ORIGINAL_ARTICLE
Colectomy in Patients with Colonic Carcinoma: Laparoscopic Versus Open Methods
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
2020-03-01
196
203
10.21608/zumj.2019.10198.1082
Cancer Colon
Open colectomy
laparosopic colectomy
Bassam
Mahmoud
doc.bassam@live.com
1
General Surgery department, Faculty of Medicine, Zagazig University, Egypt.
LEAD_AUTHOR
Alaa
Khalil
a_khalil2@hotmail.com
2
Faculty of medicine, Zagazig University
AUTHOR
Wael
Lotfy
waellotfy@hotmail.com
3
Faculty of medicine, Zagazig University
AUTHOR
Mohamed
Abdelhamid
dr_moh2003@yahoo.com
4
Faculty of medicine, Zagazig University
AUTHOR
Hassan
Ashour
drhassanashour@hotmail.com
5
Faculty of medicine zagazig university egypt
AUTHOR
Ramadan
Mahmoud
ramadan7791@gmail.com
6
Faculty of medicine, Zagazig univeristy
AUTHOR
ORIGINAL_ARTICLE
PREDICTION OF EARLY ANASTOMOTIC LEAKAGE FOLLOWING COLORECTAL CANCER SURGERY IN ZAGAZIG UNIVERSITY HOSPITALS
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
2020-03-01
204
214
10.21608/zumj.2019.11299.1175
colorectal cancer
Anastomosis
leak
C-reactive protein
Procalcitonin
Pola
Anwar
dr.polanagy@gmail.com
1
General Surgery Department, Faculty of Medicine, Zagazig University Hospitals, El-Sharkia, Egypt.
LEAD_AUTHOR
Mohammed
Abd El-Rahman
msaidgenerals@gamil.com
2
General Surgery departments, Faculty of Medicine, Zagazig University.
AUTHOR
Taha
Baiomy
dr.taha2020@yahoo.com
3
General Surgery departments, Faculty of Medicine, Zagazig University.
AUTHOR
Hassan
Ashour
drhassanashour@hotmail.com
4
General Surgery departments, Faculty of Medicine, Zagazig University.
AUTHOR
ORIGINAL_ARTICLE
Complications of Endoscopic Bariatric Surgery
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
2020-03-01
215
220
10.21608/zumj.2019.12651.1224
Body Mass Index
Bariatric surgery
Endoscopic surgery
HELAL
SASI
hlal1s1985@gmail.com
1
general surgery of facility of medicine zagazig universty
LEAD_AUTHOR
Khalid
Fahmi
khalid.safwat@gmail.com
2
Professor and Head of General Surgery Department, Faculty of Medicine-Zagazig University
AUTHOR
emad
salah
emadsalah@gmail.com
3
Professor of General Surgery, Faculty of Medicine - Zagazig University
AUTHOR
Wael
Awad
wael_awad@zu.edu.eg
4
Assistant Professor of General Surgery, Faculty of Medicine-Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Single Burr Hole Craniostomy for Evacuation of Chronic Subdural Hematoma
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
2020-03-01
221
232
10.21608/zumj.2019.11139.1153
Burr hole craniostomy
Glasgow coma scale
chronic subdural hematoma
Esam
Alnajar
esammussa85@gmail.com
1
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
LEAD_AUTHOR
Sami
Hassanain
samihassanain@yahoo.com
2
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
AUTHOR
Hosni
Salama
hosnisalama@yahoo.com
3
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
AUTHOR
Ashraf
Algallad
dr.ashrafalgallad@yahoo.com
4
neurosurgery department, faculty of medicine, zagazig university, zagazig, egypt.
AUTHOR
ORIGINAL_ARTICLE
Closed Reduction and Lateral Percutaneous Pin Fixation for Displaced Supracondylar Humerus Fractures in Children
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
2020-03-01
233
238
10.21608/zumj.2019.10859.1150
Lateral Pinning
SCHF
Ulnar N injury
Mahmoud
AboHasan
dr.mahmod89@gmail.com
1
Orthopedic surgery, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
Khaled
Idrees
drkhalidid@yahoo.com
2
Professor of Orthopedic Surgery Faculty of Medicine - Zagazig University
AUTHOR
Mohammed
Fahmy
mhamed375@gmail.com
3
Professor of Orthopedic Surgery Faculty of Medicine - Zagazig University
AUTHOR
Mohammed
sebaei
mohamedsebaei9@gmail.com
4
Orthopedic Surgery Department Faculty of Medicine; Zagazig University Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Conservative Management and Plate Fixation of Mid-Shaft Clavicular Fractures in Adults: Comparative Study
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
2020-03-01
239
247
10.21608/zumj.2019.10215.1105
Clavicle fracture
clavicle fixation
conservative clavicle treatment
Mahmoud
Abuzeid
mahmoudabuzeid78@gmail.com
1
Orthopedic, faculty of medicine, zagazig university, zagazig, egypt
LEAD_AUTHOR
Hossam
Khairy
h_khiry@hotmail.com
2
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
AUTHOR
Amro
Eladawy
aeladawy@gmail.com
3
Orthopaedic, faculty of medicine, Zagazig university, Zagazig, Egypt.
AUTHOR
ahmed
elmalt
ahmedelmalt@hotmail.com
4
orthopaedic,faculty of medicine,zagazig university,zagazig,Egypt
AUTHOR
ORIGINAL_ARTICLE
Arthroscopic Management of Tennis elbow
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
2020-03-01
248
254
10.21608/zumj.2019.16344.1463
Key words
Arthroscopic, Tennis elbow, Management
ahmed
alsayed
kingahmed_008@yahoo.com
1
orthopedic surgery,faculty of medicine,zagazig university,egypt
LEAD_AUTHOR
Abdelsalam
Eid
eid_md@yahoo.com
2
Department of Orthopedic Surgery,Faculty of Medicine, Zagazig University,
AUTHOR
.mohamed
Elzoheiry
elzohairy.me@gmail.com
3
Department of Orthopedic Surgery,Faculty of Medicine, Zagazig University.
AUTHOR
Fahmy
Fahmy
fahmysamir72@yahoo.com
4
Orthopedic department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Presentation of Allergic Fungal Rhinosinusitis in Sinonasal polyposis
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
2020-03-01
255
261
10.21608/zumj.2019.11491.1191
paranasal sinus
mycology
Allergic Fungal Rhinosinusitis
Peter
Shafick
drpeterent@gmail.com
1
Otorhinolaryngology department , Zagazig university , Egypt
LEAD_AUTHOR
Atef
El Bahrawy
atef.bahrawy@hotmail.com
2
Otorhinolaryngology department, Faculty of medicine zagazig university, Egypt
AUTHOR
Magdy
Abd El Fattah
magdyfatahent@yahoo.com
3
Otorhinolaryngology department, Faculty of medicine zagazig university, Egypt
AUTHOR
Wael
Nasr
waelfayez_ent@gmail.com
4
Otorhinolaryngology department, Faculty of medicine zagazig university
AUTHOR
ORIGINAL_ARTICLE
SHORT TERM OUTCOME OF PARA-AORTIC LYMPHADENECTOMY IN CASES OF OVARIAN CANCER
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
2020-03-01
262
270
10.21608/zumj.2019.11214.1170
lymphadenectomy
ovarian cancer
treatment complications
Mustafa
Omara
omaramustafa@yahoo.com
1
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
LEAD_AUTHOR
ashraf
Refaie
ashrefaie@hotmail.com
2
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
AUTHOR
Ahmed
Mahmoud
ahmedsekotory@hotmail.com
3
Obstetrics and Gynecology,Faculty Of Medicine,Zagazig University,Zagzaig,Egypt
AUTHOR
yehia
Ali
yehia.elalfy57@gmail.com
4
Pathology Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Amr
Elnemr
amrabmohsen@yahoo.com
5
Obstetrics and Gynecology Department,Faculty Of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
practical aspects of lymph node dissesction in gynecologic malignancy
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
2020-03-01
271
278
10.21608/zumj.2019.11205.1172
lymph node dissection
gynecological malignancy
pelvic¶ aortic lymph node
Abdalla
Gad
dr.abhasssng@gmail.com
1
Obs&gun faculty of medicine zagazig university zagazig Egypt
LEAD_AUTHOR
ashraf
Refaie
ashrefaie@hotmail.com
2
obstetric and gynecology department zagazig university hospitals
AUTHOR
yehia
el alfi
yehia.elalfy57@gmail.com
3
Pathology deartment, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
gamal
amira
gamalamira@yahoo.co.uk
4
surgical oncology department national cancer insititute cairo university
AUTHOR
mahmoud
negm
5
obstetric and gynecology department zagzazig university hospitals
AUTHOR
tarek
el beheidy
beheidyt@gmail.com
6
obstetric and gynecology department zagazig university hospitals
AUTHOR
ORIGINAL_ARTICLE
Effect Of Oral Contraceptive Pills Pretreatment On Ovarian Response In Patient with Clomiphene Resistant
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
2020-03-01
279
286
10.21608/zumj.2019.12587.1220
: Oral Contraceptive Pills
Ovarian Response
Clomiphene Resistant
marwa
abuazza
samaroma780@gmail.com
1
Faculty of Medicine - Al-Mergeb University AL-khoms hospital
LEAD_AUTHOR
badia
soliman
badia_seliem@yahoo.com
2
professor of obstetrics& gynecology Faculty of Medicine – Zagazig University
AUTHOR
soha
seim
soha_galal@yahoo.com
3
professor of obstetrics& gynacolog Faculty of Medicine – Zagazig University
AUTHOR
mervat
harira
harira_mervat@yahoo.com
4
professor of obstetrics& gynecology Faculty of Medicine – Zagazig University
AUTHOR
ORIGINAL_ARTICLE
INTERRUPTED VERSUS CONTINUOUS SUTURING OF EPISIOTOMY : A COMPARATIVE STUDY
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
2020-03-01
287
296
10.21608/zumj.2019.12551.1221
Episiotomy
Continuous
interrupted
suturing
Lamis
Soliman
drlamis89@gmail.com
1
Department of obstetrics and gynecology, faculty of medicine, zagazig university, zagazig, Egypt
LEAD_AUTHOR
Mahmoud
Ghareeb
drmahmoudghareeb@yahoo.com
2
Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, zagzig, Egypt
AUTHOR
Azza
Abd Elhameid
drazzamageid@yahoo.com
3
Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, zagazig, Egypt
AUTHOR
Mohamed
Lashin
elbakrylashin@yahoo.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine. Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Endometrial Scratching by Hysteroscope or Pipelle curette on The Outcome of Assisted Reproduction
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
2020-03-01
297
306
10.21608/zumj.2019.12345.1216
Endometrial scratching
ICSI
Endometrium
Endometrial receptivity
manar
tharwat
dr.manartharwat@gmail.com
1
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
LEAD_AUTHOR
Eman
Hafez
eman1mahfouz@yahoo.com
2
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
AUTHOR
Entesar
Mahdy
entesarmahdy2019@gmail.com
3
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
AUTHOR
Mohamed
Ibrahem
ma7moud.1@gmail.com
4
Obstetrics & Gynecology Department Faculty of Medicine - Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Laparoscopic hysterectomy versus abdominal hysterectomy in enlarged sized uterus
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
2020-03-01
307
3012
10.21608/zumj.2019.12654.1225
large uterus
laparoscopic hysterectomy
conventional hysterectomy
mustafa
mustafa
shafiekmostafa@yahoo.com
1
obestetric and gynacology department -faculty of medicine - zagazig unversity
AUTHOR
mohammed
azzam
ahmedmetwally058@gmail.com
2
faculty of medicine -zagazig unversity
AUTHOR
Youssef
Aboelwan
aboelwan@yahoo.com
3
Obstetrics &Gynaecology - Faculty of Medicine - Zagazig University - Egypt
AUTHOR
ahmed
el kataway
ahmedmetwally440@gmail.com
4
faculty of medicine zagazig university
LEAD_AUTHOR
ORIGINAL_ARTICLE
Continuous Epidural Versus Continuous Spinal Anesthesia for Elderly Patients Undergoing Radical Cystectomy: A Comparative Study
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
2020-03-01
313
322
10.21608/zumj.2019.11498.1193
continuous spinal
epidural
geriatric
cystectomy
Khaled
Abd alla
khaled7assan83@gmail.com
1
anesthesia,facuilty of medicine, zagazig university, zagazig, egypt
LEAD_AUTHOR
Moustafa
Nasr
dr_moustafamagdy@yahoo.com
2
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egyptt
AUTHOR
Lobna
Eldorgham
leldorgham@gmail.com
3
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Dina
El sadek
dinamaghraby@yahoo.com
4
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Feasibility of Targeting Lactate Clearance versus Central Venous Oxygen Saturation during Early Resuscitation of Septic Patients
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
2020-03-01
323
334
10.21608/zumj.2019.12277.1214
Sepsis
Septic shock
lactate clearance
central venous oxygen saturation
Mostafa
Ramadan
mostafaanesthesia83@gmail.com
1
anesthesia and surgical intensive care, Faculty of medicine, Zagazig University, alSharkya , Egypt
LEAD_AUTHOR
Sahar
Saad El Deen
saharelgammal@gmail.com
2
anesthesia and surgical intensive care, fculty of medicine, zagazig universiy, Al Sharkya, Egypt
AUTHOR
Khaled
Elsayed
khaledseleem2000@yahoo.com
3
anesthesia and surgical intensive care, fculty of medicine, zagazig universiy, Al Sharkya, Egypt
AUTHOR
Salwa
Waly
salwa.waly@yahoo.com
4
Anaesthesia and Surgical Intensive Care. Faculty of Human Medicine. Zagazig University. Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion Weighted Imaging & Dynamic Contrast Enhanced Magnetic Resonance Imaging in Assessment of Asymmetric Breast Densities
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
2020-03-01
335
343
10.21608/zumj.2019.11327.1183
Breast
DWI
DCE-MRI
Breast MRI
Hajer
Abdalla
hajerabushaafa@gmail.com
1
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
Hazem
Mousa
hazem_el_shahat@hotmail.com
2
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ghada
Abdulmonaem
ghada12009@yahoo.com
3
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Dena
El Sammak
denaelsammak@gmail.com
4
Radio diagnosis Department, Faculty of Medicine, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Intended 3D conformal irradiation of internal mammary lymph node is better than incidental irradiation in breast cancer patients.
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
2020-03-01
344
355
10.21608/zumj.2019.14223.1296
Internal mammary lymph node
Incidental
Intended
breast cancer
Radiotherapy
Yossra Taha
El-Drgham
yossra_taha@hotmail.com
1
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Ahmad
Al.Hosainy
ahosainy40@yahoo.com
2
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Heba
Mounir
hebamounir@yahoo.com
3
Clinical Oncology and Nuclear Medicine Department, Faculty of medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Mohammed
Bayomy
mohammed_fathy29121981@yahoo.com
4
Clinical Oncology and nuclear medicine department, faculty of medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR