Publications by authors named "Mohamed ElBadry"

18 Publications

  • Page 1 of 1

Nutritional status associated with clinical outcomes among patients hospitalized with COVID-19: A multicenter prospective study in Egypt.

Nurs Health Sci 2021 Dec 17. Epub 2021 Dec 17.

Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Few studies have addressed the relationship between the nutritional status of patients with COVID-19 and their disease course. This multicenter prospective study aimed to evaluate the nutritional status of patients hospitalized with COVID-19 and its association with their clinical outcomes. Sociodemographic, physical, clinical, and nutritional data of 121 patients with confirmed COVID-19 were collected upon admission and at discharge from three COVID-19 quarantine hospitals in Egypt via a questionnaire and a standardized scale. The majority (73.6%) of the patients had a reduced dietary intake over the last week before admission, and 57% were severely ill. Overall, 14% had a high risk of malnutrition on admission, increasing to 26.3% at discharge. Malnutrition was present in most (85.7%) of the intensive care unit patients and deaths, compared with recovered patients (14%). We concluded that malnutrition might worsen the clinical outcomes and increase the morbidity and mortality of COVID-19 patients. A multidisciplinary approach is recommended to manage patients with COVID-19, considering their nutritional status before and during infection, with early detection of high-risk patients in order to design and provide the appropriate nutritional support.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/nhs.12913DOI Listing
December 2021

Predictors for Severity of SARS-CoV-2 Infection Among Healthcare Workers.

J Multidiscip Healthc 2021 25;14:2973-2981. Epub 2021 Oct 25.

Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Cairo, Egypt.

Background: Healthcare workers (HCWs) are still at higher risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections than the general population. Identifying risk factors associated with severe SARS-CoV-2 infections is of paramount importance to protect HCWs and the non-infected patients attending different healthcare facilities.

Purpose: To recognize the predictors for severity of SARS-CoV2 infection among HCWs working in either COVID-19 or non-COVID-19 healthcare settings. Also, to assess compliance of HCW to standard precautions of infection control and explore the possible risk factors for SARS-CoV-2 infection among HCWs.

Methods: A cross-sectional study was conducted among HCWs with suspected or confirmed SARS-CoV-2 infection, from different Egyptian governorates. They were asked to fill in a web-based self-reporting questionnaire. The questionnaire assessed the demographic and socio-economic characteristics of participants, compliance of HCWs to standard precautions of infection control and COVID-19 presentation.

Results: Our study enrolled 204 HCWs (52.3% physicians). Infection of SARS-CoV-2 was confirmed in 61.3% by RT- PCR; 35.8% were admitted to hospital, and of these, 3.9% were admitted to the intensive care unit. While 30.4% had mild disease, 48.5% had moderate disease, 17.2% had severe disease and 3.9% had critical disease. Regression analysis for variables predicting COVID-19 severity among study healthcare workers showed that associated chronic diseases and management at home were the main independent variables predicting severity of their SARS-COV-2 infection, while the variables age, sex, residence, occupation or drug history of immunosuppressives had no role in severity prediction.

Conclusion: Associated chronic diseases and management at home were the main independent variables predicting severity of SARS-COV-2 infection among HCWs. So, HCWs with chronic diseases should not work in COVID-19 designated hospitals, and there should be a screening strategy for their infection with SARS-COV-2. HCWs must not be negligent in adhering to strict precautions of infection control. HCWs infected with SARS-COV-2 must be managed in hospital not at home.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/JMDH.S335226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557804PMC
October 2021

Adjustment of tension applied in transobturator tapes in females with intrinsic sphincteric deficiency: Two centers' prospective, comparative, randomized surgical trial.

Urol Ann 2021 Apr-Jun;13(2):134-141. Epub 2021 Jan 22.

Urology and Nephrology Center, Minia University, Minya, Egypt.

Objectives: Stress incontinence is the most common type of urinary incontinence in females. Recently, the gold standard treatment is mid-urethral tapes, however their efficacy is questioned in intrinsic sphincter deficiency (ISD). In our study, we try to adjust the tension applied during transobturator tapes (TOT) to evaluate its effectiveness in ISD, in order to prevent obstruction or failure and persistence of stress urinary incontinence.

Materials And Methods: This study was prospectively conducted on eighty female patients having ISD, presenting at the Urology Departments in Alexandria and Minia University Hospitals. The patients were randomly assigned to two groups, with Group I including forty patients, who underwent TOT using tension-free technique, and Group II including forty patients using our new tension adjustment technique under saddle anesthesia. Patients filled the International Continence Questionnaire and Urinary Distress Inventory and did pressure flow study pre- and postoperatively. Postoperatively, the patients filled Patient Global Impression of Improvement and underwent translabial ultrasound (U/S) to estimate the distance between the tape and the urethra.

Results: In Group I, 70% of the patients were cured with mean Valsalva leak point pressure (VLPP) of 51.43 ± 3.39 preoperatively, 20% were not improved, and 10% were improved with a mean VLPP of 44.5 ± 3.54 preoperatively, which increased to 86 ± 4.24 postoperatively. In Group II, 95% of the patients were cured with a mean VLPP of 50.74 cmHO ± 6.56 preoperatively and 5% improved but not cured with a mean VLPP of 31 cmHO preoperatively, which increased to 127 cmHO at a bladder capacity of 400 ml. All patients in both groups underwent translabial U/S 6 months postoperatively. The distance between the mid-tape and the outer urethra measured by translabial US showed no significant difference between the two studied groups.

Conclusion: Performing TOT using our tensioned proposed technique in ISD seems to be effective and with low morbidity. Intraoperative adjustment of tension using Valsalva maneuver under saddle anesthesia gives better outcomes than the conventional tension-free technique. The concept of tension-free vaginal tape should be challenged.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/UA.UA_73_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210713PMC
January 2021

Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibodies in Egyptian Convalescent Plasma Donors.

Front Microbiol 2020 24;11:596851. Epub 2020 Nov 24.

Center of Scientific Excellence for Influenza Viruses, National Research Center, Giza, Egypt.

Using convalescent plasma as immunotherapy is an old method for treatment of infectious diseases. Several countries have recently allowed the use of such therapy for the treatment of COVID-19 patients especially those who are critically ill. A similar program is currently being tested in Egypt. Here, we tested 227 plasma samples from convalescent donors in Egypt for neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using a microneutralization (MN) assay. A third of the tested samples did not have antibody titers and 58% had titers between 1:10 and 1:80. Only 12% had titers >1:160. We also compared MN assays using different virus concentrations, plaque reduction neutralization (PRNT) assays, and a chemiluminescence assay that measures immunoglobulin G (IgG) binding to N and S proteins of SARS-CoV-2. Our results indicated that a MN assay using 100 TCID50/ml provides comparable results to PRNT and allows for high throughput testing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmicb.2020.596851DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732494PMC
November 2020

Hepatitis B Awareness and Vaccination Patterns among Healthcare Workers in Africa.

Am J Trop Med Hyg 2020 12 1;103(6):2460-2468. Epub 2020 Oct 1.

Department of Gastroenterology and Hepatology, Hennepin Healthcare, Minneapolis, Minnesota.

Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a -value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, < 0.001; 74% versus 58%, < 0.001; and 62% versus 45%, = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, < 0.0001 and 52% versus 60%, = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4269/ajtmh.20-0521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695068PMC
December 2020

Improvement of platelet in thrombocytopenic HCV patients after treatment with direct-acting antiviral agents and its relation to outcome.

Platelets 2021 Apr 6;32(3):383-390. Epub 2020 Apr 6.

Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Little is known about evolution of platelet count after treatment with direct-acting antiviral agents (DAAs). The study aimed to evaluate the changes in platelet count after treatment with DAAs among thrombocytopenic patients with HCV-related advanced fibrosis and cirrhosis. A total of 915 chronic HCV patients with advanced fibrosis and cirrhosis who were treated with different DAAs-based regimens were retrospectively enrolled in final analysis. Included patients were those with thrombocytopenia (TCP). Platelet count was recorded at baseline, end of treatment (EOT) and 24-weeks after EOT (SVR24). Changes in platelet count and its relation to SVR were analyzed. The overall SVR24 rate was 98.8%. The platelet count showed statistically significant improvement from baseline to EOT (107 (84-127) × 10/mm vs. 120 (87-153) × 10/mm( = <0.0001) but remained unchanged thereafter to SVR24. Among responders, the platelet count significantly increased at SVR24 compared to baseline (<0.0001) but in relapsers, there was improvement in platelet count that didn't reach statistical significance (0.9). Logistic regression analysis showed that higher Child-Pugh score and more advanced fibrosis at baseline were significant predictors of decreasing of platelet count and development of severe TCP at SVR24. Among thrombocytopenic patients with HCV-related advanced fibrosis and cirrhosis, the platelet count improved after treatment with DAAs regardless to treatment response.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09537104.2020.1742313DOI Listing
April 2021

An account of the real-life hepatitis C management in a single specialized viral hepatitis treatment centre in Egypt: results of treating 7042 patients with 7 different direct acting antiviral regimens.

Expert Rev Gastroenterol Hepatol 2018 Dec 24;12(12):1265-1272. Epub 2018 May 24.

c Endemic Medicine and Hepato-Gastroenterology Department, Faculty of Medicine , Cairo University , Cairo , Egypt.

Background: A large Egyptian treatment program for HCV was launched in2014 after the introduction of direct-acting antiviral agents (DAAs). This program depended mainly on establishing specialized independent centres for HCV treatment. These centres represent the major strengths in the Egyptian model of care, as they provide integrated care for HCV patients and have enabled Egypt to treat more than one million patients in 3 years. The New Cairo Viral Hepatitis Treatment Center (NCVHTC) is an example of these specialized centres.

Methods: The Egyptian experience in the management of HCV was evaluated by analysing the data of real-life HCV management in the NCVHTC from 2014 to 2017. Results of different treatment regimens in addition to their strengths, limitations and areas for improvement are discussed in this report.

Results: A total of 7042 HCV patients have been evaluated for treatment in the NCVHTC. Among them, 5517 patients received treatment by seven different DAA regimens with excellent results.

Conclusions: All regimens were highly effective at treating HCV in a real-life setting, apart from SOF/RBV, which was the least effective. A nationwide screening program and enhancing the follow-up of treated patients are the main missing pillars in the Egyptian model.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17474124.2018.1476137DOI Listing
December 2018

A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms.

Arab J Urol 2017 Jun 6;15(2):153-158. Epub 2017 Mar 6.

Department of Urology, Radboud University Nijmegen Medical Centre, The Netherlands.

Objective: To determine the ability of bladder wall thickness (BWT) in combination with non-invasive variables to distinguish patients with bladder outlet obstruction (BOO).

Patients And Methods: Patients completed the International Prostate Symptom Score (IPSS) questionnaire and prostate size was measured by transrectal ultrasonography (US). Pressure-flow studies were performed to determine the urodynamic diagnosis. BWT was measured at 250-mL bladder filling using transabdominal US. Recursive partition analysis (RPA) recursively partitions data for relating independent variable(s) to a dependent variable creating a tree of partitions. It finds a set of cuts of the dependent variable(s) that best predict the independent variable, by searching all possible cuts until the desired fit is reached. RPA was used to test the ability of the combined data of BWT, maximum urinary flow rate (), post-void residual urine volume (PVR), IPSS, and prostate size to predict BOO.

Results: In all, 72 patients were included in the final analysis. The median BWT, voided volumes, PVR, mean , and IPSS were significantly higher in patients who had an Abrams/Griffiths (A/G) number of >40 (55 patients) compared to those with an A/G number of ≤40 (17 patients). RPA revealed that the combination of BWT and gave a correct classification in 61 of the 72 patients (85%), with 92% sensitivity and 65% specificity, 87% positive predictive value, and 76% negative predictive value (NPV) for BOO (area under the curve 0.85). The positive diagnostic likelihood ratio of this reclassification fit was 2.6.

Conclusions: It was possible to combine BWT with to create a new algorithm that could be used as a screening tool for BOO in men with lower urinary tract symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.aju.2017.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653605PMC
June 2017

Does sacral pulsed electromagnetic field therapy have a better effect than transcutaneous electrical nerve stimulation in patients with neurogenic overactive bladder?

Arab J Urol 2017 Jun 29;15(2):148-152. Epub 2017 Mar 29.

Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.

Objective: To compare the effectiveness of pulsed electromagnetic field therapy (PEMFT) and transcutaneous electrical nerve stimulation (TENS) on neurogenic overactive bladder dysfunction (OAB) in patients with spinal cord injury (SCI).

Patients And Methods: In all, 80 patients [50 men and 30 women, with a mean (SD) age of 40.15 (8.76) years] with neurogenic OAB secondary to suprasacral SCI were included. They underwent urodynamic studies (UDS) before and after treatment. Patients were divided into two equal groups: Group A, comprised 40 patients who received 20 min of TENS (10 Hz with a 700 s generated pulse), three times per week for 20 sessions; Group B, comprised 40 patients who received PEMFT (15 Hz with 50% intensity output for 5 s/min for 20 min), three times per week for 20 sessions.

Results: In Group B, there was a significant increase in the maximum cystometric capacity ( < 0.001), volume at first uninhibited detrusor contraction ( < 0.002), and maximum urinary flow rate ( < 0.02).

Conclusion: The UDS showed that the effects of PEMFT in patients with neurogenic OAB secondary to suprasacral SCI was better than TENS for inducing an inhibitory effect on neurogenic detrusor overactivity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.aju.2017.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653612PMC
June 2017

Laparoscopic repyeloplasty after failed open repair of ureteropelvic junction obstruction: a case-matched multi-institutional study.

Scand J Urol 2017 Oct 8;51(5):402-406. Epub 2017 Aug 8.

c Urology Department , Alexandria University , Alexandria , Egypt.

Objective: The aim of this study was to retrospectively review the experience and midterm results of laparoscopic pyeloplasty (LP) in patients with previous failed open pyeloplasty in comparison to primary LP.

Materials And Methods: Thirty-two patients who had undergone previous failed open surgery for management of ureteropelvic junction obstruction (UPJO) were reviewed. The patients underwent transperitoneal dismembered LP. All operations were performed by the same laparoscopist from March 2009 to June 2013. Surgical results were compared to 72 patients who underwent primary LP carried out by the same surgeon during the same period.

Results: The laparoscopic repyeloplasty group consisted of 14 men and 18 women. The mean age was 29 ± 6 years. The mean operative period was 133 ± 42 and 110 ± 57 min; the mean length of stay in hospital was 2.7 ± 2.3 and 1.3 ± 2.1 days; and the mean follow-up period was 32.4 ± 14 and 29.3 ± 11.2 months in the secondary and primary LP groups, respectively. The success rate was 90.6% for secondary LP and 94.4% for primary LP. There was no conversion in either group. The percentage of intraoperative and postoperative complications in secondary LP was 9.4% and 12.5%, respectively, compared with 0% and 5.6% in the primary LP group.

Conclusions: Laparoscopic repyeloplasty is a safe and viable treatment option for secondary UPJO, with a success rate similar to that of primary repair but with longer operative time. Considerable experience in laparoscopic reconstructive procedures is a prerequisite for optimal results.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/21681805.2017.1347819DOI Listing
October 2017

Phosphodiesterase type 5 inhibitors: Irrational use in Saudi Arabia.

Arab J Urol 2016 Jun 5;14(2):94-100. Epub 2016 May 5.

Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.

Objective: To identify the criteria of phosphodiesterase type 5 inhibitor (PDE5i) users and to analyse the knowledge, attitude, and practices of PDE5i use amongst Saudi men.

Subjects And Methods: A web-based, cross-sectional survey was conducted in Saudi Arabia between January and April 2015. Sexually active adult men were interviewed using a website questionnaire designed by the authors. Descriptive statistics were used to analyse the data.

Results: In all, 1008 men participated in the survey with 378 (37.5%) reporting use of PDE5i. Of those using PDE5i, 144 (38.1%) reported erectile dysfunction and 234 (61.9%) reported normal erection (recreational users). We found several demographic features, including high education level, health field occupation, high income, smoking, and increased frequency of sexual intercourse amongst the PDE5i users. Most of the PDE5i users (92.3%) had knowledge about PDE5i and 84.1% of them bought it without medical prescription. The most commonly used PDE5i was tadalafil (46.1%) and most of the users (79.9%) reported improvement in their sexual activity after PDE5i usage. Amongst the recreational users, the main reasons for PDE5i usage were curiosity (38.5%) and improving self-confidence (25.6%). Of them, 69.2% reported benefits from PDE5i usage, mainly in the form of enhancement of erection (36.7%) and increasing erection duration (31.2%).

Conclusion: PDE5i use appears to be frequent in Saudi Arabia. Most of the users had knowledge about PDE5i and claimed to get benefits from it, even if used as a recreational drug.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.aju.2016.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963165PMC
June 2016

Transurethral Pneumatic Cystolithotripsy: A Novel Approach.

J Endourol 2016 06 24;30(6):671-3. Epub 2016 May 24.

1 Department of Urology, School of Medicine, Minia University , Minia, Egypt .

Objective: Various endoscopic instruments used in treating renal stones have been used in managing bladder calculi. Our aim is to evaluate the use of transurethral ureteroscopic pneumatic cystolithotripsy for the management of large bladder calculi.

Patients And Methods: In a retrospective study conducted between May 2005 and July 2011, 53 patients with solitary bladder stones were subjected to our technique, transurethral ureteroscopic pneumatic cystolithotripsy. The mean patient age was 54.3 years. The mean stone size was 4.8 cm. Diagnostic cystoscopy was performed first. A semirigid ureteroscope with a pneumatic probe was introduced through the cystoscope sheath, and pneumatic lithotripsy was performed. The cystoscope sheath works as a draining channel, allowing bladder evacuation. The bladder collapses over the stone and, subsequently, prevents stone migration, which shortens the lithotripsy's duration. Stone immobilization allows the transmission of full pneumatic power to the stone. The stone fragments were removed through periodic bladder irrigation using an Ellick evacuation-irrigation system, and a 16F Foley catheter was placed at the end of the procedure.

Results: Our technique was effective in all cases, including stone-free bladders. No surgical complications were detected. The mean operative time was 83 ± 21.0 minutes, which is comparable to that of standard management. The mean duration of lithotripsy and evacuation was 29.7 ± 18.4 minutes. In the postoperative period, patients were followed up for 18 months, with no urethral stricture being reported in any case.

Conclusion: The transurethral ureteroscopic pneumatic cystolithotripsy procedure is a safe technique for the management of large bladder calculi. It allows the bladder to collapse over the stone, leading to stone immobilization and, subsequently, decreasing lithotripsy duration. Our procedure is associated with a minimal chance of postoperative urethral injury because all stone fragments are evacuated through the cystoscope sheath, without contact with the urethral urothelium.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/end.2015.0862DOI Listing
June 2016

Adjustable vs. ordinary transobturator tape for female stress incontinence. Is there a difference?

Arab J Urol 2015 Jun 12;13(2):134-8. Epub 2015 Mar 12.

Urology and Nephrology Center, Mansoura University, Egypt.

Objectives: To determine whether there are any significant differences in complications and success rate between adjustable transobturator tape (TOA) and ordinary transobturator tape (TOT) in the treatment of female stress urinary incontinence (fSUI), as the TOA was recently introduced for the treatment of female SUI, its advantage being the ability to adjust the tape after surgery to address over- or under-correction.

Patients And Methods: In all, 96 women with SUI (mean age 53 years, SD 10) were included in the study. Patients were randomised into two equal groups (group 1, TOA, vs. group 2, TOT). The operative duration, blood loss, intra- and post-operative complications, and the success rate, were compared between the groups.

Results: There was no statistically significant difference between the groups in cure rates (83% vs. 80%, groups 1 and 2, respectively) or in postoperative stay. The mean operative duration in group 2 was significantly shorter than in group 1. No intraoperative bleeding requiring a blood transfusion was recorded, and there were no bladder injuries. Postoperative adjustment of the tape was only required in three patients in group 1.

Conclusions: The TOA is a safe and accurate method for treating fSUI, but with experienced surgeons there was no difference in the cure rate and postoperative outcome between TOA and TOT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.aju.2015.02.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561926PMC
June 2015

Upper urinary tract retroperitoneoscopic surgery under epidural anesthesia: Shifting towards outpatient treatment.

Scand J Urol 2015 Apr 30;49(2):181-4. Epub 2014 Oct 30.

Departments of Urology.

Objective: Laparoscopy for urological surgery is usually carried out under general anesthesia. However, laparoscopy under epidural anesthesia has been reported to be successful for laparoscopic cholecystectomy, hernia repair, gynecological procedures, renal biopsy and renal cyst unroofing.

Materials And Methods: From August 2011 to July 2013, 46 patients (26 male, 20 female) with a mean age of 35 years underwent retroperitoneoscopic surgery (15 nephrectomy, 21 ureterolithotomy, 10 renal cyst excision) under epidural anesthesia, performed by the same surgeon. Inclusion criteria were patients with benign upper urinary tract pathology, no history of flank operation, American Society of Anesthesiologists score I-II and body mass index less than 25. Pulse oximetry, electrocardiography, non-invasive arterial blood pressure and respiratory rate were monitored intraoperatively. The partial pressure of carbon dioxide in arterial blood and pain assessment via a visual analogue scale were assessed every 30 min. The serum cortisol level was measured to evaluate the surgical stress under epidural anesthesia.

Results: All operations were completed laparoscopically with no conversion to open surgery. Hypotension was observed in six patients (13%) and 16 (34.7%) experienced shoulder pain. The mean operative time was 90 min. No postoperative analgesia was given. All patients could ambulate 4 h after the operation and were discharged on the same day; the mean hospital stay was 6.5 h.

Conclusions: Retroperitoneoscopy for benign upper tract pathology combined with epidural anesthesia is a feasible and an attractive method for both surgeon and patient. No postoperative pain and early recovery are the most beneficial results of this technique. Further studies, applying this technique in patients with cardiopulmonary problems, should be conducted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/21681805.2014.971426DOI Listing
April 2015

Computed tomography-virtual cystoscopy in the evaluation of a bladder mass: Could it replace standard conventional cystoscopy?

Arab J Urol 2013 Dec 23;11(4):369-74. Epub 2013 Aug 23.

Urology Department, Minia University, Minia, Egypt.

Objective: To determine the role of computed tomography-virtual cystoscopy (CT-VC) in the detection and evaluation of bladder cancer, compared to standard conventional cystoscopy (CC).

Patients And Methods: Twenty-five patients with a clinical presentation of a bladder mass(es) were selected from an outpatient urology clinic between May 2011 and August 2012. All patients were then assessed using multi-slice CT of the bladder, CT-VC and CC. The results were then compared amongst axial CT images, multiplanar reconstruction (MPR) images, CT-VC and CC, and compared with the pathological results.

Results: Forty lesions were found at CC in the 25 patients. MPR images had a greater sensitivity for detecting small masses of ⩽5 mm, and for identifying the location of the masses, especially basal (100%), than had axial images. The diagnostic results varied significantly (P = 0.031 and 0.039) between CC and axial images. The difference was slightly significant (P = 0.063) for MPR images and was not significant (P = 0.99) for virtual images.

Conclusions: Compared to CC, CT-VC was much less invasive, but it was not possible to take a biopsy and provide tissue for histopathology, and it could not depict flat lesions or mucosal colour changes. Therefore, CT-VC could be considered for bladder mapping before CC, in the follow-up of patients with superficial transitional cell carcinoma after transurethral resection of the tumour, in combination with urine cytology, and for patients in whom CC is difficult or contraindicated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.aju.2013.06.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582599PMC
December 2013

Expression of Snail transcription factor in prostatic adenocarcinoma in Egypt: correlation with Maspin protein expression and clinicopathologic variables.

Int J Clin Exp Pathol 2013 15;6(8):1558-66. Epub 2013 Jul 15.

Department of Pathology, Faculty of Medicine, Minia University, El-Minia, Egypt.

Background: Snail transcription factor and Maspin tumor suppressor serpin are involved in the regulation of progression, invasion and metastasis of many human malignancies. However, there is very limited data in the literature about their role in prostatic adenocarcinoma. The present study was designed to investigate Snail and Maspin expression, their interrelationship and their relationship to different clinicopathologic variables in clinically detectable prostatic adenocarcinoma.

Material And Methods: Tissue sections from 110 resected prostatic lesions distributed as 80 cases of prostatic adenocarcinoma and 30 cases of benign prostatic hyperplasia (BPH) were evaluated for Snail and Maspin proteins expression by immunohistochemistry.

Results: Snail protein expression was detected in 53.8% of prostatic adenocarcinomas versus none of BPH cases (p = < 0.001). A significant positive correlation of Snail expression to cancer grade (p = 0.015), lymph node metastasis (p = 0.026) and pTNM stage (p = 0.036). Maspin expression was detected in 36.6% of prostatic adenocarcinomas versus 93.3% of BPH cases (p = < 0.001). A significant negative correlation of Maspin expression to cancer grade (p = 0.007) and lymphovascular invasion (p = 0.017). Also detected was a significant negative relationship between Snail and Maspin expression in cancer cases under investigation (p = 0.002).

Conclusion: Snail immunohistochemical expression can be promising as a potential prognostic biomarker in prostatic adenocarcinoma since it was significantly associated with clinicopathologic variables of progressive disease. A potential role for Snail in regulating Maspin expression is suggested based on the finding of negative association between Snail and Maspin expression in prostatic adenocarcinoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726971PMC
March 2014

Extracorporeal shock wave lithotripsy as first line treatment for urinary tract stones in children: outcome of 500 cases.

Int Urol Nephrol 2012 Jun 16;44(3):661-6. Epub 2012 Feb 16.

The Urology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

Purpose: The continued evolution of stone treatment modalities, such as endourologic procedures, open surgery and shock wave lithotripsy, makes the assessment of continuous outcomes are essential. Pediatric urolithiasis are an important health problem allover the world, especially in Middle East region. We evaluate the safety, efficacy and factors affecting success rate and clearance of stones in children treated with shock wave lithotripsy.

Patient And Methods: Between 2005 and 2010, a total of 500 children with stones in the upper urinary tract at different locations were treated by Extracorporeal shock wave lithotripsy (ESWL) in our department, Sohag University, Egypt. We have used the Siemn's Lithostar Modularis machine, Germany. A total of 371 boys and 129 girls with the average age of 8.63 ± 5 years, and a range from 9 months to 17 years were included in this study. Diagnosis of their urinary calculi was established either by the use of abdominal ultrasound, plain X-ray, intravenous urography, or CT scan. The stones were located in the kidney in 450 (90%) patients; 298 (66%) pelvic, 26 (5.7%) upper calices, 57 (12.6%) mid calices, and lower calices in 69 (15.3%) patients. The average of their stone sizes was 12.5 ± 7.2 mm. The other 50 children their stone were located in the proximal ureteral stones in 35 patients (70%); middle third in 5 (10%) patients and in the distal ureter in 10 (20%) patients. The average ureteral stone size was 7.5 ± 3.2 mm. All children were treated under general anesthesia with adequate lung and testes shielding using air foam. We treated the distal ureteral stones of young children in the supine position through greater sciatic foramen and lesser sciatic foramen as the path of shockwave instead of prone position, which is not a comfortable or natural position and could adversely affect cardiopulmonary function especially under general anesthesia. Localization was mainly done by ultrasound, and X-ray was only used to localize ureteral calculi. For follow-up, we have used abdominal ultrasound, plain X-ray, and CT scan if needed to confirm stone disintegration and clearance.

Results: The overall success rate for renal and ureteral calculi was 83.4 and 58.46%, respectively. The re-treatment rate was 4% in renal group and 28% for the ureteral group. No serious complications were recorded in our patients. Minor complications occurred in 15% of our patients; renal colic was reported in 10% of our treated patients, and repeated vomiting was reported in 5% that respond to antiemetics. In the renal group; children with history of pervious urologic surgical procedures had low success rate of stone clearance after ESWL. In the ureteral group stone burden, stone location, had a significant impact on stone clearance outcome.

Conclusion: This study showed that SWL in pediatric age group for both renal and ureteral stone is cost effective, safe with an acceptable re-treatment rate; however children with large stone burden or previous urologic surgery have low success rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11255-012-0133-0DOI Listing
June 2012

Prevalence of auditory neuropathy (AN) among infants and young children with severe to profound hearing loss.

Int J Pediatr Otorhinolaryngol 2009 Jul 5;73(7):937-9. Epub 2009 May 5.

Audiology Unit, ENT Dept., Menoufiya University, Egypt.

Unlabelled: Auditory neuropathy is a challenging disorder and needs special habilitative/rehabilitative approach. This study aimed to detect its prevalence among infants and young children with severe to profound hearing loss. 112 infants and young children with age ranged 6-32 months were examined and diagnosed as having severe to profound hearing loss and were referred for hearing aid fitting. Those infants were reassessed in our centers for detecting cases with auditory neuropathy. The study group was subjected to immittancemetry, behavioral observation audiometry, ABR and cochlear microphonics.

Results: 15 patients were found to have auditory neuropathy according to our criteria for diagnosis.

Conclusions: The prevalence of AN in the study group was 13.4%. CM were recommended to be tested routinely during ABR assessment whenever abnormal results are obtained.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijporl.2009.03.009DOI Listing
July 2009
-->