Aims: Surgical site infection (SSI) remains a significant cause of morbidity and financial burden on patients. This study aimed to describe the incidence and risk factors associated with developing SSI in adult patients after abdominal surgery. Methods: In this 6-month prospective observational study, adult patients undergoing abdominal surgery at the Gastrointestinal Surgery Unit of our tertiary referral center were included. Excluded from the study were patients lost to follow-up, those undergoing, urological, vascular, plastic, or transplant surgeries. Patients were followed up for 30 days, data collection was done using a standardized data collection form, and SSI was diagnosed according to the Centers for Disease Control and Prevention definition. Univariate and multivariate analyses were performed to identify risk factors for SSI. Results: The study included a total of 212 patients. The incidence of SSI was 32.5%. Emergency operations, male gender, and high body mass index were identified as independent predictors of SSI. The most commonly isolated organisms in analyzed cultures were Klebsiella spp. Conclusion: A high rate of SSI following abdominal surgery was observed. Periodic audits to assess compliance with established standard infection control measures, review of prophylactic antibiotic guidelines, as well as addressing modifiable risk factors have the prospect of reducing SSI.

Patients with prior abdominal surgeries are at higher risk of intra-peritoneal adhesions near the trocar entry site, increasing the likelihood of organ injury during laparoscopic cholecystectomy (LC). This study evaluates a novel technique where the epigastric trocar is inserted first, after creating pneumoperitoneum, to allow safe dissection of adhesions under direct vision before placing the umbilical trocar. This prospective study included 244 patients with symptomatic uncomplicated gallstone disease and a history of previous abdominal surgeries extending to the umbilicus. Patients were randomly assigned to two groups: Group I (n = 98) underwent traditional umbilical trocar-first LC using the Hasson technique, while Group II (n = 146) received LC using the epigastric trocar-first approach. Operative time, complications, and conversion rates were analyzed. There was no significant difference in the demographics between both groups. The epigastric trocar-first approach significantly reduced total operative time (41.6 ± 7.7 min vs. 46.8 ± 8.8 min, p = 0.031) and small bowel injury rates (p = 0.006). Otherwise, intraoperative complications were comparable. Conversion to open surgery was lower in Group II (2.1

Background: Pancreaticoduodenectomy (PD) is a complex surgery performed for pancreaticoduodenal pathology. Previous studies have found conflicting results regarding morbidity and mortality associated with performing PD operation for elderly patients. Objectives: The primary endpoint of the study is to examine the safety of performing PD in older populations. Secondary endpoints include comparing the frequency of morbidity and mortality in the elderly group with that of the younger age group after PD operation. Patients and Methods: A retrospective study comprising 267 patients who underwent PD in our institute for different indications, between January 2018 and January 2023. Demographics, American Society of Anesthesiologists scores, comorbidities, total hospital stays, postoperative complications, and 30-day mortality were analyzed. The patients were subdivided into two groups based on their age: those younger than 65 years (group I) and those aged 65 years and above (group II). Results: The elderly group experienced a significantly longer total hospital stay, including longer postoperative ICU admission; a higher rate of readmission, with no significant difference was found between both groups as regards the total operative time, intraoperative blood loss, postoperative morbidity, and reoperation and 30-day mortality rates. Conclusion: This research illustrates that PD is safe for individuals aged 65 and above, with similar rates of postoperative complications, reoperation, and mortality rates when compared to their younger counterparts. By carefully selecting patients and providing attentive perioperative care, satisfactory outcomes can still be achieved for elderly patients.

The occurrence of gastric stump carcinoma (GSC) is increasingly observed following pancreaticoduodenectomy (PD), as its indications broaden and the number of long-term survivors continues to rise. A 35-year-old female patient who had vague upper abdominal complaints for 45 days developed gastric stump carcinoma four years after pylorus preserving pancreaticoduodenectomy for pancreatic head carcinoid tumor. She had signet ring cell carcinoma involving the incisura angularis. Completion partial stump gastrectomy was done. GSC is uncommon following a PD. However, early detection and intervention are essential, and heightened awareness of such cases is necessary.

The objective of this web-based study is to analyze the attributes of bariatric surgery cases ensuing health implications. Additionally, the study seeks to delve into the factors influencing post-bariatric psychological evaluations and the impact of various bariatric surgeries on weight loss and psycho-social assessment scores for patients who had undergone bariatric surgeries within a specific bariatric surgery center in Egypt between January 2017 and January 2024. An analytical cross-sectional study recruited 411 adults who had undergone different bariatric procedures by the same surgical team. We collected the data using a validated self-administered questionnaire that included the Body Image Scale (BIS), the Rosenberg Self-Esteem Scale (RSES), the quality-of-life score (QOLS), and the modified General Patient Satisfaction Score after Bariatric Surgeries (GSABS). The most commonly performed bariatric surgery was sleeve gastrectomy (SG), accounting for 82.7

- Malgré les progrès de la technologie chirurgicale, la conservation de la rate reste une méthode efficace, moinscouteux. Laprésence des imageries efficaces permetidentifierles risqueset deprévention d’importance primordiale.BUT :- Cette étude décrire le tauxde suces et l’échecdu traitement de conservation de la rate.Patients et Méthodes : - Cette étude prospective, lespatients de traumatismeabdominal fermeadmis à l’unité d’urgence chirurgie générale d’hôpitaluniversitaire d’Alexandriele 1erjanvier 2023 au30 juillet 2023Inclusles patients admis dans cette unité pour traumatisme abdominal fermer,dont le traumatisme de la rate a été confirmé.Exclules patients perdus de vue et subissant la chirurgie dès l’arrive.La collecte de donnée a été effectué à l’aide d’un formulaire de donnés standardisé. - Despite advances in surgical technology, spleen preservation remains an effective, less expensive method. The presence of effective imaging makes it possible to identify risks and prevention of paramount importance.AIM :- This study will describe the rate of blunt splenic trauma and failure of spleen conservation treatment.Patients and Methods :- This prospective study, patients with blunt abdominal trauma admitted to the general surgery emergency unit of Alexandria University Hospital from January 1 ,2023 to July 30, 2023.Inclusion criteria, Patientsadmitted to this unit for close abdominal trauma, whose spleen trauma was confirmed.Exclusion criteria, patients who lost follow-up and those undergoing surgery upon arrival.Data collection was carried out using a standardized data form.

Geotextile is a geosynthetic-based soil stabilization technique recently used to reinforce the soil and stabilize the canal slopes. In this study, the effect of using different nonwoven geotextile configurations on soil reinforcement and slope stability for irrigation canals subjected to loads on a canal berm was experimentally and numerically investigated. First, a laboratory model was constructed, the materials were prepared, and testing procedures were performed. The experiments were conducted to investigate settlement due to footing loads of width B acting on a canal berm in a dry case under different scenarios of geotextile soil reinforcement. Different lengths (l = 1.5, 2.0, and 4.0 B) and depths (d = 0.5, 1.0, and 2.0 B) of geotextile layers were used. Second, the experimental data were used to calibrate and validate the PLAXIS-3D model. Third, a series of simulation scenarios were conducted to investigate the joint effect of geotextile configurations on settlement. After that, the PLAXIS-3D model was used to determine the factor of safety (FoS) of the Ismailia Canal (i.e., real case study) side slope under different loading conditions with and without geotextile reinforcement. Finally, a cost analysis was conducted for Ismailia Canal under different geotextile configurations. Results showed a close agreement between experimental and PLAXIS-3D simulation results. Results also showed that geotextile reinforcement enhances bearing capacity ratio (BCR) and reduces settlement. As the length of the geotextile layer increases, the BCR increases and the settlement decreases. Among the investigated geotextile configurations, the optimum configuration was found when l = 4 B and d = B. In addition, soil reinforcement by geotextile for Ismailia Canal under an excavator load of 40 tons lowered the settlement values by about 10

Background: The advancement in medical care has led to an increase in patients with acute cholecystitis (AC) and cardiopulmonary comorbidities referred for surgery. Grade II AC, according to Tokyo Guidelines in 2018 (TG18), is characterized by severe local inflammation with no systemic affection. The optimal treatment for patients with high-risk grade II AC has not yet been clearly established, which is still a dilemma. For these patients, laparoscopic cholecystectomy (LC), despite being the only definitive treatment, is still a challenge. The introduction of percutaneous cholecystostomy as a temporary minimally invasive alternative technique allows an immediate gallbladder decompression with a rapid clinical improvement. However, the next step after percutaneous transhepatic gall bladder drainage (PTGBD) in these high-risk patients is still a debate, with no definitive consensus about the ideal treatment of choice as well as its optimal timing. In our study, we followed a treatment algorithm for high-risk patients that involved early gallbladder decompression by PTGBD, followed by LC at different intervals once the patient is considered fit for surgery. Method: A retrospective study of 58 patients with high-risk grade II AC with cardiopulmonary comorbidity from our medical records was included. They were managed initially with PTGBD, an LC was then performed either within 7 days after drain insertion (early group, 26 patients), while an LC was performed later for the remaining patients within 6-8 weeks after PTGBD (late group, 32 patients). The results of the two groups were analyzed. Result: Procalcitonin and C-reactive protein were significantly higher in the late group. No significant difference was found between both groups with regard to operative time, PTGBD-related complications, and major perioperative complications. Timing after PTGBD did not affect the incidence of operative complications. Total hospital stay was significantly shorter in the early group. Conclusion: PTGBD is a safe initial intervention for high-risk patients with AC with a low morbidity and high success rate. Urgent LC after PTGBD can be performed safely for well-selected high-risk patients with the timing of surgery is personalized according to each patient's clinical situation. Early LC (after PTGBD) has the advantage of shorter hospital stay, low cost, as well as avoiding the risk of biliary complications and mortality if waiting a delayed surgery with no significant difference in morbidity compared with late LC.

Chylous ascites (CA) is a rare complication after abdominal surgeries, particularly donor hepatectomy and liver transplantation. We present a case of CA developed following donor right hepatectomy. Initially managed with a high-protein, low-fat diet and Sandostatin (R) (Octreotide Acetate), the patient's condition improved but did not resolve. Subsequently, the treatment plan was modified to include clear oral fluids, total parenteral nutrition, and Sandostatin (R), resulting in a significant improvement and ultimate discontinuation of CA drainage. This case sheds light on the management strategies for CA following donor hepatectomy and emphasizes the need for a multimodal approach.

This work aims to investigate the influence of Cu addition on the microstructure and mechanical properties of ductile cast iron (DCI). A step-like mold was used to study the evolved microstructures at different cooling rates. It was observed that adding Cu to DCI increased the pearlite content and refined significantly the lamellar structure. This effect was more pronounced at the thicker sections (slower cooling rates). Tensile strength improved obviously with the increase in pearlite content from 550 MPa at 27 % pearlite (0.02 wt.% Cu) to 875 MPa at 83 % pearlite (2.47 wt.% Cu). However, the elongation decreased sharply from 19 to 5 % upon increasing Cu content from 0.02 to 2.47 wt.% at 20 mm thickness. The impact toughness was affected negatively by Cu addition, where the value of toughness decreased from 65 J at 0.02 wt.% Cu to ~17 J at 2.47 wt.% Cu at 20 mm.

Although rare, Complicated Meckel's diverticulum (MD) is responsible for a variety of uncommon abdominal surgical emergency presentations. Because of these unique presentations, Meckel's diverticulum is a distinctive, peculiar astoundment in surgical practice. In this article, We reviewed previously published cases with both Gastrointestinal Stromal Tumors (GISTs) and MD to define the nature of both pathologies and their relation, the character, presentation, and timing of diagnosis of this rare coincidence. We illustrated this relation with a case of a perforated Meckel's diverticulum associated with multiple intestinal Gastrointestinal Stromal Tumors (GISTs) in a 58-year-old male presenting with features of acute appendicitis operated through a McBurney's incision.

BACKGROUND: 5-fluorouracil (5-FU) is an anticancer drug used to inhibit the proliferation of many different tumor cells. Since severe side effects are associated with this drug, its combination with different natural compounds would allow the use of a significantly lower dose of 5-FU. Oleuropein (OLEU), has been shown to have inhibitory effects on various types of cancers. AIM: The main objective of the current study was to assess the cytotoxic effect of OLEU and the chemotherapeutic drug 5-FU on Human Tongue Carcinoma Cancer Cell Line (HNO-97) and Human Normal Oral Epithelial Cell Line (OEC) either independently or combinatory effect. MATERIALS AND METHODS: 3-(4,5- dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide (MTT) assay for cell viability, and half-maximal inhibitory concentration (IC50) was calculated. Flowcytometry for cell cycle analysis was performed. Also, in vitro scratch assay was done to assess the inhibitory effects of OLEU on the migration of cells.RESULTS: MTT assay study demonstrated that OLEU and 5-FU alone or in combinations have produced a significant inhibitory effect on both normal and cancer cell lines with a favorable impact for OLEU on cancer cell lines rather than the normal one. A significant increase in the cell inhibitory % was reported between the single and the combinations treated groups as compared to the non-treated control group. Cell cycle analysis via flowcytometry showed that OLEU had induced cell cycle arrest at G0/1 phase, decreased S phase and G2/M phase either independently or in combination for 24h and 48h when compared with a non-treated control group. A Scratch assay test showed that OLEU could induce delayed wound healing. CONCLUSIONS: The findings of the present study suggest that OLEU can exert an anti-cancer effect on HNO-97 and may have the potential for potentiation of 5-FU cytotoxic effects and reduction of its adverse effects. In addition, OLEU could inhibit cancer progression and expansion from the initial tumor.

Uncertainties are unavoidable in geotechnical engineering design. Quantifying uncertainties and the related risks are very important in the overall design. For problems involving complex soil-structure interactions, using a fixed partial or global safety factor may lead to unrealistic failure or conservative design. The probabilistic analysis could be used as a basis for handling various types of uncertainties. The reliability analysis for complex structures requires a coupling between two models. A finite element model (FEM) to evaluate the limit state function (LSF) and a reliability model to deal with the random variables and reliability methods. Since the coupling between FEM and reliability methods is considered a new field, there is a need to use a hybrid technique for coupling. In the present paper, a developed technique for coupling between PLAXIS 2D v20 and Probabilistic tool-kit (PTK) is illustrated and checked throughout verification examples. The main goal is to present an “easy to use” reliability analysis technique to identify the probability of failure, the reliability index, and the influence factors for complex geotechnical structures. The results show that the developed coupling technique has a good reliability analysis result compared with the previous studies and it can be used to optimize the current design procedure for geotechnical structures.

Five extracting solvents (water, methanol, ethanol, acetonitrile and ethyl acetate) were involved to Evaluate antimicrobial of 13 different plants including different plant parts against 12 fungal species.The results showed promising antifungal activity of the ethanolic extract of C. verum and S. aromaticum that exhibited the strongest effect against P. marneffie, C. albicans, and A. niger.Two active compounds were purified using silica gel column chromatography followed by thin layer chromatography (TLC), and the characterization of active compounds was carried out by using IR, NMR and Mass spectroscopic analysis followed by determination of the minimum inhibitory concentration (MIC).First compound (A) belongs to ethanolic extract of C. verum was identified as (raffinose), The second compound (B) belong to ethanolic extract of S. aromaticum was identified as (oleanolic acid).Additionally, cytotoxicity of both purified compounds was carried out, where compound (B) showed high inhibitory activity against all tested carcinoma cells, while compound (A) did not produce any antitumor activity.Also, an antioxidant test was done for both compounds and the results showed that both compounds (A and B) have antioxidant activity.In conclusion, compound (B) had antifungal, antitumor and antioxidant activity while compound (A) had antifungal and antioxidant activity but, it had not antitumor activity against all tested carcinoma cells.

Quay walls and deep excavations are typical applications of geotechnical retaining structures. These structures must be acceptable safe, and cost-effective. The design of retaining structures is usually carried out by using characteristic values for soil properties as a conservative estimation for Serviceability Limit State (SLS) and combined with safety factors for Ultimate Limit State (ULS). The soil parameters used in the design are uncertain values due to many reasons. Recently, probabilistic approaches started to take place in the engineering community. These approaches guaranty a reasonable level of reliability and reduces the risk and the investment cost. In the present paper, a developed technique for coupling between PLAXIS 2D V20 and Probabilistic Tool-Kit (PTK) will be employed to perform a reliability analysis for port-said east port diaphragm quay wall. This study aims to identify the probability of failure and the importance factors for each structural component using the First Order Reliability Method (FORM) and study the effect of varying the statistical data for the most significant soil parameters. The results show that the developed technique can perform the reliability analysis effectively. Also, it showed that the statistical data for soil parameters have a considerable effect on the probabilistic analysis results.