Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications
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A pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
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Abstract
As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onse
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Many conservative sphincter-preserving procedures had been described to be effective in
healing of anal fistula without excision or de roofing.
Objective: To verify the outcome of mere photocoagulation of the fistula tract on healing of low anal
fistula.
Materials and Methods: Using 810nm diode laser, the tracts of low anal fistulae in a cohorts of six male
patients (mean age of 32 yr) had been photocoagulated by retrograde application of laser light through an
orb tip optical fiber threaded in to the tract. Swabs for culture and sensitivity testing were obtained before
and after laser application. Patients were followed up regularly to announce fistula healing.
Results: Mean laser exposure time was 6.6 min., mean
Chronic kidney disease (CKD) is a major public health concern around the world. UMOD gene variants are linked to a higher incidence of hypertension and CKD in the general population. This study aimed to investigate the role of uromodulin rs13333226 and rs13333144 genes association with chronic kidney disease.The study samples were divided into two groups. The first group included 100patient samples and 70 chosen among them were under the dialysis and had kidney failure aged between 18-88 years old. The second group included 30 samples from healthy individuals who were used as a control. One of the ways used to identify the genotype is the tetra-primers amplification refractory mutation system–polymerase chain reaction (ARMS
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Back ground: Chronic hepatitis C (HCV) is the most common chronic liver disease at present, and HCV infection is found with variable prevalence in dialysis populations in different parts of the world.
Objective: The aim of this study was to determine the concentration of sialic acid and immunoglobulins level in the sera of patients with chronic renal failure whom infected with Hepatitis C virus, and the effect of hemodialysis on them.
Patients&Methods: Regarding to this aim, total sialic acid levels (TSA) and immunoglobulins level were studied on the blood samples of 20 patients with chronic renal failure + Hepatitis C virus (positive group) and 20 patients with chronic renal failure (negative group) and 20 healthy volunteers.
Depletion of fossil fuel is one of the main reasons why the bioethanol has become popular. It is a renewable energy source. In order to meet the great demand of bioethanol, it is best that the bioethanol production is from cheap raw materials. Since the golden shower fruit is not being utilized and is considered as waste material, hence, this study was conducted to make use of the large volume of the residue as feedstock to test its potential for bioethanol extraction.The main goal of this study is to obtain the most volume of bioethanol from the golden shower fruit liquid residue by the factors, days of fermentation (3, 5, and 7 days) and sugar concentration (15, 20 and 25 brix) of the liquid residue. Also, part of the study is to compu
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Background: One of the most important prognostic indicators in cancer is the lymph node dissection. Lymphadenectomy considered as a risk factor for deep vein thrombosis in patients with gynecological malignancy who underwent surgery. D-dimer was used to detect deep vein thrombosis, thus, it’s important to predict complications of post-operative Lymphadenectomy.
Objective: To predict the risk of deep venous thrombosis by used serum D-dimer and wells score after pelvic lymphadenectomy in gynecological cancer.
Patients and method: A cross sectional study conducted in Obstetrics and Gynecology/ ward in medical city, from 1st, January 2021 to 30th, De
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