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Article: A Clinical Score For Predicting Complications Following Breast Reduction.

Eleiba, Rami Ali / Elfeki, Bassem / Ismail, Khalid Ahmed / Hegazy, Safwat Adel

JPMA. The Journal of the Pakistan Medical Association

2023 Volume 73Suppl 4, Issue 4, Page(s) S82–S86

Abstract: Objectives: To establish a clinical score for morbidity prediction based on patient-related risk factors after breast reduction surgery.: Method: The retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, ... ...

Abstract	Objectives: To establish a clinical score for morbidity prediction based on patient-related risk factors after breast reduction surgery. Method: The retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, Kafrelsheikh University Hospital, Egypt, and comprised data of female patients with bilateral macromastia who underwent breast reduction, using the inferior pedicle invertedT technique between February 2019 and June 2020. After data retrieval, risk factors and complications were documented and related to the patients'risk factors Data was analysed using SPSS 20. Results: Of the 30 cases, 20(66.7%) were aged ≥35 years, 16(53.3%) had body massindex ≥37kg/m2 and 27(90%) were non-smokers. The mean preoperative haemoglobin level was 12.15±1.115g/dL and the mean weight of tissue resected on both sides was 2074.17±696.12gm. Factors significantly associated with complications included smoking, suprasternal notch to nipple distance ≥38cm, haemoglobin <12.5g/dL, the weight of excised tissue ≥2000gm and a positive family history of macromastia. The total score of the morbidity prediction scale ranged 2-190, with the best cut-off value being ≥93. The scale had 100% sensitivity,specificity, positive predictive value, negative predictive value and 100 percent accuracy. Conclusions: Ability to predict postoperative surgical-site morbidity may optimise safety as well as outcome after reduction mammaplasty.
MeSH term(s)	Female ; Humans ; Retrospective Studies ; Mammaplasty/adverse effects ; Mammaplasty/methods ; Nipples/surgery ; Hypertrophy ; Treatment Outcome
Language	English
Publishing date	2023-07-24
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
DOI	10.47391/JPMA.EGY-S4-18
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Article ; Online: Incidence and Nature of Respiratory Events in Patients Undergoing Bronchoscopy Under Conscious Sedation.

Tariq, Asma / Hill, Nicholas S / Price, Lori Lyn / Ismail, Khalid

Journal of bronchology & interventional pulmonology

2022 Volume 29, Issue 4, Page(s) 283–289

Abstract: Background: During diagnostic bronchoscopies, conscious sedation improves patient tolerance, but it can contribute to hypercapnia and hypoxia by various mechanisms including depression of ventilatory drive. This prospective study was undertaken to ... ...

Abstract	Background: During diagnostic bronchoscopies, conscious sedation improves patient tolerance, but it can contribute to hypercapnia and hypoxia by various mechanisms including depression of ventilatory drive. This prospective study was undertaken to determine the frequency of respiratory events and associated oxygen desaturations during bronchoscopy with conscious sedation. Patients and methods: The Nox-T3 monitoring system was placed before starting the bronchoscopy and remained in place for 30 minutes following the procedure. The primary endpoint was the occurrence of obstructive and central apneic events during bronchoscopy under conscious sedation. Results: Obstructive events (apnea and hypopnea) occurred in 100% of patients (n=31), and central apneas occurred in 58% of patients (n=18) during the procedure with a median of 9 and 2 events per patient, respectively. During recovery, a significant proportion of patients had detectable obstructive (86%) and central (36%) events. Higher body mass index was associated with oxygen desaturation to <90% and with the need for escalation of care. Furthermore, a conscious sedation regimen that included propofol was significantly associated with central apneic events. Conclusion: Respiratory events are common during and immediately postprocedure after conscious sedation for bronchoscopy. Most events are obstructive, and the use of propofol predisposes to central apneas during the procedure. Both types of events are associated with a higher body mass index. Oxygen desaturation to <90% triggers escalation of care. A further prospective study will be required to determine the clinical significance of these apneic events and whether alleviating these events will improve the safety and outcomes of bronchoscopic procedures performed under conscious sedation.
MeSH term(s)	Bronchoscopy/adverse effects ; Bronchoscopy/methods ; Conscious Sedation/adverse effects ; Conscious Sedation/methods ; Humans ; Incidence ; Oxygen ; Propofol/adverse effects ; Prospective Studies ; Sleep Apnea, Central/chemically induced
Chemical Substances	Oxygen (S88TT14065) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2022-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000837
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Article: Expanding Scope About Factors Influencing Seroma Formation After Breast Cancer Surgery.

Eldamshety, Osama / Lamey, Ahmed / Ismail, Khalid Ahmed / Esmail, Taha / Tolba, Mohamed / Elmoneim Mahmoud, Reda

JPMA. The Journal of the Pakistan Medical Association

2023 Volume 73Suppl 4, Issue 4, Page(s) S282–S286

Abstract: Objectives: To determine the incidence of seroma formation after breast cancer surgery, and its association with common risk factors.: Method: The correlationalstudy was conducted at the General Surgery department of Kafrelsheikh University Hospital, ...

Abstract	Objectives: To determine the incidence of seroma formation after breast cancer surgery, and its association with common risk factors. Method: The correlationalstudy was conducted at the General Surgery department of Kafrelsheikh University Hospital, Egypt, from March 2020 to March 2022 and comprised patients having breast cancerstage I, II or III, as per the Tumour Node-Metastasis classification, who were scheduled to undergo modified radical mastectomy, breast conserving surgery or reconstructive surgery. Baseline, intraoperative and postoperative data was collected on a proforma. Data was analysed using SPSS 22. Results: Of the 50 female patients with mean age 45±5.20 (range: 20-70 years), 30(60%) were in the elderly group aged >45 years, while 20(40%) were aged <45years. Overall, 12(24%) cases developed seroma; 9(30%) in the elderly group. There were 24(48%) cases of modified radical mastectomy, and 8(33.3%) had seroma. Electrocautery was used for breast dissection in 30(60%) cases, and, among them, seroma developed in 10(33.3%) patients. Conclusions: Age, body weight, afflicted breast side, site, and size of breast mass were not found to be significant predictors of seroma formation following breast cancer surgery.
MeSH term(s)	Aged ; Female ; Humans ; Adult ; Middle Aged ; Breast Neoplasms/pathology ; Mastectomy/adverse effects ; Seroma/epidemiology ; Seroma/etiology ; Lymph Node Excision/adverse effects ; Drainage ; Postoperative Complications/etiology
Language	English
Publishing date	2023-07-24
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
DOI	10.47391/JPMA.EGY-S4-55
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Article: Safe Stapleless Laparoscopic Splenectomy; Use Of Hem-O-Lok To Control The Splenic Hilum.

Farahat, Sherif Mohammed / Elbatarny, Akram / Elshimy, Khalid Mohamed / Medhat, Sherif / Ismail, Khalid Ahmed / Arafa, Mohamed Ahmed

JPMA. The Journal of the Pakistan Medical Association

2023 Volume 73Suppl 4, Issue 4, Page(s) S228–S232

Abstract: Objectives: To evaluate Hem-o-Lok polymer clips' feasibility, safety and cost-effectiveness in controlling the splenic pedicle during paediatric laparoscopic splenectomy.: Method: The prospective study was conducted from May 2019 to December 2021 at ... ...

Abstract	Objectives: To evaluate Hem-o-Lok polymer clips' feasibility, safety and cost-effectiveness in controlling the splenic pedicle during paediatric laparoscopic splenectomy. Method: The prospective study was conducted from May 2019 to December 2021 at Kafrelsheikh University Hospital, Egypt, and comprised children of either gender aged <18 years who had benign haematological diseases and were indicated for laparoscopic splenectomy. During the procedure, Hem-o-Lok clips were used for controlling the splenic pedicle. Patients were encouraged to ambulate the same day, and the drain was removed 24hours postoperatively. The cases were followed up for three months postoperatively. Results: Of the 23 subjects, 11(47.8%) were boys and 12(52.2%) were girls. The overall mean age was 8.74±3.44 years (range: 4-15 years). There were 6(26%) cases of spherocytosis, 1(4.3%) immune thrombocytopenic purpura and 16(69.6%) with thalassemia major. The mean operative time was 93.43±29.87 minutes(range: 65-180 minutes). There was no conversion to open splenectomy and no mortality. There were 2(8.7%) cases of minor and 1(4.3%) of major intraoperative bleeding. All the 3(100%) cases were controlled laparoscopically. No postoperative bleeding occurred and no cases required postoperative blood transfusion. Conclusions: Controlling both the splenic artery and vein using Hem-o-Lok clips was found to be feasible, safe and cost-effective.
MeSH term(s)	Male ; Female ; Humans ; Child ; Child, Preschool ; Splenectomy/methods ; Prospective Studies ; Spleen ; Laparoscopy/methods ; Postoperative Hemorrhage
Language	English
Publishing date	2023-07-24
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
DOI	10.47391/JPMA.EGY-S4-45
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Article: Outcomes Of Mesh Fixation Versus Non Fixation In Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair: A Randomized Clinical Study.

Ali, Reda Fawzy / Elhussainy, Ragab Mahmoud / Aouf, Ahmed Mahmoud / Ismail, Taha Ahmed / Ismail, Khalid Ahmed

JPMA. The Journal of the Pakistan Medical Association

2023 Volume 73Suppl 4, Issue 4, Page(s) S8–S12

Abstract: Objectives: The present study aimed to compare the results of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair with and without mesh fixation regarding postoperative pain, recurrence, operative time, and complications.: Methods!# ...

Abstract	Objectives: The present study aimed to compare the results of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair with and without mesh fixation regarding postoperative pain, recurrence, operative time, and complications. Methods: This randomized controlled clinical trial included 100 patients who underwent TAPP inguinal hernia with mesh fixation (group A) or a fixation-free procedure (group B) for early onset inguinal hernia at the General Surgery Department, Kafrelsheikh University Hospital, from January 2021 to June 2022. Results: The parameters for pain assessment (NRS) in the first week (mean 7 (5 - 8)), the first month (mean 3 (1 - 5)), and after three months(mean 0 - (70% of patients), (mean 1- (30% of patients) were significantly higher in the fixation group (p<0.001). The fixation group had significantly more operative time than non fixation, with a mean (69.34±13.55, 60.92±10.18) respectively. Recurrence rate and postoperative complications did not show any significant difference between the studied groups. Conclusions: Mesh non-fixation for laparoscopic TAPP hernia repair is safe, practical, and effective with minimal postoperative pain and no increased risk of recurrence.
MeSH term(s)	Humans ; Hernia, Inguinal/surgery ; Hernia, Inguinal/complications ; Surgical Mesh/adverse effects ; Laparoscopy/adverse effects ; Pain, Postoperative/epidemiology ; Pain, Postoperative/etiology ; Postoperative Complications/etiology ; Herniorrhaphy/adverse effects ; Recurrence ; Treatment Outcome
Language	English
Publishing date	2023-07-24
Publishing country	Pakistan
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
DOI	10.47391/JPMA.EGY-S4-2
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Article: Oncoplastic Volume Displacement Surgical Techniques For Early Primary Breast Cancer: A Case Series.

Eldamshety, Osama / Lamey, Ahmed / Ismail, Khalid Ahmed / Esmail, Taha Ahmed / Tolba, Mohamed / Ali, Reda Fawzy

JPMA. The Journal of the Pakistan Medical Association

2023 Volume 73Suppl 4, Issue 4, Page(s) S330–S333

Abstract: Oncoplastic breast surgery (OPS) is a new strategy for expanding breast-conserving surgical options, lowering mastectomies rates, and preventing deformities. OPS is based on the use of plastic surgical reconstruction after breast cancer removal. The ... ...

Abstract	Oncoplastic breast surgery (OPS) is a new strategy for expanding breast-conserving surgical options, lowering mastectomies rates, and preventing deformities. OPS is based on the use of plastic surgical reconstruction after breast cancer removal. The study aims to assess volume displacement oncoplastic procedures for early primary breast cancer in terms of recurrence and cosmoses. A case series study was done on 20 patients with early breast cancer who underwent oncoplastic volume displacement techniques in the period from March 2019 to March 2021 in Kafrelsheikh University Hospital, Egypt. OPS techniques included were Racquet, Benelli, Batwing and Grisotti technique. The study concluded that OPS are oncologically safe (100%) with no recurrence and a better aesthetic outcome (90%).
MeSH term(s)	Humans ; Female ; Breast Neoplasms/surgery ; Mammaplasty/methods ; Mastectomy, Segmental/methods ; Mastectomy ; Plastic Surgery Procedures
Language	English
Publishing date	2023-07-23
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
DOI	10.47391/JPMA.EGY-S4-64
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Article ; Online: A case of Cheyne-Stokes breathing emerging in a patient with atrial fibrillation and an implanted hypoglossal nerve stimulator.

Hong, Hanna / Oster, Joel / Grover, Aarti / Ismail, Khalid

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

2021 Volume 17, Issue 8, Page(s) 1731–1735

Abstract: Treatment emergent central sleep apnea (TECSA) can occur with positive airway pressure (PAP) therapy, mandibular advancement devices, and now recent cases with hypoglossal nerve stimulator (HNS) therapy during treatment for obstructive sleep apnea (OSA). ...

Abstract	Treatment emergent central sleep apnea (TECSA) can occur with positive airway pressure (PAP) therapy, mandibular advancement devices, and now recent cases with hypoglossal nerve stimulator (HNS) therapy during treatment for obstructive sleep apnea (OSA). There have been few published reports of Cheyne-Stokes breathing (CSB) emerging after implantation of an HNS. We present a case of a 76-year-old male with chronic atrial fibrillation and OSA who developed significant CSB after implantation of an HNS device. As popularity increases for alternative treatments of OSA, there should be close monitoring for emergence of CSB, especially in those who may have a propensity for high loop gain abnormalities contributing to central sleep apneas, such as patients with chronic atrial fibrillation. Further research is needed on CSA in patients with HNS implantation and atrial fibrillation, the prevalence of TECSA in the growing HNS therapy population, and the development of future management strategies. Citation: Hong H, Oster J, Grover A, Ismail K. A case of Cheyne-Stokes breathing emerging in a patient with atrial fibrillation and an implanted hypoglossal nerve stimulator.
MeSH term(s)	Aged ; Atrial Fibrillation/complications ; Atrial Fibrillation/therapy ; Cheyne-Stokes Respiration/complications ; Cheyne-Stokes Respiration/therapy ; Humans ; Hypoglossal Nerve ; Prostheses and Implants ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/therapy
Language	English
Publishing date	2021-06-24
Publishing country	United States
Document type	Case Reports
ZDB-ID	2397213-0
ISSN	1550-9397 ; 1550-9389
ISSN (online)	1550-9397
ISSN	1550-9389
DOI	10.5664/jcsm.9314
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Article ; Online: Impact of Changing the Surrounding Urban Context on Sustainable Design of Historic Buildings

Yahya Hafedh Abed / Ismail Khalid J. Aluddin / Ali Turki Hasan

E3S Web of Conferences, Vol 318, p

2021 Volume 04010

Abstract: Research aims are to explain the impact of the built environment on the efficiency of sustainability of historical buildings. The most vital factor of sustainability in hot and semi-dry climates is the thermal efficiency of inner spaces. The conventional ...

Abstract	Research aims are to explain the impact of the built environment on the efficiency of sustainability of historical buildings. The most vital factor of sustainability in hot and semi-dry climates is the thermal efficiency of inner spaces. The conventional building materials used in historic buildings in Mosul have high thermal efficiency, but it works with the surrounding built environment as an integrated thermal system. This surrounding built environment could be exposed to dramatic changes within the efforts of reconstruction of Mosul city. Al-Aghawat mosque was selected as a case study due to its surrounding urban context and original conventional building materials. This research adopts ENVImet analysis method. Physiologically Equivalent Temperature (PET) index was assumed to be the indicator for thermal comfort in hot and semi-dry weather. ENVI-met program applied for simulation of two cases at the hottest day in the summer of 2019-2020 through climatic data. The first case estimates the air temperature in the inner and open spaces of the mosque with its original surrounding context and then checks the air temperature of the same spaces after removing the surrounding context. The results reveal changes in thermal efficiency within the two cases. In order to conserve the thermal efficiency of the historic buildings, the researchers recommended adopting a conservation strategy of the surrounding context.
Keywords	building materials ; built environment ; thermal comfort ; envimet ; al-aghawat mosque ; Environmental sciences ; GE1-350
Subject code	720 ; 690
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	EDP Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Effects of sodium chloride partial substitution with bitterness‐treated potassium and magnesium chloride on some properties of white‐brined cheese

ALQtaishat, Nour / Saleh, Mohammed / Al‐Ismail, Khalid / Abu Ghoush, Mahmoud

International journal of dairy technology. 2022 Aug., v. 75, no. 3

2022

Abstract: Blocking bitterness imparted from salt replacers to develop nonbitter sodium‐free salts is a major challenge in the food industry and a potential strategy to improve public health. This study aimed to treat the bitterness of potassium and magnesium ... ...

Abstract	Blocking bitterness imparted from salt replacers to develop nonbitter sodium‐free salts is a major challenge in the food industry and a potential strategy to improve public health. This study aimed to treat the bitterness of potassium and magnesium chloride and investigate the effects of partially substituting sodium chloride with different formulations of these treated salts on white brined cheese properties. An 80% reduction of sodium content (i.e. 2.69% in the control to 0.66% in one treatment) was achieved. Sensory testing showed that 50% sodium substitution with treated potassium exhibited higher overall and saltiness‐liking scores than the control. Substitution with treated potassium chloride increased bitterness acceptability score having a value of 7.8/9 at Week 4.
Keywords	bitterness ; cheeses ; dairy technology ; food industry ; magnesium chloride ; potassium ; potassium chloride ; public health ; sodium ; sodium chloride
Language	English
Dates of publication	2022-08
Size	p. 668-678.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	1363788-5
ISSN	1364-727X
ISSN	1364-727X
DOI	10.1111/1471-0307.12867
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Early Postoperative Sequelae After Open Sky Access in Nasal Osteotomy: A Comparative Study.

Zaher, Mahmoud M / Elfeki, Bassem / Ismail, Khalid A / Ismail, Taha A / Hegazy, Safwat A

Annals of plastic surgery

2022 Volume 88, Issue 5, Page(s) 480–484

Abstract: Introduction: Nasal osteotomy is a powerful cornerstone step in almost all rhinoplasty procedures and is a major cause of postoperative periorbital ecchymosis and edema after rhinoplasty. Different accesses for osteotomy have been described, the most ... ...

Abstract	Introduction: Nasal osteotomy is a powerful cornerstone step in almost all rhinoplasty procedures and is a major cause of postoperative periorbital ecchymosis and edema after rhinoplasty. Different accesses for osteotomy have been described, the most popular of which is the external perforating and the internal continuous methods. These accesses are blind maneuvers and have some drawbacks such as possible visible scar formation in the percutaneous access or high rate of mucosal tear in the endonasal access. Open sky access osteotomy after wide subperiosteal dissection had been described to overcome those disadvantages. Early postoperative sequelae have not been assessed in the literature after using this access. In the present study, we aim to assess early postoperative sequelae after using this technique in comparison with percutaneous perforating osteotomy. Materials and methods: The study was conducted between November 2017 and January 2021. Forty patients were randomly assigned into 2 equal groups. Group A was subjected to lateral osteotomy by percutaneous perforating method, whereas group B underwent lateral osteotomy by the open sky access technique using a 2-mm curved osteotome. Early postoperative periorbital sequelae were assessed on the second and seventh postoperative days, using the grading system suggested by Kara et al (Plast Reconstr Surg. 1999;104:2213-2218). Mucosal tear was assessed on the second postoperative day using nasal endoscopy after removal of nasal packs. Results: There was a statistically nonsignificant difference between the studied groups regarding ecchymosis and edema occurring on the second or seventh days. Meanwhile, mucosal tear was significantly less in the open sky access osteotomy group. Conclusions: Open sky access osteotomy is a safe method for lateral nasal osteotomy with direct visualization of the surgical field. It does not require a skin incision that could lead to a scar formation. It produces less mucosal tear than percutaneous perforating osteotomy. No statistically significant difference is found between both techniques regarding postoperative periorbital ecchymosis and edema on the second and seventh postoperative days.
MeSH term(s)	Cicatrix/complications ; Disease Progression ; Ecchymosis/etiology ; Edema/etiology ; Humans ; Lacerations ; Osteotomy/adverse effects ; Osteotomy/methods ; Postoperative Complications/etiology ; Rhinoplasty/adverse effects ; Rhinoplasty/methods
Language	English
Publishing date	2022-02-18
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003099
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