Introduction
Laparoscopic single anastomosis gastric bypass (SAGB) is increasingly performed for morbidly obese patients.
Aim of Work
This pilot study aims primarily at evaluating the incidence of ...bile gastritis after SAGB. The occurrence of reflux oesophagitis and reflux symptoms were also assessed.
Patients and Methods
This study included 20 patients having no reflux symptoms. All patients underwent a SAGB as a primary bariatric procedure by a single surgeon. Patients included consented to have an upper GI endoscopy done at 6 months postoperatively. Gastric aspirate was sent for bilirubin level assessment. Gastric and esophageal biopsies were submitted for histopathology and campylobacter-like organism (CLO) test.
Results
In our study, the rate of bile gastritis was 30%. In 18 patients, the level of bilirubin in gastric aspirate seems to be related to the degree of mucosal inflammation. The remaining two patients had microscopic moderate to severe gastritis with normal aspirate bilirubin level. Two patients with bilirubin level in aspirate more than 20 mg/dl had severe oesophagitis, gastritis with erosions, and metaplasia. Relationship between bilirubin level and histopathological findings of gastric biopsy examination was statistically significant with a
P
value of 0.001.
Conclusion
The incidence of bile gastritis in this cohort is higher than reported in the literature, and this may be worrying. The correlation between endoscopic findings and patients’ symptoms is poor. Bilirubin level and pH in aspirate might be useful tools to confirm alkaline reflux. Its level might help to choose candidates for revision surgery after SAGB. This needs further validation with larger sample size.
Background
Risk factors are traits or behaviors that have an influence on the development of breast cancer (BC). Awareness of the prevalent risk factors can guide in developing prevention ...interventions.
Purpose
To evaluate the correlation between the breast density, body mass index, and the risk of breast cancer development in relation to the menopausal status in a native African-Arab population.
Material and methods
The study included 30,443 screened females who were classified into cancer and non-cancer groups and each group was further sub-classified into pre- and postmenopausal groups. The breast density (BD) was reported and subjectively classified according to the 2013 ACR BI-RADS breast density classification. The weight and height were measured, and the body mass index (BMI) was calculated and classified according to the WHO BMI classification.
Results
A statistically significant difference was calculated between the mean BMI in the cancer and non-cancer groups (p: .027) as well as between the pre- and postmenopausal groups (p < .001). A positive statistically insignificant correlation was calculated between the breast density and the risk of breast cancer in the premenopausal group (OR: 1.062, p: .919) and a negative highly significant correlation was calculated in the postmenopausal group (OR: 0.234, p < .001).
Conclusion
BMI and BD are inversely associated with each other. The current studied population presented unique ethnic characteristics, where a decreased BD and an increased BMI were found to be independent risk factors for developing breast cancer.
Introduction Breast cancer is the most common malignancy among Egyptian women . Following axillary lymph node dissection, arm lymphedema can develop in 7–77% of cases. To detect and preserve ...upper-limb lymphatics and lymph nodes after axillary surgery, the axillary reverse mapping (ARM) technique was developed. This procedure may help avoid arm lymphedema. Aim of work To establish the ARM-node involvement of cancer cells and study their location to assess the effectiveness of ARM using patent blue dye. Methodology At Kasr Alainy University Hospital, this prospective randomized controlled study was carried out. There were 42 breast cancer patients in total, including 21 each in the study group and the control group. Following dye injection, stained ARM lymph nodes and lymphatics were preserved in the study group during axillary lymph node (ALN) dissection if grossly negative and removed if grossly positive, whereas individuals in the control group had the standard technique. After 1 month, all subjects underwent a second evaluation, during which the arm circumference was measured and recorded at a point 10 cm near the medial epicondyle. Results In the study group, in 18 patients (85.7%) their lymph nodes were stained. Six patients had suspiciously colored lymph nodes that were surgically removed, but no metastatic disease was apparent in the rest of the group. Early upper-limb lymphedema was not detected in the study group (0%), with 9.5% in the control group. Conclusion Arm lymphedema can be avoided by doing ARM while performing ALN dissection. Future research should be conducted on more patients and for a longer length of time, according to the findings of this study.
As there are no large scale Egyptian surveys estimating the prevalence of cardiac disease and the incidence of SCD in a non-selected population, the purpose of this report was to assess the relation ...between family history of SCD and the presence of CAD or coronary risk factors in first degree relatives of SCD victims searching for potential victims.
A questionnaire screening CAD risk factors and cardiac problems as indicators for SCD was developed, Data were collected from 8786 candidates by means of a questionnaire only protocol (random samples (8117)) and questionnaire plus clinical examination, ECG and laboratory investigations during medical convoys (random samples (669)). Data were coded and verified according to presence and absence of CAD risk factors, IHD and other risk factors in order that a triage could be performed in the general population to detect adults at risk of SCD.
Family history of CAD, DM and HTN head the list of risk factors more frequently associated with family history of SCD clearly pointing the role played by those comorbidities in pointing to potential victims of SCD.
Compared to those with no family history of SCD, those with positive family history of SCD were 8.7 times more associated with family history of DM, 12 times more associated with family history of CAD, 7 times more associated with family history of HTN.
This study underscores the importance of searching for positive family history of sudden cardiac death as a warning marker a red flag that makes familial evaluation strongly recommended.
In most industrial applications, AC drives are used. These drives require power electronic modules to convert AC to DC and also DC to AC. The power modules used for power conversion consist of power ...semiconductor switches. There is distortion in the voltage and current obtained from the power modules due to non-linear behaviors of semiconductor switches. To reduce the distortion in the input current, inductors are used along with the line impedance. A high value of inductance is required to maintain the percentage of THD within limits set by the latest standards. Along with the increased size and cost, it also reduces the power factor and output DC voltage at higher loads. The use of a passive power filter (PPF) is the conventional method followed for the reduction of percentage THD and promotion of the power factor. PPFs comprise passive elements such as the resistor, inductor, and capacitor. These passive elements are connected at the point of common coupling (PCC) in shunt to compensate for the harmonics present in the input current. In this study, a modified multi-tuned passive filter is considered to reduce the source current harmonics. A bridge rectifier with resistive load, three-phase induction motor drive, and linear resistive–inductive load is connected at the point of common coupling to analyze the harmonics present in the source current, and also unbalanced created in one phase. To achieve proper selection of the resistance value for the passive filter, the class topper optimization technique is used. To validate the simulation results obtained for the multi-tuned passive filter, the hardware is implemented with a three-phase AC induction motor drive load, in which the speed of the motor is controlled with voltage by a frequency control algorithm using an FPGA controller; The 50% THD is reduced by using the fifth-order filter alone, 75% by combining the fifth- and seventh-order filters, 85% by combining the 5th-, 7th-, 11th-, 13th-, and higher-order filters, and 90% for varying loads. For single-phase AC induction motor load, THD % is reduced to 4%, and for three-phase AC induction motor drive, THD % is reduced to 10% with the same value of the filter.
Background Sentinel lymph node (SLN) biopsy has emerged as an alternative to routine axillary node dissection in early-stage node-negative breast cancer. However, there have been controversies in ...clinical application because of its various identification rates and false-negative rates. We analyzed endoscopic sentinel node biopsy as a feasible procedure for visualization of the axillary space and resection of the sentinel node using endoscopic technique. Objective To evaluate the implementation of the technique and to compare the feasibility, effectiveness, outcome, and complications of endoscopic axillary SLN biopsy versus open technique in early-stage breast cancer. Patients and methods Between October 2020 and May 2021, 48 patients with breast cancer with clinically node-negative results were injected methylene blue or patent blue dye. A total of 24 female patients underwent endoscopic sentinel node biopsy and 24 female patients underwent the traditional method at the breast unit of Department of Surgery at Cairo University Hospitals. The following were evaluated during the study period: feasibility of technique, seroma formation, shoulder mobility, numbness, and pain at the postoperative site. Results In 24 patients undergoing the endoscopic technique using insufflation and minimal instrument dissection, the SLN at level I was inspected at its anatomical site and individual lymph nodes were easily identified. One patient developed lateral chest wall infection in the form of cellulitis (4%). The same patient experienced postoperative seroma. Intercostobrachial nerve affection was seen in 29% in the endoscopic method; however, it was 75% in the open method owing to nerve manipulation, not owing to direct injury. Conclusion Using endoscopy, we found that this technique allows (a) a minimally invasive working space, (b) recognition of anatomic landmarks, and (c) instrument manipulation within the axilla to identify and extract lymph nodes and apply the sentinel node technique. In almost every case, an excellent anatomical orientation was achieved. The retrieval rate for the sentinel node in endoscopic technique was 100% as found in the open technique.
Introduction The most prevalent female cancer is breast cancer. A significant prognostic factor and determinant of treatment is the state of axillary lymph nodes (LNs). Axillary LNs can be classified ...into pathological, indeterminate, and benign by ultrasonographic (US) assessment.
Aim In early-stage breast cancer, the indeterminate axillary LNs are measured. This offers the full advantage of the available diagnostic instruments, fine-needle aspiration cytology (FNAC), and sentinel lymph node biopsy (SLNB) technique driven by US, and thus prevents excessive dissection of the axillary lymph node. In a step-wise sequence, suggestions are made for the treatment of indeterminate axillary LNs.
Patients and methods This is a randomized, controlled sample that is prospective. Between October 2017 and October 2018, 60 female patients diagnosed with early-stage breast cancer with indeterminate axillary nodes were admitted to the breast cancer unit at Kasr Alainy University Hospital, Cairo University. Sensitivity, accuracy, positive predictive value, and negative predictive value of preoperative US-guided FNAC versus upfront frozen indeterminate node intraoperative SLNB were contrasted, and both findings were correlated to the final histo-guided FNAC.
Results Sensitivity of SLNB was 83.33%, whereas sensitivity of the FNAC was 75%, with the negative predictive value of 83.33%, specificity of 83.3%, and positive predictive value of 75%.
Conclusion FNAC is only moderately sensitive (75%), and inadequate sampling and being an operator dependent are potential limits of it. In addition, positive FNAC may cost the patient unnecessary axillary lymph node dissection.
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