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Study of Burnout Syndrome among Sample of Caregivers of Children with Disruptive Behavior Disorders

Prof. Reda Mohammad Ismail ¹, Ass. Prof. Rania Hussein Mohammad ², Dr. Shaymaa Mohammed Arafa ³, Asmaa Mohammad Khamis Mohammad ⁴

¹ Professor and Head of Psychiatric Department, Faculty of Medicine, Al-Azhar University; Egypt.

² Ass. Professor of Psychiatry, Faculty of Medicine, Al-Azhar University; Cairo, Egypt.

³ Lecturer of Psychiatry, Faculty of Medicine, Al-Azhar University; Cairo, Egypt.

⁴ M.B., B. Ch, Psychiatry Resident, Al-Azhar University, Egypt.

¹redaismail2004@yahoo.com; ²mohalarania99@yahoo.com; ³sheima_doctor@yahoo.com; ⁴layanashraf2018@gmail.com

Abstract: Background: Parental burnout is a syndrome related to parenthood and characterized by three dimensions: emotional and physical exhaustion, emotional distancing of parents from their children, and loss of parental accomplishment. Many factors can explain the inter individual differences in parental burnout. Objectives: Reviewing the available literature on burnout of the care giver of children with disruptive behavior disorders, and their coping strategies. Assess the frequency of burnout among caregivers of children and adolescents with disruptive behavior, asses psychological profile of caregivers of behaviorally disturbed children and adolescents, asses other factors associated with burnout, evaluate their coping strategies. Subjects and Methods: This study was a cross sectional comparative study that explores the frequency of burn out, sociodemographic factors, coping strategies among the care givers of children and adolescent with disruptive behavior disorders compared to care givers of apparently healthy matched group. The patients recruited from outpatient clinic of psychiatry department at Al-Zahraa hospital Al-Azhar University after diagnosis of their children to have disruptive behavior disorder by using of - Mini-International Neuropsychiatric Interview for Children and adolescents. This study was carried from February 2019- July 2019. Results: In relation to the socio-economic status of caregivers in the study, the present study results revealed that about 68% of the study sample were low socio-economic status compared to 64% in the control group. This may be due to the area covered by al zahraa university hospital is public area with low socioeconomic state. Conclusion: Caregivers of children with disruptive behavior disorders have high levels of burn out. More than 60% of the caregivers have burnout. The caregivers burnout was affected by their, age, sex, relation to the child, marital satisfaction, work, and socio-economic status to which they are belonging, and also affected by the sex of the child, type of disruptive behavior disorders, severity the disorder of a however, it had no relation with the caregivers' educational level residence, or marital status. The caregivers used many coping strategies. The most used coping strategy is concentration on the problem.

[Reda Mohammad Ismail, Rania Hussein Mohammad, Shaymaa Mohammed Arafa, Asmaa Mohammad Khamis Mohammad. Study of Burnout Syndrome among Sample of Caregivers of Children with Disruptive Behavior Disorders. J Am Sci 2019;15(11):1-10]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 1. doi:10.7537/marsjas151119.01.

Keywords: Burnout Syndrome, Caregivers, Disruptive Behavior Disorders

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Treatment of Solubilized Vat Dye to Cope With the Competitive Market in the Field of Dyeing Technology

Amr Emad Eldin Allam and Safaa Taha Mustafa Elsayed Shaaban

Textile Dyeing and Finishing Technology Department –Faculty of Applied Arts, Helwan University, Egypt.

safaashaaban@yahoo.com

Abstract: In this study Anthrasol Blue IBC dye (solubilized vat dye) was prepared to be interact with environmental conditions as sunlight to develop the color, this mean it could back to life again in another usage, it will be used in garments, art boards, artistic works, it is easy to control and have an artistic view to get light and dark shades. On the other side there is a similar commercial dye in the market called INKODYE (blue), and it is a soluble vat dye that uses light rather than oxygen to fix the dye.

[Amr Emad Eldin Allam and Safaa Taha Mustafa Elsayed Shaaban. Treatment of Solubilized Vat Dye to Cope With the Competitive Market in the Field of Dyeing Technology. J Am Sci 2019;15(11):11-15]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 2. doi:10.7537/marsjas151119.02.

Keywords: Solubilized vat dye, Inkodyes and interact with environmental conditions.

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Role of Vitamin D in Bronchiectasis (CF versus non CF patients)

Tharwat Ezzat Deraz ¹, Heba Allah Ahmed Ali ¹, Dina Ali Mohamed ²

¹ Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

² Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

moonessawy@gmail.com 

Abstract: Background: Bronchiectasis is a disease characterized by irreversible abnormal dilatation of bronchial tree. It may result from multiple etiologies most commonly infections, congenital or genetic disorders or idiopathic. Cystic fibrosis (CF) is the most common lethal autosomal recessive respiratory disease in the western world with an estimated incidence of 1 per 300 live births. Most patients with CF succumb to respiratory failure from chronic pulmonary failure infections. Vitamin D deficiency occurs frequently in patients with cystic fibrosis (CF) & non CF bronchiectasis. Vitamin D is important for optimal mineralization of bone. Vitamin D deficiency in these patients can arise from various causes including pancreatic exocrine insufficiency, lack of outdoor activity, and alterations of vitamin D metabolism. Objectives: To assess vitamin D level and determine its effect on pulmonary exacerbations in cystic fibrosis and non-cystic fibrosis bronchiectasis. Patients and Methods: Clinical trial. Chest department & chest clinic in El demerdash children hospital. This study included 40 patients (20 cystic fibrosis patients, 20 non cystic fibrosis bronchiectasis patients), 20 controls. Patients were recruited from the chest clinic of the children’s Hospital, Ain Shams university hospitals. Vitamin D serum level was measured in CF & non CF bronchiectasis patients and controls & pulmonary function tests was done to all the patients prior starting vitamin D supplementation then vitamin D serum level was followed up in the patients after treatment & also pulmonary function tests were repeated. Controls were assessed by basal serum vitamin D level. Results: We found that mean age for bronchiectasis group 9.35±4.49 while mean age for cystic fibrosis patients5.35 ±4.02, we detected male predominance in cystic fibrosis patients (75%) while in non-CF bronchiectasis male predominance is 55% also we found that 67.5% of our patients were from consanguineous parents, consanguineous marriage is more prevalent in CF more than non CF patients as. 75% of CF patients had consanguineous parents (15 cases), while 60% of non CF bronchiectasis cases had consanguineous parents (12 cases). A large number of patients (18 patients) had positive family history of same condition (45% of cases). family history is more prevalent in cystic fibrosis patients than non CF bronchiectasis patients. 6o% of CF patients (12 cases) had family history & history of sib death with same condition, while only 30% of non CF bronchiectasis patients had positive family history of same condition. In our study it was found that vitamin D deficiency was prevalent more among cystic fibrosis patients then non cystic fibrosis bronchiectasis patients then in controls ( 75%, 45% & 10% respectively ) with high significance statistically, while vitamin D insufficiency was prevalent more in non CF patients then CF patients then controls ( 40%, 20% & 15% respectively ), and vitamin D sufficient levels detected more in control group then bronchiectasis group then CF patients ( 75%, 15% & 5% respectively ). We found also that there is highly significant change in severity of exacerbation in both groups after vitamin D supplementation, % of improvement in severity of exacerbation is more in non-cystic fibrosis bronchiectasis than in cystic fibrosis bronchiectasis. that degree of improvement in FEV1 in group A (non CF bronchiectasis) improved by 16 % & in group B by 15% which is highly significant statistically & that degree of improvement in FVC in group A (non CF bronchiectasis) improved by 11 % & in group B by 14% which is highly significant statistically & that degree of improvement in FEV1/FVC in group A (non CF bronchiectasis) improved by 8 % & in group B by 13% which is highly significant statistically. Conclusion: There is an association between vitamin D deficiency and bronchiectasis (both CF & non-CF). It was found that bronchiectasis patients are more vitamin D deficient than normal population. The more deficiency in Vitamin D, the more sever the lung disease. Vitamin D deficiency is also associated with more risk for pulmonary exacerbations (IV antibiotics need, hospital stay, ICU admission and missed school days). Improving vitamin D status in bronchiectasis patients leads to improvement of pulmonary functions, less frequent & less sever exacerbations & hospital stay.

[Tharwat Ezzat Deraz, Heba Allah Ahmed Ali, Dina Ali Mohamed. Role of Vitamin D in Bronchiectasis (CF versus non CF patients). J Am Sci 2019;15(11):16-23]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 3. doi:10.7537/marsjas151119.03.

Keywords: Vitamin D, Bronchiectasis, CF and non CF patients

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Assessment of Laparoscopic Hernial Repair of Primary Paraumbilical Hernia through Transabdominal Preperitoneal Technique

Ayman Abdullah Abdraboh, Hossam Sobhy Abdel Raheem, Abdel Rahman Ali El Saied

Department of General Surgery and Endocrine Surgery Department Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract: Background: Para-Umbilical Hernia (PUH) is one of the most common surgical problems with rise in the repair rate annually. Previously PUHs were repaired by tension-free suture technique. Due to a high unacceptable recurrence rate this procedure lost popularity. A real change in view of PUH repair came with the introduction of meshplasty. Objective: To assess the outcomes, benefits and complications of laparoscopic hernial repair of primary paraumbilical hernia through Transabdominal preperitoneal technique. Patients and Methods: This quasi-experimental study included 20 patients with primary paraumbilical hernia patients with primary paraumbilical hernia who underwent Transabdominal Preperitoneal (TAPP) repair technique at Ain Shams University Hospital (El-Demerdash). Results: Our study found that female patients more than males (60% vs. 40%). Their age ranged from 25 to 48 years, with an average age of 38 years. Overweight and obese patients constituted the majority of study participants (40% and 45%, respectively). Their BMI ranged from 22 to 38 kg/m² with an average of 29.5 kg/m². Conclusion: The results of our study about laparoscopic transabdominal preperitoneal in paraumbilical hernias showed that this approach to be a feasible operation with low recurrences. The main advantage of this method is avoidance of contact between the mesh and visceral organs.

[Ayman Abdullah Abdraboh, Hossam Sobhy Abdel Raheem, Abdel Rahman Ali El Saied. Assessment of Laparoscopic Hernial Repair of Primary Paraumbilical Hernia through Transabdominal Preperitoneal Technique. J Am Sci 2019;15(11):24-29]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 4. doi:10.7537/marsjas151119.04.

Keywords: Paraumbilical hernias, transabdominal preperitoneal

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Role of Soluble Mesothelin Related Peptide (SMRP) Tumour Marker as a Prognostic Value of Mesothelioma Patients Pre and Post Operative

Ahmed Anwar EL Nouri¹, Hatem Yazed Sayed Ahmed², Hany Hassan El Sayed³, Ahmed Mostafa Mohamed Mohamed³, Abdalrahman Nabil Rashaad⁴

¹Professor of Cardiothoracic Surgery and Head of Thoracic Surgery Unit, Ain Shams University, Cairo, Egypt

²Professor of Cardiothoracic Surgery Ain Shams University, Cairo, Egypt

³Assistant Professor of Cardiothoracic Surgery Ain Shams University, Cairo, Egypt

⁴Assistant Lecturer of Cardiothoracic Surgery, Minia University, Minia, Egypt

E-mail: abdalrahmanrashaad7@gmail.com

Abstract: Background: Soluble mesothelin-related peptides (SMRP) are a potential tumor marker for malignant mesothelioma. It that has been proposed for differential diagnosis from pleural metastatic cancer, as well as prognosis and treatment monitoring of malignant pleural mesothelioma (MM). Aim of The work: To Study the Value of SMRP as a tumor marker in prediction the response to treatment and the prognosis in patient of malignant mesothelioma who undergone pleurectomy decortication as more accepted surgical procedure in comparison to who only had chemotherapy. Patient and Methods: Through a clinical trial started from April 2017 till November 2018 With a minimum follow-up of 6 months was required and up to 12 months, there were sixty patients of mesothelioma. First thirty underwent pleurectomy decortication during their management. In the remaining thirty only chemotherapy was the only therapeutic decision. Serum samples collected pre and post management in each group. Change of SMRP was studied as a predictor of overall survival and the quality of life in according to degree of pain and dyspnea control. Results: There were no statistically significant differences in according to demographic criteria in both groups. Which was essential for accuracy of the study. Most of the patients were epitheloidmesothelioma, there were only three sarcomatoid MPM in the study. There was statistically significant difference in according to the percentage of change of SMRP in between surgery and chemotherapy (p value;0.04) which reflected on survival of P/D patients as its median was 22 months. According to mortality there were 6 in surgical group and 11 in chemotherapy group. Change of SMRP also correlated with statistical significant difference in according to pain and dyspnea (pre & post operative) (p value; 0.03 and 0.01 respectively) with no significant difference in patients had chemotherapy. Conclusion: SMRP may be a useful tumor marker for detecting the progression of malignant mesothelioma and expecting the response to treatment in according to overall survival and post operative quality of life.

[Ahmed Anwar EL Nouri, Hatem Yazed Sayed Ahmed, Hany Hassan El Sayed, Ahmed Mostafa Mohamed Mohamed, Abdalrahman Nabil Rashaa. Role of Soluble Mesothelin Related Peptide (SMRP) Tumour Marker as a Prognostic Value of Mesothelioma Patients Pre and Post Operative. J Am Sci 2019;15(11):30-38]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 5. doi:10.7537/marsjas151119.05.

Key words: Mesothelioma, SMRP, Pleurectomy / decortication, prognosis

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Sparing versus Division of Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia

Prof. Dr. Mohamed Ahmed Helmy Shehab, Dr. Karim Fahmy and Mohamed Hamdy Abd El Halim Mohamed*

General Surgery Department, Faculty of Medicine, Ain Shams University, Egypt

E-mail: blueheartt@live.com

Abstract: Background: The inguinal hernias are common with lifetime occurrence of 27% for men and 3% for women. Inguinal hernia repairs represent one of the most common general surgery operations worldwide. An estimated 20 million inguinal hernia repairs are performed each year worldwide. Aim of the Work: To assess the influence of preservation versus elective division of the ilioinguinal nerve on chronic pain after tension-free inguinal hernioplasty in patients with inguinal hernia and admitted to the department of surgery, Ras El Tin General Hospital. Patients and Methods: This study included 80 patients who presented by inguinal hernia to the outpatient clinic who were admitted to the department of surgery, Ras El Tin General Hospital. Results: Our results showed that in the last follow up visit after 12 months of the operation, 5 patients of Group I (12.5 %) only had very mild pain with all other patients denied presence of any pain. Conclusion: Chronic postoperative pain after tension-free inguinal hernioplasty is pain which persists beyond normal tissue healing assumed to be 3 months.

[Mohamed Ahmed Helmy Shehab, Karim Fahmy and Mohamed Hamdy Abd El Halim Mohamed. Sparing versus Division of Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia. J Am Sci 2019;15(11):39-51]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 6. doi:10.7537/marsjas151119.06.

Keywords: Inguinal Hernia - Ilioinguinal Nerve

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Assessment of the efficacy of low dose hydrocortisone Infusion in severe community Acquired Pneumonia

Amr E. Abdel-Hameed, Ahmed A. Elshebiny, Mohamed N. Abdel-Fattah

Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt

Billytaha73@gmail.com

Abstract: Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Despite the developments in antibiotic therapy, no substantial progress has been made in the last decades. Additional therapeutic interventions along with antibiotics may help to improve outcome in patients with CAP. Aim of the Work: to assess the efficacy of low dose hydrocortisone Infusion in severe community-acquired pneumonia. The current study was conducted on 70 patients, attending Ain Shams University Hospital, with clinical or radiological findings of community-acquired pneumonia, they were assessed clinically, radiologically and haematologically. These hospitalized patients were classified into 2 groups: Control group included 35 patients with community acquired pneumonia receiving a placebo infusion (control group). Intervention group included 35 patients with community acquired pneumonia randomly receiving 200 mg hydrocortisone (2 hydrocortisone vials, 200 mg / 4 ml) intravenously for 7 days (intervention group). Results: In our study, there is statistically non-significant difference between the studied groups regarding age or gender. In the current study, there are statistically non-significant differences between the studied groups regarding respiratory rate, HCO₃, SpO₂, CRP and GCS at the first day. On the other hand, there are significant differences between both groups regarding respiratory rate, HCO₃, SpO₂, CRP and GCS on third and seventh day. On measuring change over time in each group, there are significant fluctuations in respiratory rate, HCO₃, SpO₂, CRP and GCS over time. On the other hand, there are significant differences between both groups regarding pulse, systolic blood pressure, pH, PCO₂ and TLC on the seventh day. On measuring change over time in each group, there are significant changes in pulse, systolic blood pressure and TLC over time and there is significant increase in pH and PCO₂ over time in the hydrocortisone group, while there are non-significant changes in pH and PCO₂ in placebo group. On measuring change over time in each group, there is significant fluctuation in diastolic blood pressure over time. There are statistically non-significant differences between the studied groups regarding temperature, random blood sugar and serum creatinine at the first, third or seventh day. On measuring change over time in each group, there are significant fluctuations in temperature, random blood sugar and serum creatinine over time. However, there are a significant difference between them regarding presence of pleural effusion on first day and a non-significant difference between them regarding pleural effusion on 7th day. Also, there are significant differences between the studied groups regarding percent change in respiratory rate, pulse, systolic, diastolic blood pressure, temperature, GCS, PCO₂, PCO₂, C-reactive protein, total leucocytic count, random blood sugar and serum creatinine. Conclusion: We found that in patients with severe community-acquired pneumonia, control of inflammation with prolonged low-dose hydrocortisone infusion hastens resolution of pneumonia and prevents the development of sepsis-related complications. A course of low-dose hydrocortisone infusion was associated with a significant reduction in duration of mechanical ventilation, hospital length of stay, and hospital mortality.

[Amr E. Abdel-Hameed, Ahmed A. Elshebiny, Mohamed N. Abdel-Fattah. Assessment of the efficacy of low dose hydrocortisone Infusion in severe community Acquired Pneumonia. J Am Sci 2019;15(11):52-59]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 7. doi:10.7537/marsjas151119.07.

Key words: low dose, hydrocortisone infusion, pneumonia

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Impact of Managers' Dogmatism, Psychological Empowerment and Mutual Organizational Trust in Emotional Exhaustion

Dr. Mohamed Nasr Saeed

Assist. Prof. in Business Administration Dept., Faculty of Commerce, Benha University, Egypt.

Email: dr.mo7amed.n@gmail.com

Abstract: This research has focused on studying the risky impact of managers' dogmatism of educational administrations and their dogmatic between the rigidity and openness to the emotional exhaustion of teachers in the undergraduate education sector (primary, preparatory, and secondary), due to the Vital importance of this sector. emotional exhaustion is also important as one of axes of quality of life. Then, the effect of psychological empowerment as an intermediate variable in the relation between managers'-mind (openness vs dogmatic) and emotional exhaustion. On the other hand, mutual organizational trust was studied as a moderator variable between (managers' open-minded vs managers' dogma-minded) and emotional exhaustion. Through the results of exploratory study for researched public government schools and statistical analysis of a sample of (385) teachers. This is through four main hypotheses, while hypothesis (H₃) included four sub-hypotheses. (H₀1) and (H₀2) hypothesis was refused. In contrast, (H₃) and (H₄) hypothesis was admitted (agreeable). the result of (H₀1) emphasized a (negative) relation of (managers'-open-mind) and a (positive) relation of (managers'-dogmatic-mind) with emotional exhaustion. however, (H₀2) improved there are significant hypothetical differences between teachers' opinions about their level of realizing of emotional exhaustion and its risky effect on teachers' health and their personality and poor their organizational and educational performance. While, the hypothesis (H₃) emphasize that psychological empowerment intermediates the relationship between (managers'-openness-minded vs dogmatic-minded) and emotional exhaustion partially and wholly. Whilst The hypothesis (H₄) confirmed that the mutual organizational trust moderates the relationship between managers'-mind (open vs close) and emotional exhaustion. The study also suggests some recommendations and the implementations' mechanism of these recommendations with regard to the issues of managers'-dogmatism and managers'-open-minded, flexibility, participatory management, management by objectives, creativity, supporting delegation to activate psychological empowerment through enhancement the mutual organizational trust between teachers and educational departments' managers in researched public schools. In addition, it is self-evident that the study recommends that schools' managers should consider a periodical review to see whether teachers - or even some of them - are suffering from emotional exhaustion and begin to deal with this by reducing managers'-dogmatic, and enhancement open-minded, flexibility, Psychological empowerment and enhancement mutual organizational trust between teachers and their departments' managers.

[Mohamed Nasr Saeed. Impact of Managers' Dogmatism, Psychological Empowerment and Mutual Organizational Trust in Emotional Exhaustion. J Am Sci 2019;15(11):60-90]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 8. doi:10.7537/marsjas151119.08.

Keywords: dogmatism; openness-minded; dogmatic-minded; emotional exhaustion; psychological empowerment; meaning; competence; self-determination; impact; mutual organizational trust

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Laparoscopic Sleeve Gastrectomy versus Minbypass: Incidende of Leak and How to Manage

Alaa Abbas Mustafa, Tamer Mohamed Saied, Mohamed Gamal Al-Fouly, Mohamed Ibrahim Mohamed Abd-Allah

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt.

mohamed0abdallah@gmail.com

Abstract: Background: A variety of surgical procedures are available but, the question is which procedure is the ideal choice, unfortunately it is difficult to identify the most effective option based on patient characteristics and co-morbidities. Furthermore, little is known regarding the effect of various surgical procedures on glycemic control and on type 2 D.M remission. Bariatric surgery techniques include restrictive procedures, malabsorptive procedures and combined procedures which depends on both malabsorption and decrease size of stomach such roux-en-y and mini-gastric bypass surgeries. Objective: To make a comparison between incidence of Leak after Mini Bypass or Sleeve Gastrectomy. Also to highlight the best way for its management. Patients and Methods: Our study included the initial experience for 40 morbidly obese patients who fulfilled the selection criteria and formed the study population. The patient population was divided into two groups, group I & II which included 20 morbidly obese patients who had done LSG and LMGB respectively. Patients were followed up as regard occurrence of leakage by doing C.T with contrast and upper GI endoscopy for suspected cases. 6 months comparative data was recorded as regard post-operative leakage in both procedures. Results: The study showed that LMGB is superior to LSG as regard incidence of post operative leakage. Although our study results support LMGB as a less incidence of post operative leakage, further studies with larger sample size and long follow up periods are needed to verify results of this thesis. Conclusion: Leakage in this study occurs in four patients (out of 40, with rate of 10%). Three of them occur in patients underwent laparoscopic sleeve gastrectomy and only one patient with laparoscopic mini gastric bypass with non-significant difference between both approaches.

[Alaa Abbas Mustafa, Tamer Mohamed Saied, Mohamed Gamal Al-Fouly, Mohamed Ibrahim Mohamed Abd-Allah. Laparoscopic Sleeve Gastrectomy versus Minbypass: Incidende of Leak and How to Manage. J Am Sci 2019;15(11):91-101]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 9. doi:10.7537/marsjas151119.09.

Keywords: Gastroesophageal reflux disease, laparoscopic adjustable gastric band, gastro-jejunal anastomosis

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Role of Prophylactic Central Neck Dissection for Early Papillary Thyroid Cancer

Prof. Dr. Emad El-Din Farid Ibrahim, Prof. Dr. Shaaban Mohamed Mohamed Abdulmaged, Dr. Dina Hany Ahmed, Dr. Ahmed Serag El-Din Hessein, Sameh Wagdy Abdel Ghaffar Hussein

General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

samehwagdy96@yahoo.com

Abstract: The role of prophylactic central lymph node dissection in the management of PTC is still a controversy. There is no convincing evidence that prophylactic central neck dissection provides an improvement in overall survival, recurrence rate, or any clinically significant variable when applied without discrimination to all PTC patients. The recurrence rate found in this study of 5% confirms the rarity of lymph node recurrence and leaves many doubts regarding the usefulness of prophylactic central neck dissection. Also, the ATA presented many contradictions for emerging PCND in routine TT surgery for PTC patients, however its recommendations is based on the risks and stages of tumor. Our study does not show significant increase in morbidity with prophylactic central neck dissection than with Thyroidectomy alone. On the other hand, PCND upgraded 35% of the patients included in our study to N1, and this is regarded by many as over-diagnosis and may lead to overtreatment in the form of higher doses of RAI. Therefore, in our opinion, until conclusive evidence emerges of the actual benefit of prophylactic central neck dissection procedure in the treatment of PTC without suspicious enlarged nodes, it may be avoided. In conclusion, Total Thyroidectomy appears to be the adequate treatment for clinically node-negative PTC. Based on current literature and our results, we support the American Thyroid Association’s recommendations that prophylactic central neck dissection should be reserved only for the use in high risk patients and advanced (T3 and T4) papillary thyroid cancers and could be considered for the more appropriate selection of patients for radioiodine treatment. Unfortunately, no pathological or clinical factors are able to predict with any degree of certainty the presence of nodal metastasis. The potential use of molecular markers will hopefully offer a further tool to stratify the risk of recurrence in patients with PTC and allow a more specific approach to offer prophylactic central neck dissection to patients with the most benefit. Multi-institutional larger studies with longer follow-up periods are necessary to provide definitive conclusions.

[Emad El-Din Farid Ibrahim, Shaaban Mohamed Mohamed Abdulmaged, Dina Hany Ahmed, Ahmed Serag El-Din Hessein, Sameh Wagdy Abdel Ghaffar Hussein. Role of Prophylactic Central Neck Dissection for Early Papillary Thyroid Cancer. J Am Sci 2019;15(11):102-109]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 10. doi:10.7537/marsjas151119.10.

Keywords: Prophylactic, Central, Neck, Dissection Papillary, Thyroid, Cancer

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Predictive Factors for Remission of Type 2 Diabetes Mellitus after Laparoscopic Gastric Sleeve

Medhat Khalil, Mohamed M. Abouzeid and Haitham Moustafa El Maleh

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

E-mail: abouzeid2000@hotmail.com

Abstract: Background: Globally, obesity and its accompanying type 2 diabetes mellitus (T2DM) are enduring health-care difficulties. There are a close relationship between obesity and T2DM and still facing difficulties in control and management of them by the current available therapies, including drug therapy, food, and modification of behavior. There is robust indication that bariatric surgery could cure type II diabetes mellitusin patients with obesity. Aim of the Work: To determine different predictive factors affecting the outcome of type T2 DM after laparoscopic gastric sleeve. Patients and Methods: Prospective study included 40 obese diabetic patients with T2 DM who underwent laparoscopic sleeve gastrectomy. Diagnosis of T2 DM was depending on criteria of ADA: HbA1c ≥ 6.5%, random blood glucose ≥200 mg/dl, FPG > 126 mg/dl, or use of oral diabetes medication or insulin. Glycemic marker in the form of HbA1c and fasting blood sugar were measured just prior to surgery and at 3 months and 6 months postoperatively. Results: 42.5% of patients developed remission of type II DM, these patients are younger patients, with shorter diabetic age, age of diabetes was determined from the date of diagnose to the date of operation, with mean of 4 years (from 3 years to 6 years) with range of 1-20 years, moreover patients not using insulin with optimum pre-operative glycemic control with normal fasting blood sugar and HbA1c were the best candidates to achieve remission. Conclusion: Remission of T2DM is one of the major achievable goals of SG, identification of potential predictors of diabetes remission help to achieve this goal.

[Medhat Khalil, Mohamed M. Abouzeid and Haitham Moustafa ElMaleh. Predictive Factors for Remission of Type 2 Diabetes Mellitus after Laparoscopic Gastric Sleeve. J Am Sci 2019;15(11):110-116]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 11. doi:10.7537/marsjas151119.11.

Keywords: Metabolic Disease - Diabetes Mellitus –Laparoscopic Sleeve Gastrectomy

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Assessment of Surgical management of idiopathic granulomatous mastitis

Abdullah Hamed Ibrahim¹; M.D and Ahmed Gamal El-Din Osman²; M.D.

¹ Lecturer of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

²Assistant Professor of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

drabdallah333@gmail.com

Abstract: Context: Idiopathic granulomatous mastitis (IGLM) is a uncommon chronic non-specific inflammation of the breast that similar to cancer both mammographically and clinically. IGLM; in spite of its frequency is low, but it represent a high concern owing to misdiagnosis as carcinoma of the mammary gland, yet confirming a suitable control is critical. Objective: The aim of this study is to assess the surgical management in patient with idiopathic granulomatous mastitis. Methodology: The work is a cohort prospective study performed on patients presenting to Ain-Shams University hospital’s breast clinic diagnosed with idiopathic granulomatous mastitis and underwent surgical intervention (excisional biopsy) from 2015 to 2018. 40 patients identified with histopathological diagnosis of IGLM. Results: In our study, 26 patients out of 40 patients ( 65%) had a history of pregnancy in the last 5 years prior to diagnosis of IGLM with 24 patients (60%) having a history of previous lactation. Surgical management was employed after the control of the process using corticosteroids (Prednisolone). 24 patients presented with mass, 4 with pain and overlying skin changes (sinuses) and 12 patients with abscess. Conclusion: Surgical excision is a suitable option after the control of the inflammatory process using corticosteroids.

[Abdullah Hamed Ibrahim and Ahmed Gamal El-Din Osman. Assessment of Surgical management of idiopathic granulomatous mastitis. J Am Sci 2019;15(11):117-123]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 12. doi:10.7537/marsjas151119.12.

Keywords: Surgical Management, Idiopathic granulomatous mastitis

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Test the membership Reality of quartet Tempel groups of galaxies

Sabry A. Mohamed^1,2

¹ National Research Institute of Astronomy and Geophysics, 11421, Helwan, Cairo, Egypt

² Physics Dept., College of Science Al-Zulfi, Majmaah University, Saudi Arabia

E-mail: sabryali@nriag.sci.eg; sa.mohamed@mu.edu.sa

Abstract: Groups of galaxies are usually defined as a small number of galaxies in the small region in the sky cataloged by different selection criteria and techniques. There are many problems in galaxy groups catalogues because of most of selection criteria depend on the member's distance from the center of the groups and the radii of the members too. Later studies on some of these catalogues showed that some of the galaxies in the groups don’t belong to their groups and were discarded that in turn could lead to removing the group from the catalog. The aim of this study is to test the membership of the galaxies in their groups by applying a clustering analysis technique (The Euclidean Separation Distance Coefficients) to test the physical reality (similarity or dissimilarity) of quartet galaxy groups taken from Temple et al (2012) Catalogue. The results shows that, there are 2844 groups have one discordant galaxies (have different astrophysical attributes) should be discard from the catalogue and should recomputed the astrophysical main properties in these group.

[Sabry A. Mohamed. Test the membership Reality of quartet Tempel groups of galaxies. J Am Sci 2019;15(11):124-134]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 13. doi:10.7537/marsjas151119.13.

Keywords: galaxies: general, galaxies: groups: general-galaxies: statistics –catalogues, galaxies: clustering

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