Surgery Commons^™

Effect Of Low-Flux Versus High-Flux Dialyzers On Interleukin 6 (Il-6) Level In Patients Undergoing Maintenance Haemodialysis, Hussein Salem Farahat Salem, Mohamed Nabil Raafat, Ismail Mohamed El Mancy, Ibrahim Metwaly Bayomi

Al-Azhar International Medical Journal

Background: One of the leading causes of death and suffering in the 21st century is chronic kidney disease (CKD). Due to the rise in risk factors like obesity and diabetes, as well as the rising number of people affected with CKD, our study aimed to study the effect of using low-flux in comparison to high-flux dialyzers on serum IL-6 levels in patients undergoing regular hemodialysis (HD).

Patients and Methods: Our study was a randomized controlled trial. Sixty patients were enrolled: 20 CKD patients, 20 dialysis patients using low- flux, and 20 patients using high-flux polysulfone dialyzers. Dialysis sessions were four …

Phenytoin-Induced Cerebellar Atrophy: A Case For Reversibility Of Neurological Decline., Edwin Mogere, Davis Cheruiyot, Nassiuma Manakhe

General Surgery, East Africa

This case serves as a reminder of the infrequent, yet consequential occurrence of cerebellar degeneration linked to phenytoin usage. Whilst emphasizes the importance of monitoring patients on long-term phenytoin therapy, and it further suggests considering employing bedside imaging tools such as Ultrasound fusion imaging for follow-up of patients at risk of this type of disorder. We present a case study involving a 23-year-old woman who experienced significant neurological impairment resulting in severe cerebellar atrophy while undergoing phenytoin treatment. On cessation of phenytoin, the patient exhibited improvement with enhanced cerebellar function.

Comparative Study Between Orthotopic Neobladder And Ileal Conduit Diversion For Patients With Cancer Bladder After Radical Cystectomy, Saied Hosny Bendary, Ahmed Alsayed Mohmed, Ahmed Fathy Sayed Ahmed Aly

Al-Azhar International Medical Journal

Background: Several techniques are employed for urine diversion following radical cystectomy, such as the ileal conduit, cutaneous urinary reservoir, and orthotopic neobladder. The many forms of urine diversion significantly influence multiple dimensions of quality of life (QoL), encompassing elements such as urinary function, physical well-being, sexual health, psychological adjustment, everyday functioning, and body image-related unhappiness. Aim and objectives: Is to compare between quality of life (QoL), results and complications of orthotopic urinary diversions and ileal conduit diversion after radical cystectomy in patients with muscle-invasive bladder cancer. Subjects and methods: This is a prospective study conducted at Oncosurgery Department, Al-Azhar University …

Updated Role Of Ultrasonography In Comparison With Magnetic Resonance Imaging In Evaluation Of Various Causes Of Chronic Ankle Pain, Alaa Eldein Mohamed Badr, Mohamed Abdelfattah Yousef, Abdelhakeam Atef Abdelhakeam

Al-Azhar International Medical Journal

Background: Ankle pain refers to any kind of discomfort in either or both ankles. A common cause of ankle pain is an ankle sprain. Apart from sprains and other traumas, gout and arthritis can also result in ankle pain. Ankle discomfort can arise from various types of arthritis, such as osteoarthritis, rheumatoid arthritis, chronic gouty arthritis, psoriatic arthritis, and septic arthritis. Aim of the work: To analyze the updated roles of magnetic resonance imaging and ultrasonography in evaluating different causes of persistent ankle discomfort. Patients and methods: The fifty randomly selected patients with no age or sex specification were subjected …

Evaluation Of Yolk Sac Diameter, Gestational Sac Diameter, Embryonic Heart Rate As Prognostic Factor Of 1st Trimester Outcome, Fahd Abdelal Al Omda, Mohamed Ibrahim Mohamed, Abdelrahman Ali Abdallh Okasha

Al-Azhar International Medical Journal

Background: Ultrasound at 5 weeks gestation reveals the yolk sac's hypoechoic centre and echogenic rim. Between 8 and 11 weeks of pregnancy, it expands and then disappears. Larger yolk sacs cause more miscarriages. Normal yolk sacs reduce first-trimester complications. A normal yolk sac predicts a 94% typical result. By 5 weeks, the embryonic heartbeat is visible. The fetal heart rate rose from 118 to 167 beats per minute between 6 and 10 weeks. An embryonic heart rate (EHR) of 100 BPM is abnormal and related to an 83.3% loss rate early in pregnancy (6-9 weeks). Aim: Does Assessment of gestational …

Classical Antagonist Protocol In Comparison With Agonist Stop Protocol In Pcos Women Undergoing Icsi Trial: A Randomized Controlled Trial, Mohamed Sameeh Kamal Mohamed, Hassan Ahmed Abdrbo, Mohamed Mohamed Farahat

Al-Azhar International Medical Journal

Background and aim: Polycystic ovary syndrome (PCOS) is distinguished by hyperandrogenism, oligomenorrhea, and a cystic ovarian morphology. Ovarian hyperstimulation syndrome (OHSS) is more likely to occur in women with PCOS who undergo IVF. The utilization of hCG to begin the ovum's ultimate maturation is a significant mechanism in OHSS . The ESHRE guidelines recommend that in women with PCOS undergoing ICSI/IVF treatment the gonadotrophine releasing hormone antagonist protocol is optimal or superior to gonadotrophin releasing agonist long protocol. In this study we aimed to Compare pregnancy rate between classical (standard) antagonist protocol to agonist stop/antagonist protocol in women with PCOS …

Topical 15% Lactic Acid Solution Versus Topical Betamethasone Valerate Lotion In Treatment Of Multiple Patchy Alopecia Aerate., Ramy Taher Mohamed Aboelghait, Amr Mohamed Zaki, Emad Mahmoud El Rewiny

Al-Azhar International Medical Journal

Background: Alopecia areata (AA) is a kind of alopecia that affects the retinal pigment epithelium, nails, and hair follicles sporadically. It is a kind of hair loss that doesn't leave scars and often manifests as rounded patches. Alopecia areata may be treated with a variety of methods, including topical, systemic, and injectable ones. Aim of the work: The major aim of this research is to evaluate the efficacy of topical lactic acid 15% solution versus topical betamethasone Valerate Lotion in management of multiple patchy alopecia aerata. Patients and methods: 50 patients in all were included, after consenting each of them …

A Comparative Study Of The Transverse Cerebellar Diameter Of The Fetus With The Biparietal Diameter And Femur Length In Estimation Of Diagnostic Accuracy Of Gestational Age In The Second And Third Trimesters Of Pregnancy, Mohamed Mohamed Gebreel, Mofeed Fawzy Mohamed, Sherif Ahmed Hassan Abdel Fattah

Al-Azhar International Medical Journal

Background: The management of antenatal care and the successful planning of an appropriate intervention or therapy depend greatly on the determination of gestational age (GA). When dates are ambiguous or there is a suspicion of intrauterine growth retardation, transverse cerebellar diameter (TCD) provides a significant advantage in predicting GA. Aim of the work: to compare TCD measurement to existing fetal biometric measures such as femur length (FL) and biparietal diameter (BPD) in order to evaluate the diagnostic accuracy of TCD measure in estimating GA throughout the second and third trimesters. Patients and methods: The obstetrics and gynecology department of El-Sheikh …

Comparative Study Between Fibrin Glue And Intra Corporeal Mesh Fixation In Trans Abdominal Preperitoneal Laparoscopic Inguinal Hernial Repair, Mahmoud Tarek Mohammed Ahmed Moamn, Ashraf Abdel-Hammid Abdel-Monem, Abdel-Hafez Abdel- Aziz Selim

Al-Azhar International Medical Journal

Introduction: Inguinal hernia, which often necessitate surgery, have a prevalence of 15–45 percent around the world, depending on age. The most common surgical treatment for inguinal hernia is mesh implantation. Current surgical options for mesh fixation involve, but are not limited to, sutures, tacks or staples, self-fixing meshes, fibrin, and other glues. Aim: To evaluate the performance of fibrin glues and sutures for fixing mesh during laparoscopic inguinal hernia repair. Patients and Methods: Forty adult male patients with inguinal hernias were randomly assigned to have either laparoscopic transabdominal pre-peritoneal repair or open repair at Al-Azhar university facilities. Individuals were separated …

Specular Microscopic Evaluation Of Corneal Endothelium After Intravitreal Injection Of Ranibizumab For Treatment Of Diabetic Macular Edema, Ahmed Mahmoud Ahmed Elarabi, Mohamed Zakaria Eid, Hatem Mahmoud Samy Abdelkawy

Al-Azhar International Medical Journal

Background: The eye disorder known as diabetes-related macular edema (DME) is frequent and dangerous. DME is one of the easiest conditions to treat even though it can cause vision impairment. Photocoagulation, intravitreal medicines, in addition to surgical excision are some of the therapy options that are currently available. Aim of the work: to evaluate how intravitreal Ranibizumab injections affected corneal endothelial changes over the course of 3 months in patients diagnosed with DME. Patients and Methodology: A case-control study at Giza Memorial Institute of Ophthalmic Research from May 2022 till Nov 2022. compared patients with DM who have good glycemic …

Correlation Between Subclinical Hypothyroidism And Repeated Miscarriage In Pregnant Women, Haitham A. Azeem, Ali A. Madian, Mohamed R. Izzaldin, Mona R. Mohamed

Al-Azhar International Medical Journal

Background: Abortion is a minor complication of pregnancy, defined as the spontaneous loss of the fetus, which occurs in 15-20% of pregnant women. Recurrent miscarriages, which occur in approximately 1% of women of childbearing age and are defined as miscarriages of two or more pregnancies in consecutive pregnancies. Aim: To determine the association between subclinical hypothyroidism in pregnant women and recurrent miscarriage. Patients and Methods: This observational study was conducted in December 2021 and May 2022 on nine pregnant women at Assiut University's Al-Azhar Hospital. Patient groups who complained of recurrent miscarriage (at least two unexplained recurrent miscarriages) and control …

Glycemic State In Hospitalized Covid-19 Patients, Haitham A Azeem, Abdelhamid A Abdelhafez, Ebtisam S. Hassanin, Zeinab N. Abd El-Galil

Al-Azhar International Medical Journal

Background: Diabetes has become an important risk factor for major morbidity and death, hospitalizations, disease severity, acute renal failure, acute respiratory distress syndrome, ICU admissions and patient death. with coronavirus disease 2019. Aim: To study glycemic changes and outcomes in diabetic and non-diabetic patients hospitalized with COVID-19. Patients and Methods: In this retrospective study, 500 hospitalized adult patients over 18 years of age with COVID-19 were referred to Al-Azhar – Assiut and Chest – Assiut University Hospitals with nasopharyngeal vaccination against SARS-CoV-2. Our study spanned approximately seven months of confirmed COVID-19 from January 2021 to July 2021. Results: Patients with …

Assessment Of The Prevalence Of Pulmonary Hypertension And Volume Status In Regular Hemodialysis Patients, Ahmed Alaa Eldin Ahmed Saad, Abd Elhamid Ismaeil Abd Elhamid, Mohamed Hassan Attia, Ali Ashraf Abd Elaty Ali

Al-Azhar International Medical Journal

Background: Cardiovascular disease is well acknowledged as a significant cause of death among individuals diagnosed with chronic renal disease. It constitutes approximately 50 percent of mortality cases among those undergoing dialysis treatment. In recent studies, it has been discovered that the presence of pulmonary hypertension serves as a robust and autonomous prognostic indicator for mortality among those undergoing hemodialysis. Aim of work: to assess the prevalence of pulmonary hypertension and its relation to volume status in hemodialysis patients. Patients and Methods: a prospective comparative study that was conducted on (50) patients on regular hemodialysis in the Nephrology Unit of Kobry …

Assessment Of Changes In The Anterior Segment By Anterior Segment Optical Coherence Tomography And Intraocular Pressure After Phacoemulsification In Glaucomatous And Non-Glaucomatous Patients, Mahmoud Abd El-Haleem Soliman Rabee, Hassan Metwally Bayoumy, Osama Ramadan Mahmoud

Al-Azhar International Medical Journal

Background: Phacoemulsification is widely recognized as the prevailing ocular surgical procedure conducted on a global scale. Multiple studies have provided evidence of a decrease in intraocular pressure (IOP) following phacoemulsification. The assessment of anatomical features in the anterior chamber has emerged as a key area of interest in determining the extent of IOP reduction following cataract surgery. Anterior Segment Optical Coherence Tomography(AS-OCT) has recently emerged as an objective and noninvasive method to assess the anterior chamber anatomy. Aim of the work: The aim of the work is to study the effect of phacoemulsification on the anterior chamber and IOP in …

Phacoemulsification In Cases Of Zonular Weakness Using In Situ Nuclear Disassembly Without Nuclear Rotation, Mohammed Abdel Moneim Mahdy, Hossam Zeyada, Youssef Hassan Mohammed Ibrahim Mansour

Al-Azhar International Medical Journal

Background: Due to zonular dehiscence or weakness, cataract surgery may result in late intraocular lens subluxation or dislocation, vitreous loss, dropped nuclei fragments, or all of these complications. Aim of the work: The objective of this study is to evaluate the occurrence and intensity of intraoperative problems in pseudoexfoliation (PEX) cases when employing in situ nuclear disassembly without nuclear rotation. Patients and methods: On 100 eyes of 100 cases with zonular weakness, this prospective, interventional, comparative study was carried out. Fifty patients undergoing phacoemulsification with in situ nuclear disassembly and the other 50 patients undergoing conventional chopping technique whom were …

Using Of Fragment Specific Plate 2.5 Millimetre In Cases Of Distal Radius Fracture, Ibrahim Ahmed Hussien, Amro Ahmed Fouaad, Ahmed Samy Al-Noamany

Al-Azhar International Medical Journal

Background: Fractures of the distal radius inside the joint are a common injury. Whether caused by high-energy trauma or, more commonly among the elderly and those with osteoporosis, low-energy trauma, these fractures tend to be unstable and require immediate medical attention. The use of external fixators for intra-articular distal radius fractures has been supplanted by the use of internal fixators. Aim and objectives: to examine the radiological and clinical results of treating distal radius fractures that occurred on the dorsum of the individual's right and left arms (dorsal or dorso-radial) using a fragment-specific plate (2.5 mm). Subjects and methods: Hospitals …

Liver Biochemical Abnormalities Among Covid-19 Patients, Sahar Hassan Abd-Allah, Ashraf Mohammad Elkabeer, Ahmed Mohamed Mostafa, Ayman Abd Elaziz Abd Elrhman, Ebtisam Showky Ahmed Hassanin

Al-Azhar International Medical Journal

Background: The sever acute respiratory syndrome corona virus-2 (SARS_CoV-2) is a novel Corona virus that causes Corona virus disease 2019 (COVID- 19). Except for respiratory symptoms, COVID-19 patient often develop different degrees of liver injury. Notably, COVID-19 patients with pre-existing liver diseases, especially liver cirrhosis, have higher incidence of liver biochemical abnormality, liver injury, and even hepatic decompensation event. Aim: To determine the liver biochemistry changes in COVID-19 patients. Patients and methods: In this retrospective study was conducted in quarantine department, Assuit Chest Hospital was conducted on 761 COVID-19 patients. Patients were divided into 2 groups: hepatic and non-hepatic groups. …

Comparative Study Between Intrathecal Hyperbaric Prilocaine Versus Hyperbaric Bupivacaine In Anorectal Surgery, Saeed Mohammed Ali Fayed, Ahmed Mahmoud Mohammed El-Garhy, Mohammed Zakaria Gad El-Karem Abd El-Aziz

Al-Azhar International Medical Journal

Background: The prevalence of ambulatory anorectal surgeries has been increasing, these procedures are deemed appropriate for day case surgery with the use of spinal anaesthesia. This study aims to compare the anaesthetic characteristics of intrathecal hyperbaric bupivacaine 0.5% and intrathecal hyperbaric prilocaine 2% in the context of elective anorectal surgery. Patients and Methodology: The research methodology used in this study is a prospective, double-blinded randomized approach. A total of eighty-eight patients were divided into two similar-sized groups, and randomly allocated to the trial. Group A, got intrathecal administration of 15 mg hyperbaric bupivacaine 0.5%, whereas group B, received intrathecal administration …

Sonographic Prevalence Of Peripheral Enthesitis Among Patients With Inflammatory Bowel Disease (Ibd), Abdul Rahman S. Hamid, Mohamed I. Abdelkareem, Amro Metwaly Hassan, Mohamed Z. Shoaeir

Al-Azhar International Medical Journal

Background: Musculoskeletal manifestations are the most frequent extra-intestinal complications of IBDs, and they are an important cause of morbidity and impairment of quality of life. Aim: to assess the prevalence (frequency and pattern) of peripheral enthesitis in patients with IBD by using B-mode ultrasonography and power Doppler ultrasonography (PDUS) with Glasgow Ultrasound Enthesitis Scoring System (GUESS) and correlate these findings with clinical and laboratory parameters of IBD. Patients and Methods: In this observational study 50 people with inflammatory bowel diseases (IBD)—ulcerative colitis (UC), Crohn's disease (CD), and rheumatoid arthritis (RA)—were included, there were 33 The patients chosen from those who …

Ultrasound-Guided Transversus Abdominis Plane (Tap) Block For Pain Control In Patients Intraoperative Cesarean Section, Yehia Abdel Salam Wafa, Mofeed Fawzy, Mohamed Othman Mahmoud Nagy

Al-Azhar International Medical Journal

Background: Transversus abdominis plane (TAP) block is a peripheral nerve block that anesthetizes the abdominal wall. The thoracolumbar nerves (T10-L1) are located in the fascial plane (TAP) among the internal oblique & transverses abdominis muscles. Aim of the study: The objective of the research is to analyze the evidence and assess the analgesic efficacy of ropivacaine TAP block for 24 hours following Pfannenstiel incision caesarean surgery. Patients and methods: A prospective randomized controlled clinical trial was conducted on 60 females undergoing cesarean section in the Department of Obstetrics and Gynecology of Al-Azhar University Hospital and El-Fayoum General Hospital. The participants …