Background: Lymphedema remains to be a great source of morbidity for breast cancer survivors. The aim of this work is to study upper limb lymphedema following breast cancer therapy for breast cancer patients regarding its incidence, risk factors, diagnostic techniques, risk reduction and optimal management.Methods: This prospective study was done on two hundred breast cancer patients who underwent breast cancer management. The study was done in the period between May 2016 and July 2018. Exclusion criteria were Male patients, Female patients with metastatic breast cancer and who already had upper limb lymphedema before breast cancer management. All patients underwent follow up for incidence, risk factors, diagnostic techniques and management of lymphedema. Statistical analysis used: The collected data were organized, tabulated and statistically analyzed using SPSS softwareResults: The incidence of lymphedema was (18 %) distributed as follow: grade I = 55.6%, grade II = 33.3%, grade III = 11.1 % and grade IV = 0 %. The most relevant risk factors for development of lymphedema were: age between 41 and 50 years and diabetes mellitus. Higher incidence of pain (66.7%) and restricted motion (61.1%) were observed in lymphedema cases.Conclusions: Old (41:50 years) and diabetic patients are at the highest risk for developing lymphedema. Breast cancer patients of stage IIIB who had undergone modified radical mastectomy or who developed postoperative seroma are at higher risk for developing lymphedema. Physical exercises and compression garment are important part of treatment plan.
Our preliminary results support the prognostic value of the Penrod score in the treatment of geriatric hip fracture patients. With the help of the Penrod score, it may be possible to identify patients, who are expected to significantly profit from an intensified treatment in a geriatric fracture center (clusters 2B, 3A, and 3B). By utilizing this score, improved outcomes and simultaneously a more effective utilization of valuable health care resources could be achieved.
Ventral hernias commonly encountered in surgical practice account for 15-20% of all abdominal wall hernias. Results of tissue repair have been disappointing. The optimal approach for abdominal incisional hernias is still under discussion. The aim of the study was to evaluate the retro muscular mesh repair technique in the treatment of ventral hernia as one of the standard techniques for treatment of such cases. This prospective study on 50 consecutive patients was performed from July 2016 to July 2017. Patients were prepared to be operated by the retro muscular mesh repair technique. All patients were evaluated with respect to operative time and postoperative complications. Results were documented and statistically analysed. In this study on 50 patients, there were 30 female patients (60%) and 20 male patients (40%). The age of the studied patients ranged between 26 and 65 years with mean age of 49.8 years. The mean operative time was 88.5±15.3 min. The mean period of drainage was 2.3±1.3 days. Seroma was encountered in one case only 2%. No recurrence was reported in the studied patients during the period of follow-up (12months). On the basis of this study, we conclude that retro muscular (sublay) mesh repair is the ideal technique for incisional hernia repair.
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