eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
196
203
10.21608/zumj.2019.10198.1082
28707
Original Article
Colectomy in Patients with Colonic Carcinoma: Laparoscopic Versus Open Methods
Bassam Mahmoud
doc.bassam@live.com
1
Alaa Khalil
a_khalil2@hotmail.com
2
Wael Lotfy
waellotfy@hotmail.com
3
Mohamed Abdelhamid
dr_moh2003@yahoo.com
4
Hassan Ashour
drhassanashour@hotmail.com
5
Ramadan Mahmoud
ramadan7791@gmail.com
6
General Surgery department, Faculty of Medicine, Zagazig University, Egypt.
Faculty of medicine, Zagazig University
Faculty of medicine, Zagazig University
Faculty of medicine, Zagazig University
Faculty of medicine zagazig university egypt
Faculty of medicine, Zagazig univeristy
Introduction: colon cancer is one of the most common cancers all over the world. There are many methods for surgical removal of the cancer as open conventional colectomy and laparoscopic colectomy. The aim of this study is to compare between the two methods to establish the advantages and disadvantages of laparoscopic colectomy in comparison to open colectomy.Methods: Patients were divided into 2 groups according to the type of surgical interference. Group 1: included "15 patients" comprised those who had colonic carcinoma with laparoscopic intervention. Group 2: included "15 patients" comprised those who had colonic carcinoma with open surgical intervention. This study included patients with colonic carcinoma were admitted to Zagazig University Hospitals. Cases were collected in the period from December 2016 to December 2018.Results: the results showed that there are no significant differences between laparoscopic colectomy and open colectomy. Laparoscopic colectomy showed advantages over open colectomy in terms of short hospital stay (P=0.02), rapid recovery, early return to work and good oncological outcomes.Conclusion: Laparoscopic colectomy can be performed with good technical efficiency, quick recovery of bowel function, and mild disability, less operative blood loss, less operative trauma and shorter hospital stay. The short-term oncologic results of laparoscopic colectomy seem to be acceptable and comparable with conventional methods. We recommend using Laparoscopic colectomy in colonic carcinoma as a gold standard in our hospital to get the aforementioned advantages.
https://zumj.journals.ekb.eg/article_28707_3b16108aee1fa8000ed077e821bed6b7.pdf
Cancer Colon
Open colectomy
laparosopic colectomy
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
204
214
10.21608/zumj.2019.11299.1175
32942
Original Article
PREDICTION OF EARLY ANASTOMOTIC LEAKAGE FOLLOWING COLORECTAL CANCER SURGERY IN ZAGAZIG UNIVERSITY HOSPITALS
Pola Anwar
dr.polanagy@gmail.com
1
Mohammed Abd El-Rahman
msaidgenerals@gamil.com
2
Taha Baiomy
dr.taha2020@yahoo.com
3
Hassan Ashour
drhassanashour@hotmail.com
4
General Surgery Department, Faculty of Medicine, Zagazig University Hospitals, El-Sharkia, Egypt.
General Surgery departments, Faculty of Medicine, Zagazig University.
General Surgery departments, Faculty of Medicine, Zagazig University.
General Surgery departments, Faculty of Medicine, Zagazig University.
Background: Anastomotic leak (AL) is the most common unfavorable complication after colorectal surgery. Early discharge benefits the patient but carries a potential risk of developing AL. So the early diagnosis of AL is critical. Aim: To assess whether C-reactive protein (CRP) and Procalcitonin (PCT) will predict AL before early discharge. Methods: This study was carried out in Surgical-oncology Unit, General Surgery Department, Zagazig University Hospitals, during the period from May 2018 to November 2018. The study included 24 patients with Colorectal cancer undergoing elective open colorectal resection with anastomosis. CRP and PCT were measured pre-operatively, 8h after incision, and on the 3rd and 5th postoperative day (POD). 30-day readmissions, re-laparotomy, and mortality were recorded. Results: 5 patients had AL (20.8%). 5th day postoperative CRP and PCT were significantly lower in patients without AL than patients with AL. The present study revealed the diagnostic performance of CRP in the prediction of AL where 5th day CRP>198.23mg/mL had 100% sensitivity, 94.74% specificity, 83.3% positive predictive value, 100% negative predictive value and 95.8% accuracy in the prediction of AL. Also, the study revealed diagnostic performance of 5th day PCT in the prediction of AL where a cutoff of more than 1.212 ng/dl, 5th day PCT had 80% sensitivity, 100% specificity, 100% positive predictive value, 95% negative predictive value and 95.8% accuracy in prediction of AL. Conclusion: CRP and PCT measurements can positively identify patients at risk of AL with CRP being more accurate and a potentially powerful marker.
https://zumj.journals.ekb.eg/article_32942_96ac5f3a164203985624837a378505f9.pdf
colorectal cancer
Anastomosis
leak
C-reactive protein
Procalcitonin
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
215
220
10.21608/zumj.2019.12651.1224
38884
Original Article
Complications of Endoscopic Bariatric Surgery
HELAL SASI
hlal1s1985@gmail.com
1
Khalid Fahmi
khalid.safwat@gmail.com
2
emad salah
emadsalah@gmail.com
3
Wael Awad
wael_awad@zu.edu.eg
4
general surgery of facility of medicine zagazig universty
Professor and Head of General Surgery Department, Faculty of Medicine-Zagazig University
Professor of General Surgery, Faculty of Medicine - Zagazig University
Assistant Professor of General Surgery, Faculty of Medicine-Zagazig University
Background: Obesity is a serious problem for males and females around the world. World Health Organization have determined obesity when body mass index equal or above 30 Kg/m2, where obesity is classified into 3 classes including; class I for BMI ranged between 30-35Kg/m2, Class II for BMI ranged between 35-40 kg/m2 and Class III for BMI over than 40 Kg/m2 . Aim : The aim of this study was to study the Complications of Endoscopic Bariatric Surgery after different bariatric surgeries. Patients and methods: This study was carried out in the Department of General Surgery in Zagazig University Hospitals and included 36 obese patients attending at zagazig university hospital fulfilling the inclusion criteria. Results: This study was conducted to study the Complications of Endoscopic Bariatric Surgery. This study included 36 patients; they were 26 females and 10 males (72.2% and 27.8% respectively). Their ages ranged from 29 to 60 years with a mean age of 47.52 ± 8.88 years. Conclusions: There is an increasing role for the endoscopist in the multidisciplinary treatment of obesity, particularly in the surgery complications. Since it prefer to use many techniques to overcome postoperative complications of Endoscopic Bariatric Surgery.
https://zumj.journals.ekb.eg/article_38884_f5bf59af76571b1d4a8e805c7fb0f346.pdf
Body Mass Index
Bariatric surgery
Endoscopic surgery
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
221
232
10.21608/zumj.2019.11139.1153
34766
Original Article
Single Burr Hole Craniostomy for Evacuation of Chronic Subdural Hematoma
Esam Alnajar
esammussa85@gmail.com
1
Sami Hassanain
samihassanain@yahoo.com
2
Hosni Salama
hosnisalama@yahoo.com
3
Ashraf Algallad
dr.ashrafalgallad@yahoo.com
4
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
AbstractBackground: Chronic subdural hematoma (CSDH) is a rising neurosurgical entity especially in elderly people. Objectives: To assess the value of using single burr hole craniostomy in the evacuation of chronic subdural hematoma according to the clinical picture. Methods: Prospective single-center study included 24 patients having CSDH. The postoperative outcome was assessed immediately after surgery in the ward, and then two weeks in the outpatient clinic for follow up. All patients underwent single burr hole craniostomy during the period between April 2018 to September 2018. Results: Our results were close to other reports. Epidemiologically, female to male ratio of 1:2.4 the main symptom was a headache (62.5. Disturbed conscious level (66.67%) was the main presenting sign. trauma was a commonest risk factor (45.8%) followed by hypertension and diabetes mellitus (20.83%) each. All patients had GCS above 11, over 83% of patients had a significant midline shift of above 5mm, which is significant for the complications and hospital stay. Most of the participants were Markwalder grade two (45.8%) followed by grade one (37.5%) before the operation, in comparison with Markwalder grade zero (79.2%) followed by grade one (12.5%) after the operation. High significant results were found between and the GOS and hospital stay, and between the GOS and GCS.Conclusion: single burr-hole craniostomy maneuver is comprehensive and safe management; having a short operating time with low recurrence and mortality rate.
https://zumj.journals.ekb.eg/article_34766_d41d8cd98f00b204e9800998ecf8427e.pdf
Burr hole craniostomy
Glasgow coma scale
chronic subdural hematoma
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
233
238
10.21608/zumj.2019.10859.1150
30111
Original Article
Closed Reduction and Lateral Percutaneous Pin Fixation for Displaced Supracondylar Humerus Fractures in Children
Mahmoud AboHasan
dr.mahmod89@gmail.com
1
Khaled Idrees
drkhalidid@yahoo.com
2
Mohammed Fahmy
mhamed375@gmail.com
3
Mohammed sebaei
mohamedsebaei9@gmail.com
4
Orthopedic surgery, Zagazig University, Zagazig, Egypt
Professor of Orthopedic Surgery Faculty of Medicine - Zagazig University
Professor of Orthopedic Surgery Faculty of Medicine - Zagazig University
Orthopedic Surgery Department Faculty of Medicine; Zagazig University Zagazig, Egypt
Background: Lateral percutaneous pin fixation of Supracondylar humerus fracture (SCHF) is usually performed after accepted closed reduction. The aim of this study was to achieve fracture stability, maintained reduction and satisfactory results while minimizing the risk of iatrogenic ulnar nerve injury. Patients and methods: Twenty patients with extension Gartland type II and III SCHFs managed by closed reduction and lateral percutaneous pinning from December 2016 to December 2017 were enrolled in single center, prospective, observational, randomized controlled clinical trial. Postoperative immobilization was with an above elbow back splint and an arm sling. On days 1, 7, 14, and 21; obtained radiographs were evaluated. Results: according Flynn’s criteria; all cases had satisfactory functional and cosmetic results. Only one case of a local infection was reported and treated with antibiotic therapy. Currently, all patients could perform daily activities. Discussion: lateral pinning technique had achieved fracture stability, maintenance of reduction and alignment, satisfactory functional and anatomical results in the form of a cosmetically accepted upper limb with normal range of movement while minimizing the risk of neurovascular complications as iatrogenic ulnar nerve injury in displaced SCHFs in children. Conclusion: With anatomic reduction and stable fixation, CRPP with lateral-entry K-wires fixation of pediatric SCHFs is similar to the conventional cross-wire fixation in terms of the stability, but superior in terms of ulnar nerve safety, hence giving excellent results. Level of evidence: V prospective randomized controlled study.
https://zumj.journals.ekb.eg/article_30111_fcf5f5c56741db0eb75b889eb46004c1.pdf
Lateral Pinning
SCHF
Ulnar N injury
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
239
247
10.21608/zumj.2019.10215.1105
29946
Original Article
Conservative Management and Plate Fixation of Mid-Shaft Clavicular Fractures in Adults: Comparative Study
Mahmoud Abuzeid
mahmoudabuzeid78@gmail.com
1
Hossam Khairy
h_khiry@hotmail.com
2
Amro Eladawy
aeladawy@gmail.com
3
ahmed elmalt
ahmedelmalt@hotmail.com
4
Orthopedic, faculty of medicine, zagazig university, zagazig, egypt
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
orthopaedic,faculty of medicine,zagazig university,zagazig,Egypt
Introduction Fracture clavicle used to be treated conservatively. But, risk of mal-union and shoulder dysfunction has raised many concerns regarding this way of treatment. Operative treatment for clavicle fracture gained popularity recently for displaced fracture clavicle. So, in our study we compared between the two methods of treatment.Patients and methods We conducted a prospective study for all adult patient presented to our hospital with unstable fracture clavicle from August 2016 to September 2017. Patients were divided in two groups A and B, with exclusion of poly-trauma patients. Group A treated conservatively and group B treated by open reduction and internal fixation with plate and screws on the superior surface of the clavicle. The patients were followed up and assessed by constant shoulder score.Results The study included 20 patients in two group 10 patient for each group. The demographic data in both groups showed no significant differences. Follow up was 6.2 and 7.3 months in both groups respectively. Union occurred in 5.8 and 5.3 months in both groups respectively. The difference was insignificant for follow up and union; p value> 0.05. Functional outcome was excellent in 8 and good in 2 in group A, and excellent in 6, good in 4 in group B. This difference was found to be significant, p value ˂ 0.05.Conclusion From our study and supported by others we recommend that conservative treatment should be the first choice for most patients and operative fixation to be reserved for selected cases.
https://zumj.journals.ekb.eg/article_29946_0cf968ec48703de64064589afdca926f.pdf
Clavicle fracture
clavicle fixation
conservative clavicle treatment
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
248
254
10.21608/zumj.2019.16344.1463
48904
Original Article
Arthroscopic Management of Tennis elbow
ahmed alsayed
kingahmed_008@yahoo.com
1
Abdelsalam Eid
eid_md@yahoo.com
2
.mohamed Elzoheiry
elzohairy.me@gmail.com
3
Fahmy Fahmy
fahmysamir72@yahoo.com
4
orthopedic surgery,faculty of medicine,zagazig university,egypt
Department of Orthopedic Surgery,Faculty of Medicine, Zagazig University,
Department of Orthopedic Surgery,Faculty of Medicine, Zagazig University.
Orthopedic department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AbstractBackground: Tennis elbow, also known as “Lateral epicondylitis”, is a common disease, affect 1% to 3% of the population between 35 and 50 years old. 1Purpose: To evaluate the functional outcomes of arthroscopic management of lateral epicondylitis in orthopedic department, Zagazig University Hospitals.Study Design: interventional study.Methods: 20 patients with elbow pain in one side or both sides with persistent disability symptoms at least six months after failed conservative treatment were carried out in the department of orthopedic surgery, Zagazig University Hospitals from November 2017 to December 2018, their age between 25-70 years old,(14)70% males and (6) 30% females, The diagnosis was based on the history, physical examination and magnetic resonance examination, patients were evaluated with VAS and Mayo scores. They were treated with arthroscopic release of ECRB tendon.Results: Patients were reintegrated into their activities at 3 weeks postoperatively. Pain as a sign and capital symptom improved significantly within 10 days of surgery. Mayo score improved postoperatively. The Mean± SD preoperative Mayo score was 60.5±7.23 and raised to 95.25±4.12 postoperative and to 97.5±3.03 after follow up for six months. The Mean± SD preoperative VAS score was8.8±0.76 and raised to 0.85±0.74 and to 0.6±0.5 after follow up. Conclusion: Arthroscopic management of lateral epicondylitis has low morbidity, which makes it safe, and efficient therapeutic choice when necessary and implemented appropriately in recurrent cases of chronic lateral epicondylitis and good resolution capacity, which enables improvement of pain and function of the elbow.Key words; Arthroscopic, Tennis elbow, Management.
https://zumj.journals.ekb.eg/article_48904_9697f6812cb68d712c983e656e3ca4eb.pdf
Key words
Arthroscopic, Tennis elbow, Management
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
255
261
10.21608/zumj.2019.11491.1191
34283
Original Article
Presentation of Allergic Fungal Rhinosinusitis in Sinonasal polyposis
Peter Shafick
drpeterent@gmail.com
1
Atef El Bahrawy
atef.bahrawy@hotmail.com
2
Magdy Abd El Fattah
magdyfatahent@yahoo.com
3
Wael Nasr
waelfayez_ent@gmail.com
4
Otorhinolaryngology department , Zagazig university , Egypt
Otorhinolaryngology department, Faculty of medicine zagazig university, Egypt
Otorhinolaryngology department, Faculty of medicine zagazig university, Egypt
Otorhinolaryngology department, Faculty of medicine zagazig university
Background: Allergic fungal rhinosinusitis (AFRS) was first reported as a distinct clinical disorder in 1976. AFRS is defined largely by the presence of allergic fungal mucin, which is a thick, tenacious, eosinophilic secretion with characteristic histologic findings There is no convincing evidence for clinical improvement of CRS with anti-fungal therapy. The fungi causing AFRS have a great diversity. This study aimed to assess presentation of AFRS in patients with sinonasal polyposis.Patients and methods: This prospective study was carried out in OLR-HNS Department, Zagazig University on 36 patients having sinonasal polyposis scheduled for functional endoscopic sinus surgery. All patients were subjected to full history taking, general and local examinations, routine preoperative laboratory and radiological assessments,assessment of Total IgE level and removal of the nasal polypi with microbiological study and histopathological examination for fungal elements. Results: 13.9% of the studied patients show positive fungal stain.80% of them show Aspergillus Fumigates on fungal culture while 20% show Candida Albicans. 80% of the patients diagnosed with AFRS were from rural areas. 72.2% of the studied patients had allergy. IgE levels in AFS patients ranged between 572.10 – 623.10 IU/ml while those in patients with polyposis only ranged between 191.20 – 381 IU/ml. Most of the studied patients presented with mild polyp, thick mucopurulant discharge and had total opacification in all sinuses and obstructd OMC. Conclusion: Diagnosing AFRS in patients with sinonasal polyposis could improve the outcome of surgery and reduce the recurrence rate by proper treatment postoperatively.
https://zumj.journals.ekb.eg/article_34283_a8434506fb553303287f11ee609fc60c.pdf
paranasal sinus
mycology
Allergic Fungal Rhinosinusitis
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
262
270
10.21608/zumj.2019.11214.1170
29802
Original Article
SHORT TERM OUTCOME OF PARA-AORTIC LYMPHADENECTOMY IN CASES OF OVARIAN CANCER
Mustafa Omara
omaramustafa@yahoo.com
1
ashraf Refaie
ashrefaie@hotmail.com
2
Ahmed Mahmoud
ahmedsekotory@hotmail.com
3
yehia Ali
yehia.elalfy57@gmail.com
4
Amr Elnemr
amrabmohsen@yahoo.com
5
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
Pathology Department, Faculty of Medicine, Zagazig University, Egypt.
Obstetrics and Gynecology Department,Faculty Of Medicine, Zagazig University, Zagazig, Egypt
Background: This study Assess the frequency and nature of intraoperative and postoperative complications as well as short term outcomes in ovarian cancer patients treated with open surgery including para-aortic lymph node dissection (PALND). Methods: This descriptive cross-sectional study enrolled 36 patients underwent extensive PALND up to the renal vessels as a part of open surgery for suspected early and advanced stages of ovarian cancer in Obstetrics and Gynecology Department, Zagazig University Hospitals, Egypt, during the period from August 2015 to November 2017. Results: In this study, the duration of PALND itself is more or less than one hour (mean 66.1+_13.7 and range 45-80 m) and the median volume of blood loss was (105 ml). 8 patients (22.2%) received intra and postoperative blood transfusion, the range of hospital stay for all patients was (7-14) days. the rate of postoperative ICU admission was (16.6%). There were no postsurgical treatment-related deaths. The most frequent postoperative complications were ileus (8.3%), LL lymphatic edema (8.3%) and major wound healing complications (11.1%). Conclusion: ovarian cancer patients may safely undergo comprehensive staging involving PALND in open surgeries without significant perioperative morbidity, if provided by trained Gynae-oncologists.
https://zumj.journals.ekb.eg/article_29802_5ad09398208445df781a225ffa84a5fe.pdf
lymphadenectomy
ovarian cancer
treatment complications
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
271
278
10.21608/zumj.2019.11205.1172
30284
Original Article
practical aspects of lymph node dissesction in gynecologic malignancy
Abdalla Gad
dr.abhasssng@gmail.com
1
ashraf Refaie
ashrefaie@hotmail.com
2
yehia el alfi
yehia.elalfy57@gmail.com
3
gamal amira
gamalamira@yahoo.co.uk
4
mahmoud negm
5
tarek el beheidy
beheidyt@gmail.com
6
Obs&gun faculty of medicine zagazig university zagazig Egypt
obstetric and gynecology department zagazig university hospitals
Pathology deartment, Faculty of Medicine, Zagazig University, Egypt.
surgical oncology department national cancer insititute cairo university
obstetric and gynecology department zagzazig university hospitals
obstetric and gynecology department zagazig university hospitals
ABSTRACTBackground: The technical progresses both in surgery and in intensive anesthetic therapy have made possible the development of surgical techniques more and more radical. Among the surgical techniques developed, the lymph node dissection is included. The benefits of LND in gynecological cancers have either not been studied systematically or are not as obvious as the frequency of its use would suggest. The present work aims to evaluate the role of lymph node dissection in gynecological malignancies Methods: 48 patients with gynecological cancers were included in the study. Lymph node dissection was done for all cases and any morbidity or mortality related to procedure .Results In this study, an overall positivity rate of 45.8% was found. that a median of 26 nodes can be collected from the pelvic area and 9 nodes from the para-aortic region. This study showed that 72.7 % of patients had 3-10 positive nodes, and that the obturator group is a major route for lymphatic spread in cervical and the external iliac group is a major route for lymphatic spread in endometrial carcinoma aortic nodes were most involved with ovarian carcinoma 42.7% of patients with para-aortic node metastases had positive-pelvic The incidence rate of major complications reported in this study which show no mortality and 28 cases have no complications but there is 6 patients complicated by lymphoma 6 patients with wound infectionConclusion: Lymph node dissection is a feasible procedure and it has therapeutic and prognostic role in gynecological operations
https://zumj.journals.ekb.eg/article_30284_25e9b28f08ef75eb62aa86326e7e3bf7.pdf
lymph node dissection
gynecological malignancy
pelvic¶ aortic lymph node
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
279
286
10.21608/zumj.2019.12587.1220
32038
Original Article
Effect Of Oral Contraceptive Pills Pretreatment On Ovarian Response In Patient with Clomiphene Resistant
marwa abuazza
samaroma780@gmail.com
1
badia soliman
badia_seliem@yahoo.com
2
soha seim
soha_galal@yahoo.com
3
mervat harira
harira_mervat@yahoo.com
4
Faculty of Medicine - Al-Mergeb University AL-khoms hospital
professor of obstetrics& gynecology Faculty of Medicine – Zagazig University
professor of obstetrics& gynacolog Faculty of Medicine – Zagazig University
professor of obstetrics& gynecology Faculty of Medicine – Zagazig University
Abstract:Background: Clomiphene citrate (CC) is the first drug and the most available treatment for ovulation induction due to it is low cost, easy to administrate and with low side effect. It can induce ovulation in 75% of women. 27% of anovulatory female with normal FSH level who do not respond to CC considered to be CC resistant. Combined Oral contraceptive pills are used for anovulatory infertile women to improve reproductive outcome.Aim of the study: To evaluate the effectiveness of pretreatment with combined oral contraceptive pills in clomiphene resistant cases regarding ovulation & pregnancy rate.Subjects and methods: A randomized clinical trial was conducted on 32 subfertile women proved to be resistant to clomiphene citrate. They were divided in to two groups: Group A (Study group) included 16 females received continuous OCPs for 42 days and after withdrawal bleeding received clomiphene citrate 150 mg tablet orally started on day 2 to day 6 of menstrual cycle. Group B (control group) included 16 females not received treatment for two spontaneous cycles and then received clomiphene citrate 150 mg tablet orally started on day 2 to day 6 of menstrual cycle. There was highly significant difference between the both groups in all three cycles regarding ovulation rate and pregnancy rate with higher rate in study group than control group.Conclusion: Pretreatment with OPCs pills results in excellent rates of ovulation and pregnancy in patients who were previously clomiphene resistant.
https://zumj.journals.ekb.eg/article_32038_c7348f7d4b931f2ce76733ea705350e4.pdf
: Oral Contraceptive Pills
Ovarian Response
Clomiphene Resistant
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
287
296
10.21608/zumj.2019.12551.1221
35052
Original Article
INTERRUPTED VERSUS CONTINUOUS SUTURING OF EPISIOTOMY : A COMPARATIVE STUDY
Lamis Soliman
drlamis89@gmail.com
1
Mahmoud Ghareeb
drmahmoudghareeb@yahoo.com
2
Azza Abd Elhameid
drazzamageid@yahoo.com
3
Mohamed Lashin
elbakrylashin@yahoo.com
4
Department of obstetrics and gynecology, faculty of medicine, zagazig university, zagazig, Egypt
Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, zagzig, Egypt
Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, zagazig, Egypt
Department of Obstetrics and Gynecology, Faculty of Medicine. Zagazig University, Zagazig, Egypt
BackgroundMillions of pregnant ladies worldwide experience perineal suturing after labour and the kind of repair may affect healing and perineal pain.ObjectivesTo assess the effects of continuous versus interrupted suturing techniques for repair of episiotomy following childbirth.Patients and Methods The study included 150 pregnant women admitted for labour underwent a mediolateral episiotomy before vaginal delivery at Zagazig University Hospitals and AlAhrar teaching hospital. in the period from October 2017 to December 2018 In this study, Patients were randomly allocated into two groups A and B.Group A: were repaired by continuous suturing technique using polyglactin 910 (vicryl) sutures No 2/0. Including 75 patients. Group B: were repaired by interrupted suturing technique using polyglactin 910 (vicryl) sutures No 2/0. Including 75 patients.ResultsThe results showed that there was highly statistically significant difference between two groups as regard time needed for repair, amount of suture material and Perineal pain at 6 & 12 hours measured by VAS scales lower at continuous group, and non significant difference after that.There was non significant difference between two groups regarding Amount of blood loss, Perineal repair rate, Need for analgesics, Post natal stay, Wound infection, Healing defects ,Dyschezia, Dyspareunia Cosmetic disfigurement and Patient satisfaction.ConclusionContinuous suturing technique is recommended over interrupted suturing technique since it is associated with less perineal pain in first days of post natal period, suture material amount used and less time needed to be performed.
https://zumj.journals.ekb.eg/article_35052_6e47ded6daabe949b4a2b7cccb8a72eb.pdf
Episiotomy
Continuous
interrupted
suturing
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
297
306
10.21608/zumj.2019.12345.1216
36376
Original Article
Evaluation of Endometrial Scratching by Hysteroscope or Pipelle curette on The Outcome of Assisted Reproduction
manar tharwat
dr.manartharwat@gmail.com
1
Eman Hafez
eman1mahfouz@yahoo.com
2
Entesar Mahdy
entesarmahdy2019@gmail.com
3
Mohamed Ibrahem
ma7moud.1@gmail.com
4
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
IntroductionEndometrial scratching (or injury) is defined as intentional damage to the endometrium. The objective of this study was to investigate the effect of the method of endometrial scratching by hysteroscope or pipelle curette on the outcome of assisted reproduction. Scratching had done in the follicular phase of the preceding cycle to embryo transfer in infertile women aged 20-40 years.MethodsIn this study, 225 ICSI cycles were studied and divided into three groups: - hysteroscope group (75) scratching by scissor, pipelle group (75) scratching by pipelle curette, control group (75) no scratching had done. For each woman in hysteroscope and pipelle groups an appointment was scheduled on day7–14 of the cycle before the planned start of COS to perform endometrial scratching.ResultsThere were statistical significant differences between women in the pipelle group, hysteroscope group and control group as regard positive pregnancy test P value = 0.046, clinical pregnancy P value = 0.042, ongoing pregnancy P value = 0.039 and implantation rate P value = 0.044. With further analysis to each intervention group separately with control group, there were statistical significant differences between women in the pipelle group and control group. There was improvement in pregnancy rates in hysteroscope group than control group but with no statistical significant differences. ConclusionEndometrial scratching performed in the follicular phase of the preceding cycle to ovarian stimulation by pipelle curette or hysteroscope is associated with improved clinical and ongoing pregnancy rates in infertile women undergoing ICSI
https://zumj.journals.ekb.eg/article_36376_8e4e0ec23686273f2a64cd55069dfb5b.pdf
Endometrial scratching
ICSI
Endometrium
Endometrial receptivity
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
307
3012
10.21608/zumj.2019.12654.1225
37993
Original Article
Laparoscopic hysterectomy versus abdominal hysterectomy in enlarged sized uterus
mustafa mustafa
shafiekmostafa@yahoo.com
1
mohammed azzam
ahmedmetwally058@gmail.com
2
Youssef Aboelwan
aboelwan@yahoo.com
3
ahmed el kataway
ahmedmetwally440@gmail.com
4
obestetric and gynacology department -faculty of medicine - zagazig unversity
faculty of medicine -zagazig unversity
Obstetrics &Gynaecology - Faculty of Medicine - Zagazig University - Egypt
faculty of medicine zagazig university
Background: The laparoscopic hysterectomy of enlarge uterus is a challenge to the surgeon irrespective of the surgical route. Big leiomyomas occupy the pelvis, thus decrease the ability to see the surrounding anatomic structures and partially impairing the surgeon’s perform to correctly develop the pelvic spaces..The current work compares of laparoscopic hysterectomy for large uterus (weighing ≥ 280 gm) with an abdominal hysterectomy,Methods: This prospective interventional clinical study submitted from January 2015 to December 2018 to assess the perioperative outcomes of 60 consecutive women with an enlarged uterus (weighing ≥ 280 gm determined preoperative by ultrasound), of whom 30 underwent laparoscopic hysterectomy and 30 an abdominal hysterectomy, all for benign gynecological conditions after exclusion of contraindications to laparoscopy.Results: Baseline patient characteristics were similar between the both groups, except for body mass index with laparoscopic group show higher index (34.3±1.3 kg/m2). Among the perioperative complications, only the risk of ileus was significantly higher in the group that underwent abdominal hysterectomy. Laparoscopic hysterectomy shortened the length of hospitalization significantly but did not affect the operative time and blood transfusion. Conclusion: Total laparoscopic hysterectomy of enlarged uterus is a suitable effective alternative to traditional abdominal hysterectomy when the laparoscopic team is well trained. However more studies are necessary before this technique can become routinely preconized.
https://zumj.journals.ekb.eg/article_37993_7a621cf5cd64c6d8b505c738b5123d2a.pdf
large uterus
laparoscopic hysterectomy
conventional hysterectomy
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
313
322
10.21608/zumj.2019.11498.1193
33417
Original Article
Continuous Epidural Versus Continuous Spinal Anesthesia for Elderly Patients Undergoing Radical Cystectomy: A Comparative Study
Khaled Abd alla
khaled7assan83@gmail.com
1
Moustafa Nasr
dr_moustafamagdy@yahoo.com
2
Lobna Eldorgham
leldorgham@gmail.com
3
Dina El sadek
dinamaghraby@yahoo.com
4
anesthesia,facuilty of medicine, zagazig university, zagazig, egypt
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egyptt
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
Background: Bladder cancer is common in geriatrics who have high operative risk and less tolerability to surgical stresses. This study aims at comparing epidural versus continuous spinal anesthesia for elderly patients undergoing radical cystectomy regarding hemodynamics, total volume of bupivacaine used, patient’s and surgeon's satisfactions and incidence of complications.Patient and Methods: Twenty male patients divided into 2 equal groups. Group I received continuous epidural anesthesia, 1-1.5 ml/segment of isobaric bupivacaine 0.5%+25µg fentanyl were injected to achieve T4 block then maintenance by 5 ml/h of isobaric bupivacaine 0.5% after 2 segment regression. Group II received continuous spinal anesthesia, 7.5 mg hyperbaric bupivacaine 0.5%+25µg fentanyl were injected. If T4 block wasn’t achieved after 15 minute, 2.5 mg of hyperbaric bupivacaine 0.5% was given also during surgery 2.5 mg of hyperbaric bupivacaine 0.5% was given after 2 segment regression to maintain T4 block.Results: Mean age of both groups was comparable. Heart rate showed a significant decrease at 15 minutes after local anesthetics injection in group II (69.90±5.45 vs 76.70±4.97), while no significant differences were recorded later. Group I showed a statistically significant decrease in MAP in mmHg at 10 min (71.93 vs 92.63), at 35 min (65.07 vs 87.83), at 135 min (71.47 vs 84.00), and at 255 min (69.63 vs 80.23). Total dose of bupivacaine was significant smaller in the group II (44.45±4.34mg versus 260.00±21.08mg). Conclusion: Continuous spinal anesthesia has advantage of more hemodynamic stability with adjustable lower dose of injected local anesthetic and excellent patients’ and surgeons’ satisfaction.
https://zumj.journals.ekb.eg/article_33417_b797508b4f48a3ad24b499d55873e2df.pdf
continuous spinal
epidural
geriatric
cystectomy
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
323
334
10.21608/zumj.2019.12277.1214
33947
Original Article
Feasibility of Targeting Lactate Clearance versus Central Venous Oxygen Saturation during Early Resuscitation of Septic Patients
Mostafa Ramadan
mostafaanesthesia83@gmail.com
1
Sahar Saad El Deen
saharelgammal@gmail.com
2
Khaled Elsayed
khaledseleem2000@yahoo.com
3
Salwa Waly
salwa.waly@yahoo.com
4
anesthesia and surgical intensive care, Faculty of medicine, Zagazig University, alSharkya , Egypt
anesthesia and surgical intensive care, fculty of medicine, zagazig universiy, Al Sharkya, Egypt
anesthesia and surgical intensive care, fculty of medicine, zagazig universiy, Al Sharkya, Egypt
Anaesthesia and Surgical Intensive Care. Faculty of Human Medicine. Zagazig University. Egypt
Background: Early and appropriate management of patients with sepsis and septic shock markedly improves the clinical outcomes and decreases the mortality rate.Methods: It was a prospective randomized study in which 62 adult septic patients of both sexes were randomly assigned to either ScvO2 group or lactate clearance group. All patients were resuscitated to optimize central venous pressure and mean arterial pressure then targeting either ScvO2 of at least 70% or lactate clearance of at least 20%. The study protocol was continued until all goals were achieved or up to 6 hours. Mortality at 28 days was measured for all patients. All the obtained data showed no significant differences between the two main groups except for the duration of the vasopressor free days. Thereby, two subgroups were created from the same acquired data as a ScvO2 only subgroup (n=12) and Lactate clearance only subgroup (n=10).Results: The overall mortality was 51.6%. Main group analysis revealed comparable results except for the duration of vasopressor free days which was longer in lactate clearance group. Subgroup results: the mortality rate was significantly lower in lactate clearance only subgroup [20% (2/10)] versus [75% (9/12)] in ScvO2 only subgroup. Moreover, the durations of vasopressors and organ failure free days were longer in lactate clearance only subgroup.Conclusion: Achievement of lactate clearance of ≥ 20% goal only was associated with lower rate of mortality and better clinical outcomes than achievement of ScvO2 ≥ 70% goal only during early resuscitation of septic patients.
https://zumj.journals.ekb.eg/article_33947_e742b05058fbf02a32733ad1fb45f664.pdf
Sepsis
Septic shock
lactate clearance
central venous oxygen saturation
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
335
343
10.21608/zumj.2019.11327.1183
35053
Original Article
Role of Diffusion Weighted Imaging & Dynamic Contrast Enhanced Magnetic Resonance Imaging in Assessment of Asymmetric Breast Densities
Hajer Abdalla
hajerabushaafa@gmail.com
1
Hazem Mousa
hazem_el_shahat@hotmail.com
2
ghada Abdulmonaem
ghada12009@yahoo.com
3
Dena El Sammak
denaelsammak@gmail.com
4
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Radio diagnosis Department, Faculty of Medicine, Zagazig University
Abstract Objective: The aim of the study is to determine the diagnostic value of both DCE-MRI & DW-MRI in assessment of cases with mammographic asymmetrical breast densities.Methods: This study was carried out at Radiodiagnosis Department, Zagazig University Hospitals, on 29 patients with breast asymmetry. Diagnostic work up included Mammography, US, & MRI.Results: The study included 29 females with mammographic breast asymmetry, 17 were having global asymmetry, while 12 with focal asymmetry.65.52% of asymmetry in this study was due to benign causes while 34.48% was due to malignant causes, DCE-MRI provided special characterization of lesions by their morphology & dynamic enhancement with 90% sensitivity 84.21% specificity, & 86.2% accuracy. DWI & ADC value provided differentiation between malignant & benign lesions, malignant lesions showed restricted diffusion with lower ADC values than benign lesions, the mean ADC value for benign lesions was (1.4±0.45x10-3sec/mm2), & the mean ADC value for malignant lesions was (0.85±0.29x10-3sec/mm2), & the cutoff ADC value was (
https://zumj.journals.ekb.eg/article_35053_46503584f55bcd43e7cf0a9bdf486fec.pdf
Breast
DWI
DCE-MRI
Breast MRI
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2020-03-01
26
2
344
355
10.21608/zumj.2019.14223.1296
42504
Original Article
Intended 3D conformal irradiation of internal mammary lymph node is better than incidental irradiation in breast cancer patients.
Yossra Taha El-Drgham
yossra_taha@hotmail.com
1
Ahmad Al.Hosainy
ahosainy40@yahoo.com
2
Heba Mounir
hebamounir@yahoo.com
3
Mohammed Bayomy
mohammed_fathy29121981@yahoo.com
4
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
Clinical Oncology and nuclear medicine department, faculty of medicine, Zagazig University, Zagazig, Egypt
Background: Internal mammary lymph node irradiation is a matter of debate. Aim of work: was to make a dosimetric comparison between two different approaches for internal mammary lymph node volume irradiation. Methods: prospective study was conducted in the Zagazig University Clinical Oncology and Nuclear Medicine Department. 38 patients with breast cancer presented in the period between March 2017 to March 2019. After finishing conformal three dimensional radiotherapy planning for breast cancer, we delineated internal mammary lymph nodes volume. Incidental internal mammary irradiation plan was the conventional tangential fields that cover chest wall or whole breast volume. Intended internal mammary irradiation plan was wide tangential fields that cover internal mammary lymph nodes volume. Results: Average of mean dose to internal mammary lymph nodes volume was significantly increased from 4581 cGy in incidental plan to 5213.6 cGy in intended plan (p
https://zumj.journals.ekb.eg/article_42504_1e0049c89694115f1d110bdf6922e3a8.pdf
Internal mammary lymph node
Incidental
Intended
breast cancer
Radiotherapy