month and after 3 months, with P value >0.05.Statistically there was no significant difference between 7W & 10W groups as regards time to return to work, CEAP scores and postoperative complications except the significant difference in Pain over the treated vein being less in 7W laser power group.

Conclusion
For endovenous laser ablation of varicose veins, both 7W and 10W laser power are indicated. They are risk-free and provide the greatest impact with the fewest difficulties for the chosen vein diameter. In our investigation, we came to the conclusion that patients with small GSV diameter required low laser power (7W), while those with large GSV diameter required high laser power (10W).
Short-term effect of laparoscopic sleeve gastrectomy on hyperlipidemic obese patients
Authors: Sabry Ahmed A. , Sorour Magdy Akel , Gaber Marwa Hemat , Essa Antwan Yousry Eskander , Elkeleny Mostafa R. 
Published: August 2023

Introduction
Obesity has become a global epidemic and a major health problem in the twenty-first century. Studies have demonstrated that weight loss lowers increased serum total cholesterol and low-density lipoprotein (LDL) cholesterol and raises high-density lipoprotein (HDL) cholesterol. One of the most recent procedures for managing weight loss in obese people with other options is laparoscopic sleeve gastrectomy (LSG).

Objectives
The aim of this study was to evaluate the short-term effect of laparoscopic sleeve gastrectomy on lipid profile in hyperlipidemic obese patients during the nine months of postoperative care.

Methods
From July 2020 to October 2021, 50 hyperlipidemic obese patients who were eligible for bariatric surgery underwent this prospective study at Main University Hospital in Alexandria, Egypt. Before and one, three, six, and nine months after the surgical intervention, measurements of body weight, body mass index (BMI), waist circumference, fasting and postprandial blood sugar, serum cholesterol, triglyceride, HDL, and LDL levels were taken.

Results
The patients’ average age was 33.72±7.95 years. BMI, weight, blood sugar, and other measurements all significantly decreased. The mean body mass index (BMI) of the patients was 48.59±5.78 kg/m2 before surgery, however, it was reduced to 32.58±3.91 kg/m2 nine months afterwards. Studies revealed a statistically significant rise in HDL levels in the serum and a statistically significant fall in triglycerides, total cholesterol, and LDL levels. Results also revealed a favorable association between preoperative differences in age, BMI, and diabetes state and postoperative lipid profile alterations.

Conclusion
Laparoscopic sleeve gastrectomy (LSG) decreases body mass index, improves glucose and lipid metabolism, and alters the lipid profile by significantly lowering total cholesterol, triglycerides, and LDL cholesterol while significantly raising HDL cholesterol.
Effect of post-gastric sleeve pyloric length on control of type II diabetes mellitus
Authors: Hassan Lotfy S. , Fahmy Mohamed H. , Elmonim Ahmed Maher Abd , Elshal Mohamed 
Published: August 2023

Background
Although the effectiveness and safety of laparoscopic sleeve gastrectomy (LSG) have been demonstrated, there is still debate about the best surgical method, with the resection distance from pylorus (DP) being among the most contentious topics. In patients who had LSG for morbid obesity, the effect of the resection distance from the pylorus on the management of type II diabetes mellitus during the postoperative phase was examined.

Patients and methods
After receiving each patient’s agreement, a total of 46 obese individuals were enrolled. Patients were prospectively randomized into two groups, group A (‘AP group’) and group B (‘AR group’), based on the distance between the initial reload firing and the pylorus (4 cm for group A and 2 cm for group B, respectively). Blood sugar levels were measured three, six months, and one year following LSG. After a year of follow-up, the percentage of excess weight loss (%EWL) was calculated.

Results
Postoperative weight was statistically significant lower and EWL% was statistically significant higher in group B: LSG ‘2 cm’ compared to group A: LSG ‘4 cm’. As regard outcomes of type 2 diabetes mellitus after LSG, in spite of nonsignificant statistical value, we reported that there was higher frequency of complete remission after 3, 6 and 12 months in group B: LSG ‘2 cm’ compared to group A: LSG ‘4 cm’ and cases with complete remission were associated with significant higher EWL%.

Conclusion
Patients undergoing laparoscopic sleeve gastrectomy are recommended to have shorter resection distance from pylorus (DP) done. It has been linked to superior surgical results, weight reduction, and diabetes mellitus management with no problems recorded.
Comparison between laparoscopic versus open appendectomy in morbid obese patients
Authors: Galal Abdelrahman Mohammad , Saleem Abd-El-Aal Ali , Helmy Mena Zarif 
Published: August 2023

Purpose
To evaluate the laparoscopic approach advantages for the management of acute appendicitis in morbidly obese patients.

Methods
A prospective study included all morbidly obese patients who had presented to the emergency department at Sohag University Hospitals and were diagnosed with acute appendicitis between the 1st of June 2022 and the 31st of January 2023. All those patients were invited to participate in the research by randomization. The authors informed patients and their first-degree relatives about both techniques, signed a consent form for participation in the study. The authors categorized them into two groups; laparoscopic approach (group I) and open approach (group II). Comparisons were based on operative time, intraoperative complications, length of hospital stay, postoperative complications, and time until return to normal daily activities.

Results
The study enrolled 64 patients: 33 had a laparoscopic appendectomy, and 31 had an open appendectomy. The groups were similar in terms of clinicopathologic characteristics. The operating time was significantly shorter for Group I patients than Group II (Group I, 49.09±16.21 min vs. Group II, 68.03±15.78 min; P value less than 0.05). Regarding the length of hospital stay, twenty-six patients (78.8%) were discharged within the 1st 24 h in the laparoscopic group versus 17 patients (54.8%) in the open group (P value 0.041). The time until return to the routine daily work was significantly shorter in the laparoscopic group (11.27±2.6 days) than in the open group (17.23±4.8 days) (P value less 0.05). Four postoperative complications were reported in the study population: wound complications (infection, seroma formation), residual abdominal abscess, paralytic ileus, and thromboembolic complications (Deep venous thrombosis and pulmonary embolism). Group II had a statistically significant higher complication rate (32.3%) than Group I (9.09%) (P value 0.007).

Conclusion
Laparoscopic appendectomy had superior clinical outcomes than an open appendectomy in morbidly obese patients. In addition to minimal invasiveness and better cosmetic results, it has a great advantage as a diagnostic and therapeutic tool in morbidly obese patients with suspected appendicitis. It is also a safe and feasible approach with a low rate of complications with a well-trained expert surgeon.
Evidence Generating Community Health Intervention Project – An Innovative Practice to Cultivate Research Culture among Medical Students
Authors: Pandit Niraj B , Chauhan Grishma D , Patel Nilesh G , Patel Maharshi V 
Published: August 2023

Deprived research culture among medical students and lack of research at medical student level was thought-provoking key to start “An Evidence Generating Community Health Intervention Project” (EviGenCHIP). EviGenCHIP is unique innovative program initiated by the Department of Community Medicine and Medical Education Unit. There are more than 600 medical colleges in India. It is an opportunity to sensitize and develop research culture in young minds of Indian medical graduates. The study aimed to sensitize medical students about the role of research and evidence in medical science and thus developing research culture among undergraduates.

Methods:
This was the education-based observation cross-sectional study. Students themselves identify the health problem during their learning time. They would do scientific research on the selected problem and find out best solution for that problem. Every year, the institute conducts this program for 3rd MBBS students during April to October. At the starting of the project, the institute conducts sensitization session to teach them basics of research and epidemiology method. Then, the institute divides the students among small groups and allocates one faculty to guide them in their projects. At the end, the institute conducts the presentation session and appreciates students as well faculties with certificate.

Results:
Since 2014, EviGenCHIP started, total 110, 106, 84, 76, 121, 152, and 150 students have participated in 2014, 2015, 2016, 2017, 2018, 2019, and 2021, respectively. Total 25, 20, 13, 16, 21, 24, and 31 faculties have participated in EviGenCHIP project for respective year. It has long-term impact. Feedback of EviGenCHIP showed that students are developing research culture, which might not be possible with traditional academics. Conclusion - EviGenCHIP like projects have long term impact. It will take time to create research culture in medical colleges but support at college level and university level surely change the culture. Conclusion: EviGenCHIP like projects have long term impact. It will take time to create research culture in medical colleges but support at college level and university level surely change the culture.
Prevalence of Hypertension, Overweight, and Obesity in Type 2 DM Patients Attending a Tertiary Health Care Facility in Enugu, Nigeria
Authors: Nwagbara Ijeoma Jacinta , Onyeanusi Joel C , Ogbu Innocent SI , Obi-Ezeani Chikaodili Nwando 
Published: August 2023

Context:
Diabetes mellitus (DM) is one of the noncommunicable diseases with an increased worldwide prevalence which differs from country to country. Hypertension and obesity may coexist in diabetes, thus enhancing complications and morbidities.

Aim:
The study determined the prevalence of hypertension, overweight, and obesity in type 2 DM patients attending a tertiary health care facility in Enugu, Nigeria.

Setting and Design:
A total of 296 type 2 DM patients attending the diabetes clinic at Enugu State University Teaching Hospital, Parklane, Enugu, were recruited for this study.

Subjects and Methods:
Blood pressure, weight, height, waist and hip circumferences were measured according to standard methods, waist to hip ratio and body mass index (BMI) were calculated. 3 ml of fasting blood sample was collected for blood glucose analysis. Statistical significance was considered at P < 0.05.

Results:
Of the 296 patients, 176 (59.5%) were female, whereas 120 (40.5%) were male. BMI was significantly higher in females when compared with the males (P = 0.002). The prevalence of hypertension was 36.8%, 35.2% in females and 39.2% in males. 26.7% were obese (30.1% females and 21.7% males) while 43.9% were overweight (42.6% females and 45.8% males). The prevalence rates of hypertension, overweight, and obesity were high in patients aged 56 years and above. Overweight and obese hypertensive patients had the prevalence rates of 45.9% and 40.4%, respectively.

Conclusion:
Hypertension and overweight or obesity persist in type 2 diabetic patients. The high prevalence of hypertensive overweight/obese diabetes patients calls for stringent measures through lifestyle modifications such as weight reduction, physical activity and dietary intake.