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Elbalal M.,Gezira Center for endoscopy and laparoscopic surgery | Mohamed A.B.,Gezira Center for endoscopy and laparoscopic surgery | Hamdoun A.,National Cancer Institute NCI | Yassin K.,Alneelain University | And 2 more authors.
Pan African Medical Journal

The pharyngeal pouch (Zenker's diverticulum) is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle (i.e. above the upper sphincter of the oesophagus). It occurs commonly in elderly patients (over 70 year) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss.We are reporting a case of an oropharyngeal dysphagia due to a Zenker's diverticulum in 75 years old Sudanese man with a chronic history of dysphagia for solids. The pathophysiology of Zenker's diverticulum, clinical presentation, and management are reviewed. © Moawia Elbalal et al. Source

Nassar M.Y.,Benha University | El-Shahat M.F.,Ain Shams University | Khalile S.M.,National Organization for Drug Control and Research NODCAR | El-Desawy M.,Nuclear Research Center - Negev | Mohamed E.A.,National Cancer Institute NCI
Journal of Thermal Analysis and Calorimetry

Mesalazine (MZ) drug has been used for several decades as a primary treatment for inflammatory bowel diseases. The drug was investigated using thermal analysis (TA) measurements and electron impact mass spectral fragmentation at 70 and 15 eV of electron energy. The optimum molecular geometry and the total energy of the neutral and the positively charged MZ molecules were calculated by density functional theory method with 6-311++G(d,p) basis sets. Stability of the molecules arising from hyperconjugative interactions, charge delocalization, and the natural atomic charges has been analyzed using natural bond orbital analysis. In electron ionization mass spectrometry, the primary rupture is due to successive loss of H2O (OH from carboxyl and H from phenolic OH of the ring) and CO of the acetyl group. Thermogravimetric results have revealed two stages of mass loss at 75.3 and 25.3 % in ranges 225-350 and 350-650°C, respectively. The first one may be due to successive losses of different groups or molecules with fast rate of decomposition. A comparison between MS and TA helped in selection the proper pathway representing the fragmentation mechanism of this drug. © 2014 Akadémiai Kiadó, Budapest, Hungary. Source

Sakkary M.A.,National Cancer Institute NCI
World Journal of Surgical Oncology

Background: Prolonged and excessive drainage of serous fluid and seroma formation constitute the most common complications after mastectomy for breast carcinoma. Seroma formation delays wound healing, increases susceptibility to infection, skin flap necrosis, persistent pain and prolongs convalescence. For this, several techniques have been investigated to improve primary healing and minimize seroma formation.Materials and methods: Between June 2009 and July 2010 forty patients with breast carcinoma, scheduled for modified radical mastectomy, were randomly divided into 2 groups, the study group (20) and the control group (20). In the study group; the mastectomy flaps were fixed to the underlying muscles in raws, at various parts of the flap and at the wound edge using fine absorbable sutures. In the control group; the wound was closed in the conventional method at the edges. Closed suction drains were used in both groups. Patients, tumor characteristics and operative related factors were recorded. The amount and color of drained fluid were recorded daily. The drains were removed when the amount become less than 50 cc. The total amount and duration of drained fluid and the formation of seroma were recorded and the results were compared between the two groups.Results: In the flap fixation group, the drain was removed in significantly shorter time compared to the control group (p < 0.001). Also, the total amount of fluid drained was significantly lower in the flap fixation group (p < 0.001). The flap fixation group showed a significantly lower frequency of seroma formation compared to the control group, both clinically (p = 0.028) and ultrasonographically (p = 0.047).Conclusions: The mastectomy flap fixation technique is a valuable procedure that significantly decreases the incidence of seroma formation, and reduces the duration and amount of drained fluid. However, it should be tried on a much wider scale to prove its validity. © 2012 Sakkary; licensee BioMed Central Ltd. Source

Okasha H.H.,Cairo University | Naga M.I.,Cairo University | Esmat S.,Cairo University | Naguib M.,Cairo University | And 7 more authors.
Endoscopic Ultrasound

Objective: Pancreatic carcinoma is one of the leading cancer morbidity and mortality world-wide. Controversy has arisen about whether the percutaneous approach with computed tomography/ultrasonography-guidance fine needle aspiration (US-FNA) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the preferred method to obtain diagnostic tissue. Our purpose of this study is to compare between the diagnostic accuracy of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic cancer. Patients and Methods: A total of 197 patients with pancreatic masses were included in the study, 125 patients underwent US-FNA (Group 1) and 72 patients underwent EUS-FNA (Group 2). Results: EUS-FNA has nearly the same accuracy (88.9%) as US-FNA (87.2%) in diagnosis of pancreatic cancer. The sensitivity, specificity, positive predictive value and negative predictive value for EUS-FNA was 84%, 100%, 100%, 73.3% respectively. It was 85.5%, 90.4%, 94.7%, 76% respectively for US-FNA. EUS-FNA had a lower complication rate (1.38%) than US-FNA (5.6%). Conclusion: EUS-FNA has nearly the same accuracy as US-FNA of pancreatic masses with a lower complication rate. Source

Abdel Rahman H.,Cairo University | Moussa E.A.H.,Menoufia University | Zekri W.Z.K.,Cairo University | El Debawy E.,National Cancer Institute NCI | And 4 more authors.
Journal of the Egyptian National Cancer Institute

Background and purpose: Neuroblastoma is the most common extracranial and deadly solid tumor in children. It accounts for 15% of the deaths from cancer in the pediatric age group. Approximately half of the newly diagnosed children are at " high risk" of treatment failure.The aim of this study is to evaluate the response rate of salvage chemotherapy by the ICE (Ifosfamide, Carboplatin, and Etoposide) regimen when administered to previously treated primary refractory or progressive high risk neuroblastoma patients. Patients and methods: Sixty-six patients from the National Cancer Institute (NCI), Cairo University and the Children Cancer Hospital Egypt (CCHE) received salvage chemotherapy (ICE) either due to primary resistance in 51/66 (77.2%) or due to disease progression on primary chemotherapy in 15/66 (22.8%). Results: They were 40 males (60.6%) and 26 females (39.4%). Patients' age ranged between 3. months and 12.5. years. The most common tumor site was suprarenal, followed by retroperitoneal mass. Two patients (3%) died from chemotherapy toxicity during ICE administration. Evaluation of tumor response in the remaining 64 patients showed the following: CR/PR in 24 patients (36.5%), SD in 11 patients (16.6%), and PD in 29 patients (43.9%).Fourteen patients (21.2%) were considered eligible for auto BMT, while 50/64 patients (78.8%) failed this second line (salvage) chemotherapy and had palliative lines of therapy.By the end of the study (May 2010), 47/66 (71.2%) of the patients were still alive, while 19/66 (28.8%) were dead. Two out of 14 patients (14.2%) who underwent HSCT died from post transplantation disease progression, while 12/14 (85.8%) were in CCR. Conclusion: Chemotherapy by ICE for primary resistant or progressive stage III/IV NB seems well tolerated. With a 36.6% response rate, 18% CCR, and 3% treatment mortality rate, it could be considered a good salvage therapy in the category of patients who are condemned for palliation. © 2011. Source

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