Introduction: Premature rupture of membrane (PROM) is defined as a rupture of the amniotic membranes before 37 weeks' gestation and before the onset of labour, while extreme PPROM occurs before 26 weeks' gestation. PROM is a serious condition leading to approximately one-third of preterm births and it complicates about 3% of pregnancies. (Idrisa et al., 2019). Aim of the study: To evaluate prevalence, fetal and maternal outcome of premature rupture of membranes among pregnant women attending Minia Maternity University hospital. Patients and Method: Study Settings and Design This prospective study was conducted at the department of obstetrics and gynecology at Minia Maternity University Hospital during the period from 1 st october 2019 to 31 st march 2020. Demographic data: The study included 456 patients with Premature Rupture Of Membranes at Minia maternity university hospital . Age of patients range from 18 to 48 years old; Gestational age was recorded once the patient is admitted between 24 up to 37 weeks; Gravidity of patients were between G1 -G 10; Parity of patients were between P0 up to P9 with previous history of abortion ranged between (0-7). Summary and Conclusion: Premature rupture of membranes (PROM) also called pre-labor rupture of membranes, is a condition that can occur in pregnancy. It is defined as rupture of membranes (breakage of amniotic sac).
Background: Iron accumulation is an inevitable consequence of chronic blood transfusions and results in serious complications in the absence of chelation treatment to remove excess iron. Desferioxamine reduces morbidity and mortality although the administration schedule of slow, parentral infusions several days each week limits compliance and negatively affects long-term outcome, so different strategies have been developed to overcome these problems such as deferiprone or deferasirox alone or dual chelator therapy. Aim of Study:Was to evaluate the effect of monotherapy and alternating therapy of iron chelators (deferioxamine, deferiprone, deferasirox) after six months of follow-up of regular administration of these iron chelators in hematology Clinic in pediatric Insurance Hospitals in Beni Suef.Patients and Methods: This study was carried out on 120 children with beta thalassemia major in hematology Clinic in pediatric Insurance Hospitals in Benisuef. They were divided into four groups. Group A: 30 patients received oral deferiprone (DFP) at 75mg/kg/day for 4 days/week and subcutaneous desferioxamine (DFO) at 40mg/kg/day for the other 3 days/ week for 6 months. Group B: 30 patients who received oral deferiprone only at 75mg/kg/day in 3 divided doses for 6 months. Group C: 30 patients who received subcutaneous desferoxamine only at 40mg/kg/day daily for 6 months. Group D: 30 patients who received oral desferasirox at a dose of 30mg/kg/day, single dose daily, taken on an empty stomach at least 30 minutes before food for 6 months.Results: There were highly significant reduction in serum ferritin levels and serum iron levels after chelation therapy in each studied group. There was also elevation in TIBC after chelation therapy in each studied group. The reduction of serum ferritin levels and serum iron levels and the elevation of TIBC were higher in group A (alternating) followed by group C (desferioxamine) followed by group D (deferasirox) and lastly group B (deferiprone). There was no statistically significant difference between the studied groups before and after chelation therapy. There was no significant difference as regard to urinary iron before chelation therapy in all studied group and also between the studied groups of patients after chelation therapy. But 24h urinary iron showed a significant
Aim of the study: Even though laparoscopic hepatectomy (LH) has proved to be both safe and effective in specialized centers; the restricted indications for resection in the case of benign liver lesions has resulted in poorly reported outcomes. Our aim was to describe the short and long-term results of LH to treat benign hepatic lesions, including quality of life (QoL) evaluation. Patients and Methods: Thirty-one LHs were performed between 2016 and 2018 in 30 patients. We evaluated QoL with the SF-36 test and a body image satisfaction questionnaire by personal interview before surgical treatment and at 1 month, 3 months, 6 months and 1 year after surgery. Results: Median age was 38 years (range 21-71) and the majority were females (68%). The most frequent etiology was hepatic adenoma in 16 patients (52%), followed by focal nodular hyperplasia (n = 4), cavernous hemangioma (n = 3), hepatic abscess (n = 3), cystadenoma (n = 5) and hepatolithiasis (n = 1). The majority of resections were minor (66%) and the conversion rate was 6.2%. Pathological examination confirmed negative margins in all patients. Postoperative mortality was nil, while morbidity was 6.2%. Median hospital stay was 4 days (range 1-32 days). In a median follow-up of 48 months (range 2-120), 2 patients experienced recurrence. QoL variables were similar between the preoperative and postoperative periods. Conclusion: LH should be considered the main therapeutic approach for treating selected patients with benign liver lesions who require surgical resection because it presented both null mortality and low morbidity, along with rare recurrence, a good quality of life and high esthetic satisfaction.
Objectives: Bile duct injury (BDI) remains a potentially devastating complication of cholecystectomy. BDI is associated with significant morbidity, high costs, impaired quality of life, and decreased survival. After major BDI, reconstructive surgery by Hepaticojejunostomy (HJ) is usually indicated The study aimed to analyze and evaluate the presentation, characteristics, related investigation, and outcomes of reconstructive Hepaticojejunostomy in patients with postcholecystectomy bile duct injuries. Patients and methods; This study was done in El-Minia university hospital (minia Hepatobiliary unit), including 26 patients who underwent Hepaticojejunostomy Roux-en-Y for post-cholecystectomy bile duct injury (BDI) between May 2017and May 2020, retrospectively and prospectively. Results: The study included 26 patients suffered from iatrogenic BDIs; 19 patients (73%) underwent OC, and 7patients (27%) underwent LC. Regarding injury type; the Leaking, Obstructing, collection, peritonitis, and vascular injuries were 26.9%, 46.1%, 19.3%, 7.7%, and 4.4% respectively. However, the Strasberg classification of injury was as follow E1 = 15.4%, E2 = 46.1%, E3 = 30.8%, and E4 = 7.7%. In this retrospective study, between may 2017and December 2020, 26 patients with major bile duct injuries sustained during cholecystectomy and requiring surgical treatment in the form of HJ Roux-en-Y were referred to minia hepatobiliary center Preoperatively, US was done for all patients, CT in 3(11.5%), PTC in 3(11.5%), ERCP in 17(65%) and MRCP was done for 16 (61.5%) patients. Conclusion: Early detection of BDI and early referral to specialized hepatobiliary referral centers are essential for early management of BDI and prevention of its complications and any attempt of repair by non-specialized general surgeon should be avoided. Surgical reconstruction using Roux-en-Y Hepaticojejunostomy mucosa to mucosa repair remains the golden standard procedure of choice for treating these injuries with successful outcome and better long-term result. We recommend long-term follow up of the patients after surgical repair for at least 10 years as anastomotic stricture was diagnosed after long peroid. Further studies should be performed for the best management of recurrent anastomotic stricture. Associated vascular injuries should be emphasized and accurately evaluated.
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