Aorto-Uni-Iliac Stent Grafts with and without Crossover Femorofemoral Bypass for Treatment of Abdominal Aortic Aneurysms: A Parallel Observational Comparative Study

We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease. 537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR. We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B). Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities. Technical success was 97% (n=33) in group A and 85% (n=5) in group B (P=0.31). Primary and assisted clinical success at 24 months were 88% (n=30) and 12% (n=4), respectively, in group A, and 85% (n=5) and 15% (n=1), respectively, in group B (P=0.125). Reintervention rate was 10% (n=3) in group A and 0% in group B (P=0.084). No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period. AUI without crossover bypass is a viable option in selected cases.

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A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽

10.1093/qjmed/hcab103.005 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Tarek Hussein Kamel ◽

Amr Lotfy Farag ◽

Dr/Sherif Hassanin Ahmed ◽

Chresteen Talaat Samy Hanna

Keyword(s):

Colorectal Cancer ◽

Comparative Study ◽

Disease Free Survival ◽

University Hospital ◽

Treatment Modalities ◽

Clinicopathologic Features ◽

Free Survival ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

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Perioperative glutamine supplementation restores disturbed renal arginine synthesis after open aortic surgery: a randomized controlled clinical trial

AJP Renal Physiology ◽

10.1152/ajprenal.00340.2015 ◽

2016 ◽

Vol 311 (3) ◽

pp. F567-F575 ◽

Cited By ~ 6

Author(s):

Saskia J. H. Brinkmann ◽

Nikki Buijs ◽

Mechteld A. R. Vermeulen ◽

Efraim Oosterink ◽

Henk Schierbeek ◽

...

Keyword(s):

Clinical Trial ◽

Reperfusion Injury ◽

Ischemia Reperfusion Injury ◽

Ischemia Reperfusion ◽

Aortic Surgery ◽

Glutamine Supplementation ◽

Abdominal Aortic Surgery ◽

Abdominal Aortic ◽

Group A ◽

Group B

Postoperative renal failure is a common complication after open repair of an abdominal aortic aneurysm. The amino acid arginine is formed in the kidneys from its precursor citrulline, and citrulline is formed from glutamine in the intestines. Arginine enhances the function of the immune and cardiovascular systems, which is important for recovery after surgery. We hypothesized that renal arginine production is diminished after ischemia-reperfusion injury caused by clamping of the aorta during open abdominal aortic surgery and that parenteral glutamine supplementation might compensate for this impaired arginine synthesis. This open-label clinical trial randomized patients who underwent clamping of the aorta during open abdominal aortic surgery to receive a perioperative supplement of intravenous alanyl-glutamine (0.5 g·kg−1·day−1; group A, n = 5) or no supplement ( group B, n = 5). One day after surgery, stable isotopes and tracer methods were used to analyze the metabolism and conversion of glutamine, citrulline, and arginine. Whole body plasma flux of glutamine, citrulline, and arginine was significantly higher in group A than in group B (glutamine: 391 ± 34 vs. 258 ± 19 μmol·kg−1·h−1, citrulline: 5.7 ± 0.4 vs. 2.8 ± 0.4 μmol·kg−1·h−1, and arginine: 50 ± 4 vs. 26 ± 2 μmol·kg−1·h−1, P < 0.01), as was the synthesis of citrulline from glutamine (4.8 ± 0.7 vs. 1.6 ± 0.3 μmol·kg−1·h−1), citrulline from arginine (2.3 ± 0.3 vs. 0.96 ± 0.1 μmol·kg−1·h−1), and arginine from glutamine (7.7 ± 0.4 vs. 2.8 ± 0.2 μmol·kg−1·h−1), respectively ( P < 0.001 for all). In conclusion, the production of citrulline and arginine is severely reduced after clamping during aortic surgery. This study shows that an intravenous supplement of glutamine increases the production of citrulline and arginine and compensates for the inhibitory effect of ischemia-reperfusion injury.

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Comparative Study on the effect of Varicocelectomy on Infertile Patients with Normal and Low Serum Testosterone Level

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1630997 ◽

2021 ◽

pp. 23-29

Author(s):

Mohammed Saad Mohammed Sherif ◽

Ayman Mohammed Hagras ◽

Mohammed Hassan Radwan ◽

Mohammed Abo El-enen Khalwash

Keyword(s):

Comparative Study ◽

Testosterone Level ◽

Serum Testosterone ◽

University Hospital ◽

Semen Parameters ◽

Serum Testosterone Level ◽

Male Population ◽

Group A ◽

The Mean ◽

Group B

Introduction: Varicocele is a dilation of the pampiniform venous plexus and the internal Spermatic vein. It is detected approximately in 15% to 20 % of the general male Population; with the prevalence increasing to 40% in infertile men. Methodology: This prospective, comparative study was conducted on 134 male patients with primary infertility who attended the outpatient clinic of Urology Department, Tanta University Hospital during the period between April 2017 to April 2019. The patients were divided into two groups: Group A (56 patients) with low testosterone level. Group B (78 patients) with normal testosterone level. Results: In group A, the mean ± SD of testosterone level improved significantly to 2.93 ± 0.77 and 3.36 ± 0.86 after 3 and 6 months respectively (p1-value=0.001* and p2-value=0.001* respectively). In group B, the mean ± SD of testosterone level improved significantly to 6.22 ± 1.51 and 6.82 ± 2.25 after 3 and 6 months respectively (p1-value=0.026* and p2-value=0.001* respectively). Conclusion: varicocelectomy could improve semen parameters, serum testosterone level and pregnancy rate.

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A Comparative Study: The Use of Collagen Implant versus Mitomycin-C in Combined Trabeculotomy and Trabeculectomy for Treatment of Primary Congenital Glaucoma

Journal of Ophthalmology ◽

10.1155/2017/9241459 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Alaa Abdel Sadek Singab ◽

Osama Ali Mohammed ◽

Mohammed Iqbal Hafez Saleem ◽

Mortada Ahmed Abozaid

Keyword(s):

Comparative Study ◽

Mitomycin C ◽

Preoperative Evaluation ◽

Anterior Segment ◽

University Hospital ◽

Congenital Glaucoma ◽

Primary Congenital Glaucoma ◽

Collagen Implant ◽

Group A ◽

Group B

Purpose. To compare Ologen implant versus mitomycin-C (MMC) in combined trabeculotomy and trabeculectomy as a treatment of primary congenital glaucoma. Setting. Sohag University Hospital, Egypt. Design. A prospective comparative study. Methods. Thirty-four eyes of twenty-one patients with primary congenital glaucoma were included in this study. All patients were subjected to preoperative evaluation including complete anterior segment examination under general anesthesia. The patients were divided into two groups: patients of the first group (group A) underwent combined trabeculotomy and trabeculectomy with Ologen implantation while those of the second group (group B) underwent combined trabeculotomy and trabeculectomy with MMC application. Results. Postoperatively, the IOP in group A was as follows: 8 eyes developed IOP levels less than 14 mmHg (complete success), 3 eyes had levels between 14 and 16 mmHg (accepted result), 2 eyes had levels between 16 and 20 mmHg (guarded result), and only 2 eyes showed levels exceeding 20 mmHg (failed procedure), while in group B, 7 eyes showed complete success, 3 eyes had accepted result, 3 eyes had guarded result, and 2 eyes had failed procedure. Conclusion. Ologen is a safe and effective adjuvant in combined trabeculotomy and trabeculectomy for treatment of primary congenital glaucoma.

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COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1372 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Shrikant . ◽

R.D. Mehta ◽

B.C. Ghiya

Keyword(s):

Partial Response ◽

Comparative Study ◽

Recurrence Rate ◽

Vitamin D3 ◽

Complete Response ◽

Recurrence Rates ◽

Additional Advantage ◽

Cost Effective Treatment ◽

Group A ◽

Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

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Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49882 ◽

2020 ◽

Vol 21 (2) ◽

pp. 105-110

Author(s):

Md Shawkat Alam ◽

Sudip Das Gupta ◽

Hadi Zia Uddin Ahmed ◽

Md Saruar Alam ◽

Sharif Muhammod Wasimuddin

Keyword(s):

Comparative Study ◽

Acute Urinary Retention ◽

Bladder Capacity ◽

Inclusion Criteria ◽

College Hospital ◽

Medical College ◽

High Incidence ◽

Group A ◽

Group B ◽

Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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A Comparative Study of Open Versus Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms

Journal of Vascular Surgery ◽

10.1016/j.jvs.2013.02.163 ◽

2013 ◽

Vol 57 (5) ◽

pp. 40S

Author(s):

Stavros K. Kakkos ◽

Konstantinos O. Papazoglou ◽

Ioannis A. Tsolakis ◽

George Lampropoulos ◽

Spyros I. Papadoulas ◽

...

Keyword(s):

Comparative Study ◽

Endovascular Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Abdominal Aortic ◽

Open Versus

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A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00149-3 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Mohammed Ibrahim Khamis ◽

Ahmed Saeed Mohamed ◽

Hesham Mohamed El Azazy ◽

Hala Salah El Ozairy ◽

Mohamed Moien Mohamed

Keyword(s):

Comparative Study ◽

Brachial Plexus ◽

Normal Saline ◽

Motor Block ◽

Brachial Plexus Block ◽

Sensory Block ◽

Motor Blockade ◽

Group A ◽

Group B ◽

Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

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Prophylactic temporary abdominal aortic balloon occlusion for patients with pernicious placenta previa: a retrospective study

BMC Anesthesiology ◽

10.1186/s12871-021-01354-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Huo ◽

Hansheng Liang ◽

Yi Feng

Keyword(s):

Placenta Previa ◽

Balloon Occlusion ◽

Artery Embolism ◽

Abdominal Aortic ◽

Significant Difference ◽

Group A ◽

Group B ◽

Clinical Records ◽

Group D ◽

Central Placenta Previa

Abstract Background Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa. Methods This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D). Results Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept. Conclusions PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.

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Management of walled-off necrosis with nasocystic irrigation with hydrogen peroxide versus biflanged metal stent: randomized controlled trial

Endoscopy International Open ◽

10.1055/a-1480-7115 ◽

2021 ◽

Vol 09 (07) ◽

pp. E1108-E1115

Author(s):

Sudhir Maharshi ◽

Shyam Sunder Sharma ◽

Sandeep Ratra ◽

Bharat Sapra ◽

Dhruv Sharma

Keyword(s):

Hydrogen Peroxide ◽

Adverse Events ◽

Clinical Success ◽

Controlled Trial ◽

Procedure Time ◽

Metal Stent ◽

Technical Success ◽

Group A ◽

Group B ◽

Walled Off Necrosis

Abstract Background and study aims Walled-off necrosis (WON) is a known complication of acute necrotizing pancreatitis (ANP). There is no study comparing nasocystic irrigation with hydrogen peroxide (H2O2) versus biflanged metal stent (BMS) in the management of WON. The aim of this study was to compare the clinical efficacy of both the treatment strategies. Patients and methods This study was conducted on patients with symptomatic WON who were randomized to nasocystic irrigation with H2O2 (Group A) and BMS placement (Group B). Primary outcomes were clinical and technical success while secondary outcomes were procedure time, adverse events, need for additional procedures, duration of hospitalization, and mortality. Results Fifty patients were randomized into two groups. Group A (n = 25, age 37.8 ± 17.6 years, 16 men) and Group B (n = 25, age 41.8 ± 15.2 years, 17 men). There were no significant differences in baseline characteristics between the two groups. The most common etiology of pancreatitis was alcohol, observed in 27 (54 %) patients. Technical success (100 % vs 96 %, P = 0.98), clinical success (84 % vs 76 %, P = 0.76), requirement of additional procedures (16 % vs 24 %, P = 0.70) and adverse events (4 vs 7, P = 0.06) were comparable in both the groups. The duration to clinical success (34.4 ± 12 vs 14.8 ± 10.8 days, P = 0.001) and procedure time (36 ± 15 vs 18 ± 12 minutes, P = 0.01) were longer in Group A compared to Group B. Conclusions Nasocystic irrigation with H2O2 and BMS are equally effective in the management of WON but time to clinical success and procedure time is longer with nasocystic irrigation.

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