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Evaluation of the versatility of perforators-enhanced rhomboid flap technique for ischial sores reconstruction

Chinese Journal of Plastic and Reconstructive Surgery 2024年第2期6卷 65-71页

作者： Waleed Aldabaany Ashraf Hussein Elghamry montaser hosny Mohamed Yassin Department of Plastic Surgery Faculty of Medicine Fayoum University

Background: Prolonged pressure on the skin known as pressure sores, can cause frequent injuries to the skin and underlying tissues. However, several prevention approaches, including non-surgical and surgical management,are available. In flap surgery for pressure sores, a variety of flap types may be used; each offers certain benefits and some incidences of complications and recurrence. This study evaluated the versatility of the perforatorenhanced rhomboid flap technique for ischial sore ***: This prospective study was conducted in the Plastic Surgery Department of Fayoum University *** perforator-enhanced rhomboid flap technique was employed in 20 patients with ischial pressure sores who failed to respond to conservative treatment. A proper history was obtained and a preoperative arterial duplex was performed to determine the site of the prominent perforators for their preservation at the base of the *** follow-ups and evaluations were ***: The mean age of the study group was 43.7 ± 13.1, ranging from 19 to 65 years. Moreover, 80% of the participants were males while 20% were female. The main etiology of the sores was paraplegia in 45% of *** mean surface area of sores was 24.8 ± 6.3 cm2. In 75% of cases, the color match of the flap was rated as excellent. Similarly, 70% of the patients rated flap thickness as excellent. In 55% of the cases, the scar appearance was deemed excellent. Overall satisfaction was reported as excellent by 40% of the patients, while only 5% reported poor satisfaction. Approximately, 10% of the cases were identified with seroma, and 30% had wound dehiscence of a mean size of 1.33 ± 0.98 cm and required around 6.8 ± 1.9 weeks to ***: The perforator-enhanced rhomboid flap technique is a versatile method for reconstructing ischial pressure sores owing to its technical ease, short operative time, reliable vascularity, aesthetic outcome, matching skin color, and short recov

关键词： Ischial pressure sores Perforators-enhanced rhomboid flaps Reconstruction

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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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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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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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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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Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

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World Journal of Cardiovascular Diseases 2020年第6期10卷 385-394页

作者： Mohamed Ahmed Sabry Said Shalaby montaser Cardiology Department National Heart Institute Giza Egypt Cardiology Department Faculty of Medicine Menoufiya University Shebien El Kom Egypt

Background: Percutaneous mitral balloon valvuloplasty is the main procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases;however, mitral regurgitation (MR) remains the major procedure complication. Objectives: This study was conducted to investigate predictors of MR as a complication followingpercutaneous mitral valvuloplasty (PMV) using multitrack balloon technique. Methods: This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points. Results: Most patients (N = 109, 90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR

关键词： Mitral Stenosis Mitral Regurgitation Multitrack Balloon Mitral Valvuloplasty

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ZnO DOPED SODIUM SILICATE PREIONIZE N_(2) LASER

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Chinese Physics Letters 1989年第11期6卷 491-494页

作者： M.montaser F.Sabry S.A.Ibrahim hysics Department Faculty of ScienceMonofia UniversityShibin El-koamEgypt Faculty of Science Jordan Univ.of Science and Technology IrbidJordan

An experimental study of the effect of ZnO doped sodium silicate thin film,used as a semiconductive preionizer on the output energy is *** output energy of the nitrogen laser increased by two *** performance of the pr... 详细信息

关键词： LASER film conductive

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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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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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Assessment of Left Ventricular Mechanical Function in Cardiac Syndrome X: Speckle Tracking Imaging Study

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World Journal of Cardiovascular Diseases 2018年第12期8卷 557-568页

作者： Mahmoud Kamel Ahmed Emara Said Shalaby montaser Mahmoud Said Menufia University Hospital Shibin El Kom Egypt

Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle tracking?echocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ±6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (-15.05 ± 3.28 vs. -20.22 ± 2.49;p 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48;p = 0.74) and (-19.88 ± 8.63 vs. -21.93 ± 5.69;p 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.

关键词： Cardiac Syndrome X Left Ventricular Systolic and Diastolic Function 2D-Speckle Tracking Strain and Strain Rate Imaging

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