Medicine and Health Sciences Commons^™

Prognostic Factors Of Myasthenia Gravis Remission After Thymectomy At National Referral Hospital In Indonesia, Suprayitno Wardoyo, Winda J. Layardi

The New Ropanasuri Journal of Surgery

Introduction. Thymectomy is a recommended treatment for myasthenia gravis, enfacing the problem of a low remission rate. However, Indonesian-specific characteristics of myasthenia gravis are somehow different from those of well-developed countries. Thus, identifying prognostic factors influencing remission is required for patient selection to provide optimal preoperative issues.

Methods. A retrospective cohort proceeded in our tertiary hospital, enrolling those diagnosed with myasthenia gravis who underwent thymectomy for four years. Disease period modified Osserman classification, age, sex, preoperative plasmapheresis, preoperative steroid therapy, type of surgery, and thymic pathology were the variables of interest for three-year follow-up. In addition, these variables …

Quality Of Life And Its Associated Factors In Patients After Esophagectomy At A Single National Referral Center, Dogma H. Sirirui, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Esophagectomy is the standard surgical treatment for resectable esophageal cancer patients. However, the success rate for this procedure was about 25–35% and was associated with a severe risk of postoperative complications. In addition, patients after esophagectomy have decreased their quality of life (QOL), but no research has been done in Indonesia. Therefore, this study was conducted to determine the quality of life after esophagectomy in Indonesia based on the patient population at Dr. Cipto Mangunkusumo General Hospital (CMGH).

Method. A retrospective study was conducted using quality–of–life instruments issued by the European Organization for Research and Treatment of Cancer (EORTC). …

Potential Of Tumor Cell Seeding And Clinical Impact On Percutaneous Breast Biopsy Tracks: A Literature Review, I G.N. Gunawan Wibisana, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. Based on its effectiveness, a percutaneous breast biopsy was chosen because it has minimum side effects and fewer complications, does not distort the breast tissue architecture, and can be performed on an outpatient basis. However, the biopsy can damage the integrity of tumor cells, creating seeding at the site of the track made. Therefore, core biopsy is the method of choice for breast lesion sampling using a 14G needle that provides greater sensitivity. This study aims to explain whether the percutaneous biopsy track has the potential for the formation of tumor cell seeding and its clinical impact.

Methods …

Prognostic Factors For Mortality Of Pediatric Burn Injury In A National Tertiary Referral Center, Heru Angkoso, Aria Kekalih

The New Ropanasuri Journal of Surgery

Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. Data from the Ministry of the Health Republic of Indonesia showed the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics.

Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted …

Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy And Core Biopsy In Breast Cancer, Anak Agung Ngurah Bagus Satya Sueningrat, Mendy Mendy

The New Ropanasuri Journal of Surgery

Introduction. Needle biopsy, including core needle biopsy (CNB) and vacuum-assisted breast biopsy (VABB) with or without radiological support) is the initial investigative method of choice for the preoperative diagnosis of breast lesions. Ultrasound-guided VABB (US-VABB) has become widely accepted because of its high accuracy. In this review, the diagnostic performance indices of CNB were compared with US-VABBB techniques.

Method. A literature search proceeded in online databases compiling studies from the last 20 years in the PubMed, EBSCOhost, ScienceDirect, and ProQuest databases. Eighteen eligible studies compared US-VABB and CNB for diagnostic accuracy. All studies were cohort retrospective. This literature search proceeded …

Transplantation In Pediatrics Liver Failure Associated With Acute Hepatitis Of Unknown Etiology, Afid B. Putra, Agi S. Putranto, Muftah Risyaldi, Luthfian A. Nurachman

The New Ropanasuri Journal of Surgery

Introduction. On 5^th April 2022, some cases of severe acute hepatitis of unknown etiology in children were reported in the United Kingdom. Since then, the number has increased rapidly, with 650 probable cases identified worldwide. This review focuses on available information about managing acute liver failure (ALF) in pediatrics with acute hepatitis of unknown etiology through the perspective of hepatobiliary surgery.

Method. A literature review proceeded on some databases, namely PubMed and Google Scholar. Epidemiological data and technical policy were obtained from World Health Organization and some government institutions.

Results. Severe acute hepatitis can progressively develop into acute liver …

The Correlation Between Premenopausal Estrogen And Estrogen Receptors In Breast Cancer, Ahmad Kurnia, Dedy Pratama, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. The correlation between the premenopausal estrogen hormone and estrogen receptors is unknown. The hormone estrogen has a risk factor for causing breast cancer. Meanwhile, the estrogen receptor plays a role in determining further treatment plans in breast cancer patients. Patients with high estrogen receptors have a better prognosis. If the premenopausal estrogen hormone can affect the estrogen-receptor, then the estrogen hormone can be modified to have a better prognosis.

Method. A cross-sectional study enrolled 32 subjects with complete data and was statistically analyzed to find the correlation between premenopausal estrogen hormone and estrogen-receptors.

Results. The estradiol ranged from 15.3 …

The Potential Of Liquid For Breast Cancer: A Review, Sonar Soni Panigoro, Clarissa Kezia Yuella -

The New Ropanasuri Journal of Surgery

Introduction. Tissue biopsy is the current gold standard for cancer diagnosis, targeted treatment, and prognosis. However, biopsy is an invasive procedure that could result in postoperative bleeding, pain, and infection. Such limitations may now be resolved by the clinical technique known as liquid biopsy, which enables a better representation of disease status.

Method. This literature review was conducted through online databases (PubMed, Ascopubs, EuroPMC) using the following keywords: "liquid biopsy", "ctDNA", "CTC", "breast cancer", "pathogenesis of breast cancer", "tumor microenvironment”, “ctdna detection technologies”, "early diagnosis", "targeted therapy" ,"monitoring disease progression”, and "prognosis”. The literature search was conducted using the PRISMA …

Surgical Intervention For Endobronchial Tuberculosis With Total Bronchial Occlusion: A Case Report, Muhammad A. Putra, Matthew Billy, Radhyaksa Ardaya, Rut Hp Ekasiwi, Sari Rahmawati, Karel Hs Sumarsudi

The New Ropanasuri Journal of Surgery

Introduction. Endobronchial Tuberculosis (EBTB) is a specific TB form affecting the tracheobronchial tree with microbial and histopathological evidence. Early diagnosis is essential to provide timely treatment and prevent complications but also proves difficult due to the low positive rate of acid–fast bacilli (AFB) staining of sputum smears and non–specific clinical and radiological findings.

Case Illustration. We reported a 19–year–old man with a productive cough suspected of pulmonary tuberculosis, with a positive GeneXpert test and negative AFB smear. He received anti–tuberculosis drugs for six months. Although the symptoms initially seemed to improve, the patient complained of dyspnea during moderate activities in …

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

Histopathological Study About The Effects Of Chronic Concomitant Administration Of Both Pregabalin And Ibuprofen On The Skeletal, Cardiac And Smooth Muscles Of Male Albino Rats, Hytham Hemeida, Fouad El Dabbah, Nagy Alfadaly, Al-Sayed Tealeb

Al-Azhar International Medical Journal

Background: there is not enough information available to assess the relationship between Pregabalin use and muscular damage. Also, the effect of pregabalin ibuprofen combination on musculature not well assessed till now. Objectives: The study aimed to evaluate the possible chronic concomitant effect of both pregabalin and ibuprofen on skeletal, cardiac and smooth muscles in male albino rats. Subjects and methods: One hundred adult healthy male albino rats weighting 200 – 250 gm were obtained from the animal house, Faculty of Medicine, Assiut University, Egypt. The animals were classified into five groups: Group one (Negative control):10 male albino rats, received normal …

Intravenous Versus Intramuscular Oxytocin In The Prevention Of Atonic Post-Partum Hemorrhage After Vaginal Delivery, Taha Abd Elghany, Mofeed Mohamed, Muhamed Abdelmoaty

Al-Azhar International Medical Journal

Background: Primary postpartum hemorrhage (PPH) is among of the most main sources of mother deaths throughout the world. The changed profile of laboring women, who are now more probable to be aged, overweighted, or have substantial clinical co-morbidities, is leading to an increase in obstetric difficulties, Aim and objectives: in a double-blind controlled experiment, to examine the impact of an intramuscular (IM) single dose of oxytocin (10 IU per 1 mL) and placebo IV administration (1 mL 0.9 % saline gradually administered ) with an IV single dose of oxytocin (10 IU per 1 mL administered gradually over 1 min) …

The Role Of Repetitive Transcranial Magnetic Stimulation In Spastic Hemiplegic Cerebral Palsy In A Sample Of Egyptian Children, Ahmed Muhammad, Hossam Emam, Abdel-Ghaffar Fayed

Al-Azhar International Medical Journal

ABSTRACT Background; One of the most common neurologic disorders is cerebral palsy. To improve quality of life, many tools have been employed. rTMS is a new established technique to treat spasticity and improve the outcome of rehabilitation program in various neurologic conditions. Aim and objectives; To assess the effect of high frequency rTMS on improving spasticity and motor performance in spastic hemiplegic CP in a sample of Egyptian children. Patients and methods; 65 children aged between 4-18 years attending the Neuro-Pediatric Unit of Al-Azhar University hospitals were recruited in the period from beginning of Jan, 2022 to the end of …

Mid-Secretory Uterine Artery Doppler Indices And Endometrial Thickness In Patients With Unexplained Recurrent Pregnancy Loss, Eshraq Mohammed, Ahmed Nasr, Wael Hamed

Al-Azhar International Medical Journal

Back ground : Recurrent pregnancy loss (RPL) occurs in up to 3% reproductive age couples. Potential uterine predictors for implantation measurable by ultrasound include endometrial thickness and volume, endometrial pattern, as well as blood flow in the uterine and sub-endometrial arteries. Aim: to evaluate endometrial thickness and uterine artery blood flow using Transvaginal color Doppler ultrasound during the midluteal phase of the menstrual cycle for women with unexplained recurrent pregnancy loss (RPL). Patients and methods: A prospective controlled clinical trial was conducted on 90 non pregnant women :45 Patient group and 45 Control group. All participants underwent comprehensive examinations and …

Effects Of Sildenafil On The Testes Of The Nondiabetic And Diabetic Adult Albino Rats (Light And Electron Microscopic Study), El-Sayed Jahin, Mustafa Al-Jizawi, Fayez Abd-Elfattah

Al-Azhar International Medical Journal

Background: Sildenafil citrate is effective in men with erectile dysfunction. Sildenafil induces degenerative changes in seminiferous tubules and interstitial histological alterations. Diabetes mellitus may cause an end-organ damage in many systems as the genitourinary system. The testis is the primary sex organ and is formed mainly of stroma and parenchyma. It is a mixed gland that performs both endocrine and exocrine activities. Objective: To reveal the effect of sildenafil citrate in high and toxic doses on the histological structure of the healthy and diabetic rat testes. Material and methods: The research was carried out at the animal house at Faculty …

Cervical Cytologic And Colposcopic Changes In Cases Using Intrauterine Devices For Along Time, Eslam Farg, Samir Ali, Abd-Elmonsef Mostafa

Al-Azhar International Medical Journal

Background: Intrauterine Contraceptive Device (IUD) is a safe, convenient and inexpensive method of contraception involving neither repetition nor interference with sexual activity. Aim of the work: To to examine cytologic and colposcopic changes in individuals utilising IUCDs in the cervical region.for long periods of time and to create awareness among the IUCD users for regular follow up. Patients and methods: The Obstetrics and Gynecology Department of Al-Hussein University Hospital conducted this cross-sectional study. 200 monogamous individuals with IUCD who have been free of STIs for three to five years made up the study group (Group 1). On the other hand, …

Role Of Diffusion Weighted Imaging And Apparent Diffusion Coefficient Value In Diagnosis Of Asymptomatic / Inactive Multiple Sclerosis Plaques, Aws Al-Isawi, Abdulah El Keshn, Hussien Roshdy

Al-Azhar International Medical Journal

Background: Although in most cases, the diagnosis of MS remains a clinical, magnetic resonance imaging became a fundamental imaging technique for the investigation and monitoring patients with MS, as it allows the visualization of lesions in the brain and spinal cord and help in understanding and follow of the disease and it is widely used to confirm the clinical diagnosis. Aim of the study: To evaluation of asymptomatic or inactive multiple sclerosis plaques by using diffusion weighted imaging and ADC value. Patients and methods: We evaluated prospectively 50 patients with known multiple sclerosis and fulfilled McDonald Criteria 2017. Patients of …

Intravenous Iron Sucrose Versus Intramuscular Iron Sorbitol In Management Of Iron Deficiency Anemia During Pregnancy, Mohamed Hamed, Abd Allah Ahmed, Islam Sultan

Al-Azhar International Medical Journal

Background: The greatest prevalent nutrient shortage in pregnant women across the globe is iron deficiency anemia (IDA). Maternal anemia continues to significantly increase neonatal morbidity and death, and there is worry over the elevated incidence of iron and other micronutrient deficiencies among pregnant women in poor nations. Aim of the work: To examine the effectiveness and safety of intramuscular iron sorbitol citric acid complex and intravenous iron sucrose in the treating of iron deficiency anemia (IDA) in gestation. Patients and methods: At the Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, 100 pregnant women were separated into two …

Helicobacter Pylori And The Severity Of Preeclampsia, Marwan Ali, Ahmed Abd Elfattah, Mohamed Abo-Ghabha, Noha Sabry

Al-Azhar International Medical Journal

Background: The main cause of maternal morbidity and mortality, intrauterine growth retardation, as well as fetal prematurity, is pre-eclampsia. Helicobacter pylori was found to infect several parts of the stomach and duodenum and has consequently been linked to a higher risk of gastric cancer. Pre-eclampsia is more frequent in women infected with H. pylori than in women who are not. Aim of the work: To assess the relation between severity of pre-eclampsia and of Helicobacter pylori infection. Patients and methods: This case-control research involved 100 pregnant women at the Obstetrics and Gynecology Departments of Al-Azhar Hospital and Mansoura International Hospital, …

The Diagnostic Function Of Office Hysteroscopy And Three-Dimensional (3d) Endometrial Volume Measurement In The Evaluation Of Women With Perimenopausal Bleeding, Mohamed Nafad, Abd El-Moneam Zakaria, Ahmed Abdel Fattah

Al-Azhar International Medical Journal

Background: In the peri- and postmenopausal years, abnormal uterine bleeding (AUB) is the most prevalent reason for gynecological appointments. Aim of the work: To detect the role of office hysteroscopy and three-dimensional (3D) endometrial volume measurement in the evaluation of women with perimenopausal bleeding. Patients and methods: This study was conducted at Al-Azhar University in Al Hussein university hospital from March 2017 to October 2019 Obstetrics and Gynecology department. The research included 100 studied cases complaining of perimenopausal bleeding at the outpatient clinic. Results: hyperplasia followed by complex endometrial hyperplasia and only 1 case of endometrial carcinoma was discovered. In …

Prevalence Of Child Sexual Abuse In Sohag Governorate In Egypt During One Year From January To December, 2020., Adel Hamdy, Ibrahim Mohamed, Mohamed Abdelhamid

Al-Azhar International Medical Journal

Background: Child sexual abuse is a major threatening problem to child health which predispose to different distressing short-term and long-term complications including psychic, cognitive, physical and social hazards. Objective: To evaluate all alleged child sexual abuse cases that presented to Forensic Medicine Authority in Sohag Governorate of Egypt during 2020. Patients and Methods: There were (69) alleged cases of child sexual abuse presented to the Forensic Medicine Authority in Sohag Governorate during 2020. A history were taken from children to analysis and identify the situation of the assault then general and local examinations were done for detection of any positive …

Study Of Laparoscopic Nissen Versus Anterior Partial Fundoplication In Management Of Gastro Esophageal Reflux Disease In Children, Mahmoud Ghaly, Mohammed Ellithy, Ibrahim Gamaan

Al-Azhar International Medical Journal

Background: GERD is the most common upper gastroesophageal disorder in the Western population. A number of strategies have been recommended to prevent this problem. Aim of the Work: to compare the Nissen fundoplication with partial anterior fundoplication. Patients and Methods: The present comparative study included thirty patients who had symptomatic GERD admitted in pediatric surgery department ,Al-Azhar University hospitals and all patients submitted to preoperative clinical evaluation and investigations. Patients were randomly allocated to undergo either laparoscopic Nissen fundoplication (group I) or laparoscopic partial anterior fundoplication (group II). All patients in our study signed a consent form. Results: there was …

The Surgical Outcome Of Chronic Rhinosinusitis With Emphasis On Rhinogenic Headache, Mohamed Eloby, Salaheddin Ali, Mohamed Alawady

Al-Azhar International Medical Journal

Background: Chronic rhinosinusitis (CRS) is a persistent inflammatory disease. The pathogenesis of CRS involves many factors including genetics, status of the sinonasal microbiome, infections, and environmental influences. Aim of the study :To monitor the outcome of sinus surgery and to evaluate headache severity, duration, and frequency. Patients and methods: A prospective study was conducted at Al-Azhar University Hospital. We targeted 60 patients belonging to both sexes aged between 18 and 65 years. Divided into 3 groups: Group (1): Chronic Rhinosinusitis with or without concha bullosa, Group (2): Chronic Rhinosinusitis with or without hypertrophy turbinate, and Group (3): Chronic Rhinosinusitis with …

Comparative Study Between Clinical Outcomes Of All Inside Technique And Standard Antero-Medial Technique In Anterior Cruciate Ligament Reconstruction, Abd Elkakim Farrag, Mohamed Alhalawany, Mahmoud Hamada

Al-Azhar International Medical Journal

Background: Although theoretically superior to traditional technique, anatomical single bundle ACLR via all-inside technique does not appear to demonstrate statistically significant advantages over conventional technique, as with the Lysholm scoring system. Aim of the work: This study compared the post-operative clinical outcomes of arthroscopic ACL restoration using the "all-inside approach" versus the "traditional procedure". Patients and Methods: Between March 2020 and December 2021, fifty patients were admitted to the department of Orthopedic surgery and Traumatology in Sayed Galal University Hospital with torn ACL exhibiting high grade pivot shift (II or III) under anesthesia. Results: The mean age of the patients …

Evaluation Of The Medial Sural Artery Perforator Flap For Validity Around Knee Reconstruction, Aly Shafei, Magdy Abd-Almoktader Abdel-Kreem, Mohamed Ouf

Al-Azhar International Medical Journal

Background: Soft tissue defects overlying the knee are often the result of trauma, post-burn contracted scars, and malignancy requiring a wide excision. These defects signify a great challenge to surgeons when faced with reconstructive surgery. Aim of the Work: Evaluation of the versatility of pedicle medial sural artery perforator flap as a regional flap in reconstruction of knee and around knee soft tissue defects. Patients and Methods: Twenty patients were recruited in this study who suffered soft tissue defects of knee and peri-knee with exposed vital structures. Fourteen patients were male and six were female and their ages ranged from …

Zinc And Abdominal Aortic Calcification In Patients Under Regular Hemodialysis, Omar Sayed, Safwat Ahmed, Hani Ismail, Mohamed Elfeshawy, Mohamed Ibrahim

Al-Azhar International Medical Journal

Background: Vascular calcification is known to be significantly influenced by zinc deficiency. Low serum zinc inhibited the osteochondrogenic phenotypic flip of phosphate-induced vasculature smooth muscle cells (VSMCs), which led to the formation of vascular calcification. Abnormal mineral metabolism, like hyperphosphatemia, which leads to the phenotypic conversion of VSMCs into osteoblasts that secrete collagen, is a contributing factor for the development of arterial calcification in CKD. Aim and objectives: The goal of this research was to evaluate the link between zinc and abdominal aortic calcification in individuals receiving regular hemodialysis. Subjects and methods: This Cross-Sectional research included 40 Hemodialysis Patients The …

Total Arterial Revascularization Versus Conventional Coronary Artery Bypass Grafting; A Comparative Study, Mosaad Elgharabawi, Elhusseiny Gamil, Mohamed Mahmoud, Bahaa El Khonizy

Al-Azhar International Medical Journal

Background: The superiority of total arterial revascularization over the conventional method is a matter of continuous debate. Therefore, we aimed to compare early surgical and hospital outcomes of the total artery and conventional revascularization strategies in patients undergoing coronary artery bypass grafting (CABG). Methods: The study included 60 patients who underwent primary elective CABG from 2018 to 2020. Patients were grouped according to the revascularization strategy into two groups. Group 1 included patients who had conventional revascularization using left internal mammary artery (LIMA) and vein grafts (n= 30), and group 2 included patients who had total arterial coronary revascularization (TACR) …

Incidence Of Placenta Accreta And Its Complications In Cases Of Previous Cesarean Sections With Placenta Previa Anterior, Abdel Ghany Diab, Samir Ali, Mohamed Farahat

Al-Azhar International Medical Journal

Background: The prevalence of placenta previa has been recently estimated to be approximately 0.5% of all pregnancies, and this increase correlates to the elevated cesarean section rate. Placenta previa is a major cause of maternal morbidity and mortality because of the associated massive antepartum and intrapartum hemorrhage. Placenta previa is associated with preterm delivery, with the neonatal mortality increasing threefold. Aim of the study: The aim of this study was to determine the relationship between placenta accreta and its complications in cases of previous cesarean section with placenta previa anterior. Patients and Methods : This study conducted in Department of …

Effect Of Repetitive Transcranial Magnetic Stimulation On Essential Tremors, Ahmed Mohammed, Mohamed Al-Bahay Reda, Ahmad Ibrahim

Al-Azhar International Medical Journal

Background: The effects of cerebellar low-frequency repetitive transcranial magnetic stimulation (rTMS) in individuals suffering from essential tremor (ET) are controversial. Aim of The Work: To evaluate repetitive transcranial magnetic stimulation (rTMS) can help people with essential tremors. Patients and Methods: This case study involved 30 subjects divided into an active group of 15 ET patients and a sham group of another 15 ET patients who were treated in tertiary care at Al-Hussein and Sayed Galal Hospitals, Al-Azhar University. The Fahn, Tolosa, Marin (FTM) Tremor Rating Scale has been used to evaluate and scale tremors at baseline, as well as a …

Evaluation Of Role Of Ultrasound In Assessment Of Successful Weaning From Mechanical Ventilation In Critically Ill Patients, Hosam Erfan, Mohammed Sharaf, Mostafa Abo El Enin, Mostafa Shakweer, Othman Mossa, Essam Abdelwahab, Sara Gadwal

Al-Azhar International Medical Journal

Background: Mechanical ventilation waning failure is a common problem, and bedside ultrasonography could be helpful in prediction of the weaning process and its results. Aim of The Work: To ssess by means of ultrasound how diaphragmatic parameters are important in predicting weaning outcome by assessing diaphragmatic thickness, diaphragmatic mobility and variation. Patients and Methods: This study included 62 mechanically ventilated patients who were subjected to transthoracic ultrasonography of the diaphragm throughout a spontaneous breathing experiment and had been divided into two groups: successful extubation and unsuccessful extubation. Results: With a p-value of <0.001, a high DE after extubation was linked to extubation success. Extubation failure was linked to lower DTF before and after extubation, with a p-value of 15 had 100% sensitivity, 85.06% specificity, 70.5 PPV and 100% NPV with p-value 20.4 had 93.55% sensitivity, 93.55% specificity, 93.5% PPV, and 93.5% NPV with p-value Conclusion: Diaphragm ultrasound evaluation of DTF and DE is a simple new weaning index which can be used as a bedside technique in clinical practice and has promising predictors of weaning success or failure before and after extubation.