bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Antenatal Care Services in Four Accredited Primary Health Care Centers in Cairo, Egypt
Authors: Salem Yosra Abd El-Rahman Abd Allah , Shehata Isis Magdy Mossad , Sokkary Mohamed El , El-Awady Mohamed 
Published: August 2023

Abstract

Background
Antenatal care (ANC) is a careful, systematic assessment and follow-up of pregnant women, that includes education, counseling, screening, and treatment to assure the best possible health of the mother and her fetus. In order to assure each women gets the best quality of care, quality assessment of all items of antenatal care should be arranged regularly. This study aims to measure the perceived quality of antenatal care services, the adherence of the primary care physician to the Egyptian ministry of health guidelines as well as the overall satisfaction of pregnant women about their antenatal care services.

Methods
A cross sectional study was conducted from January till April 2021 among women aged 1849 years old who attend antenatal care clinics at four primary health centres in Cairo, Egypt. All health centres included in the study are government run facilities.

Results
Despite the high overall satisfaction (98%) reported for the antenatal care services, the total quality score was low (&lt;60%), the highest satisfaction was reported from most of accessibility point and cleanliness of the primary care centers, answering inquiries, number of the doctors, discussion of the delivery plan, health education about importance of folic acid and iron supplements, family planning and cost of the service. Lowest satisfaction reported from the PHC was for working hours of the center, history taking, examination time, health education about diet, breastfeeding, and the harmful effects of passive smoking. Although most women reported that they had the majority of the Egyptian antenatal guidelines covered by their physician, items like past medical history, personal hygiene and oral glucose challenge test were missed.

Conclusion
The findings showed the need for new approaches to upgrade the quality of antenatal care and improve the health education skills for the primary care physicians, despite the high overall satisfaction.
Safety of Concomitant Laparoscopic Cholecystectomy and Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients: A Meta-Analysis
Authors: Shafik Youhanna Shohdy , Elsayed Mohamed Gamal , Hosny Ahmed Hany Mohamed 
Published: August 2023

Abstract

Background
Laparoscopic sleeve gastrectomy is one of the most common bariatric procedure performed. The prevalence of cholelithiasis in morbidly obese individuals is 19–30 % and Gall stones are more symptomatic in obese patients than in non-obese patients. This study evaluates the safety of performing laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy in the same session.

Objective
To evaluate the safety profile of performing laparoscopic cholecystectomy and sleeve gastrectomyin the same session in terms of : The incidence of biliary leakage. The incidence of gastric leakage. The incidence of intra operative bleeding from the sleeve gastrectomy and the cholecystectomy. The incidence of post-operative bleeding. The incidence of post-operative surgical site infection. Operation time. Length of hospital stay.

Method
Selected papers for the present meta-analysis included those that provided data from January 2010 to December 2020 on factors related to the patients who undergone laparoscopic sleeve gastrectomy with and without laparoscopic cholecystectomy. When institutions have published duplicate trials, only the most updated reports were included for qualitative appraisal. All publications were limited to human subjects and English language. Abstracts, case reports, conference presentations, editorials and expert opinions were excluded.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Overall concomitant laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy appears to be a safe procedure. The increase in surgical site infection and pneumonia may warrant prophylaxis against such infections with antibiotics. Another study is needed to determine the need and efficacy of such prophylaxis
Evaluation of Post-Operative Wound Complications of Securing Mesh with Polypropylene Suture versus Staples in Lichtenstein Inguinal Hernioplasty; A Comparative Prospective Study
Authors: Mostafa Ashraf Abdel-Moghney , moaty Karim Fahmy Abdel , Hamed Mohammed Korayem Fattouh , Hammad Ahmed Mohammed Abdel-bar 
Published: August 2023

Abstract

Background
Hernia is defined as a Protrusion of a viscus or a part of viscus through an abnormal opening in the wall of its containing cavity. It is estimated that the most common type of hernia is inguinal hernia with approximately 27% to 43% rate of occurrence in males and it is 3-6% in females. Inguinal hernia repair is one of the most common surgical procedure carried out world-wide, more than 20 million people undergo inguinal hernia repair annually.

Objective
To compare polypropylene suture and staples for securing mesh in Lichtenstein inguinal hernioplasty in terms of mean operating time and postoperative complications, mainly (Pain, Wound ecchymosis, Wound infection, Wound Hematoma, Wound Seroma, Wound Abscess, Scrotal edema, Scrotal Hematoma, Scrotal Abscess).

Patients and Methods
In a randomized prospective clinical trial we elected 50 patients equally subdivided in 2 groups, 25 patients in each group. In-group A we fixed the mesh with polypropylene sutures and in group B we used staplers for fixation.

Results
There's significant decrease in mean operative time in staples group compared to polypropylene group with comparable results between both groups as regard pain and postoperative complications.

Conclusion
Using staples for securing mesh in Lichtenstein inguinal hernioplasty significantly reduced operation time with comparable results as regard postoperative pain and complications.
Comparative Study between Onlay and Sublay Placement of Polyproline Mesh in Ventral Hernia Repair
Authors: Farouk Abadeer Ashraf , AbdAllah Bishoy Samir , Boshra Gerges Wadie 
Published: August 2023

Abstract

Background
Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia.

Aim of the Work
The purpose of this study is to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) versus sublay (mesh in the retromuscular space) regarding complications (superficial skin infection, seroma collection, operative time, hospital stay and 18 months recurrence rate.

Patients and Methods
The study frame is two years starting from August 2019 to August 2021 in general surgery department at Ain shams university hospital a. Total 60 adult patients who are scheduled to undergo hernioplasty for ventral abdominal wall hernias, 30 are included group A (onlay) and 30 in group B (sublay).

Results
Maior wound infection was 10% in the onlay group in coparison by the 3.3% of sublay group. Seroma is 33.3% in onlay group while 26.7% in sublay group. Recurrence rate is 6.7% in onlay while 3.3%in sublay group.

Conclusion
Our study revealed that ventral hernias are common in females more than males mainly in the fifth decade of life. Although there are many methods in repair such herniorraphy which associated with a high rate of recurrence so mesh repair is the best in such cases. We have found that sublay hernioplasty is better than onlay hernioplasty according to the post-operative complications such as recurrence, seroma formation and wound infection. However sublay hernioplsaty takes longer operative time than the onlay technique due to the disscection to get the retromuscular space, no significant statistical difference in the operative time., no significant blood loss and hospital stay between the two techniques.
Evaluation of Wire Localization in Management of Non-Palpable Breast Cancer
Authors: Wagdy Hisham Hassan , Al-din Mohammad Mohammed Bahaa , Al-din Osman Ahmed Gamal , Ahmed Sherif Youssif , Gad Gad Mohammed , Hanoura Hatem Elsayed Mohamed Elsayed 
Published: August 2023

Abstract

Background
Breast-conserving surgery (BCS) is considered the goldstandard treatment for early breast cancer. Various techniques have been proposed for identifying non-palpable breast tumors, but the most popular method is the wireguided localization (WGL technique). The most important drawback of BCS is the possible presence of microscopic tumor at or close to the margin of excision.

Objective
To highlighting the significance of screening programs, early detection and recent advances in the management of early non palpable breast cancer.

Methods
This is a prospective study on 30 patients with a single nonpalpable breast lesion. A preoperative USG or MMG-guided hook wire localization technique was performed then intraoperative frozen section was done.

Results
Of the prospective study, 30 patients were treated with wire-guided localization and BCS. And intraoperative frozen sections. According to positive margins, patient age, menopausal status, tumor size and histologic type were associated with increased risk of positive margins. The reexcision at the time of original operation was (6/30) (20%) and need for second operation in (1/30) (3.3%) of cases. According to postoperative complication increased by neoadjuvant chemotherapy, size of mass, specimen volume, margin status and LNs affection.

Conclusion
In early diagnosis of breast cancer, the validity of the imagingguided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successful results of hook wire localization technique.
Effect of Post-Mastectomy Autologous versus Implant Reconstruction on Body Image and Quality of Life among Egyptian Women
Authors: Alamry Heba Hassan , ElAhmady Rania Mohamed , Aly Hesham Adel Sheshtawy , moaty Karim Fahmy Abdel , Rayan Mahmoud Talaat 
Published: August 2023

Abstract

Purpose
The ultimate goal is to evaluate patient satisfaction with autologous versus implant breast reconstruction, as well as the influence of these surgeries on the quality of life and body image of women who have had a mastectomy for breast cancer.

Method
A multicenter, retrospective, cross-sectional study included 117 patients who underwent mastectomy and subsequent breast reconstruction surgery at El Demerdash University Hospital and Alexandria Main University Hospital between January 2017 and March 2021. A BREAST-Q 2-0 Reconstruction module questionnaire was given to each patient.

Result
117 patients were divided into two groups: autologous breast reconstruction ABR (n = 77) and implant-based breast reconstruction IBR (n = 40). The ABR group was operated on using Transverse Rectus Abdominis Myocutaneous (TRAM) or latissimus Doris (LD) flaps. The average age of the participants in the study was 44.51 ± 6.88. Patients with silicone implants were younger on average than those with LD or TRAM flaps.
The patient's quality of life in the two areas evaluated (psychosocial and physical well-being) was excellent in implant repair but poor in TRAM flap, according to our findings. In TRAM flap, we also discovered that overall satisfaction with the breast was low.

Conculsion
TRAM flap produces a low quality of life and overall satisfaction with the breast, whereas implant reconstruction provides a high quality of life.
Management Strategies for Dysphagia Complicating Laparoscopic Nissen Fundoplication, Systematic Review
Authors: Albeialy Khaled Mohamed , Qassem Mohamed Gamal , Osman Tarek Abouzeid , Ibrahim Ahmed Mohamed 
Published: August 2023

Abstract

Background
Gastroesophageal reflux disease (GERD) is a common global disorder. Manifestations of the disease range from occasional episodes of heartburn and regurgitation to the more serious complications of stricture and Barrett’s esophagus. Most patients manage their symptoms with a combination of dietary and lifestyle modifications and overthe-counter or prescription medications.

Aim of the Work
This study aims to assess the incidence, etiology, diagnosis and management strategies for dysphagia following laparoscopic Nissen fundoplication.

Patients and Methods
Published studies discussing dysphagia as a complication of laparoscopic Nissen fundoplication. Patients developed dysphagia after laparoscopic Nissen fundoplication as primary anti-reflux surgery, the type of intervention was laparoscopic Nissen fundoplication. Types of outcome measures: Incidence, etiology, diagnosis and management strategies for dysphagia following laparoscopic Nissen fundoplication. The published English-language literature will be searched in the databases PUBMED, EMBASE, Google Scholar, Science direct and Cochrane Register of Controlled Trails (The Cochrane Library). The search terms will be employed: “Nissen fundoplication” “early dysphagia” “ late dysphagia”.

Results
In our present systematic review, we observed that the incidence of post-operative dysphagia after laparoscopic Nissen fundoplication among the included studies ranged from 8.2% to 42.8% with average percent of 33.2%. Transient postoperative dysphagia was more prominent in most of the included studies with average 52.8%, while persistent dysphagia was in reported in 47.2% of cases. In the present systematic review and meta-analysis, 707 of patients who developed postoperative dysphagia responded to conservative management with percent of 92.4%, while the remaining 58 patients required more invasive modalities. Endoscopic dilatation was performed in 54 (7.1%) of patients, while the remaining 4 patients (0.5%) were indicated for surgical reintervention.

Conclusion
Post laparoscopic Nissen fundoplication dysphagia is one of the most common complications, most cases present with a transient course that require no more than conservative management. In few conditions, more invasive procedures maybe required to control that condition.
Comparative Study between the Effect of Single Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass in Morbidly Obese Patient as Regard Remission of Type-2 DM
Authors: Mahfouz Mohamed Fayek Mohamed , Abdelmonaem Ayman Hossam Eldin , Adly Nahla Nader , Abouzekry Nader Mohamed 
Published: August 2023

Abstract

Background
Accumulating evidence obviously supports the superiority of weight loss surgery over non-surgical treatments for management of morbidly obese patients in terms of outcomes as sustained weight loss, improved quality of life and prevention, reduction, or resolution of comorbidities (e.g., Type 2 Diabetes Mellitus, dyslipidemia), as well as reduced overall mortality.

Objective
To compare Type 2 DM remission as well as the metabolic effects of 2 types of bariatric surgery; Single Anastomosis gastric Bypass and Roux-en-Y Gastric bypass, in the first year postoperative follow up in relation to DiaRem Scoring system.

Patients and Methods
This is a prospective randomized clinical trial study conducted in AinShams University Hospitals bariatric surgery unit over 40 patients with minimal follow-up of 12 months. 2 groups of patients: Group A: composed of 20 patients that undergoing OAGB as a metabolic surgery for control of Type 2 DM. Group B: composed of 20 patients that undergoing Reux-en-Y gastric bypass as a metabolic surgery for control of Type 2 DM. Patients were randomly distributed among both groups using simple randomization odds and evens where odd patients were included in group A and even patients were included in group B.

Results
We find that Roux-en-Y operation is more potent as regard remission of DM than MGB/OAGB (80% versus 65%) and that remission of DM depends on diabetes itself (duration, HBA1C, C-PEPTIDE) and these are the main determinants of remission. And DiaRem score is good predictor of DM remission in low scoring categories however in high scoring categories it is poor in prediction of DM remission

Conclusion
No statistical difference between both groups as regard remission of DM however numerically it is obvious that Roux-en-Y is more potent metabolic surgery in order to be statistically significant the study needs to be repeated over larger sample size. The main determinant noticed during the study influencing remission is the duration of DM and preoperative C-peptide level-in addition to HBA1C level. We must put into our consideration the post operative complications of MGB/OAGB as regard biliary reflux and failure which are more less in Roux-enY operation but in order to be evaluated longer duration of follow up is needed. We recommend Roux-en-Y as a metabolic surgery for patients with early onset DM type II with BMI ranging from 30-40. The study needs to be repeated over larger sample size and longer duration to determine the long term effects of metabolic surgery.
Fibroscan as Non-Invasive Modality for Studying the Effect of Hepatic Steatosis on Viral Response to Direct-Acting Antiviral in Patients with Chronic Hepatitis C
Authors: Shawky Bakir Amal , El Kader Elnakeep Sarah Abd , Faheem Heba Ahmed , Elbasiony Mohamed Adel , El Mageed Ghoneim Abdallah Abd El Hameed Abd 
Published: August 2023

Abstract

Background
HCV is a major cause of viral hepatitis leading to chronic liver disease and liver failure. With an estimated prevalence of 3% in the world population (around 170 million infected individuals worldwide), HCV heavily burdens public health. Even though the incidence of new infections is declining, at least in industrialized countries where they are restricted to intravenous drug users, morbidity and mortality associated with HCV infection are expected to increase over the next decade.

Objectives
The aim of this study to the impact of hepatic steatosis on SVR in HCV infected patients receiving DAA therapy.

Patients and Methods
This prospective observational study was conducted on 40 patients with HCV (anti-hcv seropositive with detectable HCV-RNA). All included patients were subjected to full history taking, thorough clinical examination, full laboratory investigations including: complete blood count, liver profile tests, kidney function tests, lipid profile, abdominal ultrasonography and Transient elastography with controlled attenuation parameter (CAP).

Results
The total SVR and Non-SVR rates among treated patients were 90% and 10%, respectively. The comparison between SVR and Non-SVR patients through the baseline parameters showed that patients who failed to treatment had significantly higher bilirubin, BMI and ALT. Furthermore, liver function parameters was improved significantly in majority of cases. The Impact of treatment regimens on the liver enzymes indices; transaminases was significantly declines during and after complete treatment. On the other hand, serum albumin level was significantly decreased. Regarding the complete blood count indices we found the HB% level was significantly changed with transient declining during the treatment periods. The WBCs count, PLT count were not significantly changed.

Conclusion
Hepatic steatosis was common in HCV infection, the overall SVR-12 was 90%, so that, hepatic steatosis has no impact on SVR-12 in patient with HCV infection undergoing DAA therapy. Fibrosis has no impact on SVR-12 as shown by P-value 0.729. BMI has negative impact on SVR-12 as shown by P-value 0.035. Bilirubin has negative impact on SVR-12 as shown by P-value 0.001. ALT has negative impact on SVR-12 as shown by Pvalue 0.009. HSI has no impact on SVR-12 as shown by p-value 0.077.
Evaluation of Red Cell Distribution Width (RDW) to Platelet Ratio as a Novel Non-Invasive Index for Predicting Hepatic Fibrosis in Patients with Chronic Hepatitis C before and after Antiviral Treatment
Authors: Shawky Bakir Amal , Rahman Hany Ali Abdel , Galal Salah Shaarawy , Badr Ahmed Adel Abdel Fattah 
Published: August 2023

Abstract

Background
Globally, about 71 million people have chronic HCV infection. A significant number of those who are chronically infected will develop cirrhosis or liver cancer. Approximately 399, 000 person die every year from liver cirrhosis and hepatocellular carcinoma. Liver fibrosis reflects sustained liver injury often from multiple, simultaneous factors. Assessment of the effect of antiviral treatment on liver fibrosis is desirable end point for evaluation of the efficacy of therapy.

Aim of the Work
To validate and compare the diagnostic performance of RDW to Platelet ratio for prediction of liver fibrosis before and after antiviral treatment in patient with chronic HCV infection. In Comparison with other markers of fibrosis (fib-4, APRI) scores and fibroscan.

Patients and Methods
This study was conducted on 50 adult patients with chronic hepatitis C virus subdivided into two groups. First group: 25 Non cirrhotic patients having chronic HCV infection. Second group: 25 Cirrhotic CHILD A patients having chronic HCV infection and followed up in Gastroenterology out patient’s clinic, Al Demerdash Hospital, Ain Shams University.

Results
The results obtained can be summarized as follows: RDW/PLT can predict liver fibrosis and cirrhosis with agood degree of accuracy before HCV treatment. RDW/PLT can predict liver cirrhosis (F3 & F4) with an excellent degree of accuracy after HCV treatment. RDW/PLT cannot predict early liver fibrosis (F1 & F2) after HCV treatment as results assuming apoor degree of accuracy. According to above results RDW/PLT can be used instead of liver biopsy to detect degree of liver fibrosis and cirrhosis before HCV treatment with agood degree of accuracy. While after HCV treatment we can depend on RDW/PLT to predect degree of advanced liver fibrosis and cirrhosis (F3 & F4) with an excellent degree of accuracy. But we need further studies on RDW/PLT to detect the accuracy of prediction of early liver fibrosis (F1 & F2) after HCV treatment.

Conclusion
RDW/PLT can predict liver fibrosis and cirrhosis with agood degree of accuracy before HCV treatment. RDW/PLT can predict liver cirrhosis (F3 & F4) with an excellent degree of accuracy after HCV treatment. RDW/PLT cannot predict early liver fibrosis (F1 & F2) after HCV treatment as results assuming apoor degree of accuracy. According to above results RDW/PLT can be used instead of liver biopsy to detect degree of liver fibrosis and cirrhosis before HCV treatment with agood degree of accuracy. While after HCV treatment we can depend on RDW/PLT to predect degree of advanced liver fibrosis and cirrhosis (F3 & F4) with an excellent degree of accuracy. But we need further studies on RDW/PLT to detect the accuracy of prediction of early liver fibrosis (F1 & F2) after HCV treatment.