Background: Better and early prediction of malignant thyroid nodule, and sure differentiation from benign one, is crucial need to decrease the rate of non-indicated surgeries. The aim ofthe work: To find risk factors and predictors of malignancy in patients with thyroid nodule[s]. Patients and Methods: Fifty patients with thyroid nodule[s] were included. All patients were evaluated by history taking, clinical examination and laboratory investigations. Imaging studies included thyroid ultrasound [US]. All were also submitted to fine needle aspiration cytology [FNAC] before treatment by total or subtotal thyroidectomy.Excised tissues were sent to histopathological analysis. Results:The incidence of malignancy was 22.0%. both benign and malignant groups were comparable as patient characteristics, complaints except the significant increase in cosmetic disfigurement among patients with benign nodules [92.3% vs. 45.5%]. Patients with malignant nodules had a significant increase of ill-defined margins, intranodular vascularity and enlarged lymph nodes [72.7%, 63.6% and 72.7% vs 5.1%, 12.8% and 25.6% respectively]. Ill-defined margins, enlarged lymph node and high grade in FNAC were the predictors of thyroid malignancy. Conclusion:Predictors of malignant thyroid nodules are ill-defined edges, enlarged lymph node and high grade in FNAC. This helps clinicians to spare more benign cases from surgical interference.

Background: Abdominoplasty was increasingly performed in daily surgical practice. It is usually associated with hernia. Different surgeons prefer to carry out hernioplasty with abdominoplasty. However, this was challenged by longer operative time and theoretical increase of associated complications. Objective of the Study:The present study aimed to assess the surgical outcome of the hernioplasty alone versus combined abdominohernioplasty.Patients and Methods: This study was conducted between September 2019 and September 2020. Forty patients with ventral hernias were included and divided randomly into two equal groups; First group for combined hernioplasty with abdominoplasty and the other group for hernioplasty alone. All patients were evaluated preoperatively by full history, physical examination and preoperative routine Lab investigations to assure fitness for surgery. Postoperatively, patients were observed overnight in hospital. Pain was controlled and ambulation was permitted as early as possible after surgery. To ensure patient comfort and abdominal support, a compressive binder was used. Patients were clinically reevaluated 7 days and at one, three and six months after surgery.Results: Groups A and B were comparable regarding patient age, gender, body mass index, and hernia type. The operative time and intraoperative bleeding were significantly higher in abdominoplasty group compared to hernioplasty group [154.01±13.73 minutes, 417.5±106.72 CC vs 64.75±9.11 and 92.5±32.55 respectively]. Early and late postoperative complications showed non-significant difference, except significant increase of recurrence among hernioplasty than abdominoplasty group [25.0% vs 0.0% respectively]. Abdominoplasty was associated with significant increase of total drain output, longer duration of drain and early mobility. Finally, there was significant increase of satisfaction with body size, body shape, relief of lower back pain, easy sex practice satisfaction and scar satisfaction in abdominoplasty group. Conclusion:Abdominoplasty with hernioplasty is a safe approach for ventral hernia repair, with superior aesthetic outcome and patient satisfaction than hernioplasty alone.

Background: Orofacial clefts are common congenital malformations, with alveolar cleft as the most common [75%] of all anomalies.Many treatment modalities are available. However, our clinical experience with bone graft modality is not well addressed. The aim of the work:To evaluate the effectiveness of early [2 to 12 years; before complete eruption of the cleft canine] versus late [> 12 years; after complete eruption of the cleft canine] cancellous anterior iliac bone grafting for alveolar cleft reconstruction.Patients and Methods: Twenty-three patients with alveolar clefts who were admitted for alveolar cleft reconstruction surgery were included. They were categorized into early and late secondary grafting groups. All patients inquired about their history. Submitted to full clinical examination, laboratory and radiological examinations. The imaging studies include two-dimensional orthopantomogram for all patients, while 3-D fascial computed tomography and cone-beam computed tomography were done for selected patients. Both intraoperative and postoperative data were collected, any complications were registered and patients followed up regularly up to 6 months.Results: Both groups were comparable as regarding patient characteristics except younger age in early group, and there was a statistically significant difference between early and late groups regarding cleft side and cleft permanent canine full eruption. Males represented 69.9%. The cleft was on the left side in 56.4%. Seven patients [30.4%] had maternal risk factor [five in early and two in late group]. Blood loss was less than 80 ml in all patients in both groups. All oronasal fistulas were sealed off successfully in all patients [100%] and all had normal healthy gingival contour with vital teeth adjacent to the cleft. All showed evidence of good bone filling in the alveolar defect after 6 months postoperatively. Only one patient developed hypertrophic scars at each group. Conclusion:Alveolar cleft reconstruction is preferred to perform autologous cancellous bone grafting harvested from the iliac crest bone to repair the cleft with excellent outcome on short-term follow-up.

Background: Recurrence after surgical treatment of inguinal hernia is still a challenge facing surgeons during their daily practice. Aim of the Work:The current trial aims to compare single and double mesh placement in huge inguinal hernia repair.Patients and Methods: 40 cases were involved in the study. They were classified into two equal groups according to the operative technique [A for single mesh and B for double mesh]. The study's candidates were examined and investigated thoroughly regarding their complaint, the presence of a clinically detectable hernia in the inguinal region, its size, characters, onset, duration, and associated symptoms. Then, all were examined clinically and prepared for surgical intervention after lab investigations. Results:The mean ages were 56 and 56.9 years for groups A and B. Both groups were comparable to body mass index, risk factors, type of hernia, hernia side, and intraoperative blood loss. There was a significant decrease in operative time in group A when compared to group B [54.50 ± 8.256 vs. 61.25 ± 6.664 minutes, respectively]. The overall rate of complications was lower in group B when compared to group A [30.0% vs. 50.0%, respectively]. Complications in group A were seroma [10.0%], wound infection [5.0%], scrotal edema [25.0%], and chronic pain [10.0%]; while in group B, seroma [10.0%], scrotal edema [5.0%], chronic pain [15.0%]. Recurrence was confined to group A, and reported to three patients [15.0%]. However, the difference was statistically nonsignificant. Conclusion: Double mesh technique is a safe and efficacious approach for managing huge inguinal hernia. It is associated with lower rate of recurrence than the single mesh approach with comparable operative time, complications, and outcomes.