usama hantour | Al-Azhar University (original) (raw)

Papers by usama hantour

Research paper thumbnail of Role of EUS in Evaluating Causes of Biliary Obstruction not detected by other Imaging Modalities

Al-Azhar International Medical Journal (Print), Feb 1, 2022

Background: Transabdominal Ultrasound (TUS) and other imaging modalities like Computed tomography... more Background: Transabdominal Ultrasound (TUS) and other imaging modalities like Computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) can't demonstrate all the causes of biliary obstruction. Aim of the work: This work aimed to evaluate the role of Endoscopic Ultrasound (EUS) in cases with obstructive jaundice with no definite cause detected by other imaging modalities. Patients and Methods: This is a prospective cohort study conducted on 80 patients presented with manifestations suggestive of obstructive jaundice. Patients underwent history taking, clinical examination, and routine laboratory investigations as well as tumor markers. All Patients were examined by TUS, CT, MRCP, and EUS. The final diagnosis was determined by tissue pathology and a four-month follow-up. Patients with CBD stones were referred for Endoscopic retrograde cholangiopancreatography (ERCP), while patients with operable tumors were sent for surgery. Patients with inoperable tumors were referred for oncology consultation. Result: In this study 80 patients presented with obstructive jaundice (58.7% female). As regard, the mean age of the patients was 50.7years. The common bile duct (CBD) mean diameter for all patients in TUS, CT, MRCP, and EUS was 10.7mm, 11mm, 11.5mm, and 12.4mm, respectively.The most common finding were choledocholithiasis 26 (32.5%), pancreaticobiliary malignancy 44 (55.1%), chronic pancreatitis 4 (5%), portal biliopathy 1 (1.3%), and no pathological obstruction 5 (6.3%). The overall accuracy and sensitivity of EUS for patients diagnosed with pancreaticobiliary malignancy were 95.1%, 95.9%, respectively. Conclusion: EUS is thought to be the best diagnostic imaging modality for diagnosing the causes of biliary obstruction with inconclusive, other imaging modalities.

Research paper thumbnail of Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents

Gastrointestinal Tumors

Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular c... more Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. Objective: In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. Methods: A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. Results: The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment

Research paper thumbnail of Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

The Lancet. Infectious diseases, Jan 13, 2018

Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...

Research paper thumbnail of Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents

Gastrointestinal Tumors, 2020

Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular c... more Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. Objective: In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. Methods: A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. Results: The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment

Research paper thumbnail of Role of EUS in Evaluating Causes of Biliary Obstruction not detected by other Imaging Modalities

Al-Azhar International Medical Journal (Print), Feb 1, 2022

Background: Transabdominal Ultrasound (TUS) and other imaging modalities like Computed tomography... more Background: Transabdominal Ultrasound (TUS) and other imaging modalities like Computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) can't demonstrate all the causes of biliary obstruction. Aim of the work: This work aimed to evaluate the role of Endoscopic Ultrasound (EUS) in cases with obstructive jaundice with no definite cause detected by other imaging modalities. Patients and Methods: This is a prospective cohort study conducted on 80 patients presented with manifestations suggestive of obstructive jaundice. Patients underwent history taking, clinical examination, and routine laboratory investigations as well as tumor markers. All Patients were examined by TUS, CT, MRCP, and EUS. The final diagnosis was determined by tissue pathology and a four-month follow-up. Patients with CBD stones were referred for Endoscopic retrograde cholangiopancreatography (ERCP), while patients with operable tumors were sent for surgery. Patients with inoperable tumors were referred for oncology consultation. Result: In this study 80 patients presented with obstructive jaundice (58.7% female). As regard, the mean age of the patients was 50.7years. The common bile duct (CBD) mean diameter for all patients in TUS, CT, MRCP, and EUS was 10.7mm, 11mm, 11.5mm, and 12.4mm, respectively.The most common finding were choledocholithiasis 26 (32.5%), pancreaticobiliary malignancy 44 (55.1%), chronic pancreatitis 4 (5%), portal biliopathy 1 (1.3%), and no pathological obstruction 5 (6.3%). The overall accuracy and sensitivity of EUS for patients diagnosed with pancreaticobiliary malignancy were 95.1%, 95.9%, respectively. Conclusion: EUS is thought to be the best diagnostic imaging modality for diagnosing the causes of biliary obstruction with inconclusive, other imaging modalities.

Research paper thumbnail of Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents

Gastrointestinal Tumors

Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular c... more Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. Objective: In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. Methods: A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. Results: The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment

Research paper thumbnail of Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

The Lancet. Infectious diseases, Jan 13, 2018

Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...

Research paper thumbnail of Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents

Gastrointestinal Tumors, 2020

Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular c... more Introduction: The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. Objective: In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. Methods: A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. Results: The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment