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Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

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Open Journal of Thoracic Surgery 2021年第2期11卷 47-57页

作者： montaser abd elaziz Mohammed Eltaweel Mohamed Elsayed Mohammed El-Hag-Aly Cardiothoracic Surgery Department Faculty of Medicine Menoufia University Al Minufya Egypt Faculty of Medicine Jazan University Jazan KSA

Background: Aspiration of foreign body is popular in pediatric age group and is considered as an important cause of respiratory distress and chocking in these children. Management strategies are different according to the mode of presentation. This study aims to assess the efficacy of rigid bronchoscopy and the role of bronchotomy as a safe alternative for failed removal of inhaled foreign body. Methods: We enrolled 254 patients with foreign body aspiration (FBA) up to 14 years old in a retrospective observational study. Our patients were reviewed from the Cardiothoracic Surgery Department and cases referred from Otorhinolaryngology Department, Menoufia University Hospital between June 2010 and July 2017. Using jet ventilation technique, foreign body was removed by the rigid bronchoscopy with either extracting forceps or postural drainage. Surgical interference such as bronchotomy needed in distally impacted foreign bodies (FBs). Results: Our study included 254 patients prepared for bronchoscopic FBs extraction. Most of cases (68.8%) presented early within first week (174 cases). No FBs detected in 44 cases by rigid bronchoscopy, although it was successful in 176 (69.5%) cases with non- impacted inhaled FBs. 14 cases only needed postural drainage due to inaccessible FBs, another 12 cases failed to extract FB with rigid bronchoscopy but they were managed with flexible bronchoscopy. Bronchotomy was needed for impacted FBs in eight cases (3%). Conclusion: This study’s findings support that rigid bronchoscopy is the gold standard in the diagnosis and removal of foreign body aspirations in pediatrics, but rigid bronchoscopy demonstrated less capability in the diagnosis and removal of small distally located foreign bodies. Bronchotomy is safe and effective alternative.

关键词： Bronchoscopy Bronchotomy Foreign Body

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The Need for Cardiac Pacing after Isolated Coronary Artery Bypass Graft Surgery

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Open Journal of Thoracic Surgery 2022年第2期12卷 21-32页

作者： montaser Elsawy abd elaziz Eman Gomaa Saleh Mohamed Gaber Elsayed Bassem A. Hafez Cardiothoracic Surgery Department Faculty of Medicine Menoufia University Menoufia Egypt Faculty of Medicine Jazan University Jazan Saudi Arabia Neuropsychiatry Department Faculty of Medicine Menoufia University Menoufia Egypt

Background: The aim of this study is to assess the necessity of temporary cardiac pacing and identify the predictors of pacing after coronary artery bypass graft (CABG). Methods: This was a retrospective observational study of 150 patients who had isolated CABG between November 2013 and December 2021. Patients were classified into two groups: group A, (n = 135) who did not need to be paced and group B, (n = 15) who needed temporary epicardial pacing. Only 10% (15/150) of patients in the study needed pacing. The primary outcome variable was assessment of the need for postoperative temporary cardiac pacing (TCP) (patients were paced during chest closure or at any time during hospital admission). The incidence of pacing during the postoperative period was observed. Univariate and multivariate predictors for postoperative pacing were determined and specicific predictors for cardiac pacing were found. Results: In both univariate and multivariate analysis, Old age > 65 years, diabetes mellitus, pacing to come off cardiopulmonary bypass (CPB), CPB time > 100 min, cardioversion to leave OR, antiarrhythmics to leave OR and new onset of atrial fibrillation (AF), were found to be significant predictors for the need to cardiac pacing. Conclusion: After coronary artery bypass surgery, a small percentage of patients require TCP. We emphasize unique predictors for postoperative pacing in this study.

关键词： Temporary Epicardial Pacing Coronary Artery Bypass Arrhythmias

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Moderate Secondary Tricuspid Regurgitation: Does It Worth More Time to Conserve?

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Open Journal of Thoracic Surgery 2021年第3期11卷 59-68页

作者： montaser Elsawy abd elaziz Ahmed Labib Dokhan Awny Gamal Shalaby Hesham Hassan Ahmed Mohammed Ahmed El-Hag-Aly Mohammed Fawzy Eltaweel Cardithoracic Surgery Department Faculty of Medicine Menoufia University Menoufia Egypt Faculty of Medicine Jazan University Jazan KSA Cardiology Department Faculty of Medicine Menoufia University Menoufia Egypt

Background: Concomitant repair of moderate secondary tricuspid regurgitation (STR) during mitral valve surgery is still subject of controverse. This research aims to study the early and mid-term postoperative influence of tricuspid repair on the clinical outcomes and right ventricular functions. Methods: This is a retrospective cohort study of 92 patients with moderate STR who underwent tricuspid valve repair

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Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

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Open Journal of Thoracic Surgery（胸外科期刊） 2021年第2期

作者： montaser abd elaziz Mohammed Eltaweel Mohamed Elsayed Mohammed El-Hag-Aly

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Moderate Secondary Tricuspid Regurgitation: Does It Worth More Time to Conserve?

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Open Journal of Thoracic Surgery（胸外科期刊） 2021年第3期

作者： montaser Elsawy abd elaziz Ahmed Labib Dokhan Awny Gamal Shalaby Hesham Hassan Ahmed Mohammed Ahmed El-Hag-Aly Mohammed Fawzy Eltaweel

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Minimally Invasive Hind-Foot Fusion in Charcot Patients

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Open Journal of Orthopedics 2023年第11期13卷 477-484页

作者： Sami Nogdallah Mohanad Osman Ibrahim abd-Elseed Alaa Mohamed Mohamed Khairy Osama Gamal Nubi montaser Fatooh Hozifa Mohammed Ali abd-Elmaged Department of Orthopedics Alneelain University Khartoum Sudan Department of Orthopedics Orthopaedic Registrar Sudan Medical Specialization Board Khartoum Sudan Department of Orthopedics Bashaer University Hospital MBBS Al Neelan University Khartoum Sudan Department of Orthopedics Alzaiem Alazhari University Khartoum Sudan

Background: Hindfoot fusion, is a fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints and is commonly performed for patients complaining of pain, chronic instability and gross deformity as a result of hindfoot pathology. Objective: This study aimed to assess the functional outcomes of the patients underwent hindfoot fusion, the post-operative complications and patient’s satisfaction. Methodology: This study is a prospective cohort study was conducted in Future hospital, in Khartoum, Sudan. It involved 30 patients from July 2015-July 2022. Data was collected by the primary researcher using data collection sheet, then it was cleaned and entered into Microsoft excel data sheet and was analysed using SPSS version 28 software. Results: 33.3% of the patients are aged 51 - 60 years, and >60 years. Male: Female equals 1:1. 56.7% are for the left side, only 23.3% developed complications. 63.3% patients are fully satisfied. There is a significant correlation between the AOFAS score before and after the operation. Also, a significant correlation between the means of AOFAS score after with the complications and the satisfaction of the patients. Conclusion: Minimally invasive tibio-talo-calcaneal is an alternative procedure for the treatment of severe Charcot arthropathy of the ankle. The expected functional outcome is impressive and comparable with the open surgery. However, the post-operative complications are prevalent in 23.3% of patients. Most candidates are fully satisfied with the procedure.

关键词： Ankle Sudan Patient Satisfaction Arthropathy Neurogenic

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Prevalence and Correlates of Overweight and Obesity among School Children in Sohag, Egypt

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Open Journal of Gastroenterology 2017年第2期7卷 75-88页

作者： Soumaya El Sayed Ahmed Hadhood Rasha abd Elhameed Ali montaser Mohamed Mohamed Eman Soliman Mohammed Faculty of Medicine Pediatrics Department Sohag University Sohag Egypt Faculty of Medicine Public Health and Community Medicine Department Sohag University Sohag Egypt

Background: Continually rising prevalence of obesity and overweight in children and adolescents is a major public health concern. This is due to its various and serious health hazards on one side and its preventable nature on the other side. This study aims at identification of prevalence of overweight and obesity and its risk factors among children between 6 - 14 years of age in Sohag, Egypt. Method: A cross sectional study was conducted on 711 school children between 6 - 14 years in four months’ period from February to May 2016. Weight and height of the studied children were measured to calculate BMI, which was compared with standard Egyptian growth charts for determining overweight and obesity. Then a questionnaire containing data about socio demographic, parental obesity, early life and dietary risk factors was completed by the children’s parents. Result: Out of 711 studied children, 117 (16.5%) were overweight and 104 (14.6%) were obese. Residing in urban area, having an obese parent or both of them, low level of maternal education, being on formula feeding during early life and lack of fresh vegetables and fruits in diets were significant risk factors for overweight and obesity in the studied children (P value < 0.05). Conclusion: Improperly educated mothers together with sedentary life style manifested in obesity among the parents and lack of sport practice among children constituted the majors risk factors for childhood obesity. This emphasizes the need for increased health awareness of the community about the importance of proper nutrition and physical activity.

关键词： Childhood Overweight and Obesity

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Neglected and Relapsed Clubfoot in Adults, the Functional Outcome of Acute Surgical Correction

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Open Journal of Orthopedics 2023年第2期13卷 41-49页

作者： Sami Nogdallah Hassan Mohamed Hassan ALaa Mohamed Mohamed Khairy Dafaalla Salih Hozifa Mohammed Ali abd-Elmaged montaser Fatooh Orthopedic Department Al Neelain University Khartoum Sudan Bashaer Teaching Hospital Khartoum Sudan Sudan Medical Specialization Board Khartoum Sudan Alzaiem Alazhari University (AAU) Khartoum Sudan

Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severely neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has an excellent functional outcome. Objective: To assess the functional outcome of acute correction of neglected Talipes-quinoa-varus deformity in adults. Methods: This is a cross-sectional, hospital–based multi-centric study. Forty patients were included in this study. Midfoot osteotomy and elongation of the Achilles tendon were performed on all patients. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p value Conclusion: acute correction of neglected and relapsed TEV with elongation of the Achilles tendon and single midfoot osteotomy has excellent functional outcome as assessed by AOFAS Score. The satisfaction with this procedure is impressive. The younger age population showed better outcomes with this procedure.

关键词： Neglected Relapsed Clubfoot Outcome Acute Surgical Correction

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The Radiological Outcome of Surgical Correction of Hallux Valgus with Combined Scarf and Akin Osteotomies

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Open Journal of Orthopedics 2023年第3期13卷 84-96页

作者： Sami Nogdallah Mohamed Alhassan Osman montaser Fatooh Alaa Mohamed Mohamed Khairy Hozifa Mohammed Ali abd-Elmaged Osama Gamal Nubi Orthopedics Surgery Department Alneelain University Khartoum Sudan Bashaer Teaching Hospital Khartoum Sudan Orthopaedic Registrar Sudan Medical Specialization Board Khartoum Sudan Orthopedics Surgery Department Alzaiem Alazhari University Khartoum Sudan Bashaer University Hospital MBBS Al Neelan University Khartoum Sudan

Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.

关键词： Hallux Valgus Scarf Osteotomy Akin Osteotomy Valgus Angle Intermetatarsal Angle

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Safety and Efficacy of Intrathecal Morphine in Children Undergoing Surgery for abdominal Neuroblastoma. Dose Finding, Randomized, Clinical Study

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Open Journal of Anesthesiology 2022年第12期12卷 368-378页

作者： Alaa Ali M. Elzohry Sahar abdel-Baky Mohamed Khaled M. Fares montaser A. Mohamed Ahmad M. abd El-Rahman Mohamad Farouk Mohamad ICU and Pain Management South Egypt Cancer Institute Assiut University Assiut Egypt

Background: Pediatric patients have remained undertreated for postoperative pain because of the difficulty of pain assessment and apprehension. Intrathecal opioids—including morphine—have become a popular method for providing post-operative analgesia in children. Objectives: To compare different doses of morphine via intrathecal route (2 μg/kg, 5 μg/kg, and 10 μg/kg) for post-operative analgesia in pediatric patients following for abdominal neuroblastoma surgery. Methods: This randomized, double-blinded, study was approved by local ethics committee of South Egypt Cancer Institute, Assiut University, Assiut—Egypt, and registered at https://***/ at no.: “NCT03158584”. Forty-five patients scheduled for surgical excision of abdominal neuroblastoma were divided into 3 groups (15 patients each);group (I): received intrathecal morphine 2 μg/kg added to normal saline (3 mL volume). Group (II): received intrathecal morphine 5 μg/kg. Group (III): received intrathecal morphine 10 μg/kg. Intra-, and post-operative hemodynamics, FLACC score, time to first request of rescue analgesia, total analgesic consumption, and side effects were recorded for 24 hours. Results: there was a significant reduction in FLACC score in groups II and III starting immediately till 24 hours postoperatively compared to group I (P 0.05). No significant difference was observed between groups in side effects. Conclusions: 5 μg/kg of IT morphine achieved a reasonable balance between postoperative analgesia, and the incidence of side effects in pediatric patients following major abdominal cancer surgeries.

关键词： Morphine Intrathecal Route abdominal Neuroblastoma FLACC Score Acute Pain

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