Mahmoud Elsayed Abo Alazm, Hassan Khaled Hamdy, H. Al-Abady
Background : Most head and neck patients have historically been treated with photon-based radiation techniques, such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical bene fi ts of proton therapy over IMRT in the de fi nitive, postoperative and reirradiation settings given the unique physical properties of protons. Aim of the work : To assess toxicity pro fi le of IMRT in comparison to 3D conformal radiotherapy (3DCRT) and to assess predictors for progression free survival and overall survival rates. Patients and methods : This retrospective cohort study included 131 head and neck cancer patients who were recruited from El Hussein University Hospital over 10 years then they were divided into 2 groups according to the type of radiotherapy. Results : Both groups were comparable regarding age, sex, and associated medical disorders except for ischemic heart disease and smoking. Sites of primary tumors were comparable except tongue and nasopharynx. Most of 3DCRT group received TPF as induction chemotherapy and most of IMRT group received concurrent chemotherapy. Dose of irradiation was higher signi fi cantly among IMRT group. Grades of early and late toxicity were higher among 3DCRT group. There was no statistically signi fi cant difference between both groups regarding response to treatment. Mortality cases were higher signi fi cantly among 3DCRT group. Cox regression analysis was performed to assess predictors for progression free survival and overall survival in each group. Conclusion : IMRT provide good choice as radiotherapy technique for head and neck cancers with adequate ef fi cacy similar to other techniques and better toxicity pro fi le.
{"title":"Toxicity Profile of Intensity Modulated Radiotherapy Vs. 3D-Conformal Radiotherapy in Head and neck cancer: A Retrospective study","authors":"Mahmoud Elsayed Abo Alazm, Hassan Khaled Hamdy, H. Al-Abady","doi":"10.58675/2682-339x.1687","DOIUrl":"https://doi.org/10.58675/2682-339x.1687","url":null,"abstract":"Background : Most head and neck patients have historically been treated with photon-based radiation techniques, such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical bene fi ts of proton therapy over IMRT in the de fi nitive, postoperative and reirradiation settings given the unique physical properties of protons. Aim of the work : To assess toxicity pro fi le of IMRT in comparison to 3D conformal radiotherapy (3DCRT) and to assess predictors for progression free survival and overall survival rates. Patients and methods : This retrospective cohort study included 131 head and neck cancer patients who were recruited from El Hussein University Hospital over 10 years then they were divided into 2 groups according to the type of radiotherapy. Results : Both groups were comparable regarding age, sex, and associated medical disorders except for ischemic heart disease and smoking. Sites of primary tumors were comparable except tongue and nasopharynx. Most of 3DCRT group received TPF as induction chemotherapy and most of IMRT group received concurrent chemotherapy. Dose of irradiation was higher signi fi cantly among IMRT group. Grades of early and late toxicity were higher among 3DCRT group. There was no statistically signi fi cant difference between both groups regarding response to treatment. Mortality cases were higher signi fi cantly among 3DCRT group. Cox regression analysis was performed to assess predictors for progression free survival and overall survival in each group. Conclusion : IMRT provide good choice as radiotherapy technique for head and neck cancers with adequate ef fi cacy similar to other techniques and better toxicity pro fi le.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124587867","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}
Ahmed Ragab, Kotb Eladawy, Abdallah Moh, Ahmed Elshaikh, M. Ahmed, Mohamed Elgarhy, S. Elkhateeb, A. Eladawy, Ragab Kotb, Abdallah Elshaikh, M. Ahmed, Elgarhy, Ahmed Mohamed, M. SaadEldeen, Abdallah Elkhateeb, M. Ahmed, Elshaikh Ahmed, Mahmoud Mohamed, Ahmed K. Elgarhy, Eladawy
Background : Local anesthesia relies on patients ' comfort, safety, and low complication rates. Nature of proposed surgery, surgeon ' s preference, and patients ' wishes all in fl uence anesthetic need for ophthalmic surgery. Objectives : The aim of this work was to compare lidocaine 2% with levobupivacaine 0.5% versus mixture of lidocaine 2% and bupivacaine 0.5% as low-volume local anesthetic for the eye in posterior segment surgery as double-injection peribulbar anesthesia (supratemporal and infratemporal). Patients and methods : Patients were divided into two groups, with 50 ( n ¼ 50) patients each, who were randomized using sealed envelopes: group A received lidocaine 2% with bupivacaine 0.5% double-injection peribulbar anesthesia, and group B received lidocaine 2% with levobupivacaine 0.5% in double-injection peribulbar anesthesia. Results : In group A, block failure was reported in two (4%) patients. In group B, no cases of block failure were reported. Supplementary block was required in two (4%) patients in group A and in one (two) patient in group B. No statistically signi fi cant difference was found between the two groups regarding block failure or need for supplementary block. Conclusion : Group B had quicker onset, longer duration of action, lower pain scores, and less need for postoperative analgesia. No statistically signi fi cant difference was observed between the two groups regarding intraoperative or postoperative problems.
{"title":"Comparative Study between Lidocaine with levoBupivacaine Versus Lidocaine Bupivacaine mixture for posterior segment surger","authors":"Ahmed Ragab, Kotb Eladawy, Abdallah Moh, Ahmed Elshaikh, M. Ahmed, Mohamed Elgarhy, S. Elkhateeb, A. Eladawy, Ragab Kotb, Abdallah Elshaikh, M. Ahmed, Elgarhy, Ahmed Mohamed, M. SaadEldeen, Abdallah Elkhateeb, M. Ahmed, Elshaikh Ahmed, Mahmoud Mohamed, Ahmed K. Elgarhy, Eladawy","doi":"10.58675/2682-339x.1640","DOIUrl":"https://doi.org/10.58675/2682-339x.1640","url":null,"abstract":"Background : Local anesthesia relies on patients ' comfort, safety, and low complication rates. Nature of proposed surgery, surgeon ' s preference, and patients ' wishes all in fl uence anesthetic need for ophthalmic surgery. Objectives : The aim of this work was to compare lidocaine 2% with levobupivacaine 0.5% versus mixture of lidocaine 2% and bupivacaine 0.5% as low-volume local anesthetic for the eye in posterior segment surgery as double-injection peribulbar anesthesia (supratemporal and infratemporal). Patients and methods : Patients were divided into two groups, with 50 ( n ¼ 50) patients each, who were randomized using sealed envelopes: group A received lidocaine 2% with bupivacaine 0.5% double-injection peribulbar anesthesia, and group B received lidocaine 2% with levobupivacaine 0.5% in double-injection peribulbar anesthesia. Results : In group A, block failure was reported in two (4%) patients. In group B, no cases of block failure were reported. Supplementary block was required in two (4%) patients in group A and in one (two) patient in group B. No statistically signi fi cant difference was found between the two groups regarding block failure or need for supplementary block. Conclusion : Group B had quicker onset, longer duration of action, lower pain scores, and less need for postoperative analgesia. No statistically signi fi cant difference was observed between the two groups regarding intraoperative or postoperative problems.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128245489","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}
Mohamed Ahmed Abdelaziz, E. M. Ebrahim, Mohsen Salah El-Din Zikry
Background : The most common molecular subtype of breast cancer worldwide is luminal breast cancer. It has shown a good prognostic pro fi le compared to other types. Despite the immense development of adjuvant treatment in the past years, around 20% of patients with early-stage disease relapse. Aim of the study : To evaluate the relapse pattern in luminal breast cancer and the correlation between luminal types and (AJCC 8th edition). Subject and methods : A total of 230 luminal breast cancer patients treated at Al-Hussein University Hospital between 2013 and 2018 were analyzed. Patients have been divided into the following groups: luminal A (31%) and B (32.6%), luminal B HER2 þ ve (18.6%), and luminal UC (17.3%). Results : The median follow-up was 66.7 months, and the relapse rate of luminal breast cancer was 27.8%. Although statistically not signi fi cant, luminal A had the lowest relapse rate (19.4%), while luminal B (36%), HER2 positive luminal B (23.2%), and luminal UC (32.5%) ( P ¼ 0.117). The predominant organ relapse was bone (29.6%) mainly observed in luminal A and B, 35.7% and 32.3% of patients respectively ( P ¼ 0.048). Luminal Correlation with the AJCC staging system was signi fi cant, luminal A was most often observed in early stages with 81.9% presented in Stages I to II ( P ¼ 0.008). Conclusion : Luminal breast cancer has a wide discrepancy in relapse rate and pattern. Luminal A seems to have the best prognosis for DFS. Ki-67% and HER2 testing would give a prognostic factor in luminal subcategorization and could be bene fi cial in the intensi fi cation of adjuvant therapy.
{"title":"Evaluation of Pattern of Relapse in Luminal Breast Cancer","authors":"Mohamed Ahmed Abdelaziz, E. M. Ebrahim, Mohsen Salah El-Din Zikry","doi":"10.58675/2682-339x.1686","DOIUrl":"https://doi.org/10.58675/2682-339x.1686","url":null,"abstract":"Background : The most common molecular subtype of breast cancer worldwide is luminal breast cancer. It has shown a good prognostic pro fi le compared to other types. Despite the immense development of adjuvant treatment in the past years, around 20% of patients with early-stage disease relapse. Aim of the study : To evaluate the relapse pattern in luminal breast cancer and the correlation between luminal types and (AJCC 8th edition). Subject and methods : A total of 230 luminal breast cancer patients treated at Al-Hussein University Hospital between 2013 and 2018 were analyzed. Patients have been divided into the following groups: luminal A (31%) and B (32.6%), luminal B HER2 þ ve (18.6%), and luminal UC (17.3%). Results : The median follow-up was 66.7 months, and the relapse rate of luminal breast cancer was 27.8%. Although statistically not signi fi cant, luminal A had the lowest relapse rate (19.4%), while luminal B (36%), HER2 positive luminal B (23.2%), and luminal UC (32.5%) ( P ¼ 0.117). The predominant organ relapse was bone (29.6%) mainly observed in luminal A and B, 35.7% and 32.3% of patients respectively ( P ¼ 0.048). Luminal Correlation with the AJCC staging system was signi fi cant, luminal A was most often observed in early stages with 81.9% presented in Stages I to II ( P ¼ 0.008). Conclusion : Luminal breast cancer has a wide discrepancy in relapse rate and pattern. Luminal A seems to have the best prognosis for DFS. Ki-67% and HER2 testing would give a prognostic factor in luminal subcategorization and could be bene fi cial in the intensi fi cation of adjuvant therapy.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129670940","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}
A. Ali, Islam Shawky Abd El-Aziz Saif El-Yazal, Ahmed Mahmoud Mansy
{"title":"Role of Nicorandil effect on Contrast Induced Nephropathy in patients land for elective PCI","authors":"A. Ali, Islam Shawky Abd El-Aziz Saif El-Yazal, Ahmed Mahmoud Mansy","doi":"10.58675/2682-339x.1724","DOIUrl":"https://doi.org/10.58675/2682-339x.1724","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129042799","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}
Ahmed Abd-Elfattah Mahmoud Abou-Rashed, Mohamed Hasan Tawfik, Hazem Sayed Ahmed Ayoub, Abdelrahman Ahmed Mohamed Elazhari
Background : A signi fi cant percentage of the Egyptian population is affected by end-stage kidney disease, which requires long-term hemodialysis. For patients receiving regular hemodialysis, the arteriovenous fi stula is now the method most frequently employed to provide vascular access. Objective : The current study ' s objective was to assess the role and utility of CDUS in assessing vascular access and identifying shunt complications for hemodialysis. Patients and methods : This prospective, randomized controlled trial investigation has been carried out at the Health Insurance Hospital Nasr City ' s radio-diagnosis department. We included a sample size of thirty patients who needed an arteriovenous fi stulain the upperlimb for hemodialysis. Patients rangedin age from8 to70 andwere bothmale andfemale. Results : The majority of patients had normal vessel diameters. 6 patients (20%) have a BB fi stula, 8 patients (26.7%) have an RC fi stula, and 15 patients (50%) have a BC fi stula. The study showed a mean age of AVF maturation occurs 2.17 ± 0.379 weeks after its 1st creation. Three patients had an uncomplicated 10% and 27 patients had shunt complications of 90%. The investigation revealed a signi fi cant percentage of venous thrombosis (12 patients, 40%), stenosis (9 patients, 30%), aneurysmal dilatation (6 patients, 20%), pseudoaneurysmal formation (3 patients, 10%), and fi nally steal syndrome (3.3%, 1 patient). Conclusion : Early identi fi cation and repair of a failing hemodialysis fi stula can improve the quality of hemodialysis treatment. For patients having AV dysfunction, the CDUS results from this series were useful in determining further treatment care.
{"title":"Role of Color Doppler Ultrasonography in evaluation of hemodialysis AV fistula","authors":"Ahmed Abd-Elfattah Mahmoud Abou-Rashed, Mohamed Hasan Tawfik, Hazem Sayed Ahmed Ayoub, Abdelrahman Ahmed Mohamed Elazhari","doi":"10.58675/2682-339x.1707","DOIUrl":"https://doi.org/10.58675/2682-339x.1707","url":null,"abstract":"Background : A signi fi cant percentage of the Egyptian population is affected by end-stage kidney disease, which requires long-term hemodialysis. For patients receiving regular hemodialysis, the arteriovenous fi stula is now the method most frequently employed to provide vascular access. Objective : The current study ' s objective was to assess the role and utility of CDUS in assessing vascular access and identifying shunt complications for hemodialysis. Patients and methods : This prospective, randomized controlled trial investigation has been carried out at the Health Insurance Hospital Nasr City ' s radio-diagnosis department. We included a sample size of thirty patients who needed an arteriovenous fi stulain the upperlimb for hemodialysis. Patients rangedin age from8 to70 andwere bothmale andfemale. Results : The majority of patients had normal vessel diameters. 6 patients (20%) have a BB fi stula, 8 patients (26.7%) have an RC fi stula, and 15 patients (50%) have a BC fi stula. The study showed a mean age of AVF maturation occurs 2.17 ± 0.379 weeks after its 1st creation. Three patients had an uncomplicated 10% and 27 patients had shunt complications of 90%. The investigation revealed a signi fi cant percentage of venous thrombosis (12 patients, 40%), stenosis (9 patients, 30%), aneurysmal dilatation (6 patients, 20%), pseudoaneurysmal formation (3 patients, 10%), and fi nally steal syndrome (3.3%, 1 patient). Conclusion : Early identi fi cation and repair of a failing hemodialysis fi stula can improve the quality of hemodialysis treatment. For patients having AV dysfunction, the CDUS results from this series were useful in determining further treatment care.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126337233","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}
Background : Expanded-endoscopic endonasal approaches (eEEA) to surgical targets around the internal carotid artery (ICA) remain inspiring and necessitate a special learning curve. Materials and methods : Six formalin-fi xed heads were dissected to study the 360 (cid:1) accessibility and maneuverability around ICAs from the distal dural ring to the foramen lacerum on each side ( n ¼ 12) via eEEA. The ICA course was divided into three segments: ICA in cavernous sinus, paraclival-ICA, and lacerum-ICA. Following total exposure of each ICA, the three-dimensional (3D ¼ medial/lateral, super fi cial/deep, and above/below) anatomical targets ( n ¼ 35) around each ICA were evaluated. The data were collected and analyzed. Results : Distinctively, we included 35 anatomical targets (pertinent to ICA in cavernous sinus, paraclival-ICA, and lacerum-ICA were 16, 10, and 9, respectively) in 360 (cid:1) around every ICA ( n ¼ 12) from the distal dural ring to foramen lacerum. Although reasonable visual validation was possible for all targets, microdissections were safely achievable for 19 (54.3%) targets through full or limited surgical freedom in 73.7 and 26.3%, respectively. In the remaining 45.7%, the accessibility to targets was abandoned due to hazardous manipulation. The most unreachable targets were around the lacerum-ICA (55.6%) with extremely restricted maneuverability (75%). However, favorable accessibility (60%) and full surgical freedom (100%) were around the paraclival-ICA. Conclusion : This study delivers a distinctive view to appreciate the degree of complexity and invasiveness in relation to the degree of surgical freedom around ICA via eEEA.
{"title":"Endoscopic Endonasal Accessibility and Maneuverability Around the Internal Carotid Artery from Distal Dural Ring to Foramen Lacerum: Cadaveric Study","authors":"Alhusain Nagm","doi":"10.58675/2682-339x.1681","DOIUrl":"https://doi.org/10.58675/2682-339x.1681","url":null,"abstract":"Background : Expanded-endoscopic endonasal approaches (eEEA) to surgical targets around the internal carotid artery (ICA) remain inspiring and necessitate a special learning curve. Materials and methods : Six formalin-fi xed heads were dissected to study the 360 (cid:1) accessibility and maneuverability around ICAs from the distal dural ring to the foramen lacerum on each side ( n ¼ 12) via eEEA. The ICA course was divided into three segments: ICA in cavernous sinus, paraclival-ICA, and lacerum-ICA. Following total exposure of each ICA, the three-dimensional (3D ¼ medial/lateral, super fi cial/deep, and above/below) anatomical targets ( n ¼ 35) around each ICA were evaluated. The data were collected and analyzed. Results : Distinctively, we included 35 anatomical targets (pertinent to ICA in cavernous sinus, paraclival-ICA, and lacerum-ICA were 16, 10, and 9, respectively) in 360 (cid:1) around every ICA ( n ¼ 12) from the distal dural ring to foramen lacerum. Although reasonable visual validation was possible for all targets, microdissections were safely achievable for 19 (54.3%) targets through full or limited surgical freedom in 73.7 and 26.3%, respectively. In the remaining 45.7%, the accessibility to targets was abandoned due to hazardous manipulation. The most unreachable targets were around the lacerum-ICA (55.6%) with extremely restricted maneuverability (75%). However, favorable accessibility (60%) and full surgical freedom (100%) were around the paraclival-ICA. Conclusion : This study delivers a distinctive view to appreciate the degree of complexity and invasiveness in relation to the degree of surgical freedom around ICA via eEEA.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114234278","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}
Mahmoud Mustafa Abdlmonem Mustafa, Mohamed Salah EL-din Abd EL-baky Mustafa, Ahmed Abd-Elfattah Mahmoud Abou-Rashed
{"title":"Evaluation of Early Gastric Cancer at Multidetector CT with Multiplanar Reformation and Virtual Endoscopy","authors":"Mahmoud Mustafa Abdlmonem Mustafa, Mohamed Salah EL-din Abd EL-baky Mustafa, Ahmed Abd-Elfattah Mahmoud Abou-Rashed","doi":"10.58675/2682-339x.1628","DOIUrl":"https://doi.org/10.58675/2682-339x.1628","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123836649","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}
Mohammed Refaat Mohammed Hammouda, Shehab M. El Khadrawy, Mohamed Hasan Mansour, Alaa Rashad Ibrahim Hassan, Alazzazi Rabei
Background : Epilepsy is a brain disorder characterized by recurrent attacks of seizures. A seizure is a sudden change of behavior due to a transient alteration in the electrical pattern of the brain. Since despite appropriate drug treatment, one-third of patients continue to have seizures, other treatment must be considered. Aim : This study aims at emphasizing the importance of epilepsy surgery in pediatrics by assessing surgical outcome as regard seizure freedom and surgical morbidity & mortality at Al-Azhar university hospitals. Patients and methods : Prospective study on 27 pediatric patients diagnosed as drug-resistant epilepsy, with 6 months to 1 year follow-up at least. Group A, 14 cases operated by corpus callosotomy, Group B, 10 cases underwent lesionectomy, and Group C, 3 cases underwent MST. Result : 15 cases become seizure free, and 6 cases have rare disabling seizure. Lesionectomy was better than corpus callosotomy in achieving seizure freedom, In Group A, 4 cases become seizure free in comparison to 9 cases in group B. 11 cases of patients in group A (78.6%) showed increase alertness in comparison to the clinical mentality before surgery. The complications that have occurred were transient and resolved shortly. Conclusion : Epilepsy surgery in childhood is effective & safe and needs must be considered once failed medical treatment to prevent cognitive delay. Even when complete seizure freedom is not achieved, a great decrease in frequency of seizures and number of AEDs is a remarkable result.
{"title":"Outcome of epilepsy surgery in pediatrics","authors":"Mohammed Refaat Mohammed Hammouda, Shehab M. El Khadrawy, Mohamed Hasan Mansour, Alaa Rashad Ibrahim Hassan, Alazzazi Rabei","doi":"10.58675/2682-339x.1835","DOIUrl":"https://doi.org/10.58675/2682-339x.1835","url":null,"abstract":"Background : Epilepsy is a brain disorder characterized by recurrent attacks of seizures. A seizure is a sudden change of behavior due to a transient alteration in the electrical pattern of the brain. Since despite appropriate drug treatment, one-third of patients continue to have seizures, other treatment must be considered. Aim : This study aims at emphasizing the importance of epilepsy surgery in pediatrics by assessing surgical outcome as regard seizure freedom and surgical morbidity & mortality at Al-Azhar university hospitals. Patients and methods : Prospective study on 27 pediatric patients diagnosed as drug-resistant epilepsy, with 6 months to 1 year follow-up at least. Group A, 14 cases operated by corpus callosotomy, Group B, 10 cases underwent lesionectomy, and Group C, 3 cases underwent MST. Result : 15 cases become seizure free, and 6 cases have rare disabling seizure. Lesionectomy was better than corpus callosotomy in achieving seizure freedom, In Group A, 4 cases become seizure free in comparison to 9 cases in group B. 11 cases of patients in group A (78.6%) showed increase alertness in comparison to the clinical mentality before surgery. The complications that have occurred were transient and resolved shortly. Conclusion : Epilepsy surgery in childhood is effective & safe and needs must be considered once failed medical treatment to prevent cognitive delay. Even when complete seizure freedom is not achieved, a great decrease in frequency of seizures and number of AEDs is a remarkable result.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114298214","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}
Alaa Mahfouz Mahmoud Abd Elaziz, Ahmed Yousry Elagmawi, Sherif Mohamed Azzam
{"title":"Treatment Outcome in Non-Metastatic Gastric Cancer “A Retrospective Study “","authors":"Alaa Mahfouz Mahmoud Abd Elaziz, Ahmed Yousry Elagmawi, Sherif Mohamed Azzam","doi":"10.58675/2682-339x.1705","DOIUrl":"https://doi.org/10.58675/2682-339x.1705","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"57 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113973741","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}
Background : The rise in elective cesarean section (CSs), which make about one-third of all CS cases, is primarily to blame for the rise in the cesarean birth rate. Objective : To assess the strength of the association between transvaginal ultrasonographic measurement of the lower uterine segment (LUS) in women with prior one CS undergoing a trial of vaginal birth and uterine scar defect at delivery. Patients and methods : A retrospective observational study was conducted at Al-Ahrar Zagazig Teaching Hospital during the period from June 2018 through June 2020. The LUS thickness was measured through transvaginal ultrasonography in 60 gravidas (36 e 40 weeks) with previous one CS undergoing vaginal birth after cesarean, and the scar was evaluated during delivery. Results : Uterine dehiscence was found in four (6.7%) cases. There were no cases of uterine rupture. There was a signi fi cant correlation between the grade of scar and sonographic measurement of LUS thickness using transvaginal ultrasound ( P ¼ 0.001). The scar thickness in the third trimester (36 e 40 weeks) had a signi fi cant relation with the mode of delivery. LUS thickness of 2.4 mm was considered the critical cutoff value, above which safe vaginal delivery could be achieved. This critical cutoff value was derived from the receiver-operator characteristic curve with sensitivity, speci-fi city, positive predictive value, and negative predictive value of 75.0, 85.7, 27.3, and 98.0%, respectively. Conclusion : Measurement of the LUS thickness by transvaginal ultrasonographic seems to be a good screening test with its obviously high sensitivity and negative predictive values. LUS thickness of less than 2.4 mm is associated with a higher risk of uterine defect.
{"title":"Transvaginal Ultrasonographic Assessment of Lower Uterine Segment Thickness and Prediction of Uterine Rupture In Cases of Vaginal Birth After Caesarean Delivery","authors":"Mohamed Samir Ibrahim, Yehia A. Wafa, F. El-Omda","doi":"10.58675/2682-339x.1616","DOIUrl":"https://doi.org/10.58675/2682-339x.1616","url":null,"abstract":"Background : The rise in elective cesarean section (CSs), which make about one-third of all CS cases, is primarily to blame for the rise in the cesarean birth rate. Objective : To assess the strength of the association between transvaginal ultrasonographic measurement of the lower uterine segment (LUS) in women with prior one CS undergoing a trial of vaginal birth and uterine scar defect at delivery. Patients and methods : A retrospective observational study was conducted at Al-Ahrar Zagazig Teaching Hospital during the period from June 2018 through June 2020. The LUS thickness was measured through transvaginal ultrasonography in 60 gravidas (36 e 40 weeks) with previous one CS undergoing vaginal birth after cesarean, and the scar was evaluated during delivery. Results : Uterine dehiscence was found in four (6.7%) cases. There were no cases of uterine rupture. There was a signi fi cant correlation between the grade of scar and sonographic measurement of LUS thickness using transvaginal ultrasound ( P ¼ 0.001). The scar thickness in the third trimester (36 e 40 weeks) had a signi fi cant relation with the mode of delivery. LUS thickness of 2.4 mm was considered the critical cutoff value, above which safe vaginal delivery could be achieved. This critical cutoff value was derived from the receiver-operator characteristic curve with sensitivity, speci-fi city, positive predictive value, and negative predictive value of 75.0, 85.7, 27.3, and 98.0%, respectively. Conclusion : Measurement of the LUS thickness by transvaginal ultrasonographic seems to be a good screening test with its obviously high sensitivity and negative predictive values. LUS thickness of less than 2.4 mm is associated with a higher risk of uterine defect.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131286246","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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