Hany Abdelfatah Elhady

Background: Superficial parotidectomy is the traditional treatment for benign parotid tumors but may be associated with facial nerve dysfunction and other morbidities. Intracapsular parotidectomy has emerged as a function-preserving alternative; however, concerns regarding oncologic safety remain. Randomized evidence comparing both techniques is limited. Therefore, this study aimed to compare their functional and oncologic outcomes. Objective: This study aimed to compare intracapsular parotidectomy and superficial parotidectomy in terms of operative efficiency, complications, facial nerve preservation, and tumor recurrence for benign parotid tumors. Methodology: This multicenter randomized controlled trial included patients with benign parotid tumors who were randomly assigned to undergo either intracapsular or superficial parotidectomy between May 2019 and May 2023, in Cairo, Egypt. Functional outcomes, postoperative complications, and recurrence rates were evaluated. Results: The mean age was 46.3 ± 9.5 years, with a range of 25–65 years. Most patients (84, 70%) were male, while 36 (30%) were female. The intracapsular parotidectomy (ICP) group demonstrated significantly reduced operative time (68.5 ± 12.3 vs. 88.3 ± 14.5 minutes; p = 0.01) and blood loss (120 ± 55.3 vs. 170 ± 50.5 ml; p = 0.001) compared to the superficial parotidectomy (SP) group. Facial nerve injury occurred exclusively in the SP group 9 (15%), including 3 (5%) cases of permanent palsy. Recurrence was observed in 1 (1.7%) ICP case and 3 (5%) SP cases, with no statistically significant difference ( p > 0.05). Other complications, including seroma formation and postoperative bleeding, were similarly distributed between the two groups. Conclusion: Intracapsular parotidectomy is a safe, effective, and less invasive alternative to superficial parotidectomy for benign parotid tumors. It offers shorter operative time, reduced bleeding, and improved facial nerve preservation without compromising oncological outcomes. Careful patient selection is essential for optimal results.

Objective: To evaluate the prevalence, distribution, and pathological characteristics of mesenteric lymph node involvement in patients undergoing D3 right hemicolectomy for right colon cancer (RCC). Methods: Hundred consecutive patients diagnosed with right colon adenocarcinoma who underwent D3 right hemicolectomy with complete mesocolic excision (CME) and central vascular ligation (CVL) between July 2022 and July 2024 were included. All resected specimens, including the complete mesocolon, were meticulously examined for lymph nodes and then pathologically assessed for metastatic involvement. Tumor stage, grade, presence of vascular or perineural invasion, and number of harvested and positive lymph nodes, were collected and analyzed. Results: Preliminary results indicated that a significant proportion of patients presented with positive mesenteric lymph nodes (MLNs). The mean number of harvested lymph nodes was 25.3 ± 4.1, with 40% of patients demonstrating nodal metastasis. Nodal involvement was predominantly observed in the pericolic and intermediate groups, with a small percentage of positive nodes in the D3 apical region [5%]. There was a statistically significant association between nodal status and tumor T stage (p<0.001), tumor differentiation (p=0.02), and the presence of vascular invasion (p=0.01). Conclusion: D3 right hemicolectomy effectively allows for the comprehensive evaluation of mesenteric lymph node involvement in right colon cancer.

Enteric viruses (EVs) occurrence within aquatic environments varies and leads to significant risk on public health of humans, animals, and diversity of aquatic taxa. Early and efficacious recognition of cultivable and fastidious EVs in aquatic systems are important to ensure the sanitary level of aquatic water and implement required treatment strategies. Herein, we provided a comprehensive overview of the conventional and up-to-date eco-genomic tools for aquatic biomonitoring of EVs, aiming to develop better water pollution monitoring tools. In combination with bioinformatics techniques, genetic tools including cloning sequencing analysis, DNA microarray, next-generation sequencing (NGS), and metagenomic sequencing technologies are implemented to make informed decisions about the global burden of waterborne EVs-associated diseases. The data presented in this review are helpful to recommend that: (1) Each viral pollution detection method has its own merits and demerits; therefore, it would be advantageous for viral pollution evaluation to be integrated as a complementary platform. (2) The total viral genome pool extracted from aquatic environmental samples is a real reflection of pollution status of the aquatic eco-systems; therefore, it is recommended to conduct regular sampling through the year to establish an updated monitoring system for EVs, and quantify viral peak concentrations, viral typing, and genotyping. (3) Despite that conventional detection methods are cheaper, it is highly recommended to implement molecular-based technologies to complement aquatic ecosystems biomonitoring due to numerous advantages including high-throughput capability. (4) Continuous implementation of the eco-genetic detection tools for monitoring the EVs in aquatic ecosystems is recommended.

Background: Although it was initially believed that the coronavirus disease 2019 (COVID-19) only attacked the respiratory system, reports over time demonstrated that this disease could attack the gastrointestinal tract (GIT) as well. The predominant presenting symptoms in patients infected with COVID-19 were gastrointestinal, resulting in gastrointestinal (GI) pathological changes. While clinicians’ concerns are mostly related to respiratory system manifestations, GI symptoms should be monitored and managed appropriately. Objectives: This review summarizes the essential information about COVID-19 GIT infection in terms of pathogenesis, major pathological changes, microbiological bases of infection and the possibility of feco-oral transmission, the severity of associated symptoms, the major radiological findings, the impact on GI surgery, the role of therapeutic agents in induction or magnification of GI symptoms, and a pitfall on the nutritional supplementation in COVID-19 patients.

Enrolled in this prospective randomized study, were randomly allocated into two equal groups: Group I: total thyroidectomy using a harmonic scalpel (HS) and Group II: total thyroidectomy using conventional technique. Results: There is a significant association between the technique of surgery and the decrease in Postoperative PTH, Mean Difference, Pre and Postoperative and the change Pre PTH (p-value <0.001). Conclusion: The postoperative serum level of parathyroid hormone declined significantly after thyroidectomy if the conventional method was used. Using HS during thyroidectomy is safe and effective with low rates of hypoparathyroidism. HIGHLIGHTS In treatment of many thyroid disease, total thyroidectomy is a viable option.The biggest disadvantage is the potential for complications, but it also avoids recurrence.Hypoparathyroidism after thyroid surgery is a common problem.Using a harmonic scalpel may help to decrease the reduction in parathyroid hormone levels after surgery....

Background Necrotizing enterocolitis (NEC) is a frequent serious disease of the digestive system in neonates. It is considered as an important cause of serious neonatal complication and death. Therefore, its early suspi-cion and proper management are important. Aim Early and sensitive detection of neonatal NEC through determination of levels of fecal calprotectin (FCP), serum levels of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), epithelial neutrophil activating peptide-78 (ENA-78), and interleukin 18 (IL-18). Method This prospective case control study was conducted in Tanta University Hospital from June 2016 to March 2018. The study included 20 healthy neonates (control group) and 20 NEC newborn patients. They were all subjected to the measurement of levels of FCP and serum levels of hs-CRP, PCT, ENA- 78, IL-18, Malondialdehyde (MDA), and total antioxidant capacity (TAC). Receiver operating charac- teristic (ROC) curve analysis was conducted for FCP, ENA-78, PCT, hs-CRP, and IL-18. Results The study found a detectable increase in FCP level and serum levels of hs-CRP, PCT, ENA-78, IL-18, and MDA in NEC group in comparison to their levels in the control group. Also, it found a detectable decline in the levels of TAC in comparison to its level in the control group. Conclusion FCP, ENA-78, and PCT can be considered as early markers for diagnosis of NEC.

Splenic congenital anomalies are many. Wandering spleen (WS) is a rare anomaly account for about 0.2%. It is usually associated with absent or maldevelopment of one or all splenic ligaments that hold the spleen in its place. A 15-year-old girl had complaints of repeated attacks of mid-abdominal pain for the last month. Abdominal examination revealed a central fixed and slightly tender abdominal mass in the umbilical region. Complete blood count revealed platelets (790 × 10³/mL), white blood cells (9700 × 10³/mL), and hemoglobin (8 g/dL), and other investigations were normal, but unfortunately ultrasound and computed tomography report revealed WS. Abdominal exploration revealed the spleen not in the anatomical place, and there is a mass in the umbilical region surrounded by dense adhesions. The adhesions were released and this mass discovered to be WS, splenectomy was done. Vaccination against pneumococci and Haemophilus influenza were given, and the patient discharged uneventfully on the fourth postoperative day. Asymptomatic WS could be found incidentally during surgery or during abdominal imaging for any reason. Furthermore, WS can present with an acute abdomen or recurrent abdominal pain. The only treatment is surgery even in asymptomatic cases because of the high possibility of complications. Splenopexy can be done if the spleen showed no torsion or splenomegaly or hypersplenism otherwise splenectomy is the second option.