Nasser Institute hospital

Pulmonary atresia with ventricular septal defect is a rare and complex congenital heart disease. In cases where pulmonary blood flow is supplied exclusively by major aortopulmonary collateral arteries, traditional surgical interventions may be challenging or delayed, especially in resource-limited settings. This study evaluated the feasibility, safety, and outcomes of the right ventricular outflow tract perforation through the retrograde trans-collateral approach in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries dependent pulmonary circulation. The study cohort comprised 10 patients with pulmonary atresia and ventricular septal defect who underwent attempted retrograde trans-collateral right ventricular outflow tract perforation via major aortopulmonary collateral arteries from October 2021 to February 2025, including 1 unsuccessful procedure. The median age at intervention was 4.1 years, and the median weight was 17 kg. Post-procedure, systemic oxygen saturation increased significantly (P<0.01). Follow-up imaging demonstrated substantial growth of the pulmonary arteries following retrograde trans-collateral right ventricular outflow tract recanalization, with significant improvements in both right and left pulmonary artery Z scores (P<0.01) and a significant increase in the Nakata index from a median of 49 to 111.7 mm2/m2 (P<0.01). Retrograde trans-collateral right ventricular outflow tract perforation is a feasible and safe catheter-based strategy for selected patients with pulmonary atresia with ventricular septal defect, promoting central pulmonary artery growth and serving as a bridge to future surgical repair.

Total knee arthroplasty (TKA) is a highly effective intervention for enhancing function and quality of life in cases with advanced knee osteoarthritis. Although multiple factors have been identified as influencing TKA outcomes, it remains challenging to accurately predict which patients will experience dissatisfaction postoperatively, thereby complicating efforts to optimize their management. This study aimed to evaluate the patient satisfaction outcome after TKA done at our hospital's joint replacement registry using the updated Knee Society Scoring System. This retrospective observational study was conducted on 900 cases who underwent a TKA. The same surgeon consultant, head of the department, performed all the surgeries. SF-12 scores and total new knee society scoring (satisfaction subscale, expectation subscale, function activity subscale, and total score) were markedly higher at the end of follow-up than at the baseline (P < 0.05). A negative correlation was found between new knee society scoring, and age and body mass index(P < 0.05). A positive correlation was found between new knee society scoring, and duration of follow and SF-12 as P < 0.05. New knee society scoring was markedly higher in men than women (P = 0.011). New knee society scoring was markedly different among causes of arthroplasty (P = 0.005). An overall satisfaction rate was there among the studied cases regarding SF-12 score, which measures the activity and mentality of the cases postoperatively; in addition, most of the studied group show a notable improvement in new knee society score.

BACKGROUND AND OBJECTIVES:Gangliogliomas (GGs) are rare, well-differentiated glioneuronal tumors, representing a common cause of neoplastic epilepsy. This study analyzes the presentation, management, and outcomes of a large single-center cohort.METHODS:We retrospectively reviewed 39 patients with histologically confirmed GG. Data on demographics, clinical presentation, imaging, surgical management, and follow-up were analyzed.RESULTS:The mean patient age was 20.8 years. The most common presenting symptom was epilepsy (94.9%, 37/39), with complex partial seizures being predominant. Tumors were predominantly temporal (46.2%, 18/39), followed by cerebellar (15.4%, 6/39) and parietal (12.8%, 5/39) locations. A solid-cystic morphology was the most common radiological pattern (51.3%, 20/39). Gross total resection (GTR) was achieved in 71.8% (28/39) of cases. At a mean follow-up of 7.2 years, 86.5% (32/37) of patients with preoperative epilepsy were seizure-free (Engel Class I). Seizure freedom was significantly associated with GTR (P < .001). Recurrence/progression was observed in 7 patients (17.9%), strongly associated with anaplastic histology (P < .001), and subtotal resection (P = .003). The overall prognosis was excellent for classic GG, with a 100% 10-year survival rate for low-grade tumors.CONCLUSION:GGs have a favorable prognosis after GTR, with excellent rates of seizure control. Tumor recurrence, though rare, is linked to high-grade features and incomplete resection. This series underscores the importance of maximal safe resection as the primary treatment.

Cardiovascular diseases (CVDs) remain a leading global cause of mortality, necessitating novel therapeutic strategies to address myocardial injury, adverse remodelling and impaired cardiomyocyte regeneration. Exosomes, nanoscale extracellular vesicles secreted by nearly all cell types, have emerged as pivotal mediators of intercellular communication, influencing cardiac physiology and pathology through their cargo of nucleic acids, proteins and lipids. These vesicles participate actively in processes such as cytoprotection, angiogenesis, apoptosis regulation and immune modulation, which are critical for cardiac repair and regeneration. Recent preclinical and clinical studies highlight the promising regenerative capabilities of exosomes, especially those derived from stem cells and immune cells, positioning them as innovative therapeutic tools and diagnostic biomarkers in CVD management. Despite their potential advantages over traditional cell therapies, including lower immunogenicity and enhanced targeting, several hurdles remain before exosomes can be routinely applied in clinical practice. Challenges include the lack of standardized isolation and characterization protocols, heterogeneity of exosome populations, inefficient cargo loading methods, off-target biodistribution and safety concerns related to immune response and infectious risk. Ongoing research aims to overcome these obstacles to realize exosomes' full potential in cardiovascular regenerative medicine, with diagnostic applications currently representing a nearer-term goal.

ABSTRACTBackground and AimsTongue transplantation is emerging as a novel reconstructive option aimed at restoring critical functions—such as articulation, swallowing, and taste—in patients with extensive tongue defects due to squamous cell carcinoma or trauma. This systematic review and meta‐analysis synthesizes current clinical outcomes, challenges, and future directions in tongue transplantation.MethodsA comprehensive literature search was performed in PubMed, Google Scholar, Medline, Cochrane, Web of Science, and ScienceDirect from January 2000 to August 2020, using predefined Boolean combinations of keywords (e.g., “Tongue Transplant,” “Tongue Reconstructive Surgery”). Studies were screened and selected according to PRISMA guidelines. Six studies meeting strict inclusion criteria—providing detailed patient demographics, surgical techniques, and outcomes (totaling 51 patients)—were included. Data extraction and quality assessment were performed independently by three reviewers. Meta‐analysis was conducted using Review Manager 5.4 and Jamovi 2.4.1.0. Heterogeneity was assessed with the I² statistic; for I² values ≥ 50%, a random‐effects model was used. Statistical significance was defined as p < 0.05 (two‐sided tests), with effect sizes and 95% confidence intervals reported.ResultsAnalysis revealed substantial heterogeneity among studies (I² = 85%, p < 0.001). Overall, tongue transplantation was associated with improved functional outcomes—such as restoration of swallowing and partial recovery of taste sensation—with variable degrees of success. Detailed comparative analysis of surgical techniques, donor selection, and immunosuppressive protocols highlights both common benefits and notable challenges, including technical complexity and risks related to immunosuppression.ConclusionTongue transplantation shows promise in significantly improving quality of life in select patients; however, technical, immunological, and reinnervation challenges remain. Future research should focus on refining surgical protocols, exploring tissue engineering alternatives, and standardizing post‐transplant care to optimize long‐term outcomes.

Background: Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression disorder affecting the upper extremities worldwide. It develops as a result of median nerve compression at the wrist. Release of the transverse carpal ligament by an extended longitudinal incision is the classical performance of the open method. A variety of minimally invasive techniques were introduced for the purpose of preventing the classical method's complications. Transverse carpal ligament sectioning is typically performed with generic tools. A minimally invasive technique with short longitudinal palmar incision and an original knife was introduced by Avci and Sayli with satisfactory outcomes. This article analyzes the pain, healing, and the proximal incision complications of carpal tunnel release.Patients and Methods: A Prospective and retrospective study was conducted to evaluate the outcome of proximal incision in carpal tunnel syndrome release during the period from 12/2022 to 12/2024. The study included 32 patients. We used the pre- and post-operative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), also referred to as the Levine scale, to evaluate the recruited participants.Results: Improvement of symptoms (burning, numbness, and worse night time pain) were noticed to all (32) operated patients. There was an extensive improvement of total pain and function score. No recurrence of symptoms for more surgery was reported by the patients. No other significant issues were identified.Conclusion: The proximal transverse incision for carpal tunnel release is superior because it isn't limited in practice. Pain is minimal and it heals fast with no significant complications. It also appears better, is less tense, and reduces the risk of problems with touch. The resolution of the symptoms was significant.

Subcritical glenoid bone loss in anterior shoulder instability represents a clinical dilemma with no consensus on the optimal management strategy. Although bony transfer procedures provide stability in cases of critical bone loss, they are associated with notable complications. Conversely, soft-tissue techniques such as Bankart repair are often insufficient alone. This technical note introduces a safe, reproducible modification of the dynamic anterior stabilization procedure using an arthroscopic onlay technique combined with subpectoral biceps tendon retrieval and anterior glenoid fixation.

Background: Maxillofacial defects demand reconstruction frequently as a result of the resection of benign or malignant cancers and traumatic injuries. Objectives: to evaluate the versatility of the paramedian forehead flap as a workhorse flap in the reconstruction of facial defects from a clinical application view. Methods: This prospective study has been carried out on 20 cases recruited from emergency rooms and outpatient clinics at Benha University and Nasser Institute from 1/4/2023 until 1/4/2024. The participants who agreed to participate in this clinical study signed an informed consent following being completely informed about the technique and its circumstances. Results: The flap survival rate has been seen to be 100%. Regarding Satisfaction, 1 (5%) patient was dissatisfied, 7 (35%) patients were satisfied, and 12 (60%) patients were very satisfied. No patients were very dissatisfied. Function was preserved in all patients. Regarding complication, 1 (5%) patient had wound infection which was managed with antibiotics, debridement, and removal of diseased or threatened cartilage and 1 (5%) patient had hair on the nose which was later treated with a laser hair removal procedure Conclusion: Paramedian forehead flap have high versatility and efficacy as a workhorse flap in reconstruction of facial defects with lower complication and high patient satisfactions. Wound infection and hair on the nose were the most common complications.

Purpose: Oral mucositis (OM) is one of the most frequent complications affecting colorectal cancer (CRC) patients receiving 5-fluorouracil (5-FU). The release of inflammatory cytokines like tumor necrosis factor alpha (TNF-alpha) and generation of reactive oxygen species (ROS) may play a significant role in the development and progression of OM. Statins have shown pleiotropic effects including anti-inflammatory and antioxidant activity. Hence, they might play a protective role against 5-FU induced OM. This review aims to discuss the evidence from preclinical and clinical studies regarding the potential benefits of statins in this area.Methods: The Egyptian Knowledge Bank, Google Scholar and PubMed databases were searched for published preclinical and clinical articles describing the anti-inflammatory antioxidant activity of statins and their potential role in the prevention of 5-FU induced OM from English sources. Research was performed using different key words: such as, “pathophysiology of 5-FU induced oral mucositis”, “inflammatory cytokine and 5-FU induced oral mucositis”, “oxidative stress and 5-FU induced oral mucositis”, “pleotropic effect of statins OR (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors)”, “statins in 5-FU induced oral mucositis”. Relevant resources were extracted using source pulling method of the references. Findings: Multiple studies have proven the anti-inflammatory and antioxidant properties of statins. It showed that statins can inhibit nuclear factor kappa-B (NF-KB) which consequently inhibits the subsequent cascade of inflammatory cytokines release such as TNF-alpha plus the reduction of ROS such as malondialdehyde (MDA). The effects of statins on mucositis in animal and human models have been investigated and the results were promising.