Comparative Study between Fascial Defects Closure and Non-closure in Laparoscopic Incisional and Ventral Hernia Repair
Ayman
Elwan
Al-Azhar University, Faculty of Medicine (Damietta), Surgery Department
author
Mohammed
Eid
Department of Surgery, Faculty of Medicine, Al-Azhar University (Damietta)
author
text
article
2019
eng
Background: Incisional hernias are common after abdominal surgery. Laparoscopic repair has advantages over open repair. Traditionally, laparoscopic ventral repair of hernia has been done as a bridged repair to accomplish circumferential overlap of the fascial defect. More recently, there has been a growing trend to do primary fascial closure to reapproximate the fascia before mesh insertion.Aim of the work: to present our experience with laparoscopic ventral and incisional repair of hernia to determine outcomes and different results of fascial defects closure and non-closure.Patient and methods: From January 2016 to April 2018, 68 patients suffering from ventral and incisional hernias were treated in New Damietta University Hospital. Laparoscopic repair was decided for all patients. Results: Operative time for group A ranged from 50-120 minutes (average 96.8 min), 30-90 minutes (average 66 min) for group B. Chronic postoperative pain reported in 12.9% in group A and 6.6% in group B. 16.1% from group A had seroma lasting 4 weeks, while it was reported in 36.7% from group B, which remain for 6 weeks. There were 7 patients from group A complaint of post-operative respiratory embarrassment which resolved conservatively except for one patient, who necessitated ICU admission for two days. No one from group B complaint of post-operative respiratory complications. Conclusion: Although there were no major statistical differences between fascial closure and non-closure groups, the seroma and recurrence were less in fascial closure group.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
1
6
https://ijma.journals.ekb.eg/article_34021_45343ae936ba756af2a7c38760035902.pdf
dx.doi.org/10.21608/ijma.2019.12759.1007
The Effect of Metabolic Syndrome on Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
Abo-bakr
Al-Asmar
Chest Disease Department; Faculty of Medicine; Al-Azhar University (Cairo)
author
Kamel
Hassan
Chest Disease Department, Faculty of Medicine, Al-Azhar Faculty of Medicine (Damietta), Egypt
author
Gamal
Mohamed
Clinical Pathology Department, Al-Azhar Faculty of Medicine (Damietta), Egypt.
author
Mohamed
Abd Elattif Elsherbiny
Chest Disease Department; Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2019
eng
Background: Metabolic syndrome is a multiorgan disease and it could aggravate other diseases. Its effect on chronic obstructive pulmonary disease needs to be addressed.Aim of the work: to examine if metabolic syndrome increases the frequency, duration and severity of acute exacerbations of chronic obstructive pulmonary disease.Patients and methods: 60 patients who admitted with COPD exacerbation were included and were divided into two groups: Group 1 (COPD without metabolic syndrome). Group 2 (COPD with metabolic syndrome). All submitted to full history taking, clinical examination, laboratory and radiological examination.Results: COPD severity was GOLD class II in 25.0%, class III in 51.7% and class IV in 23.3%; and disease severity was significantly higher in patients with metabolic syndrome. The frequency of COPD exacerbations showed significant increase in group 2 when compared to group 1 (2.17±0.65 vs 1.43±0.57 respectively). In addition, the duration of hospital stay increased significantly in group 2 when compared to group 1 (4.33±0.80 vs 3.37±0.61).Conclusion: metabolic syndrome could play a role in pathogenesis- or may be a consequence of- COPD. Thus, metabolic syndrome had a harmful effect on the outcome of COPD exacerbations.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
7
13
https://ijma.journals.ekb.eg/article_37818_77b455860505e81da650513ab5b78974.pdf
dx.doi.org/10.21608/ijma.2019.37818
Transthoracic Echocardiography as A friend to Pulmonologist in Respiratory Intensive Care
Atef
Elrifai
Chest disease Department; Al-Azhar Faculty of Medicine (Damietta)
author
Sayed
kinawy
Chest Disease, Faculty of Medicine, Aswan University
author
Naggeh
Mahmoud
Cardiology Department; Faculty of Medicine, Aswan University
author
Muhammad
Reihan
Cardiology Department, Faculty of Medicine; Al-Azhar University
author
text
article
2019
eng
Background: Bedside echochocardiography is a useful tool in critical care setting. Several studies support the performance of echocardiography by non-cardiologist.Aim of the work: To evaluate if bedside transthoracic echocardiography (done by intensivist) is useful to provide diagnosis of cardiovascular pathologies of patients with acute respiratory failure in respiratory intensive care, and to assess the interobserver variability between measurements done by intensivist and expert echocardiographer.Methods: Sixty patients with acute respiratory failure admitted to respiratory critical care unit were evaluated by echocardiography by an intensivist and expert echo cardiographer. Interobserver agreement for both readings was done.Results: results of the present work revealed that, there was strong agreement between the reading of both the intensivist and echocardiographer. In addition, significant abnormalities were present in the examined cases especially diastolic dysfunction.conclusions: The intensivist detected most abnormalities detected by the expert echocardiographer. The bedside echocardiography is a useful instrument in respiratory critical care unit.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
14
21
https://ijma.journals.ekb.eg/article_30631_e311e89f9a14714d400e1aa168ee8353.pdf
dx.doi.org/10.21608/ijma.2019.11059.1000
Awake Fiberoptic versus Awake Videolaryngoscopy in Difficult Intubation
Saud
Erwi
Pulmonologist and Intensivist at Armed Forces Hospital, Jazan, KSA
author
Ibrahim
Mahmoud
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University, New Damietta City, Egypt
author
Neazy
Abdelmottaleb
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University, New Damietta City, Egypt
author
text
article
2019
eng
Background: Difficult intubation is usually encountered in daily work of anesthesia and intensive care. Different inventions and techniques were tried to deal with difficult intubation.Aim of the work: To investigate the difference between awake fiberoptic and awake videolaryngoscopy in difficult intubationMethods: A two-years, randomized comparative study was conducted and included patients with ASA classes I to III, who were scheduled for elective surgical procedures with anticipated difficult intubation. Patient randomly allocated to fiberoptic intubation (FI) and videolaryngoscopy (VL) intubation. The outcome measures were time to tracheal intubation, intubation success, number of attempts and operator evaluation of the procedure.Results: Both groups were comparable as regard to patient demographics, ASA classifications, number of attempts and number of patients who experienced desaturation. The time to intubate was significantly shorter in VL when compared to FI group. The sedation score and ease scores were significantly lower in VL when compared to FI groups.Conclusions: Videolaryngoscopy-guided intubation in difficult cases was associated with better outcome than fiberoptic intubation. However, no failure was reported in both groups
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
22
28
https://ijma.journals.ekb.eg/article_36205_5ec7c9528edae881dd8b8f1703794aeb.pdf
dx.doi.org/10.21608/ijma.2019.36205
Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
Ezzedeen
Fekry
Anesthesia Department; Al-Azhar Faculty of Medicine (Cairo)
author
Mohammed
Sharf
Anesthesia and Intensive care, Al-Azhar faculty of Medicine (Damietta)
author
Yousry
Kandil
Anesthesia Department; Al-Azhar Faculty of Medicine (Damietta)
author
Salama
Harby
Al-Azhar University, Faculty of Medicine
Anesthesia and Intensive Care
author
text
article
2019
eng
Background: in neuroaxial anesthesia, there was many adjuvants used with the purpose of increasing anesthesia duration and reduction of postoperative analgesia.Objective: comparison between dexmedetomidine and fentanyl when added to 0.5% hyperbaric bupivacaine, for lower limb amputation on early stump and phantom pain after spinal anaesthesia.Patients and Methods: Ninety patient arranged for lower limb amputation surgery were randomly allocated into three groups (each 30 patients). Each patient received 2 ml of hyperbaric bupivacaine (0.5%) plus 0.5 ml normal saline in control group (Group B) or 5µ dexmedetomidine diluted in 0.5 ml normal saline in BD group or 25 µ fentanyl diluted in 0.5 ml normal saline in BF group. Anesthesia, analgesia, sedation, hemodynamic changes, adverse effects and post-operative pain up to one month were recorded.Results: The studied groups showed no significant differences regarding demographic characteristics and hemodynamic (heart rate and mean arterial pressure). Patients in group BD had significant increase of sensory and motor block time compared to BF B groups. Post-operatively, there was a significant decrease of pain in BD group in the first 24 hours when compared to control or BF group. The postoperative mean total consumption of analgesics during the first day was significantly decreased in BD when compared to BF and control groups.Conclusions: dexmedetomidine (5μg) represents a good alternative to fentanyl (25μg) as a spinal adjuvant to bupivacaine in surgery for the lower limb.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
29
36
https://ijma.journals.ekb.eg/article_31013_67c239f816d47f0660c76c7f77b69ad0.pdf
dx.doi.org/10.21608/ijma.2019.31013
Evaluation of S100B Serum Level as A biomarker of Disease Activity in Vitiligo Patients
Radwa
Abd El-Halim
Dermatology and Leprosy Hospital, Ministry of Health, Egypt
author
Hasan
Mohamed
Dermatology and Venereology Department, Al-Azhar Faculty of Medicine (Dameitta), Egypt.
author
Ibrahim
Fouda
Dermatology and Venereology Department, Al-Azhar Faculty of Medicine (Dameitta), Egypt.
author
Hesham
Abd El-Samee
Clinical Pathology Department, Al-Azhar Faculty of Medicine (Damietta), Egypt.
author
text
article
2019
eng
ABSTRACT Background: Vitiligo is a depigmenting disorder characterized by the appearance of circumscribed white macules in the skin. The aetiology of vitiligo is not clear, and although various hypotheses have been proposed. It has been suggested that autoimmunity plays an important role in the pathogenesis of vitiligo.Objective: To evaluate the serum levels of S100B as it could be used as biomarker of disease activity in vitiligo patients. Patients and Methods: The current study included 45 patients with vitiligo and 45 healthy controls. Patients were divided into two groups, segmental vitiligo (group I) including 4 patients and generalized vitiligo (group II) including 41 patients. All participants were recruited from the outpatient clinic of Al-Azhar University hospital (Damietta) and Dermatology, Venereology, Leprosy in June 2018. Results: S100B serum levels were high in patients with vitiligo as compared to the control subjects. S100B were significantly higher in non segmental vitiligo. S100B serum levels were higher in active vitiligo patients as compared to inactive vitiligo patients. There was no significant difference between the studied groups regarding age, gender, duration of the disease and Fitzpatrick skin phototype. Conclusion: Vitiligo patients have been associated with high levels of S100B, indicating its possible involvement in its pathogenesis. Levels of S100B may be a potential target for treatment. It is needed to perform further studies with larger sample size including patients and controls and follow up monitoring of activity in needed to evaluate of S100B.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
37
41
https://ijma.journals.ekb.eg/article_33976_70d351c321a70a8ba9c1c39d4c9594e9.pdf
dx.doi.org/10.21608/ijma.2019.12021.1001
Impact of Serum Level of Vitamin D on Term Neonates with Early Onset Sepsis
Yasmine
Soliman
Pediatrics Department, Faculty of Medicine, Mansoura university, Egypt
author
Magdy
Sakr
Pediatrics Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Tarek
Emran
Clinical Pathology Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Mohamed
El Samanoudy
Pediatrics Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2019
eng
AbstractBackground: Neonatal sepsis a major health challenge associated with major morbidity and mortality. Neonatal care improved recently. However, different challenges regarding management still exist. Vitamin D deficiencies was proposed as a predictor of neonatal sepsis. Objective: To highlight the impact of vitamin D levels on early onset sepsis in full term neonates.Methodology: It is a case control which carried out at the neonatal intensive care unit of Al-Azhar university hospital (Damietta), from March to April 2019. It included 50 full-term neonates with probable sepsis and 50 healthy controls of matched age and sex with no signs of sepsis.Results: vitamin D level showed significant negative correlation with sepsis, C-reactive protein (CRP), positive blood cultures; and significant positive correlations with Apgar score, hemoglobin concentration and platelets count. Regression analysis revealed that, higher CRP and lower vitamin D were associated risks of neonatal sepsis in univariate analysis. Multivariable regression analysis revealed that only lower vitamin D level is the predictor for early neonatal sepsis.Conclusion: Vitamin D levels were significantly lower in septic neonates with high sensitivity and specificity. Vitamin D supplementation to mothers during pregnancy could prevent early onset neonatal sepsis.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
42
47
https://ijma.journals.ekb.eg/article_34023_0eef55ba7bc75ba15d37303dd62e7255.pdf
dx.doi.org/10.21608/ijma.2019.12445.1002
Effect of Lactoferrin Supplementation on Iron Deficiency Anemia in Primary School Children
Abeer
El-Khawaga
Pediatric Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Hussein
Abdelmaksoud
Pediatric Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2019
eng
Background: many other studies were done to evaluate the effect of oral lactoferrin administration on iron deficiency anemia.Objective: This study was designed to assess the effects of lactoferrin supplementation on primary school children having iron deficiency anemia. Patients and Methods: Prospective cohort study was conducted on 94 patients with iron deficiency anemia. They were 58 females and 36 males. Their ages range from 6 years to 12 years with mean age of 8.4 years. In the period between October 2018 and January 2019. Each child was submitted to full history taking, complete clinical examination and laboratory investigations including complete blood count, Serum ferritin, serum iron and total iron binding capacity.Results: oral administration of bovine lactoferrin (BLf) significantly increases the number of red blood cells, hemoglobin, serum ferritin and total iron after thirty days of the treatment. BLf is a more effective and safe alternative than elemental iron for treating iron deficiency and iron deficiency anemia.Conclusion: lactoferrin is a better substitute for elementary iron in treatment of iron deficiency.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
48
52
https://ijma.journals.ekb.eg/article_34024_838aa3dfa1059b6eb5166389877b521f.pdf
dx.doi.org/10.21608/ijma.2019.12596.1003
Ondansetron VS Pethidine for The Prevention of Postoperative Shivering
Medhat
Noaman
Department of Anesthesia and Intensive care, Faculty of medicine (Damietta), Al-Azhar University
author
Fouad
Mohamed
Department of Anesthesia and Intensive care, Faculty of medicine (Damietta), Al-Azhar University
author
Adel
Diab
Department of Anesthesia and Intensive care, Faculty of medicine (Damietta), Al-Azhar University.
author
text
article
2019
eng
Objective: The aim of the present study was to evaluate the effects of ondansetron for prevention of postoperative shivering.Patients and Methods: The study was carried out on 40 patient ASA I or II scheduled for lower abdominal surgery. They were categorized into two equal groups Group I (Group P): Patients were receiving intravenous pethidine in a dose of 0.5 mg/kg. Group II (Group O): Patients were received intravenous ondansetron in a dose of 4 mg. just before induction of spinal block.Results: The studied groups showed no significant difference regarding demographic data, or postoperative shivering. However, postoperative nausea, vomiting and sedation were significantly increased in pethidine when compared to ondansetron group. Conclusion: Ondansetron is effective as Pethidine for prevention of postoperative shivering. However, side effects postoperative nausea & vomiting were significantly higher in pethidine group. Thus, ondansetron could be used as a safe and effective alternative for pethidine for postoperative shivering.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
53
57
https://ijma.journals.ekb.eg/article_36386_bfa66e14cd561ba1f05026e1826a10dc.pdf
dx.doi.org/10.21608/ijma.2019.36386
Feasibility and Accuracy of Two-and Three-Dimensional Transthoracic Echocardiography in Patients with Right Atrial Dilatation Using the Right Parasternal Approach
Khaled
Najeeb
Cardiology Department, Faculty of Medicine (Dameitta), Al-Azhar University
author
Mohamed
Bashandy
Cardiology Department, Faculty of Medicine (Dameitta), Al-Azhar University
author
Reda
Abd Elfattah
Cardiology Department, Faculty of Medicine (Damietta), Al-Azhar University
author
text
article
2019
eng
Background: Echocardiography increasingly used for diagnosis of right atrial dilatation. Three dimensional is superior than two dimensional echocardiography. However, advances and new windows continues to emerge to increase its accuracyAim of the work: to show the feasibility and accuracy of right parasternal approach and its usefulness in qualitative and quantitative assessments of right atrium in patients with right atrial dilatation in comparison with transesophageal approach.Patients and Methods: The study included thirty patients with right atrial dilatation. All patients underwent full history taking, clinical, 12-lead electro-cardiography and echocardiography. Transesophageal Echocardio-graphy was used as a gold standard for the accuracy of the right parasternal approach.Results: The study includes 30 patients with right atrial dilatation the right parasternal (RPS) view obtained in 18 patients (60%), and not obtained in 12 patients (40%). There was significant decrease of SVC anteroposterior minimal diameter (Min AP), crista terminalis (CT) width, CT length, right atrial appendage (RAA) base Maximum diameter and RAA base Minimum diameter, in 2D Echocardiography when compared to 3D Echocardiography. On the other side, there was no statistically significant difference in Right parasternal approach (3D) and Transesophageal approach.Conclusions: Parasternal approach is feasible in imaging right heart structures. In addition, three dimensional TTE had an incremental value over two dimensional TTE in the assessment of these structures
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
1
v.
1
no.
2019
58
64
https://ijma.journals.ekb.eg/article_39236_bec306265cb48a4989c98fb71b646dde.pdf
dx.doi.org/10.21608/ijma.2019.39236