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Biomedical subjects

G Mostafa

Publications and source records attributed to G Mostafa.

17 recordsLinked to original sources
PubMed2005

Effect of carbon dioxide pneumoperitoneum and wound closure technique on port site tumor implantation in a rat model.

BACKGROUND: The purpose of this study was to evaluate the effects of carbon dioxide (CO2) pneumoperitoneum and wound closure technique on port site tumor implantation. METHODS: A standard quantity of rat mammary adenocarcinoma (SMT2A)was allowed to grow in a flank incision in Wistar-Furth rats (n = 90) for 14 days. Thereafter, 1-cm incisions were made in each animal in three quadrants. There were six control animals. The experimental animals were divided into a 60-min CO2 pneumoperitoneum group (n = 42) and a no pneumoperitoneum (n = 42) group. The flank tumor was lacerated transabdominally in the experimental groups. The three wound sites were randomized to closure of (a) skin; (b) skin and fascia; and (c) skin, fascia, and peritoneum. The abdominal wounds were harvested en bloc on postoperative day 7. RESULTS: Histologic comparison of the port sites in the pneumoperitoneum and no-pneumoperitoneum groups did not demonstrate a statistically significant difference in tumor implantation for any of the closure methods. Evaluation of the closure techniques showed no statistical difference between the pneumoperitoneum group and the no-pneumoperitoneum group in the incidence of port site tumor implantation. Within the no-pneumoperitoneum group, there was a significant increase (p = 0.03) in tumor implantation with skin closure alone vs all three layers. Additionally, when we compared all groups by closure technique, the rate of tumor implantation was found to be significantly higher (p = 0.01) for skin closure alone vs closure of all three layers. CONCLUSIONS: This study suggests that closure technique may influence the rate of port site tumor implantation. The use of a CO2 pneumoperitoneum did not alter the incidence of port site tumor implantation at 7 days postoperatively.

Adenocarcinoma↗
PubMed2004

Rickets among children of a coastal area of Bangladesh.

Many children with rachitic deformities have been reported in southern coastal area of Bangladesh but the actual rate of prevalence was not known. A survey was conducted to determine the magnitude of rachitic problem among the children of Chakaria thana of Cox's Bazar district of Bangladesh. Nine hundred children between 1-15 years selected randomly from 30 villages of total 340 villages. Face to face interview of the parents was taken and the children were examined for evidences of rickets. Serum calcium, phosphorus, alkaline phosphatase (ALP) were estimated and radiology of limbs were done in all clinically suspected cases and in a control of every eighth child. Seventy eight children (8.7%) had physical features suggestive of rickets. Fifty eight (6.4%) children had 'clinical rickekts' (positive physical feature(s) but normal ALP and negative radiology), 12 (1.3%) children had 'biochemical rickets' (positive physical features and raised ALP but negative radiology) and 8 (0.9%) children had 'confirmed rickets' (positive physical features, raised ALP and positive radiology). Out of 78 children with rachitic feature(s), Pectus carinatum was found as the most common clinical feature in 26 (33.3%) children followed by genu valgum in 23 (29.4%) cases. Twenty two normal children (2.2%) had raised level of ALP (>300U/L). The prevalence of rickets is high in children of Chakaria and further study is needed to find out the exact aetiology of rickets in children there.

Adolescent↗
PubMed2001

Mini-laparoscopic versus laparoscopic approach to appendectomy.

BACKGROUND: The purpose of this clinical study is to evaluate the feasibility of using 2-mm laparoscopic instruments to perform an appendectomy in patients with clinically suspected acute appendicitis and compare the outcome of this mini-laparoscopic or "needlescopic" approach to the conventional laparoscopic appendectomy. METHODS: Two groups of patients undergoing appendectomy over 24 months were studied. In the first group, needlescopic appendectomy was performed in 15 patients by surgeons specializing in advanced laparoscopy. These patients were compared with the second or control group that included 21 consecutive patients who underwent laparoscopic appendectomy. We compared the patients' demographic data, operative findings, complications, postoperative pain medicine requirements, length of hospital stay, and recovery variables. Differences were considered statistically significant at a p-value < 0.05. RESULTS: Patient demographics, history of previous abdominal surgery, and operative findings were similar in both groups. There was no conversion to open appendectomy in either group. No postoperative morbidity or mortality occurred in either group. The needlescopic group had a significantly shorter mean operative time (p = 0.02), reduced postoperative narcotics requirements (p = 0.05), shorter hospital stay (p = 0.04), and quicker return to work (p = 0.03) when compared with the laparoscopic group. CONCLUSIONS: We conclude that the needlescopic technique is a safe and effective approach to appendectomy. When performed by experienced laparoscopic surgeons, the needlescopic technique results in significantly shorter postoperative convalescence and a prompt recovery.

Adult↗
PubMed2001

Minilaparoscopic appendectomy.

The purpose of this study was to evaluate the feasibility of using 2-mm laparoscopic instruments in the treatment of appendicitis and to identify risk factors that may limit their use. Minilaparoscopic appendectomy was performed through a 2-mm port in the umbilicus for a videoendoscope, a 2-mm working port in the right upper quadrant, and a 5/12-mm suprapubic port for an endoscopic stapler. Minilaparoscopic appendectomy was attempted in 26 consecutive patients with appendicitis. Thirty-two consecutive patients undergoing conventional laparoscopic appendectomy with 5- and 10-mm instruments and videoendoscopes before the availability of 2-mm instrumentation were analyzed for comparison. Statistical comparisons were made by the Student t test and Fisher exact test. Differences were considered statistically significant at a P value less than 0.05. There were no conversions to an open appendectomy in the minilaparoscopic appendectomy or conventional laparoscopic appendectomy group. The mean operative time was 69.5 minutes for the minilaparoscopic appendectomy group and 85.5 minutes for the conventional laparoscopic appendectomy group (P = 0.02). The mean postoperative length of stay was 1.7 days for the minilaparoscopic appendectomy group and 2.5 days for the conventional laparoscopic appendectomy group (P = 0.08). There was no significant difference in the complication rates (P = 0.31). Minilaparoscopic appendectomy was completed in 13 (50.0%) patients. Independent risk factors (P = 0.05) for conversion to 5- or 10-mm ports were a retrocecal appendix and increasing patient age. There were no differences in the mean postoperative length of stay (P = 0.12) or complication rate (P = 0.39) between the two groups, but mean operative time was longer (P = 0.05) in the converted group. Perioperative outcomes for minilaparoscopic appendectomy are comparable to those of conventional laparoscopic appendectomy. The use of 2-mm instrumentation in the management of appendicitis is limited in patients with retrocecal appendicitis. Increasing patient age and a history of abdominal surgery may influence the need to convert 2-mm ports to 5- or 10-mm ports.

Adolescent↗
PubMed2001

Effectiveness of the ultrasonic coagulating shears, LigaSure vessel sealer, and surgical clip application in biliary surgery: a comparative analysis.

Advancements in laparoscopic surgery are often dictated by the limitations of technical instrumentation. Energy sources other than electrosurgery have become popular with the promise of quick and effective vascular control. With their success surgeons have begun using these on structures other than blood vessels with little or no data establishing their efficacy or safety. This study evaluates alternative energy sources in sealing ductal structures for possible use in liver or gallbladder surgery. After elective cholecystectomy cystic ducts (n = 45) were resealed ex vivo with surgical clips (n = 14), ultrasonic coagulating shears (n = 16), or electrothermal bipolar vessel sealer (n = 15), and bursting pressures were measured. Nineteen additional human cystic ducts were randomized to seal by ultrasonic coagulating shears (n = 9) or electrothermal bipolar vessel sealer (n = 10) and fixed in 10 per cent buffered formalin for histologic evaluation of thermal spread (mm). After this nine adult pigs were randomized to laparoscopic ligation and transection of the common bile duct using surgical clips (n = 3), ultrasonic coagulating shears (n = 3), or electrothermal bipolar vessel sealer (n = 3). The animals underwent necropsy for assessment of seal integrity on the sixth postoperative day. In the ex vivo study the mean cystic duct bursting pressure was 621 mm Hg with surgical clips and 482 mm Hg with the electrothermal bipolar vessel sealer (P = 0.39). The mean cystic duct bursting pressure after ultrasonic coagulating shears was 278 mm Hg, which was statistically less than surgical clips (P = 0.007) and electrothermal bipolar vessel sealer (P = 0.02). The mean thermal spread was 3.5 mm for ultrasonic coagulating shears and 13.4 mm for electrothermal bipolar vessel sealer (P = 0.0002). All animals undergoing ligation and transection of the common bile duct with ultrasonic coagulating shears and electrothermal bipolar vessel sealer developed bile peritonitis by postoperative day 6 as a result of seal leak. All animals undergoing surgical clip ligation and transection of the common bile duct maintained seal integrity. The mean common bile duct pressure above the surgical clip was 12 mm Hg (range 10-14). In conclusion the acute ex vivo study demonstrated a significant difference in the cystic duct bursting pressure between surgical clips and ultrasonic coagulating shears and between electrothermal bipolar vessel sealer and ultrasonic coagulating shears. The ultrasonic coagulating shears and electrothermal bipolar vessel sealer failed to maintain seal integrity in the in vivo animal study. Given the failure of the ultrasonic coagulating shears and electrothermal bipolar vessel sealer in the animal model these energy sources should not be used for transection of the cystic duct or major hepatic ducts during hepatobiliary surgery.

Animals↗
PubMed2000

Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh.

Longitudinal data collected from the Demographic Surveillance System (DSS) in Matlab, a rural area in Bangladesh, are used for determining trends in and determinants of mortality of the elderly population (60 yr and over) in 1974-1996. The old-age mortality rate is high in Matlab, 1.2 times that of Sri Lankan and 1.5 times that of the Swedish elderly population in a comparable period. Mortality among the elderly population declined in 1974 1982, but much less so in 1982-1996. Proportional hazards models were used for examining determinants of mortality in a sample of about 10,000 elderly persons. This multivariate analysis used information on several social and economic variables derived from the 1982 census and mortality data of this population which was followed prospectively in 1982-1992. Marital status was the single most important determinant: widows and widowers had 1.5 to 2 times higher risk of death compared to couples where both husbands and wives were alive. Social support in old age by children also plays a role, especially for women: women living with at least one son or daughter had 18% lower mortality than women living in a household without sons or daughters. Socioeconomic factors are also important. Those who had at least some education or were relatively affluent had lower mortality than those with no education or who were less affluent.

Aged↗
PubMed1998

The utility of hemodynamic measurements acquired by pulmonary artery catheterization.

BACKGROUND: Concerns about the utility of pulmonary artery catheters (PAC) stimulated us to assess the impact of one of the parameters measured by the PAC, the pulmonary capillary wedge pressure (PCWP), on our clinical practice. METHODS: The PCWP was recorded at 4- to 6-hour intervals on 50 patients for the first 48 hours following aortic aneurysm repair. We then reviewed the patients' records looking for evidence that the PCWP measurements were used to guide therapy. For the purpose of the study, we anticipated the administration of diuretics for PCWP > or =218 mm Hg and volume resuscitation for PCWP < or =8 mm Hg. Data were correlated using Pearson rank correlation coefficient using a P < 0.05 to determine statistical significance. RESULTS: Patients with PCWPs <8 mm Hg were more likely to be treated with volume resuscitation (P < 0.05). There was no other correlation between PCWP measurements and fluid or pharmacologic management. CONCLUSIONS: Data derived from the PAC are infrequently used to guide therapy in patients who undergo abdominal aortic reconstructive surgery.

Aged↗
PubMed1995

The influence of socio-biological factors on perinatal mortality in a rural area of Bangladesh.

"The present study considers data on all pregnancies that ended in a stillbirth or live birth in a rural area of Bangladesh during the years 1982 to 1984. It considers the relationships of both biological and socio-economic factors to perinatal mortality....[Results show a] lack of association with any measure of socio-economic status.... Our study has confirmed that survival of the perinatal period is separately related to both maternal age and primiparity. Once maternal age is taken into account, high parity shows no evidence of decreasing survival chances."

Age Factors↗
PubMed1993

Levels and differentials in weight, height and body mass index among mothers in a rural area of Bangladesh.

This study examined the variation in weight, height and body mass index of 1048 mothers living in a rural area of Bangladesh in relation to age, education, number of previous pregnancies, number of dead children, religion, family type, family size, and amount of land owned by the household. Multiple regression analysis revealed a positive relationship of education with all three variables. Moslem mothers were on average in better condition than Hindus. The number of dead children showed a negative relationship with height, weight and body mass index.

Adult↗
PubMed1990

Perinatal mortality in Matlab, Bangladesh: a community-based study.

Perinatal deaths, comprising stillbirths and deaths during the first week of life, were monitored over the eight-year period 1979 to 1986 in a rural Bangladeshi population of 196,000. The perinatal mortality rate was 75 per 1000 total births. The rate was 13% higher in males than females. Stillbirth and early neonatal mortality rates were 37 and 38 per 1000 total births, respectively. The major causes of perinatal deaths are presented, as well as some of the maternal determinants. During the period under study, perinatal mortality declined regularly and significantly over time in an area covered by an intensive Family Planning and Health Services programme, but not in the adjacent control area. This raises the issue of the impact of such a programme upon perinatal mortality, and the need to include a strong maternity care component into primary healthcare strategies if further reductions of perinatal mortality are to be achieved.

Bangladesh↗
PubMed1990

Pattern of diarrhoeal deaths during 1966-1987 in a demographic surveillance area in rural Bangladesh.

Death pattern was analysed in relation to age, sex, seasonality and yearly variation during 1966-1987 in Matlab upazila of Chandpur district, Bangladesh. The overall death rate due to diarrhoeal diseases and other causes fluctuated during the period. Diarrhoeal death rate varied between 2.0 and 4.0 per 1,000 population except during the war and famine periods of 1971 and 1974-1975 respectively when it was two times higher over the preceding period of five years' average. On an average, more than 20% of all deaths appeared to be related to diarrhoea. The relative importance of diarrhoea as the cause of death did not diminish over time. Persistent diarrhoea caused more deaths than acute diarrhoea. At all times the highest diarrhoeal mortality rate was shown in children aged 1-4 years, specially in girls. Women aged under 20 years had a higher rate of diarrhoeal deaths than the men of similar age. November was the peak month of diarrhoeal deaths in this rural area. Introduction of the Maternity, Child Health-Family Planning (MCH-FP) services had significant impact of reducing diarrhoeal deaths as well as deaths from other causes.

Age Factors↗