eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
1
8
10.21608/zumj.2018.12981
12981
Original Article
SURGICAL OUTCOME OF SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY IN COMPARISON WITH THE 4-PORT TECHNIQUE IN ZAGAZIG UNIVERSITY HOSPITAL
Abd-Elhady Salama
1
Tarek Abd-Ellateif
2
Tarek Gobran
3
Ahmed Hashem
4
Bachground: Cholelithiasis is one of the most common disorders of the digestive tract encountered bygeneral surgeons worldwide. Conventional or open cholecystectomy was the mainstay of treatment for a longtime for this disease. Laparoscopic cholecystectomy (LC) has been the gold standard for removal of thegallbladder since the early 1990s. Single-incision laparoscopic surgery is becoming a more widely acceptedsurgical approach. However, the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC)are yet to be established. The present study compared outcomes following the use of SILC or conventionallaparoscopic cholecystectomy (CLC) on patients with gallbladder disease.Aim: To compare the perioperativeresults of single port laparoscopic cholecystectomy with the standard 4-port technique.Subjects and methods:The study involved 72 symptomatic gallbladder disease patients underwent laparoscopic cholecystectomy inZagazig University hospital.36 patients underwent SILC, and 36 patients underwent CLC. Clinical and surgicaloutcomes were compared.Results: The SILC and CLC groups were similar in terms of age, gender ratio, bodymass index, and diagnoses. The two groups were also found to be similar in terms of postoperative clinicalcourse and complications. The SILC group had a longer operation time, less postoperative pain, and a shorterhospital stay with better aesthetic results than the CLC group.Conclusion: SILC was as safe and feasible asCLC. The operating time was longer otherwise it has almost similar clinical outcomes to those of CLC.Keywords: Four port technique, Laparoscopic surgery, Single port surgery
https://zumj.journals.ekb.eg/article_12981_cf4921ba3626bf1fe77866ba059f532e.pdf
Keywords: Four port technique
laparoscopic surgery
Single port surgery
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
9
18
10.21608/zumj.2018.12987
12987
Original Article
ASESSMENT OF IMAGING IN CONGENITAL INNER EAR ANOMALIES AND ITS RELATION TO COCHLEAR IMPLANTATION
Ezz El-Din El Shiekh
1
Gamal Abdel-Maksoud
2
Hassan Wahba
3
Ibrahim Saber
4
ABSTRACTBackground: congenital SNHL may be caused by abnormalities of th-e membranous, or bony labyrinth. Because ofimprovements in imaging techniques and appearance of high resolution CT and MRI, anomalies of bony labyrinth canbe diagnosed. MR imaging helps in identification of non-osseous partitioning of the malformed cochlea andidentification of the neural structures contained within the internal auditory canal. The cochlear implantation hasradically changed the outlook for profoundly deaf adults and children. Aim of work: to identify different types ofinner ear anomalies, and to detect the percentage of patients who are amenable to cochlear implantation, anddifficulties that occur during the operation. Patients and methods: This prospective study was carried out on sixtypatients from 2015 till 2017 in ORL Department, Zagazig University. All patients underwent thorough preoperativeevaluation especially by high resolution CT and MRI. These patients were classified according to type of diagnosedanomaly, and CI operation were done to patients who were amenable for surgery. Results: The results of this studyshow congenital inner ear anomalies distribution according to involved part and its percent in relation to total number120 ears. Cochlear hypoplasia is present in 6 ears 4.5%, common cavity is present in 4 ears 3%, IP1 is present in 4 ears3%, 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%,dilated vestibule is present in 4 ears 3%, isolated SCC hypoplasia is present in 4 ears 3.03%, SCC hypoplasia withcommon cavity is present in 4 ears 3.03%, dysplstic SCC is present in 9 ears 6.8%, dilated IAC is present in 6 ears4.5%, hypoplastic IAC is present in 24 ears 18.2%, VCN hypoplasia is present in 24 ears 18.2%, isolated EVA ispresent in 48 ears 36.4%. In our study all operated cases were done through facial recess approach. Operated cases were51 out of 66 about 77.3%. Conclusion: CT and MRI are mandatory investigations for any patient prepared for cochlearimplantation. Preoperative diagnosis of inner ear anomalies allows exclusion of anomalies that are considered ascontraindication for CI operation.
https://zumj.journals.ekb.eg/article_12987_137d72074f443ccb7aed6ac23881e06e.pdf
Keywords: Cochlear implantation
Posterior tympanotomy approach
Mastoidectomy
Major complications
Minor complications
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
19
23
10.21608/zumj.2018.12993
12993
Original Article
IFFERENT SURGICAL TECHNIQUES OF SKULL BASE RECONSTRUCTION: EVALUATION AND OUTCOME
Hazem Soliman
1
Samy Mohamed
2
Tarek Abdel-Bary
3
Mohamed Abd Elaziz
4
ABSTRACTBackground : cerebrospinal fluid (CSF) leak is the most common complication after skull base surgery. It carriesa high risk of life threatening complications (e.g., tension pneumocephaly, meningitis, cerebritis, and brainabscess).Patients and Methods: We present twenty patients, ages 2-55 years, eight males and twelve females withdifferent skull base pathologies operated by different surgical modalities (microscopic transcranial, endoscopicendonasal and combined micro-endoscopic techniques) at neurosurgery department, faculty of medicine, ZagazigUniversity, between Jan. 2016 to Jan. 2018. Prophylactic antibiotics and anticonvulsants were rourtinely given.Lumbar drain was not used.Results: the success rate was (95%) and only one patient (5%) developed post operative CSF leak whichresponded to conservative measures. This suggests that proper sealing of the skull base defect has been achieved.There was no infection, no mortality and the long term follow up showed good functional and aesthetic results.Conclusion: The reconstructive process although being the last step in the surgical procedure, but it's a veryimportant one. It should be planned well before surgery. Meticulous repair of the already present or resultantdefect should be performed in every case.
https://zumj.journals.ekb.eg/article_12993_7bf978e3c7f7f91bebed2793ec05c2e2.pdf
Skull base defect
skull base reconstruction
cerebrospinal fluid leakage
dural reconstruction
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
24
33
10.21608/zumj.2018.12996
12996
Original Article
MODIFIED SELVESTER QRS SCORE REDUCTION FOR PREDICTION OF MYOCARDIAL SALVAGE FOLLOWING SUCCESSFUL REPERFUSION OF ACUTE ST ELEVATION MYOCARDIAL INFARCTION
Ahmed Ammar
1
Islam El-Sherbiny
2
Islam Shehata
3
Cheng Cheng
4
Islam Ghanem Ghanem
5
ABSTRACT
Background: Achieving optimal angiographic coronary flow after acute ST elevation myocardial infarction(STEMI) isn’t the best parameter of success. Perfusion of the microvasculature is more important. QRS scoreplays an important role for early risk stratification for STEMI. It is a simple electrocardiographic (ECG)parameter for assuring the presence or absence of microvascular obstruction.Aim of the work: The aim of this clinical study is to validate the 90 minutes modified Selvester QRS scorereduction as a reliable predictor of myocardial salvage, represented by 3 months global longitudinal strain (GLS)value, following successful reperfusion of acute STEMI.Material/Methods: The study population included 400 patients presented with first acute STEMI withsuccessful reperfusion by thrombolysis (Group I- 200 patients: mean age=57.1 ± 11.6 years) or primarypercutaneous intervention (PPCI) (Group II- 200 patients: mean age=58.2±9.8 years). Basal and 90 minutes afterreperfusion electrocardiography was done with assessment of ST resolution and modified Selvester QRS score.Basal and 3 months follow up echocardiography was performed with assessment of ejection fraction (EF) andGLS as an indicator for myocardial salvage with its impact on long-term clinical outcome.Results: 90 minutes ST resolution and QRS score reduction were significantly higher in PPCI group (P.: 0.04*,0.03*). Patients in group I had non-significant improvement of EF (P.: 0.22) during follow-up, but highlysignificant improvement of GLS (P.: ˂0.001**) compared to the basal echocardiographic study. Patients ingroup II had significant improvement of EF (P.: 0.01*) during follow-up, and highly significant improvement ofGLS (P.: ˂0.001**) compared to the basal echocardiographic study. As regarding correlation with 3 monthsGLS value, there was highly significant negative correlation between 3months GLS and (ST resolution and QRSscore reduction) (P.: ˂0.001**). Receiver operating characteristics (ROC) curve analysis shows that 90 minutesQRS score reduction has the best cut off value of 70% to predict 3months GLS improvement with 80%sensitivity and 79% specificity.Conclusions: Modified Selvester QRS score reduction 90 minutes after reperfusion is a cheap bedside ECGparameter added to ST resolution, can be considered as a reliable predictor of future myocardial salvage with itsimpact on long-term clinical outcome and modifying management strategies.
https://zumj.journals.ekb.eg/article_12996_cc019195724e4a67a6dd551bb5679566.pdf
Modified Selvester QRS score • Myocardial infarction• Myocardial salvage
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
34
43
10.21608/zumj.2018.12998
12998
Original Article
PREDICTION OF LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTIONS SIX MONTHS FOLLOWING MITRAL VALVE REPLACEMENT USING NEW ECHO DOPPLER INDICES
Moataz Elkot
1
Ahmed Ammar
2
Islam ELsherbiny
3
Khaled Abdelbary
4
ABSTRACTBackground: The development of left ventricular dysfunction is a major concern in the management of patients withsevere mitral regurgitation. In the initial stages, contractility impairment may be ‘‘invisible’’ by the traditional methodsto assess the ventricular function, because of different loading conditions. This fact can mask the presence of LVdysfunction. Sometimes, LV dysfunction may be ‘‘unmasked’’ only by change in loading conditions after surgicalcorrection, leading to the development of overt LV dysfunction and congestive heart failure. The identification ofcontractile dysfunction at an early stage and surgical correction may avoid the development of irreversible postoperativeLV dysfunction.Objectives: To test the efficacy of new echocardiographic indices in predicting post operative left ventriculardysfunction and compare the diagnostic accuracy of these indices .Subjects and Methods: The study included 41 patients with severe isolated Mitral regurgitation with ejection fraction> 50 %, prepared for mitral valve replacement. Patients were examined clinically and by Echocardiography pre and postoperative. The following Echo Doppler modalities were done to the patients pre operative and 6 months post operative:Global longitudinal strain(GLS) , Modified Simpson ,dp/dt , IVRT/T(E-è) the early diastolic Driving Force , earlydiastolic and early systolic mitral annular velocity by tissue Doppler. Patients were then classified into Four sub groupsaccording to post operative systolic and diastolic function, Group 1A were patients with normal post operative systolicfunction , Group 1B were patients with post operative systolic dysfunction , Group 2A were patients with normal postoperative diastolic function , Group 2B were patients with post operative diastolic dysfunction.Results: For prediction of systolic dysfunction ROC curve analysis showed high significant value of pre operative GLSin predicting post operative systolic dysfunction with cutoff value= -18.5 , high significant value of pre operativemodified Simpson in predicting post operative systolic dysfunction with cutoff value=54.5, and significant value of preoperative dp/dt in predicting post operative systolic dysfunction with cutoff value=1166 mmHg/sec. The multivariateanalysis showed that the independent variables for predicting post operative systolic dysfunction were pre operativeGLS and dp/dt.For prediction of diastolic dysfunction ROC curve analysis showed high significant value of pre operative GLS inpredicting post operative diastolic dysfunction with cutoff value=-18.5, and significant value of pre operativeIVRT/T(E-e\) in predicting post operative diastolic dysfunction with cutoff value=2.95. Multivariate analysis showedthat the independent variables for predicting post operative diastolic dysfunction were preoperative GLS & preoperativeIVRT/T (E-e\).Conclusions: We can depend on pre operative Global Longitudinal Strain (GLS) and dp/dt in predicting post operativesystolic dysfunction with cut off value=-18.5 and 1166 mmHg/sec respectively. We can also depend on preoperativeGLS and IVRT/T (E-e\) in predicting post operative diastolic dysfunction with cutoff value=-18.5 and 2.95respectively
https://zumj.journals.ekb.eg/article_12998_ce7afb0379b4c3ab48facdbba8a1813b.pdf
Keywords: Left Ventricular Dysfunction •Mitral Valve Replacment •Predictors
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
44
54
10.21608/zumj.2018.13001
13001
Original Article
MICRONEEDLING AND GLYCOLIC ACID PEEL FOR TREATMENT OF ACNE SCAR; COMPARATIVE STUDY
Amr Saadawi
1
Abdallah Esawy
2
Walaa Mohamed
3
ABSTRACTBackground: Atrophic acne scars are common and undesirable outcome of acne vulgaris related toboth its severity and delay in treatment. Such scars can be classified according to the depth and shapeof the collagen loss: ice pick, boxcar, or rolling. Many options are available for treatment of acne scarssuch as: laser surgery, radiofrequency intervention, chemical peels, chemical reconstruction of skinscars (cross technique), dermabrasion, needling, subcision, punch techniques, fat transplantation, andother tissue augmenting agents.Objective: The aim of this study was to compare between GA peelmonotherapy and microneedling with dermapen monotherapy in treatment of acne scars. Moreover,combined treatment of GA peel and microneedling with dermapen is compared to each of the abovemonotherapies in treatment of acne scars.Methods: Thirty patients of both sexes (10 men and 20women) with age ranged from 19-45 years old with different types of atrophic acne scars were enrolledin the study. Patients were randomly divided into three groups: Group I: Included ten patients (4 malesand 6 females) aged 27 - 45 years. They had microneedling with dermapen for treatment of the scars.Group II: Included ten patients (4 males and 6 females) aged 19- 42 years. They had glycolic acid 35%peel for treatment of the scars. Group III: Included ten patients (2 males and 8 females) aged 19-39years. They were treated with skin microneedling with dermapen combined with glycolic acid 35%peel.Results: Results revealed that there was statistical significant decrease between acne scar grade indermapen group before and after treatment with degree of improvement (80%). Also, in glycolic acidgroup before and after treatment with degree of improvement (70%). Statistical significant decreasebetween acne scar grade in combination group before and after treatment with degree of improvement(100%). Statistical significant increase in frequency of improvement in rolling compared to boxcar andicepick in all groups and also in boxcar compared to icepick.Conclusion: Dermapen and glycolic acidpeel are effective and safe techniques in acne scars especially (superficial scars). Combination ofdermapen and glycolic acid peel is more effective than monotherapy by either dermapen or glycolicacid peel and also helps in improvement of deep acne scars.
https://zumj.journals.ekb.eg/article_13001_9884d73d998017efa9c88965edef098d.pdf
Microneedling
Glycolic acid
acne scar
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
55
65
10.21608/zumj.2018.13003
13003
Original Article
DOPAMINE RECEPTOR D3R AND D4R MRNA LEVELS IN PERIPHERAL LYMPHOCYTES IN PATIENTS WITH SCHIZOPHRENIA AND ITS CORRELATION WITH SEVERITY OF ILLNESS
Asaad Shalanda
1
Rafek Abd Ellatif
2
Mohamed Negm
3
Amal El Shal
4
Heba Abdelsalam
5
ABSTRACTObjective: This study aimed to assess D3R and D4R mRNA levels in patients with schizophrenia.Subjects: Thirty six schizophrenia patients; 24 males (66.7%) and 12 females (33.3%) and 36 healthyindividuals; 23 males (63.9%) and 13 females (36.1%) as control subjects.Methods: All schizophrenia patients are thoroughly screened and diagnosed for schizophrenia usingDSM-IV diagnostic criteria for schizophrenia.Results: The mean values of D3 and D4 receptors mRNAs level among both studied cases and controlsshow a highly statistically significant difference (P <0.001) between both schizophrenia patients andtheir controls regarding levels of D3 and D4 mediators. D3 receptor mRNAs level influenced by PANSscale of schizophrenic patients, as level of D3 R increased in PBLs with decreased schizophreniaseverity, and the difference was statistically significant (P <0.001), while the difference in D4 R levelwas not statistically significant (P >0.05).Conclusion: This study reveals that the molecular biologically-determined dopamine receptors (DR3and DR4 mRNA) of peripheral lymphocytes are reactive after taking antipsychotics, and that increasedexpression of dopamine receptor in peripheral lymphocyte has possible clinical significance forsubgrouping of schizophrenia.
https://zumj.journals.ekb.eg/article_13003_12e93329e9c9e8e2f2e4ab8f84f8ef36.pdf
DR3: dopamine receptor 3
DR4: dopamine receptor 4
RT- PCR: real time polymerase chain reaction
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
66
71
10.21608/zumj.2018.13006
13006
Original Article
STUDY OF FINGERPRINTS PATTERN IN BREAST CANCER PATIENTS INSHARKIA GOVERNORATE, A CASE –CONTROL RETROSPECTIVE CLINICAL STUDY.
Alaa Haggag
1
Alaa Ibrahim Khalil
2
Eman Elzahed
3
Mohamed Abdelhamid
4
ABSTRACTBackground :Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer inwomen. In less-developed countries, it is the leading cause of cancer death in women; in developedcountries. Breast cancer is one of the most extensively studied cancers and its genetic basis is wellestablished.Dermatoglyphic traits are formed under genetic control early in development but may beaffected by environmental factors during first trimester of pregnancy. These patterns may represent thegenetic make up of an individual and therefore his/her predisposition to certain diseases. The finger andpalmar prints patterns have already beenstudied with respect to various genetic diseases such as theDown's gsyndrome and Klinefeltersyndrome. The fingerprints can thus represent a simple, noninvasive anatomical marker of breast cancer risk.Methods :This study was applied to fifty histopathologically-confirmed breast cancer patients and theirfingerprints patterns were assessed. At the same time , fifty age-matched controls were selected beinghave no self or family history of breast cancer and the observations were recorded abd data werecollected.Result :It was observed that whorl pattern is the most common fingerprints pattern to be identified inbreast cancer cases compared to controls. Also the quantitative difference in ridge count wasstatistically important.Conclusion : The pattern of fingerprints may be a useful tool in the future in identifying and alsoscreening of breast cancer.
https://zumj.journals.ekb.eg/article_13006_8008119119fd763a40fff31c2ef33b58.pdf
breast cancer
Fingerprints
Genetics
Screening
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
72
79
10.21608/zumj.2018.13007
13007
Original Article
SCREENING FOR B-THALASSEMIA CARRIER AMONG STUDENTS IN ASECONDARY SCHOOL IN DIARB NEGM,SHARKIA
Mervat Hesham
1
Mohammed Besher
2
Naglaa Khalifa
3
ABSTRACTBackground:Beta-Thalassemia represents a major public health problem in Egypt. The carrier rate variesbetween 5.5% to ≥ 9%; it is estimated that there are 1000/1.5 million per year live births born with β-thalassemia. In spite of optimal treatment being available, only a few patients can afford it. Unfortunately,most patients suffer from complications of blood transfusions, mainly transfusion transmitted viral infectionsand iron overload. Prevention by carrier detection and prenatal diagnosis is needed in populations with highincidence of the disease, such as Egypt.Methods:This was a prospective cross-sectional study conducted on 614 secondary school students in DiarbNegm, Sharkia Governorate. All subjects were subjected to the following: Complete blood count,Serumferritin level, Serum iron level, TIBC. Subjects with microcytic anemia were subjected to specific laboratorytests: HPLC (High Performance Liquid Chromatography) which include hemoglobin A2(HbA2).Results:Complete blood count testing of the 614 subjects in this study revealed that 55.2 % were normal and44% were anemic, 5.6% had normocytic anemia and 39.2% had microcytic anemia.Subjects with microcyticanemia were further subdivided into two groups according to their HbA2 level into; β-Thalassemia carriergroup with high level of HbA2 >3.5% and normal to high (serum iron, serum ferritin) and normal to lowTIBC were 8.5% and Non-carrier group; All with normal levels of HbA2< 3.5%, low serum iron, low serumferritin, high TIBC, were 31.6% of subjects and diagnosed as iron deficiency anemia.Carriers rate was 8.5%,53.8% were males and 46.2% were females.There were increase in mean value of RBCS count, serum ironand serum ferritin in carriers as compared to non-carriers, and decrease in mean value of HB, HCT, MCV,MCH, MCHC find TIBC level in carriers as compared to non-carriers. There was a significant positivecorrelation between HbA2 and HCT, RBCS count and serum ferritin, while significant negative correlationbetween HbA2and MCV.Conclusion: Carrier rate among 614 secondary school students in Diarb Negm,Sharkia Governorate was8.5%.Hemoglobin A2 is the gold standard for B-Thalassemia carrier screening.
https://zumj.journals.ekb.eg/article_13007_91e1726bcd9e792c5ce7c9e5ff201372.pdf
Beta-Thalassemia
microcytic hypochromic anemia
Screening
B-Thalassemia Carrier
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2018-01-01
24
1
80
92
10.21608/zumj.2018.13009
13009
Original Article
PREDICTORS OF VARICEAL BLEEDING AFTER ESOPHAGEAL VARICES BAND LIGATION IN EGYPTIAN CIRRHOTIC PATIENTS
Sahar Zaghloul
1
Hoda El Hady
2
Hussein Hussein
3
Islam Hassan
4
ABSTRACTBackground:Bleeding from oesophageal varices is a severe complication of portal hypertension. Endoscopicvariceal ligation (EVL) is the treatment of choice for acute variceal bleeding. It is also performed for primaryand secondary prophylaxis of bleeding from oesophageal varices. After Endoscopic Band Ligation (EBL),patients are at risk of post-interventional bleeding; the risk factors for this complication are poorlyevaluated.The aim of this work: was to evaluate the risk factors for predicting variceal bleeding after electiveendoscopic variceal ligation (EVL). Patients and Methods: This study will be carried out in ZagazigUniversity Hospital and El-Galaa Family Military Hospital. The patients was subjected to differentdemographic, clinical, biochemical, ultrasonographic and endoscopic findings. Results : The incidence ofbleeding after elective EVL was 6%. The results showed significant differences between the bleeders andnon bleeders regards the severity of liver disease measured by Child-Pugh score , the platelets count,hemoglobin level, prothrombin time , the liver regards its ( size, echogenicity, irregularity of the surface,presence of HFL and Portosystemic collaterals ) , the size and extension of varices. Conclusion: Forprediction of variceal bleeding after elective EVL; We can rely on many characteristics, such as age, gender,liver function, severity of varices, number of rubber bands, and so forth. But as demonstrated by themultivariate analysis, there were only four independent risk factors among these, namely moderate toexcessive ascites, PT > 18, number of rubber bands placed, size and extent of varices. These four risk factorsmay therefore be more meaningful than the others for predicting the occurrence of bleeding followingelective EVL.
https://zumj.journals.ekb.eg/article_13009_d797dcbdc26c1d0d1dcb80e32249df74.pdf