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Effect of treating chronic hepatitis C with direct-acting antivirals on extrahepatic cutaneous manifestations

World Journal of Hepatology 2020年第10期12卷 841-849页

作者： Mohamed El Kassas osama MO hegazy Eman M Salah Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt Department of Dermatology Venereology and AndrologyFaculty of MedicineHelwan UniversityCairo 11795Egypt

BACKGROUND Hepatitis C virus(HCV)is a disease with a significant global impact,affecting approximately 2%-2.5%of the world’s *** direct-acting antivirals(DAAs)have been introduced over the past few years with great success in viral *** association of chronic HCV infection with a wide spectrum of cutaneous manifestations has been widely reported in the *** To assess the effect of treating HCV with DAAs on the extrahepatic cutaneous manifestations of *** This prospective observational study included 1039 HCV positive Egyptian patients who were eligible to receive DAAs.A total of 30 patients were diagnosed with extrahepatic cutaneous manifestations and fulfilled the inclusion criteria of the *** these patients,6 had classic lichen planus,8 were diagnosed with psoriasis vulgaris and 16 had *** patients received DAAs from October 2018 to July 2019 in the form of a three-month course of sofosbuvir/daclatasvir *** with lichen planus or psoriasis were dermoscopically evaluated before treatment and 6 mo after treatment,while patients with hepatic pruritus were assessed using the 12-Item Pruritus Severity Scale over the same *** All patients with psoriasis showed significant improvement in all psoriatic plaques,and all patients with hepatic pruritus scored 0 on the 12-Item Pruritus Severity Scale indicating total improvement of *** addition,four of six patients with lichen planus showed complete *** Treatment of HCV with DAAs was significantly effective in improving virusrelated extrahepatic cutaneous manifestations.

关键词： Directly acting antivirals Extrahepatic manifestations Hepatitis C virus Lichen planus Pruritus Cutaneous manifestations

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Small for size syndrome difficult dilemma: Lessons from 10 years single centre experience in living donor liver transplantation

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World Journal of Hepatology 2017年第21期9卷 930-944页

作者： Hany Shoreem Emad Hamdy Gad Hosam Soliman osama hegazy Sherif Saleh Hazem Zakaria Eslam Ayoub Yasmin Kamel Kalid Abouelella Tarek Ibrahim Ibrahim Marawan Hepatobiliary Surgery Department National Liver InstituteMenoufiya Univer-sity Anesthesia Department National Liver InstituteMenoufiya University

AIM To analyze the incidence, risk factors, prevention, treatment and outcome of small for size syndrome(SFSS) after living donor liver transplantation(LDLT). METHODS Through-out more than 10 years: During the period from April 2003 to the end of 2013, 174 adult-to-adults LDLT(A-ALDLT) had been performed at National Liver Institute, Menoufiya University, Shibin Elkoom, Egypt. We collected the data of those patients to do this cohort study that is a single-institution retrospective analysis of a prospectively collected database analyzing the incidence, risk factors, prevention, treatment and outcome of SFSS in a period started from the end of 2013 to the end of 2015. The median period of follow-up reached 40.50 m, range(0-144 m). RESULTS SFSS was diagnosed in 20(11.5%) of our recipients. While extra-small graft [small for size graft(SFSG)], portal hypertension, steatosis and left lobe graft were significant predictors of SFSS in univariate analysis(P = 0.00, 0.04, 0.03, and 0.00 respectively); graft size was the only independent predictor of SFSS on multivariate analysis(P = 0.03). On the other hand, there was lower incidence of SFSS in patients with SFSG who underwent splenectomy [4/10(40%) SFSS vs 3/7(42.9%) no SFSS] but without statistical significance, However, there was none significant lower incidence of the syndrome in patients with right lobe(RL) graft when drainage of the right anterior and/or posterior liver sectors by middle hepatic vein, V5, V8, and/or right inferior vein was done [4/10(28.6%) SFSS vs 52/152(34.2%) no SFSS]. The 6-mo, 1-, 3-, 5-, 7-and 10-year survival in patients with SFSS were 30%, 30%, 25%, 25%, 25% and 25% respectively, while, the 6-mo, 1-, 3-, 5-, 7-and 10-year survival in patients without SFSS were 70.1%, 65.6%, 61.7%, 61%, 59.7%, and 59.7% respectively, with statistical significant difference(P = 0.00). CONCLUSION SFSG is the independent and main factor for occurrence of SFSS after A-ALDLT leading to poor outcome. However, the mana

关键词： Living donor liver transplantation Outcome after living donor liver transplantation Small for size syndrome Small for size graft Portal inflow Venous outflow

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Major Hepatic Resection in Hepatic Hydatidosis

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Surgical Science 2013年第1期4卷 20-28页

作者： Ibrahim Abdelkader Salama Mohammed Abdallah Aboushady osama hegazy Abdelsalam Sherif Mohamed Saleh Hany Abdel Mageed Shoreem Mohammed Houseni El-Amir Mahmoud Amir Department of Hepatobiliary Surgery National Liver Institute Menophyia University Shiben Elkom Egypt Department of Parasitology National Liver Institute Menophyia University Shiben Elkom Egypt Department of Radiology National Liver Institute Menophyia University Shiben Elkom Egypt

Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical procedure remains unsettled. Objective: Safety and efficacy of major hepatic resection in multiple and giant hepatic hydatidosis. Patients & Methods: 63 patients had hepatic hydatidosis associated with spleen, lung, and suprarenal hydatidosis were managed by major hepatic resection between April 2005 to April 2011. 43 (68%) males and 20 (32%) females, age range 8 - 56 years. Cysts were found in the liver only in 51 (81%) patients, liver with spleen in 5 (8%), liver, spleen with lung in 2 (3.1%), liver and lung in 4 (6.3%), liver and suprarenal in one patient (1.6%). Results: Multiple cysts were found in 38 (60%) and solitary cyst in 25 (40%) with Cysts diameter ≤5 cmin 22 (35%), 5 - 10 cm in 16 (25%), and 10 - 38 in 25 (40%). Right hepatectomy in 24 (38%), right trisectionectomy in 2 (3.2%), right hepatectomy with Segment III in 4 (6.3%), right hepatectomy with Segment I in 2 (3.2%), left hepatectomy in 12 (19%), left lateral sectionectomy in 6 (9.5%), left hepatectomy with Segment VI in 3 (4.8%), left lateral sectionectomy with right posterior sectionectomy in 2 (3.2%), right hepatectomy with splenectomy in 7 (11%) and right hepatectomy with right suprarenal in one (1.6%) patient were performed. Hospital stay was 4.2 (3 - 13 days) There was one mortality and 12 (19%) morbidities. No recurrence on follow up period (8 - 60 months) was observed. Conclusion: Radical procedure is safe and effective option for hepatic hydatidosis and should be performed when the entire lobe is diffusely involved by huge or multiple hydatidosis with little healthy liver tissue.

关键词： Ecchinococcosis Hepatic Hydatidosis Hepatic Resection Mortality Morbidity

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Determination of a novel ACE inhibitor in the presence of alkaline and oxidative degradation products using smart spectrophotometric and chemometric methods

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Journal of Pharmaceutical Analysis 2014年第2期4卷 132-143页

作者： Maha Abdel-Monem hegazy Maya Shaaban Eissa osama Ibrahim Abd El-Sattar Mohamed Mohamed Abd El-Kawy Analytical Chemistry Department Faculty of PharmacyCairo UniversityCairoEgypt Analytical Chemistry Department Faculty of PharmacyEgyptian Russian UniversityCairoEgypt National Organization of Drug Control and Research GizaEgypt

Simple, accurate, sensitive and validated UV spectrophotometric and chemometric methods were developed for the determination of imidapril hydrochloride （IMD） in the presence of both its alkaline （AKN） and oxidative （OXI） degradation products and in its pharmaceutical formulation. Method A is the fourth derivative spectra （D4） which allows the determination of IMD in the presence of both AKN and OXD, in pure form and in tablets by measuring the peak amplitude at 243.0 nm. Methods B, C and D, manipulating ratio spectra, were also developed. Method B is the double divisor-ratio difference spectrophotometric one （DD-RD） by computing the difference between the amplitudes of IMD ratio spectra at 232 and 256.3 nm. Method C is the double divisor-first derivative of ratio spectra method （DD-DR1） at 243.2 nm, while method D is the mean centering of ratio spectra （MCR） at 288.0 nm. Methods A, B, C and D could successfully determine IMD in a concentration range of 4.0-32.0 mg/mL. Methods E and F are principal component regression （PCR） and partial least-squares （PLS）, respectively, for the simultaneous determination of IMD in the presence of both AKN and OXI, in pure form and in its tablets. The developed methods have the advantage of simultaneous determination of the cited components without any pre-treatment. The accuracy, precision and linearity ranges of the developed methods were determined. The results obtained were statistically compared with those of a reported HPLC method, and there was no significant difference between the proposed methods and the reported method regarding both accuracy and precision.

关键词： Double divisor-ratio difference Double divisor-ratio derivative Mean centering of ratio spectra Chemometry Imidapril hydrochloride

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Latissimus Dorsi Mini-Flap as a Volume Replacement Technique after Partial Mastectomy for Breast Cancer in the Upper and Central Breast Quadrants: A Single Center Experience

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Surgical Science 2016年第11期7卷 496-504页

作者： Waleed Elnahas Ashraf Khater Mohamed Hamdy Emadeldeen Hamed osama Eldamshety Mohamed hegazy Department of Surgical Oncology Oncology Center Faculty of Medicine Mansoura University Mansoura Egypt

Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm3 ± 59.57) cm3, while the mean flap volume was (218.27 cm3 ± 53.64 cm3). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.

关键词： Oncoplastic Breast Surgery Latissimus Dorsi Mini-Flap Conservative Surgery

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Totally Endoscopic (Thoracoscopic and Laparoscopic) Radical Esophagectomy with Gastric Tube Reconstruction through a Small Neck Incision: An Early Experience with Thirty Egyptian Patients

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Surgical Science 2014年第5期5卷 214-223页

作者： Adel Denewer Adel Fathi Ahmed Setit Mohamed hegazy Ashraf Khater osama Hussein Sameh Roshdy Fayez Shahatto Fathy Denewer Department of Surgical Oncology Oncology Center (OCMU) Faculty of Medicine Mansoura University Mansoura Egypt

Background: Minimally invasive esophagectomy nowadays is replacing the classic open technique. Additional studies are needed to confirm its safety and efficacy. Methods: thirty patients with esophageal carcinoma were enrolled in this study. Patients were evaluated preoperatively and they underwent thoracoscopic and laparoscopic procedures for assessment of resectability. Resectablepatients underwent radical esophagectomy with gastric tube reconstruction through a four-cm neck incision. Results: 17 patients were operable and 13 patients were inoperable. The mean operative time for the whole procedure was 5.97 ± 1.66 hours. The mean blood loss was 250 ± 138.07 cc. The mean overall hospital stay was 17.47 ± 5.49 daysdays. Common postoperative complications included pneumonia (13.3%) pleural effusion (6.7%), cervical anastomotic leakage (10%), and wound infection (13.3%). One patient died in the early postoperative period. Conclusions: we conclude that totallyendoscopic (thoracoscopic and laparoscopic) esophagectomy is feasible and relatively safe technique. Beside its efficacy as an assessment tool, total esophagectomy and lymphadenectomy could be performed in the same time.

关键词： Thoracoscopic Laparoscopic Radical Esophagectomy Gastric Reconstruction Esophagus Cancer

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Evaluation of Surgical Outcome after Resection of Pancreatic Tumors, Our Experience in Mansoura Oncology Center, a Middle-Volume Center in Egypt

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Journal of Cancer Therapy 2012年第5期3卷 477-481页

作者： Nazem Shams Mahmoud Mosbah Mohammad hegazy osama Hussein Omar Farouk Sameh Roshdy Mohamed Tarek Hafez Ashraf Khater Khaled Abdel Wahab Oncology Center Mansoura University Mansoura Egypt

Background: Pancreatic cancer is the fourth most common cause of cancer related deaths in the world. Surgical resection remains the only potentially curative treatment for adenocarcinoma of the pancreas;only 10% - 20% of patients are candidate for standard pancreatic resection. Objective: To evaluate perioperative mortality, morbidity and survival for patients underwent PD in middle-volume center. Patients and Methods: Sixty patients with pancreatic tumors were enrolled in this study for different surgical procedure according to type of tumors. Results: No early postoperative complications were observed in 60% of patients, whereas 40% of patients developed one or more complication, the median survival for this group was 12.3 months with standard deviation 3.8 months.

关键词： Pancreatic Cancer Whipple Complication Survival

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Peristaltic Transport of Magnetohydrodynamic Carreau Nanofluid with Heat and Mass Transfer inside Asymmetric Channel

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American Journal of Computational Mathematics 2017年第1期7卷 1-20页

作者： Nabil T. M. Eldabe osama M. Abo-Seida Adel A. S. Abo-Seliem A. A. ElShekhipy Nada hegazy Mathematics Department Faculty of Education Ain Shams University Cairo Egypt Faculty of Computers and Information Kafrelsheikh University Kafrelsheikh Egypt Mathematics Department Faculty of Science Kafrelsheikh University Kafrelsheikh Egypt Mathematics Department Faculty of Science Minia University El-Minia Egypt Mathematics Department Faculty of science Imam Abdulrahman Bin Faisal University Al-Dammam KSA

In this work, the peristaltic motion of a nano non-Newtonian fluid which obeys Carreau model through a porous medium inside an asymmetric channel is investigated. The hall current effects with Joule heating and viscous dissipation are considered. The problem is modulated mathematically by a set of nonlinear partial differential equations which describe the conservation of mass, momentum, energy and concentration of nanoparticles. The non-dimensional form of these equations is simplified under the assumption of long wavelength and low Reynolds number, and then resulting equations of coupled nonlinear differential equations are tackled numerically with appropriate boundary conditions. Graphical results are presented for dimensionless velocity, temperature, concentration and pressure gradient in order to illustrate the variations of various parameters of this problem on these obtained solutions.

关键词： Peristaltic Motion MHD Carreau Nanofluid Asymmetric Channel Porous Medium Heat and Mass Transfer

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The Effectiveness of Intraoperative Frozen Section Analysis of Safety Margins in Breast Conserving Surgery and the Role of Surgeon in Decreasing the Rate of Positive Margins

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Surgical Science 2017年第12期8卷 499-509页

作者： Omar Farouk Ahmed Senbel Mosab Shetiwy Essam Attia Ahmed Abdallah osama El-Damshety Ashraf Khater Sameh Roshdy Amr Abouzid Amr Hossam Islam H. Metwally Omar Hamdy Amir M. Zaid Mahmoud Abdelaziz Mohamed Elmetwally Adel Fathi Emad-Eldeen Hamed Khaled Abdel Wahab Wagdi El-Kashef Mohamed Hafez Khaled Zalata Mohamed hegazy Adel Denewer Surgical Oncology Department Oncology Center Faculty of Medicine Mansoura University Mansoura Egypt Pathology Department Faculty of Medicine Mansoura University Mansoura Egypt

Introduction: Nowadays the more accepted surgical option for treating early breast cancer is breast conserving surgery. The main challenge in this type of surgery is to get free safety margins without need of second surgical operation, so many breast surgeons have started to depend on intraoperative frozen sections to ensure free safety margins. Aim of work: To assess our policy that we prefer to depend on intraoperative frozen section analysis to get free safety margin in breast conserving surgery from the 1st surgery, and its oncologic outcome. Patients and Methods: This is a retrospective study conducted in Oncology Center—Mansoura University (OCMU), where the data of 219 patients with breast cancer, who were managed by breast conserving surgery with intraoperative frozen section analysis of the safety margins, was analyzed. Results: The intraoperative frozen section analysis of safety margin was negative from the start in 183 (83.6%) patients, while it was positive in 36 patients (16.4%). Intraoperative decision of margin re-excision was applied for 29 patients (13.2%) in order to reach negative margin, modified radical mastectomy was offered for 4 patients (1.8%), while nipple sparing mastectomy with immediate breast reconstruction using latissimus dorsi flap was offered for 3 patients (1.4%). The postoperative paraffin results were typical with intraoperative frozen section analysis results in 216 patients (98.6%) and different results were obtained in only 3 patients (1.4%) who were managed by modified radical mastectomy in a second operation. Only 4 patients had local recurrence (1.8%) during the period of follow-up duration which was ranged from 1 to 86 months with mean ± SD (22.3 ± 14.1). Conclusion: The intraoperative frozen section analysis of safety margins in breast conserving surgery has very high-rate typical results with the paraffin section analysis and it is very helpful in decreasing the rate of second surgical operation in cases of infiltrated m

关键词： Breast Conserving Surgery Intraoperative Frozen Section Analysis Safety Margins Breast

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