Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101SURGICAL OUTCOME OF SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY IN COMPARISON WITH THE 4-PORT TECHNIQUE IN ZAGAZIG UNIVERSITY HOSPITAL181298110.21608/zumj.2018.12981ENAbd-Elhady Abd-ElatySalamaTarek EzzatAbd-EllateifTarek Abd ElazeimGobranAhmed AbouHashemJournal Article20180909<br /><span class="fontstyle0">Bachground: </span><span class="fontstyle2">Cholelithiasis is one of the most common disorders of the digestive tract encountered by<br />general surgeons worldwide. Conventional or open cholecystectomy was the mainstay of treatment for a long<br />time for this disease. Laparoscopic cholecystectomy (LC) has been the gold standard for removal of the<br />gallbladder since the early 1990s. Single-incision laparoscopic surgery is becoming a more widely accepted<br />surgical approach. However, the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC)<br />are yet to be established. The present study compared outcomes following the use of SILC or conventional<br />laparoscopic cholecystectomy (CLC) on patients with gallbladder disease.</span><span class="fontstyle0">Aim: </span><span class="fontstyle2">To compare the perioperative<br />results of single port laparoscopic cholecystectomy with the standard 4-port technique.</span><span class="fontstyle0">Subjects and methods:<br /></span><span class="fontstyle2">The study involved 72 symptomatic gallbladder disease patients underwent laparoscopic cholecystectomy in<br />Zagazig University hospital.36 patients underwent SILC, and 36 patients underwent CLC. Clinical and surgical<br />outcomes were compared.</span><span class="fontstyle0">Results: </span><span class="fontstyle2">The SILC and CLC groups were similar in terms of age, gender ratio, body<br />mass index, and diagnoses. The two groups were also found to be similar in terms of postoperative clinical<br />course and complications. The SILC group had a longer operation time, less postoperative pain, and a shorter<br />hospital stay with better aesthetic results than the CLC group.</span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">SILC was as safe and feasible as<br />CLC. The operating time was longer otherwise it has almost similar clinical outcomes to those of CLC.<br /></span><span class="fontstyle0">Keywords: </span><span class="fontstyle2">Four port technique, Laparoscopic surgery, Single port surgery</span><strong><br /><br /></strong>https://zumj.journals.ekb.eg/article_12981_cf4921ba3626bf1fe77866ba059f532e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101ASESSMENT OF IMAGING IN CONGENITAL INNER EAR ANOMALIES AND ITS RELATION TO COCHLEAR IMPLANTATION9181298710.21608/zumj.2018.12987ENEzz El-Din MEl ShiekhGamal AAbdel-MaksoudHassan AWahbaIbrahim MSaberJournal Article20180909<span class="fontstyle0">ABSTRACT<br />Background</span><span class="fontstyle1">: congenital SNHL may be caused by abnormalities of th-e membranous, or bony labyrinth. Because of<br />improvements in imaging techniques and appearance of high resolution CT and MRI, anomalies of bony labyrinth can<br />be diagnosed. MR imaging helps in identification of non-osseous partitioning of the malformed cochlea and<br />identification of the neural structures contained within the internal auditory canal. The cochlear implantation has<br />radically changed the outlook for profoundly deaf adults and children. </span><span class="fontstyle0">Aim of work: </span><span class="fontstyle1">to identify different types of<br />inner ear anomalies, and to detect the percentage of patients who are amenable to cochlear implantation, and<br />difficulties that occur during the operation. </span><span class="fontstyle0">Patients and methods: </span><span class="fontstyle1">This prospective study was carried out on sixty<br />patients from 2015 till 2017 in ORL Department, Zagazig University. All patients underwent thorough preoperative<br />evaluation especially by high resolution CT and MRI. These patients were classified according to type of diagnosed<br />anomaly, and CI operation were done to patients who were amenable for surgery. </span><span class="fontstyle0">Results: </span><span class="fontstyle1">The results of this study<br />show congenital inner ear anomalies distribution according to involved part and its percent in relation to total number<br />120 ears. Cochlear hypoplasia is present in 6 ears 4.5%, common cavity is present in 4 ears 3%, IP1 is present in 4 ears<br />3%, IP2 is present in 22 ears 16.7%, IP3 is present in 10 ears 7.6%, posterior rotated cochlea is present in 8 ears 6.1%,<br />dilated vestibule is present in 4 ears 3%, isolated SCC hypoplasia is present in 4 ears 3.03%, SCC hypoplasia with<br />common cavity is present in 4 ears 3.03%, dysplstic SCC is present in 9 ears 6.8%, dilated IAC is present in 6 ears<br />4.5%, hypoplastic IAC is present in 24 ears 18.2%, VCN hypoplasia is present in 24 ears 18.2%, isolated EVA is<br />present in 48 ears 36.4%. In our study all operated cases were done through facial recess approach. Operated cases were<br />51 out of 66 about 77.3%. </span><span class="fontstyle0">Conclusion: </span><span class="fontstyle1">CT and MRI are mandatory investigations for any patient prepared for cochlear<br />implantation. Preoperative diagnosis of inner ear anomalies allows exclusion of anomalies that are considered as<br />contraindication for CI operation.</span>https://zumj.journals.ekb.eg/article_12987_137d72074f443ccb7aed6ac23881e06e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101IFFERENT SURGICAL TECHNIQUES OF SKULL BASE RECONSTRUCTION: EVALUATION AND OUTCOME19231299310.21608/zumj.2018.12993ENHazem S.SolimanSamy H.MohamedTarek H.Abdel-BaryMohamed RedaAbd ElazizJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background </span><span class="fontstyle2">: cerebrospinal fluid (CSF) leak is the most common complication after skull base surgery. It carries<br />a high risk of life threatening complications (e.g., tension pneumocephaly, meningitis, cerebritis, and brain<br />abscess).<br /></span><span class="fontstyle0">Patients and Methods</span><span class="fontstyle2">: We present twenty patients, ages 2-55 years, eight males and twelve females with<br />different skull base pathologies operated by different surgical modalities (microscopic transcranial, endoscopic<br />endonasal and combined micro-endoscopic techniques) at neurosurgery department, faculty of medicine, Zagazig<br />University, between Jan. 2016 to Jan. 2018. Prophylactic antibiotics and anticonvulsants were rourtinely given.<br />Lumbar drain was not used.<br /></span><span class="fontstyle0">Results</span><span class="fontstyle2">: the success rate was (95%) and only one patient (5%) developed post operative CSF leak which<br />responded to conservative measures. This suggests that proper sealing of the skull base defect has been achieved.<br />There was no infection, no mortality and the long term follow up showed good functional and aesthetic results.<br /></span><span class="fontstyle0">Conclusion</span><span class="fontstyle2">: The reconstructive process although being the last step in the surgical procedure, but it's a very<br />important one. It should be planned well before surgery. Meticulous repair of the already present or resultant<br />defect should be performed in every case.</span>https://zumj.journals.ekb.eg/article_12993_7bf978e3c7f7f91bebed2793ec05c2e2.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101MODIFIED SELVESTER QRS SCORE REDUCTION FOR PREDICTION OF MYOCARDIAL SALVAGE FOLLOWING SUCCESSFUL REPERFUSION OF ACUTE ST ELEVATION MYOCARDIAL INFARCTION24331299610.21608/zumj.2018.12996ENAhmed ShafieAmmarIslam Abd El-MoneemEl-SherbinyIslam ElSayedShehataCheng -I-ChengIslam Ghanem AhmedGhanemJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span>
<span class="fontstyle0">Background: </span><span class="fontstyle2">Achieving optimal angiographic coronary flow after acute ST elevation myocardial infarction<br />(STEMI) isn’t the best parameter of success. Perfusion of the microvasculature is more important. QRS score<br />plays an important role for early risk stratification for STEMI. It is a simple electrocardiographic (ECG)<br />parameter for assuring the presence or absence of microvascular obstruction.<br /></span><span class="fontstyle0">Aim of the work: </span><span class="fontstyle2">The aim of this clinical study is to validate the 90 minutes modified Selvester QRS score<br />reduction as a reliable predictor of myocardial salvage, represented by 3 months global longitudinal strain (GLS)<br />value, following successful reperfusion of acute STEMI.<br /></span><span class="fontstyle0">Material/Methods: </span><span class="fontstyle2">The study population included 400 patients presented with first acute STEMI with<br />successful reperfusion by thrombolysis (Group I- 200 patients: mean age=57.1 ± 11.6 years) or primary<br />percutaneous intervention (PPCI) (Group II- 200 patients: mean age=58.2±9.8 years). Basal and 90 minutes after<br />reperfusion electrocardiography was done with assessment of ST resolution and modified Selvester QRS score.<br />Basal and 3 months follow up echocardiography was performed with assessment of ejection fraction (EF) and<br />GLS as an indicator for myocardial salvage with its impact on long-term clinical outcome.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">90 minutes ST resolution and QRS score reduction were significantly higher in PPCI group (P.: 0.04*,<br />0.03*). Patients in group I had non-significant improvement of EF (P.: 0.22) during follow-up, but highly<br />significant improvement of GLS (P.: ˂0.001**) compared to the basal echocardiographic study. Patients in<br />group II had significant improvement of EF (P.: 0.01*) during follow-up, and highly significant improvement of<br />GLS (P.: ˂0.001**) compared to the basal echocardiographic study. As regarding correlation with 3 months<br />GLS value, there was highly significant negative correlation between 3months GLS and (ST resolution and QRS<br />score reduction) (P.: ˂0.001**). Receiver operating characteristics (ROC) curve analysis shows that 90 minutes<br />QRS score reduction has the best cut off value of 70% to predict 3months GLS improvement with 80%<br />sensitivity and 79% specificity.<br /></span><span class="fontstyle0">Conclusions: </span><span class="fontstyle2">Modified Selvester QRS score reduction 90 minutes after reperfusion is a cheap bedside ECG<br />parameter added to ST resolution, can be considered as a reliable predictor of future myocardial salvage with its<br />impact on long-term clinical outcome and modifying management strategies.</span>https://zumj.journals.ekb.eg/article_12996_cc019195724e4a67a6dd551bb5679566.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101PREDICTION OF LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTIONS SIX MONTHS FOLLOWING MITRAL VALVE REPLACEMENT USING NEW ECHO DOPPLER INDICES34431299810.21608/zumj.2018.12998ENMoataz AbdelmonemElkotAhmed ShafieAmmarIslam Abd-ELmoneemELsherbinyKhaled HassanAbdelbaryJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background: </span><span class="fontstyle2">The development of left ventricular dysfunction is a major concern in the management of patients with<br />severe mitral regurgitation. In the initial stages, contractility impairment may be ‘‘invisible’’ by the traditional methods<br />to assess the ventricular function, because of different loading conditions. This fact can mask the presence of LV<br />dysfunction. Sometimes, LV dysfunction may be ‘‘unmasked’’ only by change in loading conditions after surgical<br />correction, leading to the development of overt LV dysfunction and congestive heart failure. The identification of<br />contractile dysfunction at an early stage and surgical correction may avoid the development of irreversible postoperative<br />LV dysfunction.<br /></span><span class="fontstyle0">Objectives</span><span class="fontstyle2">: To test the efficacy of new echocardiographic indices in predicting post operative left ventricular<br />dysfunction and compare the diagnostic accuracy of these indices .<br /></span><span class="fontstyle0">Subjects and Methods: </span><span class="fontstyle2">The study included 41 patients with severe isolated Mitral regurgitation with ejection fraction<br />> 50 %, prepared for mitral valve replacement. Patients were examined clinically and by Echocardiography pre and post<br />operative. The following Echo Doppler modalities were done to the patients pre operative and 6 months post operative:<br />Global longitudinal strain(GLS) , Modified Simpson ,dp/dt , IVRT/T(E-è) the early diastolic Driving Force , early<br />diastolic and early systolic mitral annular velocity by tissue Doppler. Patients were then classified into Four sub groups<br />according to post operative systolic and diastolic function, Group 1A were patients with normal post operative systolic<br />function , Group 1B were patients with post operative systolic dysfunction , Group 2A were patients with normal post<br />operative diastolic function , Group 2B were patients with post operative diastolic dysfunction.<br /></span><span class="fontstyle0">Results</span><span class="fontstyle2">: For prediction of systolic dysfunction ROC curve analysis showed high significant value of pre operative GLS<br />in predicting post operative systolic dysfunction with cutoff value= -18.5 , high significant value of pre operative<br />modified Simpson in predicting post operative systolic dysfunction with cutoff value=54.5, and significant value of pre<br />operative dp/dt in predicting post operative systolic dysfunction with cutoff value=1166 mmHg/sec. The multivariate<br />analysis showed that the independent variables for predicting post operative systolic dysfunction were pre operative<br />GLS and dp/dt.<br />For prediction of diastolic dysfunction ROC curve analysis showed high significant value of pre operative GLS in<br />predicting post operative diastolic dysfunction with cutoff value=-18.5, and significant value of pre operative<br />IVRT/T(E-e\) in predicting post operative diastolic dysfunction with cutoff value=2.95. Multivariate analysis showed<br />that the independent variables for predicting post operative diastolic dysfunction were preoperative GLS & preoperative<br />IVRT/T (E-e\).<br /></span><span class="fontstyle0">Conclusions</span><span class="fontstyle2">: We can depend on pre operative Global Longitudinal Strain (GLS) and dp/dt in predicting post operative<br />systolic dysfunction with cut off value=-18.5 and 1166 mmHg/sec respectively. We can also depend on preoperative<br />GLS and IVRT/T (E-e\) in predicting post operative diastolic dysfunction with cutoff value=-18.5 and 2.95<br />respectively</span>https://zumj.journals.ekb.eg/article_12998_ce7afb0379b4c3ab48facdbba8a1813b.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101MICRONEEDLING AND GLYCOLIC ACID PEEL FOR TREATMENT OF ACNE SCAR; COMPARATIVE STUDY44541300110.21608/zumj.2018.13001ENAmr NazirSaadawiAbdallah MohamedEsawyWalaa ElsayedMohamedJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background</span><span class="fontstyle1">: Atrophic acne scars are common and undesirable outcome of acne vulgaris related to<br />both its severity and delay in treatment. Such scars can be classified according to the depth and shape<br />of the collagen loss: ice pick, boxcar, or rolling. Many options are available for treatment of acne scars<br />such as: laser surgery, radiofrequency intervention, chemical peels, chemical reconstruction of skin<br />scars (cross technique), dermabrasion, needling, subcision, punch techniques, fat transplantation, and<br />other tissue augmenting agents.</span><span class="fontstyle0">Objective</span><span class="fontstyle1">: The aim of this study was to compare between GA peel<br />monotherapy and microneedling with dermapen monotherapy in treatment of acne scars. Moreover,<br />combined treatment of GA peel and microneedling with dermapen is compared to each of the above<br />monotherapies in treatment of acne scars.</span><span class="fontstyle0">Methods</span><span class="fontstyle1">: Thirty patients of both sexes (10 men and 20<br />women) with age ranged from 19-45 years old with different types of atrophic acne scars were enrolled<br />in the study. Patients were randomly divided into three groups: Group I</span><span class="fontstyle0">: </span><span class="fontstyle1">Included ten patients (4 males<br />and 6 females) aged 27 - 45 years. They had microneedling with dermapen for treatment of the scars.<br />Group II: Included ten patients (4 males and 6 females) aged 19- 42 years. They had glycolic acid 35%<br />peel for treatment of the scars. Group III: Included ten patients (2 males and 8 females) aged 19-39<br />years. They were treated with skin microneedling with dermapen combined with glycolic acid 35%<br />peel.</span><span class="fontstyle0">Results</span><span class="fontstyle1">: Results revealed that there was statistical significant decrease between acne scar grade in<br />dermapen group before and after treatment with degree of improvement (80%). Also, in glycolic acid<br />group before and after treatment with degree of improvement (70%). Statistical significant decrease<br />between acne scar grade in combination group before and after treatment with degree of improvement<br />(100%). Statistical significant increase in frequency of improvement in rolling compared to boxcar and<br />icepick in all groups and also in boxcar compared to icepick.</span><span class="fontstyle0">Conclusion</span><span class="fontstyle1">: Dermapen and glycolic acid<br />peel are effective and safe techniques in acne scars especially (superficial scars). Combination of<br />dermapen and glycolic acid peel is more effective than monotherapy by either dermapen or glycolic<br />acid peel and also helps in improvement of deep acne scars.</span>https://zumj.journals.ekb.eg/article_13001_9884d73d998017efa9c88965edef098d.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101DOPAMINE RECEPTOR D3R AND D4R MRNA LEVELS IN PERIPHERAL LYMPHOCYTES IN PATIENTS WITH SCHIZOPHRENIA AND ITS CORRELATION WITH SEVERITY OF ILLNESS55651300310.21608/zumj.2018.13003ENAsaad A.ShalandaRafek R.Abd EllatifMohamed G.NegmAmal S.El ShalHeba AhmedAbdelsalamJournal Article20180909<span class="fontstyle0">ABSTRACT<br />Objective: </span><span class="fontstyle2">This study aimed to assess D3R and D4R mRNA levels in patients with schizophrenia.<br /></span><span class="fontstyle0">Subjects: </span><span class="fontstyle2">Thirty six schizophrenia patients; 24 males (66.7%) and 12 females (33.3%) and 36 healthy<br />individuals; 23 males (63.9%) and 13 females (36.1%) as control subjects.<br /></span><span class="fontstyle0">Methods: </span><span class="fontstyle2">All schizophrenia patients are thoroughly screened and diagnosed for schizophrenia using<br />DSM-IV diagnostic criteria for schizophrenia.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The mean values of D3 and D4 receptors mRNAs level among both studied cases and controls<br />show a highly statistically significant difference (P <0.001) between both schizophrenia patients and<br />their controls regarding levels of D3 and D4 mediators. D3 receptor mRNAs level influenced by PANS<br />scale of schizophrenic patients, as level of D3 R increased in PBLs with decreased schizophrenia<br />severity, and the difference was statistically significant (P <0.001), while the difference in D4 R level<br />was not statistically significant (P >0.05).<br /></span><span class="fontstyle0">Conclusion</span><span class="fontstyle2">: This study reveals that the molecular biologically-determined dopamine receptors (DR3<br />and DR4 mRNA) of peripheral lymphocytes are reactive after taking antipsychotics, and that increased<br />expression of dopamine receptor in peripheral lymphocyte has possible clinical significance for<br />subgrouping of schizophrenia.</span>https://zumj.journals.ekb.eg/article_13003_12e93329e9c9e8e2f2e4ab8f84f8ef36.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101STUDY OF FINGERPRINTS PATTERN IN BREAST CANCER PATIENTS INSHARKIA GOVERNORATE, A CASE –CONTROL RETROSPECTIVE CLINICAL STUDY.66711300610.21608/zumj.2018.13006ENAlaa AhmedHaggagAlaa MohamedIbrahim KhalilEman Salah-eldinElzahedMohamed IbrahimAbdelhamidJournal Article20180909<span class="fontstyle0">ABSTRACT<br />Background :</span><span class="fontstyle2">Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in<br />women. In less-developed countries, it is the leading cause of cancer death in women; in developed<br />countries. Breast cancer is one of the most extensively studied cancers and its genetic basis is well<br />established.Dermatoglyphic traits are formed under genetic control early in development but may be<br />affected by environmental factors during first trimester of pregnancy. These patterns may represent the<br />genetic make up of an individual and therefore his/her predisposition to certain diseases. The finger and<br />palmar print</span><span class="fontstyle2">s </span><span class="fontstyle2">patterns have already beenstudied with respect to various genetic diseases such as the<br />Down's </span><span class="fontstyle2">g</span><span class="fontstyle2">syndrome and Klinefeltersyndrome. The fingerprints can thus represent a simple, non<br />invasive anatomical marker of breast cancer risk.<br /></span><span class="fontstyle0">Methods :</span><span class="fontstyle2">This study was applied to fifty histopathologically-confirmed breast cancer patients and their<br />fingerprints patterns were assessed. At the same time , fifty age-matched controls were selected being<br />have no self or family history of breast cancer and the observations were recorded abd data were<br />collected.<br /></span><span class="fontstyle0">Result :</span><span class="fontstyle2">It was observed that whorl pattern is the most common fingerprints pattern to be identified in<br />breast cancer cases compared to controls. Also the quantitative difference in ridge count was<br />statistically important.<br /></span><span class="fontstyle0">Conclusion </span><span class="fontstyle2">: The pattern of fingerprints may be a useful tool in the future in identifying and also<br />screening of breast cancer.</span>https://zumj.journals.ekb.eg/article_13006_8008119119fd763a40fff31c2ef33b58.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101SCREENING FOR B-THALASSEMIA CARRIER AMONG STUDENTS IN ASECONDARY SCHOOL IN DIARB NEGM,SHARKIA72791300710.21608/zumj.2018.13007ENMervat AbdallahHeshamMohammed RefaatBesherNaglaa AliKhalifaJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Background</span><span class="fontstyle2">:Beta-Thalassemia represents a major public health problem in Egypt. The carrier rate varies<br />between 5.5% to ≥ 9%; it is estimated that there are 1000/1.5 million per year live births born with β-<br />thalassemia. In spite of optimal treatment being available, only a few patients can afford it. Unfortunately,<br />most patients suffer from complications of blood transfusions, mainly transfusion transmitted viral infections<br />and iron overload. Prevention by carrier detection and prenatal diagnosis is needed in populations with high<br />incidence of the disease, such as Egypt.<br /></span><span class="fontstyle1">Methods:</span><span class="fontstyle2">This was a prospective cross-sectional study conducted on 614 secondary school students in Diarb<br />Negm, Sharkia Governorate. All subjects were subjected to the following: Complete blood count,Serum<br />ferritin level, Serum iron level, TIBC. Subjects with microcytic anemia were subjected to specific laboratory<br />tests: HPLC (High Performance Liquid Chromatography) which include hemoglobin A2(HbA2).<br /></span><span class="fontstyle1">Results:</span><span class="fontstyle2">Complete blood count testing of the 614 subjects in this study revealed that 55.2 % were normal and<br />44% were anemic, 5.6% had normocytic anemia and 39.2% had microcytic anemia.Subjects with microcytic<br />anemia were further subdivided into two groups according to their HbA2 level into; β-Thalassemia carrier<br />group with high level of HbA2 >3.5% and normal to high (serum iron, serum ferritin) and normal to low<br />TIBC were 8.5% and </span><span class="fontstyle0">Non</span><span class="fontstyle2">-carrier group; All with normal levels of HbA2< 3.5%, low serum iron, low serum<br />ferritin, high TIBC, were 31.6% of subjects and diagnosed as iron deficiency anemia.Carriers rate was 8.5%,<br />53.8% were males and 46.2% were females.There were increase in mean value of RBCS count, serum iron<br />and serum ferritin in carriers as compared to non-carriers, and decrease in mean value of HB, HCT, MCV,<br />MCH, MCHC find TIBC level in carriers as compared to non-carriers. There was a significant positive<br />correlation between HbA2 and HCT, RBCS count and serum ferritin, while significant negative correlation<br />between HbA2and MCV.<br /></span><span class="fontstyle1">Conclusion: </span><span class="fontstyle2">Carrier rate among 614 secondary school students in Diarb Negm,Sharkia Governorate was<br />8.5%.Hemoglobin A2 is the gold standard for B-Thalassemia carrier screening.</span>https://zumj.journals.ekb.eg/article_13007_91e1726bcd9e792c5ce7c9e5ff201372.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124120180101PREDICTORS OF VARICEAL BLEEDING AFTER ESOPHAGEAL VARICES BAND LIGATION IN EGYPTIAN CIRRHOTIC PATIENTS80921300910.21608/zumj.2018.13009ENSahar GodaZaghloulHoda AbdelazizEl HadyHussein MohamedHusseinIslam AbdelsabourHassanJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Background</span><span class="fontstyle2">:</span><span class="fontstyle3">Bleeding from oesophageal varices is a severe complication of portal hypertension. Endoscopic<br />variceal ligation (EVL) is the treatment of choice for acute variceal bleeding. It is also performed for primary<br />and secondary prophylaxis of bleeding from oesophageal varices. After Endoscopic Band Ligation (EBL),<br />patients are at risk of post-interventional bleeding; the risk factors for this complication are poorly<br />evaluated</span><span class="fontstyle2">.</span><span class="fontstyle1">The aim of this work</span><span class="fontstyle3">: was to evaluate the risk factors for predicting variceal bleeding after elective<br />endoscopic variceal ligation (EVL). </span><span class="fontstyle0">Patients and Methods: </span><span class="fontstyle3">This study will be carried out in Zagazig<br />University Hospital and El-Galaa Family Military Hospital. The patients was subjected to different<br />demographic, clinical, biochemical, ultrasonographic and endoscopic findings. </span><span class="fontstyle1">Results : </span><span class="fontstyle3">The incidence of<br />bleeding after elective EVL was 6%. The results showed significant differences between the bleeders and<br />non bleeders regards the severity of liver disease measured by Child-Pugh score , the platelets count,<br />hemoglobin level, prothrombin time , the liver regards its ( size, echogenicity, irregularity of the surface,<br />presence of HFL and Portosystemic collaterals ) , the size and extension of varices. </span><span class="fontstyle1">Conclusion: </span><span class="fontstyle3">For<br />prediction of variceal bleeding after elective EVL; We can rely on many characteristics, such as age, gender,<br />liver function, severity of varices, number of rubber bands, and so forth. But as demonstrated by the<br />multivariate analysis, there were only four independent risk factors among these, namely moderate to<br />excessive ascites, PT > 18, number of rubber bands placed, size and extent of varices. These four risk factors<br />may therefore be more meaningful than the others for predicting the occurrence of bleeding following<br />elective EVL.</span>https://zumj.journals.ekb.eg/article_13009_d797dcbdc26c1d0d1dcb80e32249df74.pdf