Background There is an increased risk of developing venous thromboembolism in patients with severe acute respiratory syndrome coronavirus disease (SARS COVID-19). As the D-dimer could be elevated in deep venous thrombosis (DVT), we aimed to investigate the incidence of DVT in patients with SARS COVID-19 and elevated plasma levels of the D-dimer. Patients and methods A prospective observational study was carried out to screen all patients with a confirmed diagnosis of SARS COVID-19 with plasma D-dimer levels above 1000 ng/ml for the presence of DVT without related symptoms using complete compression Doppler ultrasound. Results A total of 52 patients were included in the study. Among them, 34 (67.3%) were males. All patients received standardized thromboprophylaxis treatment. The screening results of complete compression Doppler ultrasound revealed DVT in eight (15.4%) patients. Among these patients, the DVT was proximal in one (1.9%) patient and bilateral distal in two (3.8%) patients. The D-dimer level was significantly higher in patients with DVT than in patients without DVT (4531 vs. 2048 ng/ml, odds ratio 9.4, 95% confidence interval 1.2–70.3). The diagnostic ability of the D-dimer was satisfactory, with an receiver operating characteristic curve of 0.71 (95% confidence interval 0.62–0.83). Conclusion The incidence of DVT without symptoms in patients with SARS COVID-19 and elevated plasma level of D-dimer was 15.4%, with a significant difference between patients with and without DVT in terms of the D-dimer. Therefore, the D-dimer is important for the diagnosis of DVT in patients with SARS COVID-19.
Background Diffusion-weighted imaging (DWI) is reliable in diagnosing intracranial cysts. However, sometimes, it could not give satisfactory diagnostic confidence. Objective To study the role of DWI in differentiation between intracranial cysts and the usefulness of apparent diffusion coefficient. Patients and methods This study included 40 patients of different age groups with intracranial cysts. All patients included were subjected to full history taking, clinical examination, laboratory investigations, routine MRI examination, DWI, and apparent diffusion coefficient map. Results Receiver operating characteristic curve was generated to identify inflammatory intra-axial lesions and to obtain the best sensitivity (80%), specificity (83.3%), positive predictive value (80%), and negative predictive value (83.3%). The relationship was significant ( P <0.028). Receiver operating characteristic curve to identify epidermoid and arachnoid cysts and to obtain the best sensitivity (100%), specificity (100%), positive predictive value (100%), and negative predictive value (100%). The relationship was significant ( P =0.013). Conclusion DWI is perfect in differentiating between necrotic tumors and abscesses, benign and malignant intracranial cysts, and between arachnoid and epidermoid cysts. But it failed in differentiating between lower-grade and high-grade glioma.
Background Early diagnosis and treatment are the keys for effective treatment of patients with hepatocellular carcinoma (HCC). The use of serological markers in patients at the highest risk of developing HCC may thus decrease HCC mortality and reduce medical costs. Midkine (MK) has an essential role in activities related to carcinogenesis such as proliferation, anti-apoptosis, transformation, migration, and angiogenesis, in many types of tumors, including HCC. Aim To evaluate serum levels of MK as a diagnostic biomarker for early detection of HCC in relation to conventional markers, such as alpha-fetoprotein (AFP). Patients and methods This study was conducted on 90 individuals who attended the Hepatogastroenterology and Infectious Diseases Department, Al-Zahraa University Hospital, Al Azhar University. The patients were divided into three groups: group I comprised 30 patients with HCC on top of hepatitis C virus and group II comprised 30 patients with cirrhotic liver post-hepatitis C virus. Control group The control group comprised 30 healthy adult participants. Results Highly statistically significant increase in serum MK in groups I and II in comparison to the control group and statistically significant increase in group I in comparison to group II. Serum MK can be used to discriminate between groups I and II at a cutoff level of more than 97.7,with 80% sensitivity, 90% specificity, 88.9% positive predictive value and 81.8% negative predictive value and area under curve=0.94. Also, it used to discriminate between groups I and III at a cutoff level of more than 76.5, with 100% sensitivity, specificity, positive predictive value, and negative predictive value with area under the curve=1.0. Conclusion MK is more accurate than AFP in diagnosing HCC, especially in detecting early stage HCC and AFP-negative HCC.
Background Lung cancer is the leading cause of cancer-related death. The accurate staging of lung cancer is important in determining the optimal treatment strategy and predicting the prognosis. Positron emission tomography (PET)/computed tomography (CT), which has the advantages of PET and CT and minimizes their limitations, is a potential tool for the staging of lung cancer. Objective This study aimed to evaluate the role of PET/CT in the staging of lung cancer. Patients and methods This study was carried out on 40 patients with pathologically confirmed lung cancer referred to the Nuclear Medicine Unit affiliated to the Department of Radiodiagnosis at Sharq El Madina Hospital, Ministry of Health, Alexandria, between November 2017 and December 2019 for initial staging of lung cancer with PET/CT or restaging after therapy. Combined PET/CT imaging was performed using the Siemens biograph 64 PET/CT scanner. Results (a) Initial staging: PET/CT was able to assess the stage of ten patients (25%), whose stage could not be assessed by CECT. Both PET/CT and CECT disagreed in the staging of six patients. PET/CT staged 10 (25%) patients that could not be assessed by contrast enhanced computed tomography (CECT) and they disagreed in staging of six patients (15%). T staging was predicted by PET/CT in the 40 patients (100%) and by CECT in 30 patients (75%), with disagreement in two patients (5%). PET/CT disagreed with CECT in N staging of 10 patients (25%). PET/CT detected distant metastasis (M) in 18 patients (45%), while CECT detected it in 14 patients (35%). (b) Restaging after neoadjuvant therapy: staging was concordant in six out of eight patients (75%) and dissimilar in two patients (25%). Conclusion PET/CT is an essential component in the initial staging of lung cancer for its better locoregional and distant staging abilities. It is also more reliable in restaging after neoadjuvant therapy, being more related to the functional activity of the residual tumor rather than its size.
Background Tobacco smoking is known for its deleterious effects on the systems of the whole body. However, the effects on the eye are not fully understood, especially the effects on the retina and choroid. Aim The current study aimed to evaluate the effects of smoking on choroidal and retinal nerve fiber layer (RNFL) thicknesses. Patients and methods The current work included 50 patients, categorized into G1 (25 healthy individuals as a control group) and G2 (25 smokers, who practiced continuous smoking for >2 years). All participants were assessed by history taking, followed by ocular examination of both eyes. The unaided and best-corrected visual acuity and intraocular pressure were determined. The slit-lamp biomicroscopic examination was performed to detect any abnormalities or media opacity of the anterior segment of the eye. It was followed by the fundus examination and optical coherence tomography to determine choroidal thickness (CT) and RNFL thickness. Results No significant differences were reported between smokers and nonsmokers regarding patient age, hemoglobin concentrations, visual acuity, or intraocular pressure. The smoking duration ranged between 3 and 30 years, and the number of daily cigarettes ranged between 5 and 30 cigarettes/day. The choroidal thickness and RNFL thickness were significantly reduced among smokers compared with nonsmokers. Finally, there was a significant, inverse correlation between CT and the smoking duration and daily smoking. Conclusion There was a significant reduction in CT and RNFL thicknesses owing to smoking. This reduction could be associated with reduced blood flow to the choroid following smoking.
Introduction Sarcopenia is a generalized loss of skeletal muscle mass combined with reduced strength and/or physical performance. Diabetic patients are prone to accelerated aging process, and these individuals are at increased risk of sarcopenia at an early age. Aim To determine the relationship between sarcopenia and diabetic nephropathy (DN). Patients and methods A prospective cross-sectional study was carried out on 60 patients with diabetes mellitus (DM), comprising 19 patients with DN and 41 patients without nephropathy, and 40 healthy controls. Sarcopenia was diagnosed using the European Working Group on Sarcopenia criteria. Results Of 60 patients, 44 (73%) were females and 16 (27%) were males, and their ages ranged from 31 to 70 years, with mean±SD age of 55.4±10 years. Sarcopenia was detected in nine (15%) patients with DM versus only one (2.5%) patient in healthy controls. The prevalence of sarcopenia was 35% in patients with DN versus 5% in those without DN. Skeletal muscle index was positively correlated with BMI in both sexes and in waist circumference in females. Conclusion The prevalence of sarcopenia was higher among diabetic patients with nephropathy than in those without nephropathy. Male sex and BMI are among the risk factors of sarcopenia in patients with DM.
Background Diabetes mellitus (DM) is a complex metabolic disorder, and its rapid emergence worldwide has led to its classification as an epidemic. Aim To increase our knowledge about omentin-1 and its relation with type 2 DM, insulin resistance, and obesity. Patients and methods This study included 50 patients with type 2 DM, with an age range from 40 to 70 years, who were divided into two groups (25 obese and 25 nonobese), as well as 40 age group (20 obese and 20 nonobese)-matched patients, who formed the control group. Each group was subjected to full history taking and clinical examination (fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, glycosylated hemoglobin, fasting insulin, and serum omentin-1 levels). Weight and height were measured. Homeostasis model assessment insulin resistance and BMI were calculated. Results The study showed a significant decrease in serum omentin-1 levels in type 2 diabetic patients in comparison with the control group. Serum omentin-1 levels inversely correlated with obesity, insulin resistance, and systolic blood pressure. Negative associations were found between serum omentin-1 level and fasting glucose, glycosylated hemoglobin, and fasting lipid levels. Conclusion Omentin-1 may be used as a biomarker for obesity and associated metabolic and vascular disorders.
Background Diabetes mellitus (DM) type 2 is a major health condition that has shown an increased incidence globally. The most common complication in type 2 DM is diabetic nephropathy (DN). Aim To determine serum galectin-3 as a prognostic biomarker in type 2 DN. Patients and methods A case–control prospective study was done in the Internal Medicine Department of AL-Zahraa University Hospital, Cairo, Egypt. The study was conducted on 90 patients, including 60 patients with type 2 DM and 30 age-matched and sex-matched healthy volunteers as a control group. The 90 patients were classified into four groups: group I included 20 diabetic patients (type 2) with an albumin/creatinine ratio (ACR) of less than 30 mg/g (normoalbuminuria), group II included 20 DM (type 2) with an ACR of 30–300 mg/g (microalbuminuria), group III included 20 DM (type 2) with an ACR of more than 300 mg/g (macroalbuminuria), and control group included 30 age-matched and sex-matched healthy individuals. History, examination, fasting blood sugar, glycated hemoglobin, urea, creatinine, estimated glomerular filtration rate, ACR, lipid profile, and serum galectin-3 were done for all participants. The study was approved by the Al Azhar University Ethics Board. Results Galectin-3 was significantly higher in patients with macroalbuminuria than in those with microalbuminuria and normoalbuminuria. Galectin-3 level has a significant positive correlation with parameters of DN progression (age, DM duration, fasting blood sugar, glycated hemoglobin, cholesterol, low-density lipoprotein, triglyceride, urea, creatinine, and ACR) and a significant negative correlation with estimated glomerular filtration rate and high-density lipoprotein levels. Conclusion Galectin-3 was significantly higher in type 2 diabetic patients with macroalbuminuria than in those with microalbuminuria and normoalbuminuria.
Background Minimal invasion surgeries have gained popularity in many fields of ophthalmology. In strabismus surgery, a similar approach is done to gain access to muscles, which is performed through keyhole openings. Objective To compare between minimal invasive strabismus surgery (MISS) technique and limbal approach for horizontal rectus muscle regarding postoperative muscular alignment and postoperative complications. Patients and methods This study included 60 eyes (36 patients of different age and sex) presenting with horizontal strabismus. The first group included 30 eyes that were managed by MISS (patient group), and the second group included 30 eyes that were managed by the limbal approach (control group). Results No significant difference was found regarding postoperative pain, conjunctival redness, and ocular alignment. There was no significant increase in complications between the two groups. Operative time was longer in the MISS technique, with highly significant difference between the two groups. Conclusion MISS technique is an alternative technique to limbal incision that can be used on horizontal muscles. It has the same effect as the limbal approach with the same success rate. It has the advantages of sparing perilimbal episcleral vessels, which make some surgeon prefer it if there is fear of anterior segment ischemia.
Background Nail disorders comprise ∼10% of all dermatological conditions. Because diagnosis is not always possible by clinical means alone, additional diagnostic procedures may be required at times. Dermoscopy of nails (onychoscopy) has shown promising results in diagnosing various nail disorders. Aim To study the dermoscopic nail findings in psoriasis and lichen planus. Patients and methods A total of 80 patients with clinically evident psoriasis and lichen planus of nail were included in this study. They were classified into two groups: group 1 included 40 patients with nail psoriasis and group 2 included 40 patients with nail lichen planus. All patients were examined clinically and by dermoscope for criteria of psoriasis and lichen planus of the nails. Results In psoriatic patients, pitting is the commonest finding observed clinically and by dermoscope. Splinter hemorrhage, pitting, leukonychia, longitudinal ridging, oil drop sign, and onycholysis are better visualized by dermoscopy, and dilated hyponychial capillaries are detected only by dermoscopy. In patients of lichen planus, longitudinal ridging is the commonest finding observed clinically and by dermoscopy. Longitudinal ridging, pitting, chromonychia, and splinter hemorrhage are better seen by dermoscopy. Linear dyschromic bands are not detected clinically. Conclusion Onychoscopy can provide valuable diagnostic information in cases of nail psoriasis and nail lichen planus.
Background Diffusion-tensor imaging (DTI) and fiber tractography are relatively recent MRI techniques that have opened an entirely new noninvasive window on the white matter (WM) connectivity of the human brain. Since their introduction, they have rapidly evolved and found application in essentially every disorder involving the WM. Aim The aim of this work was to study the clinical applications of DTI and fiber tractography in various neoplastic and nonneoplastic brain lesions, as well as to demonstrate their role in preoperative mapping of WM tracts in relation to brain lesions. Patients and methods A prospective study was conducted for 2 years on 40 patients presenting to Alexandria University with variable intracranial lesions related to WM tracts who underwent DTI and fiber tractography. The study included 25 males and 15 females. The age of the patients ranged from 6 to 76 years (mean age, 40.7 years). Qualitative analysis of DTI data was performed using directionally encoded color maps and three-dimensional tractography reconstruction. Results According to visual analysis multiple projection, association and/or commissural WM fiber tracts were involved; the most common was the corticospinal tract in 25 (62.5%) cases. WM tract involvement patterns were deviated/splayed tracts in 31 (64.6%) cases, infiltrated in nine (18.8%) cases, edematous in five (10.4%) cases, and interrupted in three (6.3%) cases. Conclusion DTI and fiber tractography are valuable noninvasive techniques providing qualitative information aiding in lesion characterization, determining WM integrity, and essential in the surgical planning for patients with intrinsic brain lesions.
Background Keratoconus is an ectatic corneal disorder characterized by progressive corneal thinning that results in corneal protrusion, irregular astigmatism, and decreased vision. Objective To evaluate changes in corneal density following corneal cross-linking (CXL) in keratoconic patients. Patients and methods This was a prospective case series study including all patients with keratoconus (50 eyes) undergoing CXL. The number of male patients in the study was 13 (26 eyes) cases, while female patients represented 12 (24 eyes) cases; the study was conducted at the outpatient clinic of the Ophthalmology Department at Al Azhar University Hospital. Results There was no statistically significant correlation between corneal densitometry and K1, K2, K-max, or thinnest corneal thickness preoperatively. There was no statistically significant correlation between corneal densitometry and K1, K2, K-max or thinnest corneal thickness at 1 month postoperatively. There was no statistically significant correlation between corneal densitometry and K1, K-max, or thinnest corneal thickness at 3 months postoperatively. Also, the table shows that there was statistically significant positive correlation between corneal densitometry and K2 with P value of 0.037 and r =0.296. There was no statistically significant correlation between corneal densitometry and K1, K2, K-max, or thinnest corneal thickness at 6 months postoperatively. Conclusion After CXL, the Scheimpflug corneal densitometry and clinical corneal haze peaked at 1 month followed by a gradual decline reaching baseline by 6 months after operation. Corneal thinning was correlated inversely with the corneal haze at 1 month postoperatively. Lens densitometry was not affected by CXL.
Background Individuals with immune thrombocytopenic purpura (ITP) have cellular immune responses that show the characteristics of tolerance mechanisms that have broken down. Objectives This study aimed to assess the percentage of regulatory T cells (Tregs) and CD4 lymphocytes that express CXCR6 in untreated newly diagnosed ITP in pediatric patients and their correlation with each other, the platelet (PLT) count and other PLT indices. Patients and methods A case–control study was carried out that included 40 pediatric patients with ITP, and 20 age-matched and sex-matched healthy controls were selected from Benha Children Hospital hematology clinic. Assessment of CD4+, CD25+, and FoxP3+as markers of Treg cells and also expression of the CXCR6 receptor on CD4+ T lymphocytes to evaluate the percentage of Tregs and CD4/CXCR6 +T lymphocytes were investigated by flow cytometry. Results There was a marked reduction in CD4/CXCR6 and Tregs ( P =0.02 and 0.001) in the ITP group versus the control group. In contrast, there was a marked increase in CD4/CD25+cells ( P =0.002) in the ITP group compared with the control group. There was a considerable reduction in the PLT count and the hemoglobin concentration in the ITP group compared with the control group ( P =0.000 and 0.01), while there was a significant increase in large platelet cell ratio and platelet distribution width in the ITP group in comparison to the control group ( P =0.04 for both of them); also, there were insignificant differences in total leukocytic count and mean platelet volume in the ITP group in comparison to the control group ( P =0.28 and 0.77). Conclusion There was a significant decrease in the concentration of CD4+ cells that express CXCR6+ and Treg percentage in ITP patients as compared with the controls, which may explain the defect in immune self-tolerance in ITP patients.
Background In addition to the physical deformity, there is often great psychological trauma due to facial scars among patients. Fat grafting in its various forms could be considered as a hallmark in scar rejuvenation therapy in the twenty-first century. This is due to the viable adipose-derived stem cells present in the nanofat. Objective The aim of this study was to evaluate the effect of nanofat grafting on postburn and post-traumatic facial scars using a standardized and validated scale [patient observer scar assessment scale (POSAS)] and photographs. Materials and methods A total of 20 patients with facial scars (10 patients post-traumatic and 10 patients postburn) were studied. Preoperative scoring of the scars was performed with the POSAS, and photographs were taken. Fat aspiration was performed from the lower abdomen and thighs using syringe liposuction under tumescent anesthesia. The lipoaspirate was mechanically emulsified, filtered, and injected intralesionally into the scar using a 27 G needle. Postoperative scar reassessment was performed at 3 months using the POSAS scale and photographs. The improvements in scar characteristics and symptoms were tested statistically. Results On statistical analysis, there was a statistically significant improvement in symptoms such as pain, itching, stiffness, thickness and irregularity and scar characteristics such as vascularity, relief, pliability, thickness, and pigmentation 3 months after injection. The photographic comparison also showed good anesthetic outcome. Conclusion Autologous emulsified nanofat injection is effective in improving the scar characteristics as well as symptoms and aiding in scar rejuvenation.
Background Acne scarring remains a challenge to treat. Both botulinum toxin type A (BTX-A) and carboxytherapy (CXT) are considered novel treatment modalities for acne scars. Aim This study aimed to compare the efficacy and safety of BTX-A versus CXT in the treatment of postacne scars. Patients and methods Forty patients aged 18–50 years, with mild to severe postacne scars, were enrolled in this study and were divided randomly and equally into two groups: group A included 20 patients who underwent three sessions of an intralesional injection into postacne scars by BTX-A at a 3-week interval and group B included 20 patients who underwent three sessions of CXT on postacne scars at a 3-week interval. Evaluation of the clinical response to treatment was performed every 3 weeks and 1 month after the last session by photos and the global scarring grading system and patient satisfaction was assessed. Results There was a significant improvement in the degree of scar severity before and after treatment in both groups. There was no significant difference between improvements in both groups, indicating that both modalities of treatment yielded similar net results. Conclusion Both BTX-A and CXT can be effective and safe therapeutic options for the treatment of postacne scars with no significant side effects.
Background The objective of this study is to systematically review the results of different studies related to the management of hip deformities secondary to Perthes’ disease in adults. Patients and methods Thirteen studies matching the inclusion and exclusion criteria, totaling 316 adults including 326 hips that underwent 119 surgical hip dislocation (SHD), 49 periacetabular osteotomy, 111 SHD with periacetabular osteotomy, 16 intertrochanteric osteotomy with acetabular roof plasty, and 31 adductor tenotomy with cheilectomy of the femoral head. Their age was in the range from 19 to 42 years with clinical follow-up range (16–135 months). The degree of pain, function, range of movements, and deformities were evaluated. Results The SHD approach has a 360° view allowing full dynamic evaluation of the hip joint, identification, and correction of the most common residual deformations, leading to functional improvement and pain relief with low complication rates. Harris hip score was a common clinical parameter in a lot of studies and showed improvement from the average range (60–68.5) before surgery to 72–95 after it. In all, 188 hips were reported to have reduction in pain at last follow-up, but adequate clinical follow-up were not available for 112 hips. However, 26 patients were reported as a failure (defined as total hip arthroplasty or persistent or increased pain). Onset osteoarthritis advancement cannot be prevented in hips. Conclusion SHD provides the opportunity to achieve any kind of simultaneous femoral and acetabular osteotomies leading to functional improvement and pain relief with low complication rates.
Background Lichen planus (LP) is a chronic mucocutaneous inflammatory disease. Its etiology remains unknown and may be caused by a cell-mediated immunological response, where autoreactive cytotoxic T lymphocytes are the effector cells, which cause degeneration and destruction of keratinocytes. Inflammation produces disturbances of lipid metabolism such as serum increase of triglycerides or decrease of high-density lipoprotein. Hyperhomocysteinemia has been regarded as a new modifiable risk factor for atherosclerosis and vascular disease. Homocysteine increases the damage to the cardiovascular system in different ways. It is widely seen now as an independent risk factor of cardiovascular disease in adults. Carotid intima-media thickness (CIMT) is a well-recognized clinical predictor of subclinical atherosclerosis. In several previous studies, patients with psoriasis exhibited greater CIMT than did the controls. In light of these studies, authorities might think that LP would also be associated with the formation of subclinical atherosclerosis, given the similarity between the pathogenesis of psoriasis and that of LP. Aim To assess carotid intima thickness and serum homocysteine level as markers of subclinical atherosclerosis in patients with LP. Patients and methods Abstract Peripheral blood samples were collected from 25 patients with LP and 25 controls to assess serum homocysteine level, blood glucose, cholesterol, and triglycerides. CIMT was measured by B mode ultrasound. Results Both serum homocysteine and CIMT were significantly higher in patients with LP than controls. Conclusion Serum homocysteine and CIMT could be reliable predictors of subclinical atherosclerosis in LP.
Objective To determine biosynthesis of silver nanoparticles (AgNPs) by different bacteria and Aspergillus species and to study the effect of these prepared AgNPs alone and in combination with selected antimicrobial agents against resistant bacteria and Candida. Methods AgNPs were synthesized using different bacterial isolates ( Bacillus cereus , Escherichia coli , Enterococcus faecalis , Pseudomonas aeruginosa , and Aspergillus niger) . AgNPs were characterized by ultraviolet/visible spectrophotometer, transmission electron microscopy, scanning electron microscope, and energy-dispersive radiograph spectroscopy analysis. Antimicrobial activity of biosynthesized AgNPs was assessed alone and in combination with antimicrobial agents against resistant bacteria and Candida. Cytotoxicity assay of biosynthesized AgNPs was also assessed. Results The AgNPs thus obtained were confirmed through observed color change, and their evaluation using ultraviolet/visible showed the highest optical density at 410–430 nm wavelength. Transmission electron microscopy and scanning electron microscope showed that the small particle size ranged and strong signal was detected by the energy-dispersive radiograph spectroscopy analysis. Antimicrobial efficacy was increased in combination with biosynthesized AgNPs ( P <0.001). There was low cytotoxic activity of B. cereus AgNPs on Medical Research Council cell strain 5 (MRC-5) cells. Conclusion B. cereus -biosynthesized AgNPs have the best antimicrobial effect against resistant bacteria and Candida, in addition to their low cytotoxicity effect on normal cells.
Background Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh placement may significantly reduce IH but is not widely used. This study aimed to assess the safety and efficacy of prophylactic mesh placement in preventing IH development after midline laparotomy. Patients and methods This was a prospective observational study on 83 patients undergoing midline laparotomy admitted to our hospital during the period from August 2017 to January 2020. The patients were randomized into two groups: the suture group (SG), with nonabsorbable running sutures, and the prophylactic mesh group, with fascial closure as in the SG but reinforced with onlay polypropylene mesh. Results There was no significant difference observed in mean age, sex, mean BMI, mean hospital stay, and mean follow-up period between both the groups. A statistically significant reduction in IH incidence was demonstrated in the mesh group, with one (2.56%) case, than in the SG, with 11 (25.0%) cases. Surgical site occurrence had higher incidences in the mesh group (25.64%) than in the SG (6.82%). Conclusion Reinforcement of the midline closure by onlay mesh has been proved to be an effective and safe method for avoidance of IH in high-risk patients in both elective and emergency operations during the follow-up period.
Introduction Breast cancer is the second leading cause of cancer-related death in women. Breast cancer affects women of all ages, races, ethnicities, socioeconomic strata, and geographic locales. Once breast cancer is diagnosed, the tumor stage has to be accurately determined before therapy is chosen and the prognosis known. Aim Whole-body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET/CT) improves staging of patients with breast cancer and significantly changes the therapeutic management of these patients. Patients and methods This study was carried out in Cairo Scan Radiology Center from March 2018 to September 2018 for 34 female patients. The age ranged from 37 to 79 years, and the mean age was 56 years. All data were acquired with a combined PET/CT in-line system. Results Combined 18-FDG PET/CT provides the ability to combine functional and morphologic information in a single study. So, combined PET/CT sensitivity was 98.11% compared with 81.7% for CT alone, with P value of combined PET/CT compared with CT alone being 0.002. Conclusion Combined 18-FDG PET/CT provides the ability to combine functional and morphologic information in a single study, thus becoming a powerful imaging modality for diagnosis and staging of breast cancer.
