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Double Incomplete Pyloromyotomy (A. ezzat Technique): A New Technique for Infantile Hypertrophic Pyloric Stenosis: Preliminary Study

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Open Journal of Pediatrics 2014年第4期4卷 253-256页

作者： Ahmed ezzat Rozeik Radi Elsherbini Hamdi Almaramhy Pediatric Surgery Unit Zagazig University Al Sharqia Governorate Egypt Pediatric Surgery Unit Mansoura University Mansoura Egypt Faculty of Medicine Taibah University Medina KSA

Background-Purpose: The study aimed to see the outcome of Double Incomplete Pyloromyotomy as new technique for surgical management of infantile hypertrophic pyloric stenosis (IHPS). Methods: This study was conducted in pediatric surgery unite, Zagazig University Hospital, Egypt. Fifteen patients were included in this study (11 male and 4 female) with IHPS from January 2012 to January 2013. Under general anesthesia, two longitudinal separated incisions at different planes as pyloromyotomy. Results: Postoperative vomiting and weight gain were recorded. Follow up period was 3 months. Vomiting improved within first 48 hours then stopped after that. Weight gain significantly increased after theoperation when compared preoperatively. Conclusion: Double Incomplete Pyloromyotomy is a new, safe and effective procedure for treatment of infantile hypertrophic pyloric stenosis.

关键词： Hypertrophic Pyloric Stenosis Double Incomplete Pyloromyotomy

Association of vitamin D receptor gene polymorphism(VDR)with vitamin D deficiency,metabolic and inflammatory markers in Egyptian obese women

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Genes & Diseases 2017年第3期4卷 176-182页

作者： Moushira Zaki Sanaa Kamal Walaa ABasha Eman Youness Wafaa ezzat Hala El-Bassyouni Khalda Amr Biological Anthropology Department National Research CentreGizaEgypt Medical Biochemistry Department National Research CentreGizaEgypt Internal Medicine Department National Research CentreGizaEgypt Clinical Genetics Department National Research CentreCairoEgypt Medical Molecular Genetics Department National Research CentreEgypt

Vitamin D deficiency might contribute to the pathogenesis of metabolic syndrome and could cause immune *** aim of this study is to analyze the associations between Vitamin D receptor(VDR)gene polymorphism,serum 25-hydroxy vitamin D,metabolic and inflammatory biomarkers in Egyptian obese *** study included 201 obese women with vitamin D deficiency and 249 obese matched age healthy controls with sufficient vitamin D *** age ranged between 25 and 35 *** biomarkers(interleukin-6 and C-reactive protein)and serum 25(OH)D were measured by enzyme-linked immunosorbent *** resistance(IR)was determined by the homeostasis model assessment of insulin resistance(HOMA-IR).Vitamin D receptor(VDR)gene polymorphisms of FokI,ApaI,and TaqI were studied by PCR using the restriction fragment length polymorphism(RFLP)*** women with vitamin D deficiency had significant higher values of inflammatory and metabolic parameters compared to ***-logistic regression showed associations between 25(OH)D deficiency and metabolic components when comparing cases with ***,cases carrying polymorphic alleles showed significant lower levels of serum 25(OH)D and higher HOMA-IR,blood pressure levels and lipid parameters compared to those with the wild type homozygote in obese cases with vitamin D *** D deficiency in Egyptian obese women with vitamin D deficiency is associated with abnormal metabolic components and abnormal inflammatory ***,VDR polymorphisms play important role in immune and inflammation status.

关键词： Inflammatory biomarkers Obese women Vitamin D deficiency Vitamin D receptor(VDR)gene polymorphism Egyptian

Early diagnostic evaluation of miR-122 and miR-224 as biomarkers for hepatocellular carcinoma

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Genes & Diseases 2017年第4期4卷 215-221页

作者： Khalda S.Amr Hanan Abd Elmawgoud Atia Rehab Abd Elazeem Elbnhawy Wafaa M.ezzat Medical Molecular Genetics Department National Research CentreCairoEgypt Biochemistry Department Faculty of Pharmacy(Girls)Al-Azhar UniversityCairoEgypt Urology and Nephrology Center Mansoura UniversityMansouraEgypt Internal Medicine Department National Research CenterCairoEgypt

Hepatocellular carcinoma(HCC)is one of the common lethal types of tumor all over the *** lethality of HCC accounts for many *** of them,the lack of reliable diagnostic markers at the early stage,in this context,serum miRNAs became promising diagnostic ***,we aimed to identify the predictive value of two miRNAs(miR-122 and miR-224)in plasma of patients with HCC preceded by chronic HCV *** miRNA assays specific for hsa-miR-122 and hsa-miR-224 were used to assess the expression levels of the chosen miRNAs in plasma samples collected from three groups;40 patients with HCC related to HCV,40 with CHC patients and 20 healthy *** study revealed that the mean plasma values of miRNA-122 were significantly lower among HCC group when compared to CHC and control groups(P1.2(RQ)and(AUC Z 0.93,P<0.001),while the accuracy of AFP to diagnose HCC was(AUC:0.619;P Z 0.06).In conclusion,the expression plasma of miR-122 and miR-224 could be used as noninvasive biomarkers for the early prediction of developing HCC at the early stage.

关键词： Diagnosis Hepatocellular carcinoma miR-122 miR-224 Sensitivity

Management of Stage IB Grade III Endometrial Cancer: Single Institute Experience

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Journal of Cancer Therapy 2019年第4期10卷 290-304页

作者： Ghada ezzat Eladawei Clinical Oncology and Nuclear Medicine Department Mansoura University Mansoura Egypt

Background and Objective: There is marked controversy regarding optimal management patients with stage IB grade III endometrial carcinoma. The present study analyzes the current practices regarding adjuvant radiation therapy for those patients in our institute and also assessed prognostic factor affecting overall survival outcome. Patients and Methods: A total 66 patients with postoperative FIGO stage 1B, grade III endometrial carcinoma were treated and evaluated between the years 2009 and 2014. Risk factors assessed age (4 cm), site of primary tumor (involvement of lower uterine segment versus no involvement), Lymphadenectomy (performed versus not performed), Lymph-vascular space invasion (positive or negative), type of surgery performed (less than total abdominal hysterectomy and bilateral salpingo-ophorectomy (TH/BSO) versus greater than or equal TH/BSO), radiation sequence with surgery (no radiation versus adjuvant radiation), and type of radiation (pelvic external beam radiotherapy versus vaginal brachytherapy versus both). Results: Adjuvant radiation therapy after surgery was associated with significantly better time to relapse (p = 0.001) in comparison to those patients who underwent surgery alone. There was statistically significant improvement of survival of patients who received adjuvant radiation therapy in comparison with those who underwent surgery alone. There was no statistically significant difference in relapse between external pelvic radiotherapy, brachytherapy and both (p = 0.161). There was no statistically significant difference in overall survival between different types of adjuvant radiation therapy (p = 0.318). Adjuvant radiation therapy (HR 0.173, 95% CI 0.049 - 0.609, p = 0.006) and tumor size (HR 4.065, 95% CI 1.120 - 14.761, p = 0.033) were the only statistically significant predictors for relapse in multivariate analysis. Adjuvant radiation therapy (HR 0.159, 95% CI 0.045 - 0.563, p = 0.004), ag

关键词： Endometrial Cancer Adjuvant Radiation Therapy External Pelvic Radiotherapy Brachytherapy Survival

ONE WORLD, ONE FAMILY, ONE BRIDGE CHAMPION——Confucius Institute crowns the 17th “Chinese Bridge” champion

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China Report ASEAN 2018年第11期3卷 44-46页

作者： Wafaa ezzat

Ayman Abd Al-maksoud Yousef, MD, Series Editor Prognostic categorization of intensive care septic patients

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World Journal of Critical Care Medicine 2012年第3期1卷 67-79页

作者： Mohamed ezzat Moemen Department of Anaesthesia and Intensive Care Faculty of medicine Zagazig University

Sepsis is one of the leading worldwide causes of morbidity and mortality in critically-ill patients. Prediction of outcome in patients with sepsis requires repeated clinical interpretation of the patients' conditions, clinical assessment of tissue hypoxia and the use of severity scoring systems, because the prognostic categorization accuracy of severity scoring indices alone, is relatively poor. Generally, such categorization depends on the severity of the septic state, ranging from systemic inflammatory response to septic shock. Now, there is no gold standard for the clinical assessment of tissue hypoxia which can be achieved by both global and regional oxygen extractabilities, added to prognostic pro-inflammatory mediators. Because the technology used to identify the genetic make-up of the human being is rapidly advancing, the structure of 30 000 genes which make-up the human DNA bank is now known. This would allow easy prognostic categorization of critically-ill patients including those suffering from sepsis. The present review spots lights on the main severity scoring systems used for outcome prediction in septic patients. For morbidity prediction, it discusses the Multiple Organ Dysfunction score, the sequential organ failure assessment score, and the logistic organdysfunction score. For mortality/survival prediction, it discusses the Acute Physiology and Chronic Health Evaluation scores, the Therapeutic Intervention Scoring System, the Simplified acute physiology score and the Mortality Probability Models. An ideal severity scoring system for prognostic categorization of patients with systemic sepsis is far from being reached. Scoring systems should be used with repeated clinical interpretation of the patients' conditions, and the assessment of tissue hypoxia in order to attain satisfactory discriminative performance and calibration power.

关键词： Prognostic markers Genome Sepsis Systemic inflammatory Response syndrome Severity scoring systems

Outcomes of pancreaticoduodenectomy in elderly patients

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Hepatobiliary & Pancreatic Diseases International 2016年第4期15卷 419-427页

作者： Ayman El Nakeeb Ehab Atef Ehab El Hanafy Ali Salem Waleed Askar Helmy ezzat Ahmed Shehta Mohamed Abdel Wahab Gastroenterology Surgical Center Mansoura University

BACKGROUND： Although the mortality and morbidity of pancreaticoduodenectomy（PD） have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly ***： We studied all patients who had undergone PD in our center between January 1995 and February 2015. The patients were divided into three groups based on age： group I（patients aged 〈60 years）, group II（those aged 60 to 69 years） and group III（those aged ≥70 years）. The primary outcome was the rate of total postoperative complications. Secondary endpoint included total operative time, hospital mortality, length of postoperative hospital stay, delayed gastric emptying, re-exploration, and survival ***： A total of 828 patients who had undergone PD for resection of periampullary tumor were included in this study. There were 579（69.9%） patients in group I, 201（24.3%） in group II, and 48（5.8%） in group III. The overall incidence of complications was higher in elderly patients（25.9% in group I, 36.8% in group II, and 37.5% in group III; P=0.006）. There were more patients complicated with delayed gastric emptying in group II compared with the other two groups. There was no significant difference in the incidence of postoperative pancreatic fistula, biliary leakage, pancreatitis, pulmonary complications and hospital ***： PD can be performed safely in selected elderly patients. Advanced age alone should not be a contraindication for PD. The outcome of elderly patients who have undergone PD is similar to that of younger patients, and the increased rate of complications is due to the presence of associated comorbidities.

关键词： pancreaticoduodenectomy elderly pancreatic fistula delayed gastric emptying

Biliary leakage following pancreaticoduodenectomy:Prevalence,risk factors and management

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 67-72页

作者： Ayman El Nakeeb Mohamed El Sorogy Hosam Hamed Rami Said Mohamad Elrefai Helmy ezzat Waleed Askar Ahmed M Elsabbagh Gastroenterology Surgical Center Mansoura University

Background: Few studies investigated biliary leakage after pancreaticoduodenectomy(PD) especially when compared to postoperative pancreatic fistula(POPF). This study was to determine the incidence of biliary leakage after PD, predisposing factors of biliary leakage, and its management. Methods: We retrospectively studied all patients who underwent PD from January 2008 to December 2017 at Gastrointestinal Surgery Center, Mansoura University, Egypt. According to occurrence of postoperative biliary leakage, patients were divided into two groups. Group(1) included patients who developed biliary leakage and group(2) included patients without identified biliary leakage. The preoperative data, operative details, and postoperative morbidity and mortality were analyzed. Results: The study included 555 patients. Forty-four patients(7.9%) developed biliary leakage. Ten patients(1.8%) had concomitant POPF. Multivariate analysis identified obesity and time needed for hepaticojejunostomy reconstruction as independent risk factors of biliary leakage, and no history of preoperative endoscopic retrograde cholangiopancreatiography(ERCP) as protective factor. Biliary leakage from hepaticojejunostomy after PD leads to a significant increase in development of delayed gastric emptying, and wound infection. The median hospital stay and time to resume oral intake were significantly greater in the biliary leakage group. Non-surgical management was needed in 40 patients(90.9%). Only 4 patients(9.1%) required re-exploration due to biliary peritonitis and associated POPF. The mortality rate in the biliary leakage group was significantly higher than that of the non-biliary leakage group(6.8% vs 3.9%, P = 0.05). Conclusions: Obesity and time needed for hepaticojejunostomy reconstruction are independent risk factors of biliary leakage, and no history of preoperative ERCP is protective factor. Biliary leakage increases the risk of morbidity and mortality especially if concomitant with POPF. Howeve

关键词： Pancreatic head carcinoma Pancreaticodudenetomy Postoperative pancreatic fistula Biliary leakage

Impact of referral pattern and timing of repair on surgical outcome after reconstruction of post-cholecystectomy bile duct injury:A multicenter study

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 53-60页

作者： Ayman El Nakeeb Ahmad Sultan Helmy ezzat Mohamed Attia Mohamed Abd ElWahab Taha Kayed Ayman Hassanen Ahmad AlMalki Ahmed Alqarni Mohammed M Mohammed Gastrointestinal Surgical Center Mansoura UniversityMansouraEgypt Minia University Hospital MiniaEgypt Aseer Central Hospital Aseer regionSaudi Arabia

Background:Bile duct injury(BDI)after cholecystectomy remains a significant surgical *** guideline exists to guide the timing of repair,while few studies compare early versus late repair *** study aimed to analyze the outcomes in patients undergoing immediate,intermediate,and delayed repair of ***:We retrospectively analyzed 412 patients with BDI from March 2015 to January *** patients were divided into three groups based on the time of BDI *** 1 underwent an immediate reconstruction(within the first 72 hours post-cholecystectomy,n=156);group 2 underwent an intermediate reconstruction(from 4 days to 6 weeks post-cholecystectomy,n=75),and group 3 underwent delayed reconstruction(after 6 weeks post-cholecystectomy,n=181).Results:Patients in group 2 had significantly more early complications including anastomotic leakage and intra-abdominal collection and late complications including anastomotic stricture and secondary liver cirrhosis compared with groups 1 and *** outcome was observed in 111(71.2%)patients in group 1,31(41.3%)patients in group 2,and 157(86.7%)patients in group 3(P=0.0001).Multivariate analysis identified that complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of favorable outcome in group 1,the use of external stent was an independent factor of favorable outcome in group 2,and level E4 BDI was an independent factor of unfavorable outcome in group *** BDI and level E4 BDI were independent factors of unfavorable ***:Favorable outcomes were more frequently observed in the immediate and delayed reconstruction of post-cholecystectomy *** ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of a favorable outcome.

关键词： Bile duct injury Hepaticojejunostomy Anastomotic stricture Biloma Biliary peritonitis