association between serum thyroid-stimulating hormone concentration and development of differentiated thyroid cancers in nodular thyroid disease

To evaluate the relation between serum thyroid-stimulating hormone [TSH] and development of differentiated thyroid cancers in nodular thyroid disease [NTD] in Egyptians. One hundred patients were included in this study at Al-Azhar University Hospitals from 2010 to 2013; all patients with NTD, who were fi t for surgery, were selected for study. The preoperative TSH level was estimated and was compared with the final histopathological diagnosis for the presence of malignant thyroid lesions. A total of 100 patients were included in the study, with an average age of 46 years. The male to female ratio was 1: 4.7. Seventy-five patients had multinodular goiter, whereas 25 patients had a solitary thyroid nodule. Eighty-six patients underwent total thyroidectomy, whereas 14 patients underwent near- total thyroidectomy. The final histopathological data showed no evidence of malignancy in 83 patients, 83% [benign group], whereas malignant lesions were present in 17 patients, 17% [malignant group]. The preoperative mean TSH level in the benign group was 1.72 +/- 1.4 mIU/L, whereas the mean TSH concentration in the malignant group was 2.61 +/- 2.2 mIU/l. There is a definite relation between serum TSH and development of differentiated thyroid cancers in NTD as the risk of thyroid malignancy increases with increased serum TSH concentrations

Intra-abdominal sepsis complicating abdominal trauma

Identifying patients with risk factors associated with the development of intra-abdominal infections makes possible early interventions to minimize morbidity and mortality. We sought to determine the incidence of intra-abdominal infection [organ/space surgical site infection] in patients undergoing operation because of abdominal trauma, to identify the risk factors associated with the development of this complication and to estimate the respective magnitudes of the risk factors. We performed a prospective cohort study in patients older than 16 years who were treated surgically for penetrating or blunt abdominal trauma, with or without other associated lesions. 116 patients with abdominal trauma were admitted to the department of surgery. Of these, we excluded 2 [1.7%] who underwent operation at different institutions; 9 [7.8%] who died within 48 hours after admission and 5 [4.3%] in whom complete follow-up [until the 30th postoperative day] was not feasible. The final study sample consisted of 100 patients. Main Outcome Measure: We performed univariate analysis to explore in an isolated way the behavior of the dependent and independent variables. Bivariate analysis was carried out with each of the independent variables and the main outcome to establish the association between individual risk factors and intra-abdominal infection. Finally, a logistic regression model was developed using the SPSS 10.0 program and the forward method. Intra-abdominal infection developed in 10 patients [10%]. Variables independently associated with this complication were an Abdominal Trauma index greater than 24, abdominal contamination and admission to the intensive care unit. The development of intra-abdominal infection in patients undergoing operation because of abdominal trauma is a complex phenomenon resulting from the multiple risk factors during the preoperative, intraoperative and postoperative periods. Multivariate logistic regression analysis allowed us to identify an Abdominal Trauma Index greater than 24, contamination of the abdominal cavity, and admission to the intensive care unit as independent risk factors for the development of organ/space surgical site infection

Management of laparoscopic cholecystectomy complications

This article aimed at throwing a light on management of bile duct injuries inflicted during laparoscopic cholecystectomy. The present research included 60 patients, presented with biliary complications after laparoscopic cholecystectomy. They were selected from Al-Azhar university hospitals and Domiate general Hospitals, in the period from March 2003 to March 2006. The results of this work proved that complications of laparoscopic cholecystectomy were well tolerated and the majority of them successfully managed conservatively and those needed surgical interference showed very good results. Although it has some complications, laparoscopic cholecystectomy is advocated to be the procedure of choice in the management of gall bladder diseases [stones] as its complications are tolerated and managed with conservative or surgical treatment with a success rate over 90%

Evaluation of endoscopically assisted abdominoplasty

This study compare between open and endoscopically assisted abdominoplasty in the treatment of abdominal hernias and contour problems in Egyptian patients. The present study included 60 patients who come for abdominal contouring or hernial repair with abdominoplasty. Patients were selected from Al-Azher University hospitals and Domiate General Hospitals. All cases were subjected to full history taking, clinical examination and laboratory investigations and then subjected to open or endoscopically assisted abdominoplasty. The results of this work proved that endoscopically assisted abdominoplasty is better than open technique as regards to aesthetic outcome and decreased morbidity of the procedure. endoscopically assisted abdominoplasty is advocated for those eligible for it and much training courses on the procedure must be planned from time to time