Short Term Results Of Cementless Total Hip Replacement In Patient With Ankylosing Spondylitis
Reda
Rabha
orthopedic
author
mohammed
elsadek
orthopedic
author
elasayed
soudy
orthopedic
author
khaled
HASSAN
orthopedic
author
text
article
2020
eng
Abstract:Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology which primarily affects the sacroiliac joints, spine, hips and, less commonly, the knee joints, resulting in severe deformities and in combination with a stiff spine, leads to further deterioration in function. Cementless total hip replacement (THR) provides long-term pain relief in a large percentage of (AS) patients. The range of hip movement is significantly increased leading to a marked improvement in their overall walking ability. The percentage of clinically significant Heterotopic Ossification (HO) and re-ankylosis rates is low.Aim of the study: To evaluate the short-term results of cementless total hip replacement (THR) in patients with (AS).Subjects and methods: A retrospective analysis of 12 Ankylosing Spondylitis patients with hips involvement in 15 hips. The right hip was affected in 4 cases, the left in 5 cases and bilateral in 3 cases treated by cementless. The patients were assed clinically by Harris hip score preoperatively & postoperatively. Anteroposterior (AP) both hips X-ray was taken pre-operatively, immediate post-operative period and at follow-up. Results: This results showed highly significant improvement in total hip score points from average 25.47 ± 4.67 points (17-32) preoperatively to average 84.47±5.84 points (71- 93) postoperatively.Conclusion: The results of cementless THR in patients with bony ankylosis are encouraging with risk of intraoperative complications needing great care and good perioperative management. Patients were satisfied with the functional outcome. So, the stable ingrowth postoperatively in our research recommends cementless implants in AS patients.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
534
541
https://zumj.journals.ekb.eg/article_41225_58ffeaa23e772a7364d48d1372c1e86e.pdf
dx.doi.org/10.21608/zumj.2019.11141.1154
SHORT TERM RESULTS OF CERAMIC ON CERAMIC TOTAL HIP ARTHROPLASTY
ehab
shehata
zagazig university
author
ahmad
radi
Ain Shams University
author
mohamed
shafik
zagazig university
author
el sayed
soudy
orthopedic zagazig university
author
text
article
2020
eng
Abstract Abstract Background: Ceramic on ceramic total hip arthroplasty is now a standard procedure in the management of degenerative hip joint disorders. The new operative techniques has made the procedure an easy process to operate and with good results for young individuals. Patients and Methods: Our study was performed on 24 patients that were operated at Orthopedic department, Zagazig university and Ain-Shams university hospital in the period between August 2014 to August 2016. All cases were treated by CoC THA. 11 males and 13 females with mean age of 33 years (range: 18-63). The etiology was femoral head avascular necrosis in 16 hips, and posttraumatic hip arthritis in 6 patients and ankylosing spondylitis in 2 hips. Clinically, the indications of operation were intolerable pain, limitation of hip motions and flexion adduction deformity. Clinical evaluation by Harris Hip Score. preoperatively, postoperatively and at follow up visits was done. Results: The age of the patients was between 18 and 63 years with mean 33 years. Regarding sex distribution 54.2% were female. There were statistical significant increase in Harris score grading among the studied cases postoperative compared to pre. Excellent results were in 18 hips (75%), and good results in 2 (8.3%), fair in 3 hips (12.5%), and 1 hip (4.2%) had poor results. 33.3 % of the patients had complication, one case had linear breakage, 3 cases had head dislocation, two infected cases, one cases suffered from squeaking and one case revised.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
542
547
https://zumj.journals.ekb.eg/article_30112_f299987aecc84ca95f3563c660f6875e.pdf
dx.doi.org/10.21608/zumj.2019.11167.1176
Short-term Results of Interlocking Nailing in Open Tibial Fracture
saqar
saqar
orthopedic surgery, faculty of medicine , zagazig university
author
khaled
hassan
orthopedic department, faculty of medicine, zagazig university
author
Hossam
Khairy
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
author
محمد
الصادق
orthopaedic
author
text
article
2020
eng
AbstractBackground and aim:Tibial fractures are the most common long bone fractures, with around 25% open fractures. The majority of open tibial fractures result from high velocity trauma. The management of these fractures can be complex due to the relative lack of soft tissue coverage and blood supply of the tibial shaft ,The aim of this study to evaluate the short-term results of tibial nailing in the open tibial fractures.Patients and methods:This study included 20 patients admitted to Zagazig University Hospitals with open tibial fractures of different causes and classified according to Gastilo and Anderson classification and (OTA) ,Written informed consent was obtained from all participants and study was approved by research ethical committee of Faculty of Medicine, Zagazig University. The work has carried out in accordance with The Code 4385 of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results:In our results, overall mean time to union was 5.47 months.Steinberg et al. studied 25 patients of open tibial fracture with average union time of 15.4 weeks . In our series we had average time to union of 7 months and a 10% incidence of infections. These results suggest that the nailing in open fractures of the tibia has faster union rates and lower rates of infection. Conclusions:The treatment of open tibial shaft fracture has evolved over the last two decades. Improved wound care, newer generation antibiotic and better metallurgy for the implants have contributed to this change.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
548
555
https://zumj.journals.ekb.eg/article_31188_0dd55054545f142864afd235c39d7db1.pdf
dx.doi.org/10.21608/zumj.2019.10507.1177
PREDICTION OF PRETERM DELIVERY IN PREGNANT WOMEN WITH THREATENED PRETERM LABOR USING TRANSVAGINAL ULTRASOUND AND NEUTROPHILS TO LYMPHOCYTES RATIO
ali
Ali
Department of Obstetrics and Gynecology,Faculty of Medicine –ZagazigUniversity,Egypt.
author
Safaa
Ibrahim
Department of Obstetrics and Gynecology,Faculty of Medicine –ZagazigUniversity,Egypt
author
Mostafa
Ahmed
Department of Obstetrics and Gynecology,Faculty of Medicine –ZagazigUniversity,Egypt
author
soad
kareem
Department of Obstetrics and Gynecology,Faculty of Medicine –ZagazigUniversity,Egypt
author
text
article
2020
eng
Abstract:Background: Preterm birth, defined as delivery before 37 completed weeks, with an annual incidence of 9-15%, is implicated in approximately two thirds of perinatal mortality worldwide. Preterm births are also associated with neonatal death & with immediate & long-term morbidities, making this a major public health issue. Objectives: This work is improvement of fetal outcome by early prediction of preterm birth in pregnant women presented by threatened preterm labor. Patients and Methods: In this study, we started with 90 women with singleton pregnancies between 24 to 42 weeks. Results: Cervical length, as measured by transvaginal ultrasonography, has been shown to predict preterm birth in asymptomatic low-risk women as well as those presenting with threatened preterm labor.Conclusions: This study demonstrated that the combined marker is more sensitive & specific for predicting spontaneous preterm delivery in pregnant women with threatened preterm labor in comparison with cervix length, NLR, C Reactive Protein alone
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
556
565
https://zumj.journals.ekb.eg/article_40730_b0d2e0ce6750670ba3645f174dfb8524.pdf
dx.doi.org/10.21608/zumj.2019.11376.1182
Reverse Breech Extraction Versus Disimpaction Of The Head During Cesarean Section For Obstructed Labor
Marwa
Farag Attia
M.Sc. student, Faculty of Medicine - Zagazig University
author
Abdel-Mageed
Sarhan
Professor and Head of obstetrics and Gynaecology Faculty of Medicine - Zagazig University
author
Hussein
Abdel-Dayem
Assistant Professor of obstetrics and Gynaecology, Faculty of Medicine - Zagazig University
author
text
article
2020
eng
Background: Obstructed labor with the fetal head impacted in the pelvis is an obstetric complication that requires cesarean delivery with skillful handling to avoid serious maternal and neonatal outcomes complications. So, the extraction and delivery of the fetal head can be done by reverse breech extraction. Objective: The objective of this study was to compare the maternal and fetal outcome of the reverse breech extraction versus standard method in Caesarean section for obstructed labour with deeply engaged fetal head. Subjects and Methods: This .prospective study was carried out at Zagazig University Hospital, Egypt during the period from January 2017 to October 2017, this study included (40) patient submitted in emergency caesarian section with deeply engaged fetal head. Results: showed that complication was statistically significant decrease in reverse breech extraction in comparison to standard group with intra operative and postoperative maternal complication, mean length stay in hospital and wound infection. Conclusion: Reverse breech extractions is an attractive and safe alternative to the standard method for intraoperative disengagement of a deeply impacted fetal head in reducing maternal and fetal morbidly.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
566
573
https://zumj.journals.ekb.eg/article_42377_84ddb2958245e447a51e99f7df1f3a98.pdf
dx.doi.org/10.21608/zumj.2019.13238.1232
Gonadotropin Releasing Hormone Agonist versus Human Chorionic Gonadotropin in Patients with PCOS as Trigger of Ovulation
Iman
BuTalag
Department of Obstetrics & Gynecology, Faculty of Medicine - Benghazi University, Libya
author
Abdel-Mageed
Sarhan
Professor and Head of obstetrics and Gynaecology Faculty of Medicine - Zagazig University
author
Mervat
Harira
Lecturer of obstetrics and Gynaecology, Faculty of Medicine - Zagazig University
author
text
article
2020
eng
Background: Many patients develop excessive response for gonadotropin stimulation through controlled ovarian stimulation (COS) cycle over the years, there was an increase in incidence of ovarian hyperstimulation syndrome (OHSS) which represents an important medical problem for the clinicians. Objectives: to compare GnRHa and hCG as ovulation trigger in patients with PCOS after controlled ovarian stimulation by estimation of ovulation rate and rate of clinical pregnancy in studied group and detect efficacy in preventing or reducing incidence of OHSS. Patients & Methods: This prospective study was carried out in the unit of Cytogenetic and Endoscopy in department of Obstetrics and Gynecology in Zagazig university hospital during the period from September 2017 to January 2018 where 52 subfertile women with anovulatory PCOS. Results: showed that there is no significant difference in the overall ovulation rate. The average rate of ovulation was 38 (33.04%) and 30 (26.06 %) in GnRHa and hCG groups. The OHSS incidence was higher in hCG group than the GnRHa group. Conclusions: hCG was the gold standard for complete oocyte maturation, the new agent seems to be GnRHa with its potential advantages over hCG trigger in OHSS reduction.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
574
581
https://zumj.journals.ekb.eg/article_40722_b0e7781d3b14907674e7d988aa3586f3.pdf
dx.doi.org/10.21608/zumj.2019.13352.1239
Letrozole versus Clomiphene Citrate with metformin for Induction of Ovulation in Obese patients with Polycystic Ovarian Disease
Salma
Kindy
Libya, Elmarkib University, Faculty of Medicine, Obstetrics & Gynecology
author
Abdel-Mageed
Sarhan
Professor and Head of obstetrics and Gynaecology Faculty of Medicine - Zagazig University
author
Ashraf
Nasr
Professor of Obstetrics & Gynecology
Faculty of Medicine - Zagazig University
author
Mohamed
Zaitoun
Lecturer of Obstetrics & Gynecology
Faculty of Medicine - Zagazig University
author
text
article
2020
eng
Background: the polycystic ovary syndrome (PCOS) is important cause of an ovulatory infertility and a notable proportion of women of reproductive age are affected. Different factors could result in different manifestations and many of these are related to predispositions. Objectives: The study was carried out to study the improvement of ovulation induction in obese patients with Polycyctic ovarian syndrome (PCOS). Subjects and methods: This is prospective clinical trial that was conducted in the infertility unit of Zagazig university Hospital on 120 patient suffering from PCOS were included in this study during the period from Actober 2018 to May 2019. This trial was designed to compare the improving induction of ovulation in obese females with Polycystic ovarian syndrome undergoing induction of ovulation by Clomid and Metformin (n=60) or Letrozole (n=60).Results: There was no significant statistical difference between Clomid and Metformin group and letrozole group in term of pregnancy rate, There was a significant statistical difference between Clomid and Metformin group and letrozole group in term of Size of dominant Graafian follicle (on day 11) (p=0.03) and the Size of dominant Graafian follicle (on day 13-14) (p=0.01).Conclusion Letrozole improves endometrial thickness and cervical mucosa and causes monofollicular ovulation but action of clomiphene citrate combined with metformin improved the ovulation and increased total number of follicles. Therefore, Letrozole can be used for the ovulation induction improvement in obese women having PCO
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
582
589
https://zumj.journals.ekb.eg/article_39888_3e8dedb9408fbdcbd272d3849018e6f8.pdf
dx.doi.org/10.21608/zumj.2019.13392.1241
Frequency of Cervical Intra-epithelial Neoplasia in Oral Contraceptive Pills Users in Zagazig University Hospitals
Attya
Attya
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig university
author
Ali
Ali
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig university
author
Hoda
AbdelSalam
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University
author
Mai
Abdelwahab
Pathology Department, Faculty of Medicine, Zagazig university
author
text
article
2020
eng
Background: Combined oral contraceptive pills (COCs) are widely used as contraceptive method. Some authors linked prolonged use of COCs to development of cervical intra-epithelial neoplasia (CIN). However, this link need more investigations to be proven.The aim of the study: was to assess the association between the long term use of combined oral contraceptive pills and the development of cervical intra-epithelial neoplasia.Patients & methods: This cross-sectional observational study was carried out in outpatient clinic of Obstetrics & Gynecology Department and Department of Pathology at Zagazig University Hospitals, Zagazig, Sharkia, Egypt, from December 2017 till January 2019. One hundred and thirty six cases were included. All women were currently using COCs or previously used it. Full history was taken from all women, PAP smear was taken, fixed on glass slide by alcohol 95%, then staining with Papanicolaou stain and finally interpretation of the results using Bethesda system 2014 was done.Results: Abnormal PAP smear was correlated with the duration of COCs use, the longer the duration of COCs use, the higher the grade of abnormal PAP smear. Other factors that correlate positively with abnormal PAP smear in COC users were older age, longer marital life and higher parity (> 3). On the contrary, mode of delivery, history of cervical cauterization or complaint of vaginal discharge had no impact.Conclusion: Positive association was noticed between the duration of COCs use and abnormal PAP smear and between its long term use and the higher grade of the abnormal PAP smear.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
590
597
https://zumj.journals.ekb.eg/article_42378_9589a9a80240a9534d63847d67f3e527.pdf
dx.doi.org/10.21608/zumj.2019.13975.1275
Endoscopic Repair of Cartilaginous Septal Perforation With Alloderm And Rotational Flap
sufyan
dwal
Otorhinolaryngology, faculty of medicine , zagazig university
author
Tarek
Omran
Professor of Otorhinolaryngology , Faculty of Medicine - Zagazig University
author
Adly
Tantawy
Professor of Otorhinolaryngology , Faculty of Medicine - Zagazig University
author
Ashraf
El-Malt
Lecturer of Otorhinolaryngology , Faculty of Medicine - Zagazig University
author
text
article
2020
eng
Background: Nasal septal perforation is an anatomical defect of the cartilaginous and/or bony nasal septum. There are many causes for septal perforaton including prior nasal surgery ,nasal trauma , cocaine abuse ,inflammatory disorders ,infection , cancer. The mechanical closure with a prosthesis such as the septal button. Silicon buttons can alleviate epistaxis, whistling and nasal obstruction, but these prostheses cannot control the production of crusting around the margins of the button which causes discomfort for patients. Objectives: the aim of this study was to evaluate endonasal endoscopic repair of cartilaginous nasal septal perforation. Patients and Methods: The study included 24 Patients; they were 16 males and 8 females, their age ranged from 18 to 53 years to 50 years underwent endoscopic repair for the perforation of cartilaginous septum with alloderm and rotational flap. Results: The study, showed that 23 cases had complete healing after endoscopy with success rate (95.8%) and one case failed due to flap necrosis (4.2%). Conclusions: Endoscopic repair for the perforation of cartilaginous septum with alloderm and rotational flap approach can be considered as an effective technique for septal perforation. The use of Alloderm, has the advantage of decreasing morbidity and suitable for all perforations sizes, acting as an excellent scaffold for re-epithelization, but is associated with high costs and the septal flap provide a good vascularity for good healing .
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
598
603
https://zumj.journals.ekb.eg/article_36377_7be580b1a989dc282d1414d96f24b81f.pdf
dx.doi.org/10.21608/zumj.2019.12362.1217
MASTOID OBLITERATION IN CHOLESTEATOMA SURGERY, DIFFERENT MATERIALS
alsayed
abdulmageed
ENT department, faculty of medicine zagazig university, zagazig city, Egypt
author
Mohamed
Mobasher
ENT department zagazig university , zagazig, Egypt
author
said
abouelezz
ENT department zagazig university zagazig , Egypt
author
ahmed
elhady
ENTdepartment zagazig university zagazig , Egypt
author
text
article
2020
eng
MASTOID OBLITERATION IN CHOLESTEATOMA SURGERY, DIFFERENT MATERIALSByMohamemed K Mobasher, Said Abuelezz, Ahmed M Alhady and Alsayed Abdulmageed Department of Otolaryngology, Faculty of Medicine – Zagazig University, Egypt.ABSTRACTBackground: The principal advantages of mastoid cavity obliteration are 1) reduced nitrogen-absorbing mucosa in the mastoid cavity preventing recurrence of retraction cholesteatoma in patients with eustachian tube dysfunction, 2) elimination of mastoid cavity preventing accumulation of squamous epithelium and bowel infection . The size of the surgical cavity can be diminished using obliteration to create a small cavity that is self cleaning and easily maintained. Both autologous and synthetic materials have been used for obliteration. Materials such as free graft, fat, cartilage, bone chips, bone pâté, hydroxyapatite, and periostio-muscular flaps are used. Aim of work: To evaluate the benefit from mastoid obliteration in cholesteatoma surgery. Patients and methods: This study was applied on 12 patients that have middle ear cholesteatoma.mastoidectomy had been done then obliteration either by natural or synthetic fillers had been done and followed up by DW-MRI Results: The patients consisted of 6 females (50%) and 6 males (50%). Their ages ranged from 14 to 52 years old. Conclusion: Mastoid obliteration can be used in combination with either the ICW or CWD techniques. It gives favourable long-term results. It is certainly the treatment of choice for persistent discharging mastoid cavities.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
604
611
https://zumj.journals.ekb.eg/article_39214_b6f97b1342ca59069adb786ffe0ec898.pdf
dx.doi.org/10.21608/zumj.2019.13572.1256
A Comparative Study of Two Different Doses of Intravenous Ondansetron for Prevention of Post-spinal Anesthesia Shivering in Inguinal Hernia Repair Surgery
jomaa
alrjael
anesthesia, medicin, zagazig, egypt
author
Zainab
Attia
Professor of Anesthesia and Surgical Intensive Care, Faculty of Medicine-Zagazig University
author
Abeer
Elsawy
Anesthesia and surgical ICU, faculty of medicine, zagazig university
author
Marwa
AbdAllah
Lecturer of Anesthesia and Surgical Intensive Care, Faculty of Medicine-Zagazig University
author
text
article
2020
eng
Background: Shivering is one of the most commonly encountered problems after both general and regional anesthesia and its incidence about 40% to 50% of the patients whom undergoing surgical operation under spinal anesthesia. The aim of this work was to compare two different clinically relevant doses of ondansetron (4mg vs 8mg) in prevention of postspinal anesthesia in inguinal herniorrhaphy. Patients and Methods: A comprehensive sample included elective unilateral inguinal hernia in Zagazig University hospitals during period of six months from November 2018 to April 2019 (10-11 cases / month) sample will be 63 cases randomly allocated into 3 groups; group A (ondansetron 4mg IV), group B (ondansetron 8mg IV) and group C (control group). Results: Each dose of ondansetron 4 mg or 8 mg have the ability to decrease the incidence of postspinal anesthesia with no significant differences between the two doses. There were no significant difference regarding side effects of the two doses of ondansetron in prevention of post spinal shivering. Conclusion: we concluded that both doses of intravenous ondansetron 4mg and 8mg are efficient and safe in reducing the incidence and severity of shivering during spinal anesthesia.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
612
619
https://zumj.journals.ekb.eg/article_40230_e210ee90fb5e26b8f703fba18ed31c48.pdf
dx.doi.org/10.21608/zumj.2019.11672.1199
Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics
Mohammed
Mekawy
anesthesia and surgical Intensive care department, faculty of medicine, zagazig university, Zagazig, Egypt
author
Mohammed
Refky
anesthesia and surgical intensive care department, faculty of medicine, Zagazig university, Zagazig, Egypt.
author
Doaa
Farid
Anesthesia and surgical intensive care department, faculty of medicine, Zagazig university, Zagazig, Egypt.
author
Ayat
Amer
Anesthesia and surgical intensive care department, faculty of medicine, Zagazig university, Zagazig, Egypt.
author
text
article
2020
eng
Background: caudal epidural block (CEB) is the most preferred modality for pediatric regional analgesia because of its effective somatic and visceral pain control, though transversus abdominis plane (TAP) block is an evolving regional anesthetic technique for abdominal wall. Our study aims to compare the analgesic effect of (CEB) versus (TAP) block in pediatrics undergoing inguinal hernia repair surgeries.Patient and Methods: The study enrolled 44 children, aged 3 to 7 years, scheduled for unilateral inguinal hernia repair surgery. Children were divided into 2 equal groups. Group A received ultrasound guided (CEB), while group B received ultrasound guided (TAP) block. We used a multimodal approach of pain control including regional block, intraoperative fentanyl when needed, standard postoperative paracetamol, and rescue ibuprofen when needed. Hemodynamic stability, fentanyl needs, time for first analgesic request, pain scores by Children’s Hospital of Eastern Ontario Pain Score (CHEOPS), and ibuprofen requirements were recorded. Results: Both (CEB) and (TAP) groups showed hemodynamic stability, meanwhile there was no need for fentanyl among all patients in both groups, and the time for first analgesia in CEB and TAP groups, was (4.59±0.59) and (7.48±1.35) hours respectively. Furthermore, the ibuprofen requirements and pain scores were statistically significantly higher in (CEB) group than (TAP) group (P-value < 0.05). Conclusion: Both TAP block and CEB provide effective analgesia in children undergoing inguinal hernia repair surgery with TAP block superiority over CEB as evidenced by longer time for first analgesic request, decreased analgesics needs, and lower pain scores.Keywords: caudal, TAP, ultrasound, pediatric, surgery.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
620
630
https://zumj.journals.ekb.eg/article_43555_fe125723f8fd0ce54f8339e528f64d7f.pdf
dx.doi.org/10.21608/zumj.2019.13760.1265
Comparative study between Racz technique alone and Racz with radiofrequency in the management of failed back surgery syndrome
Heba
Ebraheem
Anathesia and ICU , Zagazig University, Zagazig , Egypt
author
Neveen
El-Aasar
anesthesia and icu, faculty of medicine, zagazig university, zagazig city, egypt
author
ahmed
Balata
anesthesia and surgical icu, faculty of medicine, zagazig university, zagazig city, egypt
author
Usama
Ahmed
anesthesia and surgical icu, faculty of medicine, zagazig university, zagazig city, egypt
author
text
article
2020
eng
AbstractBackgroundFailed Back Surgery Syndrome refers to patients with persistent pain after spinal surgery for back pain. The technique described by Racz and colleagues involves epidurography, adhesiolysis, and injection of hyaluronidase, bupivacaine, , and 10% sodium chloride on day 1. Radiofrequency ablation is a technique uses high-frequency current to produce heat and tissue coagulation. The procedure used radio wave, applied via a percutaneous probe to generate heat, and create a lesion in the nerve.Patients and methodsThis study was conducted on 60 Failed Back Surgery Syndrome patients classified into two groups each of 30 patients. FBSS treated by Racz technique (group I) and the other group (II) treated by Racz plus radiofrequency.ResultsVAS score and Oswestry score used to assess both techniques daily for a week then weekly for a month, then monthly for 6 months, we found that both techniques showed statistically non- significant difference before the procedure, but showed a statistically highly significant difference between both groups after the techniques. There is a reduction of VAS score from a mean of 6.2 to 3.87 in group (I) and a reduction from 6.03 to 2.7 in group (II). There is a reduction of Oswestry score from a mean of 57.2 to 40.6 in group (I) and a reduction from 57.03 to 32.47 in group (II). ConclusionUsing radiofrequency with Racz catheter adhesolysis gives better results than using Racz catheter alone in cases with failed back surgery syndrome.Keywords: failed back surgery syndrome, pain, Racz, radiofrequency.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
631
639
https://zumj.journals.ekb.eg/article_43557_e83895f7f85cace0e460bdef9c641288.pdf
dx.doi.org/10.21608/zumj.2019.14257.1300
Role of Neoadjuvant Chemotherapy on the Surgical Treatment of Locally Advanced Breast Cancer
Mai
Abd Allah
General Surgery , Al Ahrar Teaching Hospital , Sharkia ,Egypt
author
Tarek
Abdellatif
Department of General Surgery, Zagazig University,Sharkia,Egypt
author
Wesam
Amr
Department of General Surgery, Zagazig University,Sharkia,Egypt
author
Hatem
Abdel Moneim
Department of General Surgery, Zagazig University,Sharkia,Egypt
author
rasha
Haggag
Department of Medical Oncology, Zagazig University, Sharkia,Egypt
author
text
article
2020
eng
Background: In developing countries preoperative chemotherapy can reduce the size of the tumor, thus allow some patients with advanced tumors which is common the opportunity of conserving breast surgery. The aim of the study was to evaluate the efficacy of neoadjuvant chemotherapy (NC) on the possibility of breast-conserving surgery (BCS) in patients for whom mastectomy (MT) was the only accepted surgical option. Methods: thirty patients who had stage III breast cancer received neoadjuvant chemotherapy comprised of doxorubicin and cyclophosphamide, followed by surgery between 2017 and 2019. Results: thirty patients included in the study, 27(90%) presented with an invasive ductal carcinoma. The mean tumor size before NC, measured using MRI, was 37 mm (range, 20-75 mm) and 29 mm (range, 12.5-75 mm) after NC. Twenty patients (66.7%) underwent MT while ten patients (33.3%) underwent BCS. The mean follow up survival time for all patients was 32±1.2 months range (29.8-34.8) months with (95% CI; 29.8-34.8).one case (3.3%) of BCS had locoregional recurrence and three cases (10%) had distant metastasis. Patients with IDC had significant higher DFS (33.5 ±1.04) months than patients with combined IDC+ILC (20±6) months and ILC(18) months.Patients with MT had better numerical (not significant) DFS (32.25±1.5) months than patients with BCS (31.6±2.3) months. Conclusion: NC had a role in reducing the size of the tumor and could be applied in patients with advanced carcinoma. It increased the chance of BCS without affecting overall survival.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
640
648
https://zumj.journals.ekb.eg/article_42160_cee4ce47af45ba9bb0248e857626149d.pdf
dx.doi.org/10.21608/zumj.2019.14080.1283
Percutaneous Versus Open Surgical Drainage of Intra-Abdominal Abscesses
Mohamed
Bayomi
General surgery department, Faculty of medicine, Zagazig university
author
Mohamed
Alkilany
Department of general surgery, Faculty of medicine, Zagazig university
author
Joseph
Israel
General surgery department, faculty of medicine, zagazig university
author
text
article
2020
eng
Background: Interventional (percutaneous) drainage of abdominal abscesses provides a safe and effective route of management and through which we can avoid the common drawbacks of the conventional surgical drainage. Aim of the work was to evaluate the efficacy of the percutaneous drainage compared to the conventional surgical drainage and report advantages if proved. Methods: This prospective randomized comparative study included patients who presented to the Surgery Department of Zagazig Emergency hospital complaining of the abdominal abscesses within the period from May 2018 to November 2018.These patients were randomly divided into two groups with each had its management approach, Interventionally drained group: 15 patients and surgically drained group: 15 patients. The procedure was explained to the patients, and they were consented as regard to the postoperative morbidity and mortality. Results: There were statistically significant difference between both groups in which application of interventional drainage decreases the post-operative hospital stay (P = 0.0004). also, maneuver costs showed significant decrease in the Interventionally drained group (P
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
649
653
https://zumj.journals.ekb.eg/article_45116_a57c6b05dc1f95b344e2aa7398bfe91f.pdf
dx.doi.org/10.21608/zumj.2019.14746.1333
Evaluation of Potential Segmental Instability with Lumbar Degenerative Disease
ahmed
sweilam
neurosurgey, faculty of medicine, zagazig university, zagazig, egypt
author
Magdy
Rashed
neurosurgery, faculty of medicine, zagazig university, zagazig, egypt
author
Mahmoud
Taha
neurosurgery, faculty of medicine, zagazig university, zagazig, egypt
author
Magdy
Elsheikh
neurosurgery, faculty of medicine, zagazig university, zagazig, egypt
author
text
article
2020
eng
Background: Lumbar degenerative disease (LDD) is a chronic condition of the lumbar spine affecting the vertebrae, facet joints and intervertebral discs and commonly causing low back pain (LBP) which may be due to instability of the motion segment. Aim: to evaluate the relation between lumbar degenerative disease and lumbar instability. Patients and Methods: Sixty patients (20 females and 40 males) complained of LBP and/or sciatica. They were studied in 4 groups categorized according to MRI grading using Modified Pfirmann Disc Degeneration Scale: Group I (19 patients grade IV), Group II (16 patients grade V), Group III (14 patients grade VI) and group IV (11 patients grade VII). In addition to full history taking, all of them were subjected to thorough clinical examination including PVAS to assess pain severity, Routine lab. investigations and Radiological examination (X-Ray: Static and dynamic, CT and MRI). Results: No significant differences between four groups regarding clinical data (LBP, sciatica, full motor power or SLR) were found but SLR angles were lower than normal within all groups, while PVAS showed significant difference between four groups (P
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
654
662
https://zumj.journals.ekb.eg/article_42697_44d36d0e13932de8a07556c8aa614f50.pdf
dx.doi.org/10.21608/zumj.2019.10350.1094
Changes in Anterior Chamber Depth and Angle Before and After Phacoemulsification of Intumescent Cataract
mohamed
awnallah
Department of Ophthalmology, Zagazig university , Zagazig ,Egypt
author
Moustafa
Salamah
Department of Ophthalmology, Zagazig university , Zagazig ,Egypt
author
Medhat
Shawki
Department of Ophthalmology, Zagazig university , Zagazig ,Egypt
author
Kamal
Solaiman
Department of Ophthalmology
Zagazig university
Zagazig
Egypt
author
text
article
2020
eng
Background:To use theSirius imaging system to precisely evaluate the changes in the anterior chamber depth(ACD)and angle(ACA)before and after phacoemulsification of intumescent cataract in eyes with different axial lengths.Subjects and Methods:A prospective study that included patients with intumescent cataract in one eye.All eyes were subjected to full ophthalmic examination, IOP, gonioscopy and axial length measurement.Anterior segment imaging of both eyes using Sirius system to determine the ACDand ACA.Eyes were classified into three groups according to their axial lengthGroup I:axial length24.5mm.Postoperative examinations were performed at1day,1week,1month and3months.Results:The study enrolled 32eyes;Group I included 11eyes,Group II included 11eyes andGroup III included 10eyes.Before surgery,the meanACD was2.03±0.46mm in Group I,2.2±0.42mm inGroup II and2.62±0.37mm inGroup III(P
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
663
668
https://zumj.journals.ekb.eg/article_42940_c260e2d3c7fcb56f91b3e01aae105c7d.pdf
dx.doi.org/10.21608/zumj.2019.15051.1360
Diagnostic Role of Angiopoietin-2 and Vascular Endothelial Growth Factor in Malignant Pleural Effusion
Doaa
Gad
Chest department, faculty of medicine, Zagazig University
author
Abdallah.I.
Badr
Cardiothoracic department,faculty of medicine,Zagazig university
author
Heba F.
Pasha
Medical Biochemistry Department, Faculty of Medicine, Zagazig University
author
text
article
2020
eng
Background Malignant pleural effusion is a prognostic and diagnostic sign in cancer lung .Role of tumor biomarkers in pleural fluid has been considered, but their diagnostic ability remains undetermined, therefore the aim of this current work is to evaluate the diagnostic role of both pleural fluid Angiopoietin-2 and vascular endothelial growth factor levels in malignant pleural effusions. Patients and methods: A case-control study including 56 patients diagnosed as pleural effusion of known origin. Both pleural fluid Ang-2 and VEGF levels were measured with other biochemical markers. Results: Pleural fluid VEGF could differentiate malignant exudative from benign exudative pleural effusion at a cut-off value 1590 (pg/ml),with higher Sensitivity 96.2%, Specificity 98.7% , PPV 100%,NPV 95% and Accuracy 97.8%. Additionally it has the ability to differentiate mesothelioma from other causes of malignant pleural effusion at 2225.5(pg/ml) cut off value, with Sensitivity 80%, Specificity 75%, PPV 66.7%, NPV 85.7% and Accuracy 76.9%.While Pleural fluid Ang-2, could detect malignant pleural effusion at a cut off value 15.7 ng/ml that yield lower Sensitivity 69.2%, Specificity 42.1%, PPV 62.1%, NPV 50% and Accuracy of 57.8% than that of Pleural fluid VEGF. Conclusion: Pleural fluid VEGF is a useful biomarker in diagnosing pleural effusion of malignant type, especially mesothelioma, while pleural fluid Angiopoietin-2 has a limited role in ruling out malignant pleural effusion. Key words: Malignant pleural effusion, vascular endothelial growth factor (VEGF), Angiopoietin-2(Ang-2), mesothelioma
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
669
678
https://zumj.journals.ekb.eg/article_74412_7743001054bd4ed668de8ec78bef96c3.pdf
dx.doi.org/10.21608/zumj.2020.22254.1688
Surgical treatment of renovascular hypertension
Amr
Salem
Experimental and Clinical Surgery Department , Medical Research Institute , Alexandria University , Alexandria, Egypt
author
Mohamed
Salem
Vascular Surgery Unit, Department osf Surgery, Faculty of Medicine, Alexandria University, Egypt.
author
Tarek
Salem
Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University , Egypt.
author
Sameh
Moustafa
Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University , Egypt.
author
text
article
2020
eng
Background: Renovascular hypertension is the commonest form of secondary hypertension. It occurs in less than 5 % of all hypertensive population. There are two forms of renovascular hypertension: Atherosclerotic and fibromuscular dysplasia. The aim was to evaluate the indications of surgical treatment of “renovascular hypertension”.Methods: Twenty cases with renovascular hypertension were included. The main investigations were: Laboratory studies, Duplex ultrasound, Intravenous pyelogram, CT angiography, aortography and selective renal angiography. Indications for surgery were : complex disease of the renal artery, aneurysm, accessory renal arteries, fibromuscular dysplasia and partial damaged of one kidney, atherosclerotic stenosis of the renal arteries and complete kidney damage. Results : The patients were divided into two groups : (Fibromuscular dysplasia group)which included 14 patients, (100.0%) were females, their age ranged from 18 to55 to 68 years with the mean±SD( 62 ±4.1), 5(83.3%)were males and 1(16.7%) was female. Renal artery bypass graft was done for 15 cases, endarterectomy in 2 cases, endarterectomy with patch graft in two cases and nephrectomy in one case. Control of hypertension was successful in 17 cases, partial control of 2 cases, while the blood pressure still high in case of nephrectomy. No mortality in both groups within 6 months follow up period. Conclusions : Surgical treatment for renovascular hypertension is mandatory for complex disease of the renal artery, aneurysms and failure of endovascular procedures. Nephrectomy is the treatment of choice for damaged kidney
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
26
v.
4
no.
2020
679
689
https://zumj.journals.ekb.eg/article_90245_04776d89316c91751af70acccf36a662.pdf
dx.doi.org/10.21608/zumj.2020.29552.1843