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Papers by Mohamed Ibrahim

The Egyptian Journal of Hospital Medicine, Oct 1, 2017

Background: Adenomyosis is a common benign gynecological affecting premenopausal woman, in which ... more Background: Adenomyosis is a common benign gynecological affecting premenopausal woman, in which there is increased overgrowth of the endometrium with invasion of the underlying myometrium. The precise pathogenesis of adenomyosis remains unknown with many theories being proposed that consider it to be a pathology that initially affects the endomyometrial junctional zone (JZ). Aim of the Work: The study aims to compare 3D transvaginal ultrasound with MRI in diagnosing adenomyosis in comparison with the gold standard histopathology. Patients and Methods: This cross-sectional study was carried out on 77 patients who were recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital planned to undergo hysterectomy (abdominal, vaginal or laparoscopic assisted hysterectomy) for adenomyosis according to the inclusion/ exclusion criteria. Results: Out of 77 patients included in the study, 67(87%) were +ve for adenomyosis by 3D TVUS, confirmed in 46(59.74%) by histopathology, while 52(67.53%) were +ve by MRI, confirmed in 39(50.64%) by histopathology.3D transvaginal US was able to diagnose adenomyosis in 67(87%) patients and fibroid in 23(29.9%) patients, while MRI was able to diagnose adenomyosis in 52(67.5%) and fibroid in 36 (46.8%). Conclusion: our study results indicated that, 3D transvaginal ultrasound is highly accurate as MRI in diagnosing adenomyosis and leiomyoma as a preoperative diagnostic tool. Recommendations: As the 3D ultrasonography is more available, cheaper, less time consuming and easier technique, it is recommended to be used in every day clinical practice, helping the clinicians to reach an accurate diagnosis, select an appropriate treatment, and individualize management for each patient to reach the best outcome therapeutic rates.

Egyptian Journal of Anaesthesia, 2018

Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid o... more Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery,

Egyptian Journal of …, 2000

Warm liver ischemia is induced whenever hepatic pedicle clamping performed during liver surgery t... more Warm liver ischemia is induced whenever hepatic pedicle clamping performed during liver surgery to minimize operative blood loss. The contributory role of intestinal congestion and injury, that follows prolonged hepatic pedicle occlusion, in aggravating liver ischemic injury and in inducing remote organ injury is underscored. The hepatic pedicles of twelve dogs were continuously interrupted for 90 minutes. In six dogs portacaval shunts were constructed prior to hepatic pedicle occlusion. Two dogs in the control group and all dogs in the shunt group survived for 24 hours after reperfusion (p < 0.05). Serum ALT concentrations at 1 and 24 h after reperfusion were significantly higher (p <0.001) in the control versus shunt group. Significantly more severe histologic injuries were demonstrated in the liver (grade 4 versus grade 1 respectively, p < 0.005) and the intestine (grade 7 versus grade 1 respectively, p < 0.005) of the control versus the shunt group. The lung and kidney showed morphologic features of acute inflammatory injury in the control but not in the shunt group. We conclude that portacaval shunts, by preventing gut congestion and injury, improve tolerance of the liver to prolonged continuous warm ischemia and prevent its systemic effects on distant organs.

The Egyptian Journal of Hospital Medicine, Oct 1, 2017

Background: Adenomyosis is a common benign gynecological affecting premenopausal woman, in which ... more Background: Adenomyosis is a common benign gynecological affecting premenopausal woman, in which there is increased overgrowth of the endometrium with invasion of the underlying myometrium. The precise pathogenesis of adenomyosis remains unknown with many theories being proposed that consider it to be a pathology that initially affects the endomyometrial junctional zone (JZ). Aim of the Work: The study aims to compare 3D transvaginal ultrasound with MRI in diagnosing adenomyosis in comparison with the gold standard histopathology. Patients and Methods: This cross-sectional study was carried out on 77 patients who were recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital planned to undergo hysterectomy (abdominal, vaginal or laparoscopic assisted hysterectomy) for adenomyosis according to the inclusion/ exclusion criteria. Results: Out of 77 patients included in the study, 67(87%) were +ve for adenomyosis by 3D TVUS, confirmed in 46(59.74%) by histopathology, while 52(67.53%) were +ve by MRI, confirmed in 39(50.64%) by histopathology.3D transvaginal US was able to diagnose adenomyosis in 67(87%) patients and fibroid in 23(29.9%) patients, while MRI was able to diagnose adenomyosis in 52(67.5%) and fibroid in 36 (46.8%). Conclusion: our study results indicated that, 3D transvaginal ultrasound is highly accurate as MRI in diagnosing adenomyosis and leiomyoma as a preoperative diagnostic tool. Recommendations: As the 3D ultrasonography is more available, cheaper, less time consuming and easier technique, it is recommended to be used in every day clinical practice, helping the clinicians to reach an accurate diagnosis, select an appropriate treatment, and individualize management for each patient to reach the best outcome therapeutic rates.

Egyptian Journal of Anaesthesia, 2018

Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid o... more Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery,

Egyptian Journal of …, 2000

Warm liver ischemia is induced whenever hepatic pedicle clamping performed during liver surgery t... more Warm liver ischemia is induced whenever hepatic pedicle clamping performed during liver surgery to minimize operative blood loss. The contributory role of intestinal congestion and injury, that follows prolonged hepatic pedicle occlusion, in aggravating liver ischemic injury and in inducing remote organ injury is underscored. The hepatic pedicles of twelve dogs were continuously interrupted for 90 minutes. In six dogs portacaval shunts were constructed prior to hepatic pedicle occlusion. Two dogs in the control group and all dogs in the shunt group survived for 24 hours after reperfusion (p < 0.05). Serum ALT concentrations at 1 and 24 h after reperfusion were significantly higher (p <0.001) in the control versus shunt group. Significantly more severe histologic injuries were demonstrated in the liver (grade 4 versus grade 1 respectively, p < 0.005) and the intestine (grade 7 versus grade 1 respectively, p < 0.005) of the control versus the shunt group. The lung and kidney showed morphologic features of acute inflammatory injury in the control but not in the shunt group. We conclude that portacaval shunts, by preventing gut congestion and injury, improve tolerance of the liver to prolonged continuous warm ischemia and prevent its systemic effects on distant organs.