Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_100_21
Mariam Saadanya, Fatma Attia, E. Mohamed, Ali El Rahim Ali, S. Sabry
Background Endoscopic retrograde cholangiopancreatography (ERCP) was first described as a diagnostic technique. ERCP is used for management of various biliary and pancreatic diseases. Post-ERCP pancreatitis is defined as new-onset abdominal pain following ERCP, which is associated with amylase levels that are elevated three times the normal range, Pancreatic stenting is widely employed after pancreatic sphincterotomy with goals of reducing both early restenosis and post-ERCP pancreatitis. The risk of pancreatitis is significantly decreased when a pancreatic stent is placed and then left in following a precut sphincterotomy. Aim To evaluate the efficacy of pancreatic stent to decrease the risk of post-ERCP pancreatitis in patients with calcular obstructive jaundice. Patients and methods A prospective randomized study was conducted that included 40 patients with obstructive jaundice with a difficult biliary cannulation who are at risk to develop post-ERCP pancreatitis in patients with calcular obstructive jaundice. Group A included 20 patients with manipulation of pancreatic duct guidewire without pancreatic stent insertion. Group B included 20 patients with manipulation of pancreatic duct guidewire with pancreatic stent insertion. Results There was a highly statistically significant. Pancreatic stent placement decreases the risk of post-ERCP pancreatitis. Conclusion Prophylactic pancreatic duct stenting after difficult cannulation of the pancreatic duct is a safe and feasible procedure and significantly reduces the rate of post-ERCP pancreatitis.
{"title":"Evaluation of pancreatic duct stenting for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis in difficult cannulating patients with calcular obstructive jaundice","authors":"Mariam Saadanya, Fatma Attia, E. Mohamed, Ali El Rahim Ali, S. Sabry","doi":"10.4103/sjamf.sjamf_100_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_100_21","url":null,"abstract":"Background Endoscopic retrograde cholangiopancreatography (ERCP) was first described as a diagnostic technique. ERCP is used for management of various biliary and pancreatic diseases. Post-ERCP pancreatitis is defined as new-onset abdominal pain following ERCP, which is associated with amylase levels that are elevated three times the normal range, Pancreatic stenting is widely employed after pancreatic sphincterotomy with goals of reducing both early restenosis and post-ERCP pancreatitis. The risk of pancreatitis is significantly decreased when a pancreatic stent is placed and then left in following a precut sphincterotomy. Aim To evaluate the efficacy of pancreatic stent to decrease the risk of post-ERCP pancreatitis in patients with calcular obstructive jaundice. Patients and methods A prospective randomized study was conducted that included 40 patients with obstructive jaundice with a difficult biliary cannulation who are at risk to develop post-ERCP pancreatitis in patients with calcular obstructive jaundice. Group A included 20 patients with manipulation of pancreatic duct guidewire without pancreatic stent insertion. Group B included 20 patients with manipulation of pancreatic duct guidewire with pancreatic stent insertion. Results There was a highly statistically significant. Pancreatic stent placement decreases the risk of post-ERCP pancreatitis. Conclusion Prophylactic pancreatic duct stenting after difficult cannulation of the pancreatic duct is a safe and feasible procedure and significantly reduces the rate of post-ERCP pancreatitis.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"28 1","pages":"645 - 650"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76307173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_113_21
B. Ibrahim, Alshimaa Mohammad Enayet, N. Metwally
Objective The aim of this study was to evaluate the added value of multidetector computed tomography in the characterization of renal cystic lesions based on the Bosniak classification and compare the old with the new one (version 2019). Patients and methods A prospective study was carried out on 21 patients from the adult group of both sexes; their age ranged from 31 to 83 years. They referred from the Urology Department and clinic to the Radiology Department in Alzahraa University Hospital. The study was carried out from January 2020 to March 2021. Results The mean age of the patients was 56.7±13.76. The incidence of renal cysts was higher in age group greater than 50 years, with a male predominance. There were insignificant differences between old and new classifications by computed tomography. According to the nature of lesion class (I and II) the classification was as follows: there were 15 benign (51.7%), four class (IIF) lesions, probably benign, (13.8%), four class (III) indeterminate lesions (13.8%), and six malignant class (IV) lesions (20.7%). The pathology and diagnosis of the lesions of the studied group revealed that six lesions (20.7%) were renal cell carcinoma, six lesions (20.7%) were complicated cysts, two lesions (6.9%) were multilocular cystic nephroma, two lesions (6.9%) were autosomal dominant polycystic kidney disease, and 13 lesions (44.8%) were benign cortical simple cysts. Conclusion The Bosniak classification applied by multidetector computed tomography is a practical and accurate method to evaluate renal cystic lesions, also limiting the number of patients wrongly diagnosed with complex lesions and subjected to unnecessary surgeries.
{"title":"Bosniak classification of renal cystic lesions based on multidetector computed tomography","authors":"B. Ibrahim, Alshimaa Mohammad Enayet, N. Metwally","doi":"10.4103/sjamf.sjamf_113_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_113_21","url":null,"abstract":"Objective The aim of this study was to evaluate the added value of multidetector computed tomography in the characterization of renal cystic lesions based on the Bosniak classification and compare the old with the new one (version 2019). Patients and methods A prospective study was carried out on 21 patients from the adult group of both sexes; their age ranged from 31 to 83 years. They referred from the Urology Department and clinic to the Radiology Department in Alzahraa University Hospital. The study was carried out from January 2020 to March 2021. Results The mean age of the patients was 56.7±13.76. The incidence of renal cysts was higher in age group greater than 50 years, with a male predominance. There were insignificant differences between old and new classifications by computed tomography. According to the nature of lesion class (I and II) the classification was as follows: there were 15 benign (51.7%), four class (IIF) lesions, probably benign, (13.8%), four class (III) indeterminate lesions (13.8%), and six malignant class (IV) lesions (20.7%). The pathology and diagnosis of the lesions of the studied group revealed that six lesions (20.7%) were renal cell carcinoma, six lesions (20.7%) were complicated cysts, two lesions (6.9%) were multilocular cystic nephroma, two lesions (6.9%) were autosomal dominant polycystic kidney disease, and 13 lesions (44.8%) were benign cortical simple cysts. Conclusion The Bosniak classification applied by multidetector computed tomography is a practical and accurate method to evaluate renal cystic lesions, also limiting the number of patients wrongly diagnosed with complex lesions and subjected to unnecessary surgeries.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"104 1","pages":"518 - 523"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87647412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_133_21
M. Aly, Magda S.Yaqout, Fathy Aly, A. Shoukry, L. Sakr
Background Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG–PET/CT) play an important role in the diagnostic workup of patients with malignant mesothelioma. Applications for FDG–PET/CT at this time help in differentiation between malignant and benign pleural lesions, staging, and the ability for surgical interference. Objectives The objective of this study was to review the role of PET/CT in diagnosis, staging, prognostication, and pre- and post-therapeutic response of malignant mesothelioma. Patients and methods This study was performed on 55 of known patients with malignant mesothelioma at Naser Institute (cancer center) from May 2016 to July 2020 referred for staging, pre-, and post-therapeutic response. Results The study proved that combined PET/CT was superior to CT and PET individually in diagnosis of patients with malignant mesothelioma and improves the sensitivity, specificity, and accuracy of local extent (T), regional lymph nodes (N), and distant metastases (M), also pre- and post-therapeutic response. Conclusion The information provided by PET/CT is likely to obtain the best imaging for the diagnosis and staging in patients with malignant mesothelioma and also for monitoring tumor response to therapy.
{"title":"The role of 18F-FDG-PET/CT in the evaluation of malignant mesothelioma","authors":"M. Aly, Magda S.Yaqout, Fathy Aly, A. Shoukry, L. Sakr","doi":"10.4103/sjamf.sjamf_133_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_133_21","url":null,"abstract":"Background Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG–PET/CT) play an important role in the diagnostic workup of patients with malignant mesothelioma. Applications for FDG–PET/CT at this time help in differentiation between malignant and benign pleural lesions, staging, and the ability for surgical interference. Objectives The objective of this study was to review the role of PET/CT in diagnosis, staging, prognostication, and pre- and post-therapeutic response of malignant mesothelioma. Patients and methods This study was performed on 55 of known patients with malignant mesothelioma at Naser Institute (cancer center) from May 2016 to July 2020 referred for staging, pre-, and post-therapeutic response. Results The study proved that combined PET/CT was superior to CT and PET individually in diagnosis of patients with malignant mesothelioma and improves the sensitivity, specificity, and accuracy of local extent (T), regional lymph nodes (N), and distant metastases (M), also pre- and post-therapeutic response. Conclusion The information provided by PET/CT is likely to obtain the best imaging for the diagnosis and staging in patients with malignant mesothelioma and also for monitoring tumor response to therapy.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"14 1","pages":"673 - 678"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89434106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_112_21
H. Ahmed, M. Mohammed, N. Metwally
Objective This study aims to assess the role of multidetector computed tomography (MDCT) in the diagnosis and assessment of patients with hemoptesis. Patients and Methods This was a prospective study carried out on a total of 20 patients who presented with hemoptysis, all referred from the Chest Department and clinic to the Radiology Department in El-Zahra Hospital for 164 slice MDCT examination; the study was carried out for a period of 1 year from January 2020 to January 2021 after receiving approval from the ethical committee of the institute. Informed consent was obtained from all patients before inclusion in the study. Results The MDCT study showed that bronchogenic carcinoma was found to be the most common cause of hemoptysis in six (30%) patients, pulmonary embolism and bronchiectasis were found in four (20%) patients, in two (10%) patients, metastasis was present due to breast and testicular cancer, and one (5%) patient, lung abscess, pulmonary hypertension, tuberculosis, and alveolar hemorrhage were present. Conclusion MDCT proved to be the imaging modality of choice in the diagnosis of hemoptysis, being superior to chest radiography in demonstrating not only causes of delay but also the extent of lung abnormalities.
{"title":"The role of multidetector computed tomography in the diagnosis and assessment of patients with hemoptesis","authors":"H. Ahmed, M. Mohammed, N. Metwally","doi":"10.4103/sjamf.sjamf_112_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_112_21","url":null,"abstract":"Objective This study aims to assess the role of multidetector computed tomography (MDCT) in the diagnosis and assessment of patients with hemoptesis. Patients and Methods This was a prospective study carried out on a total of 20 patients who presented with hemoptysis, all referred from the Chest Department and clinic to the Radiology Department in El-Zahra Hospital for 164 slice MDCT examination; the study was carried out for a period of 1 year from January 2020 to January 2021 after receiving approval from the ethical committee of the institute. Informed consent was obtained from all patients before inclusion in the study. Results The MDCT study showed that bronchogenic carcinoma was found to be the most common cause of hemoptysis in six (30%) patients, pulmonary embolism and bronchiectasis were found in four (20%) patients, in two (10%) patients, metastasis was present due to breast and testicular cancer, and one (5%) patient, lung abscess, pulmonary hypertension, tuberculosis, and alveolar hemorrhage were present. Conclusion MDCT proved to be the imaging modality of choice in the diagnosis of hemoptysis, being superior to chest radiography in demonstrating not only causes of delay but also the extent of lung abnormalities.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"24 1","pages":"511 - 517"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91351331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_123_21
Dina Adam, Madeeha Kamel, Doaa A. Mahmoud
Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.
{"title":"Refractive outcome of combined phacoemulsification and glaucoma surgery in patients of primary \"open-angle glaucoma\"","authors":"Dina Adam, Madeeha Kamel, Doaa A. Mahmoud","doi":"10.4103/sjamf.sjamf_123_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_123_21","url":null,"abstract":"Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"188 1","pages":"544 - 548"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81473930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_36_21
Somaya Ahmad, Nahed Mohamad, Boshra Ali, Rania Mahfouz El Wahed
Background Cerebroplacental ratio (CPR) assessment in late third trimester in gestational hypertension (HTN) can be used to predict adverse perinatal outcome. Aim To evaluate whether CPR assessment in late pregnancy can predict suspected fetal compromise or occurrence of adverse perinatal outcomes in singleton term pregnancy with controlled gestational HTN. Patient and methods This prospective study was conducted in El Zahraa University Hospital on 100 pregnant women who were divided equally into control group and gestational HTN group. LOGIC V5 ultrasound equipment was used to measure umbilical artery pulsatility index and middle cerebral artery pulsatility index and CPR. Results There was a statistically significant decrease of the mean CPR in gestational hypertensive group when compared with the control group (P<0.001) and a highly statistically significant decrease in the mean estimated fetal weight (P<0.001) and Apgar score (P=0.012) in gestational hypertensive group when compared with the control group. Conclusion Study of the pulsatility indices of placental and fetal circulation in women with singleton term pregnancy who developed gestational HTN can provide important information about fetal well-being to be an opportunity to improve fetal outcome.
{"title":"Cerebroplacental ratio assessment for the prediction of adverse perinatal outcomes in gestational hypertensive term pregnancy","authors":"Somaya Ahmad, Nahed Mohamad, Boshra Ali, Rania Mahfouz El Wahed","doi":"10.4103/sjamf.sjamf_36_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_36_21","url":null,"abstract":"Background Cerebroplacental ratio (CPR) assessment in late third trimester in gestational hypertension (HTN) can be used to predict adverse perinatal outcome. Aim To evaluate whether CPR assessment in late pregnancy can predict suspected fetal compromise or occurrence of adverse perinatal outcomes in singleton term pregnancy with controlled gestational HTN. Patient and methods This prospective study was conducted in El Zahraa University Hospital on 100 pregnant women who were divided equally into control group and gestational HTN group. LOGIC V5 ultrasound equipment was used to measure umbilical artery pulsatility index and middle cerebral artery pulsatility index and CPR. Results There was a statistically significant decrease of the mean CPR in gestational hypertensive group when compared with the control group (P<0.001) and a highly statistically significant decrease in the mean estimated fetal weight (P<0.001) and Apgar score (P=0.012) in gestational hypertensive group when compared with the control group. Conclusion Study of the pulsatility indices of placental and fetal circulation in women with singleton term pregnancy who developed gestational HTN can provide important information about fetal well-being to be an opportunity to improve fetal outcome.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"16 1","pages":"639 - 644"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89502673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_98_21
Abd El Kalmoush
Background Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone disease. Laparoscopic cholecystectomy is done worldwide by general surgeons, but difficult cases remain challenging even to experts in laparoscopic surgery. Redo-cholecystectomy is done owing to either interval cholecystectomy after first surgery or stone in cystic duct stump or remnant gall bladder. The most important investigation done for the patients is magnetic resonance cholangiogram. Redo-surgery is applicable to be done laparoscopic. Patients and methods A retrospective study was conducted on 11 patients whom underwent to cholecystectomy either open or laparoscopic, where one case could undergo cholecystostomy by Foley’s catheter and second one could not reach the gall bladder, and nine cases could undergo laparoscopic (four cases postpone from the start and five cases have remnant of gall bladder or retained stone in it). Clinical examination, laboratory, and radiological evaluation was done. All cases of redo-surgery were by laparoscopy. Results One case needed to convert to open surgery. Time of surgery ranged from 1 to 3 h. There is no bile leakage or common bile duct injury. There were two cases of intraoperative bleeding and one case with postoperative bleeding. Postoperative stay in hospital was 1–2 days, except a case that was converted to open, which had 3 days of hospital stay. Conclusion Redo-laparoscopic cholecystectomy is applicable and safe but needs experience in laparoscopic skills.
{"title":"Redo-laparoscopic cholecystectomy: is it applicable","authors":"Abd El Kalmoush","doi":"10.4103/sjamf.sjamf_98_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_98_21","url":null,"abstract":"Background Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone disease. Laparoscopic cholecystectomy is done worldwide by general surgeons, but difficult cases remain challenging even to experts in laparoscopic surgery. Redo-cholecystectomy is done owing to either interval cholecystectomy after first surgery or stone in cystic duct stump or remnant gall bladder. The most important investigation done for the patients is magnetic resonance cholangiogram. Redo-surgery is applicable to be done laparoscopic. Patients and methods A retrospective study was conducted on 11 patients whom underwent to cholecystectomy either open or laparoscopic, where one case could undergo cholecystostomy by Foley’s catheter and second one could not reach the gall bladder, and nine cases could undergo laparoscopic (four cases postpone from the start and five cases have remnant of gall bladder or retained stone in it). Clinical examination, laboratory, and radiological evaluation was done. All cases of redo-surgery were by laparoscopy. Results One case needed to convert to open surgery. Time of surgery ranged from 1 to 3 h. There is no bile leakage or common bile duct injury. There were two cases of intraoperative bleeding and one case with postoperative bleeding. Postoperative stay in hospital was 1–2 days, except a case that was converted to open, which had 3 days of hospital stay. Conclusion Redo-laparoscopic cholecystectomy is applicable and safe but needs experience in laparoscopic skills.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"20 1","pages":"624 - 627"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88327114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_136_21
Esraa Abdel Wahab, Bassem Abdel Hady, Ghadami Ahmad, T. Nagib
Background Coronary artery disease (CAD) constitutes one of the leading causes of death in women. Awareness of CAD as the primary cause of mortality in women has been slowly increasing. Coronary angiography (CA) is a useful tool for diagnosis and treatment of CAD. Sex differences play an important role in the pathophysiology of CAD that may contribute to different outcome. Aim To assess the pattern of CAD in women in Upper Egypt undergoing CA. Patients and methods A total of 100 women living in Upper Egypt who experienced chest pain and were indicated for coronary angiography were enrolled in the study. They were classified into two groups according to their age: group 1, with age less than 55 years old (45 patients) and group 2, with age more than 55 years old (55 patients). Interpretation of coronary angiography included detailed assessment of the presence, distribution, and severity of coronary lesions. Severe CAD was considered in patients with left main (LM) disease, patients with multivessel disease, and patients with bifurcation lesions. Result The study revealed normal coronary angiography in 20%, nonsignificant lesions in 13%, and obstructive CAD in 67% of our study population. There was significantly higher incidence of normal coronaries among patients in group 1 compared with patients in group 2 (P=0.012) and significantly higher obstructive lesions and severe CAD in patients in group 2 compared with patients in group 1 (P=0.002 and 0.011, respectively). Multivariate regression analysis for the presence of severe CAD revealed that diabetes mellitus and positive family history of premature CAD were highly significant independent predictors (P<0.001), whereas both age more than or equal to 55 years and dyslipidemia were significant independent predictors (P=0.003 and 0.002, respectively). Conclusion The incidence of CAD is high among women undergoing coronary angiography in Upper Egypt. Normal vessels, single-vessel disease, and simple lesions tend to be more in younger women, whereas severe and complicated lesions are more in elderly women.
{"title":"Pattern of coronary artery diseases in relation to various risk factors in Egyptian women in Upper Egypt","authors":"Esraa Abdel Wahab, Bassem Abdel Hady, Ghadami Ahmad, T. Nagib","doi":"10.4103/sjamf.sjamf_136_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_136_21","url":null,"abstract":"Background Coronary artery disease (CAD) constitutes one of the leading causes of death in women. Awareness of CAD as the primary cause of mortality in women has been slowly increasing. Coronary angiography (CA) is a useful tool for diagnosis and treatment of CAD. Sex differences play an important role in the pathophysiology of CAD that may contribute to different outcome. Aim To assess the pattern of CAD in women in Upper Egypt undergoing CA. Patients and methods A total of 100 women living in Upper Egypt who experienced chest pain and were indicated for coronary angiography were enrolled in the study. They were classified into two groups according to their age: group 1, with age less than 55 years old (45 patients) and group 2, with age more than 55 years old (55 patients). Interpretation of coronary angiography included detailed assessment of the presence, distribution, and severity of coronary lesions. Severe CAD was considered in patients with left main (LM) disease, patients with multivessel disease, and patients with bifurcation lesions. Result The study revealed normal coronary angiography in 20%, nonsignificant lesions in 13%, and obstructive CAD in 67% of our study population. There was significantly higher incidence of normal coronaries among patients in group 1 compared with patients in group 2 (P=0.012) and significantly higher obstructive lesions and severe CAD in patients in group 2 compared with patients in group 1 (P=0.002 and 0.011, respectively). Multivariate regression analysis for the presence of severe CAD revealed that diabetes mellitus and positive family history of premature CAD were highly significant independent predictors (P<0.001), whereas both age more than or equal to 55 years and dyslipidemia were significant independent predictors (P=0.003 and 0.002, respectively). Conclusion The incidence of CAD is high among women undergoing coronary angiography in Upper Egypt. Normal vessels, single-vessel disease, and simple lesions tend to be more in younger women, whereas severe and complicated lesions are more in elderly women.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"88 1","pages":"705 - 710"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80805943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_10_21
Ahmed Aburashed, Mahmoud Elshamy, Ismail Elsokkary
Background Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass graft (CABG) evaluation owing to high temporal and spatial resolution, besides it being noninvasive and highly effective in assessment of extracoronary manifestations. Objective To evaluate the feasibility of high-quality MDCT in assessment of patients with CABG in comparison with conventional coronary angiography. Patients and methods A total of 50 patients were enrolled for ECG-gated CT of CABGs between May 2020 and September 2020. Patients were subjected to conventional coronary angiography within 10 days after MDCT examination at Al Hussein University Hospital. Administration of beta-blocker and nitroglycerin was done before CT examination. Breath-hold training was mandatory. Results A total of 46 grafts were arterial and 74 were venous. Overall, 36 (78.2%) of the arterial grafts were patent, six (13%) were significantly narrowed, and four (8.8%) were completely occluded. Regarding venous grafts, 52 (70.2%) of them were patent, 14 (19%) were significantly narrowed, and eight (10.8%) were completely occluded. CT angiography compared with the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98%, and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion MDCT is considered the imaging modality of choice nowadays to evaluate the patency and stenosis of CABGs than the conventional coronary angiography owing to its multiple drawbacks.
{"title":"Assessment of coronary artery bypass grafts by multidetector computed tomography","authors":"Ahmed Aburashed, Mahmoud Elshamy, Ismail Elsokkary","doi":"10.4103/sjamf.sjamf_10_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_10_21","url":null,"abstract":"Background Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass graft (CABG) evaluation owing to high temporal and spatial resolution, besides it being noninvasive and highly effective in assessment of extracoronary manifestations. Objective To evaluate the feasibility of high-quality MDCT in assessment of patients with CABG in comparison with conventional coronary angiography. Patients and methods A total of 50 patients were enrolled for ECG-gated CT of CABGs between May 2020 and September 2020. Patients were subjected to conventional coronary angiography within 10 days after MDCT examination at Al Hussein University Hospital. Administration of beta-blocker and nitroglycerin was done before CT examination. Breath-hold training was mandatory. Results A total of 46 grafts were arterial and 74 were venous. Overall, 36 (78.2%) of the arterial grafts were patent, six (13%) were significantly narrowed, and four (8.8%) were completely occluded. Regarding venous grafts, 52 (70.2%) of them were patent, 14 (19%) were significantly narrowed, and eight (10.8%) were completely occluded. CT angiography compared with the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98%, and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion MDCT is considered the imaging modality of choice nowadays to evaluate the patency and stenosis of CABGs than the conventional coronary angiography owing to its multiple drawbacks.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"16 1","pages":"628 - 632"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77645361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_107_21
Lamia Altholaya, H. Kandeel, Doaa Mohammed, A. Abdul-Mohymen
Background Obesity is characterized by chronic low-grade inflammatory responses, which may explain the development of obesity-related pathologies, such as insulin resistance and metabolic syndrome (MetS). It is also associated with abnormal levels of cytokines, and osteopontin may be one of them. Aim To assess serum osteopontin level in obese adults with and without MetS and to study its relation to insulin resistance. Patients and methods This comparative study was conducted on 50 obese adults recruited from Endocrinology and Metabolism Department of Al-Zahraa University Hospital. They were divided into two groups according to the presence of MetS. Group 1 included 25 patients without MetS, and group 2 included 25 patients with MetS. Detailed history, clinical examination, and anthropometric measurements were assessed for all selected patients. Fasting plasma glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, fasting insulin, and osteopontin were measured, and then insulin resistance index (IR) was measured as follows: [INLINE:1] Results TC, TGs, LDL-C, fasting plasma glucose and insulin, HBA1c, and osteopontin were statistically significantly higher in group 2 as compared with group 1. A significant positive correlation was found between osteopontin on one hand and systolic blood pressure, diastolic blood pressure, fasting blood sugar, LDL-C, TC, TG, HbA1c, fasting plasma insulin, and homeostatic model assessment of insulin resistance on the other. No correlation was found between osteopontin and high-density lipoprotein cholesterol. Conclusion Elevated serum osteopontin level is associated with MetS and its different components and thus it may serve as a diagnostic biomarker for MetS.
{"title":"Serum osteopontin in relation to insulin resistance in obese adults","authors":"Lamia Altholaya, H. Kandeel, Doaa Mohammed, A. Abdul-Mohymen","doi":"10.4103/sjamf.sjamf_107_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_107_21","url":null,"abstract":"Background Obesity is characterized by chronic low-grade inflammatory responses, which may explain the development of obesity-related pathologies, such as insulin resistance and metabolic syndrome (MetS). It is also associated with abnormal levels of cytokines, and osteopontin may be one of them. Aim To assess serum osteopontin level in obese adults with and without MetS and to study its relation to insulin resistance. Patients and methods This comparative study was conducted on 50 obese adults recruited from Endocrinology and Metabolism Department of Al-Zahraa University Hospital. They were divided into two groups according to the presence of MetS. Group 1 included 25 patients without MetS, and group 2 included 25 patients with MetS. Detailed history, clinical examination, and anthropometric measurements were assessed for all selected patients. Fasting plasma glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, fasting insulin, and osteopontin were measured, and then insulin resistance index (IR) was measured as follows: [INLINE:1] Results TC, TGs, LDL-C, fasting plasma glucose and insulin, HBA1c, and osteopontin were statistically significantly higher in group 2 as compared with group 1. A significant positive correlation was found between osteopontin on one hand and systolic blood pressure, diastolic blood pressure, fasting blood sugar, LDL-C, TC, TG, HbA1c, fasting plasma insulin, and homeostatic model assessment of insulin resistance on the other. No correlation was found between osteopontin and high-density lipoprotein cholesterol. Conclusion Elevated serum osteopontin level is associated with MetS and its different components and thus it may serve as a diagnostic biomarker for MetS.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"15 1","pages":"573 - 577"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82101301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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