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The Effect of Hypofractionated Radiotherapy on Tumor Control and Survival in Patients with High-Risk Breast Cancer  [PDF]
Aiat Morsy, Sara H. Hammouda, Samir Shehata
Journal of Cancer Therapy (JCT) , 2019, DOI: 10.4236/jct.2019.101007
Abstract: BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%.
The Effect of Body Mass Index on Survival in Breast Cancer  [PDF]
Aiat Morsy, Samir Shehata
Journal of Cancer Therapy (JCT) , 2019, DOI: 10.4236/jct.2019.1012075
Abstract: Background: Obesity is a well-known risk factor for breast cancer recurrence and poor prognosis. The objective of this study was to evaluate the effect of body mass index (BMI) on survival in breast cancer patients. Methods: We performed a retrospective analysis of 50 breast cancer patients treated in our hospital from January 2012 to December 2013. Patients were divided according to body mass index when diagnosed into: normal weight BMI < 25 Kg/m2, over weight BMI 25 Kg/m2 to < 30 Kg/m2, obesity BMI 30 Kg/m2. In this study the effect of body mass index on progression free survival (PFS) and overall survival (OS) was evaluated.
Toxicity of Hypofractionated Radiotherapy Following Breast Conservative Surgery in Breast Cancer  [PDF]
Aiat Morsy, Sara H. Hammouda, Samir Shehata, Ali Zedan
Journal of Cancer Therapy (JCT) , 2019, DOI: 10.4236/jct.2019.105031
Abstract: Background:Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia
Intersphincteric Resection Is the Optimal Procedure for Very Low Rectal Cancer: Techniques, Morbidity, Oncologic and Functional Outcomes  [PDF]
Ali Zedan, Anwar Tawfik, Ebrahim Aboeleupn, Asmaa Salah, Aiat Morsy
Journal of Cancer Therapy (JCT) , 2019, DOI: 10.4236/jct.2019.105033
Abstract: Background: The intersphincteric resection the most extreme form of a sphincter-preserving alternative for the abdominoperineal resection. Aim of the Work: We investigated oncological, functional outcomes and morbidity after ISR. Methods: This retrospective study included 164 patients who underwent ISR with between 2010 and 2015, Male 56.1%, Female 43.9%, with a median age was 54.5 years, Median follow-up time was of 48 months, Average surgical time was 230 min, Median blood loss was 700 mL and median hospital stay was nine days. Mean tumour size was34 mm. The surgical procedure through a laparotomy (72.6%), laparoscopically (27.4%). Neoadjuvant radiotherapy 89.6% {long-course radiotherapy 74.4%, short-course radiotherapy 15.2%}, neoadjuvant chemotherapy 28.7% and adjuvant chemotherapy 70.1%. Colonic J-pouch 16.5%, Transverse coloplasty 15.9%, a side-to-end anastomosis 26.8% and straight coloanal anastomosis 40.9%. Partial-ISR 36.6%, subtotal-ISR 37.2%, total-ISR 26.2%, diverting ileostomy 6.7%.
Simple EPR/Alanine Dosimeter for Medical Application  [PDF]
Mohamed A. Morsy
Open Journal of Radiology (OJRad) , 2012, DOI: 10.4236/ojrad.2012.24022
Abstract: Linac x-ray and direct gamma irradiation sources were used in this study to irradiate simple polycrystalline alanine- in-glass (AiG) dosimeters with low-doses, typical for medical therapy, and high-doses, typical for syringes’ sterilization processe, respectively. The generated “stable” alanine radicals were quantitatively investigated by electron paramagnetic resonance (EPR) spectroscopy in the presence of an external standard reference (Mn2+/MgO) to correct for spec- trometer sensitivity variation. The results indicated that the de-amination of L-alanine is the main reaction to form the “stable” radical and the AiG-dosimeter gives comparable sensitivity for both low and high radiation doses. Moreover, a linear EPR-radiation dose response is observed over a very wide range, from 0 to 50 kGy, which is contrary to what has been reported by Bruker BioSpin using alanine’s pellet. This linear response and the well-known doses’ cumulative characteristics of alanine are in favor of the use of this simple dosimeter in ample medical applications, particularly the conventional radiotherapy treatment per patient.
Marketing Religion: The Marketing and Islamic Points of View  [PDF]
Morsy Sahlaoui, Neji Bouslama
American Journal of Industrial and Business Management (AJIBM) , 2016, DOI: 10.4236/ajibm.2016.64041
Abstract: The purpose of the present paper is to study the possible application of marketing to promote religion in the specific case of “Islam”. In fact, marketing techniques have been adapted to religious goals since the beginning of the 19th century. But with the rise of the secularization movements in the post-modern era, its application becomes vital to guaranty the survival of religions notably in the Christian case. Islam is facing the same difficulties, such as the decrease of mosque attendance, the decrease of religious commitment, xenophobia and Islamophobia. Our approach was to study marketing application such as defining the 4P’s for the religion of Islam. This would be done based on marketing science and the Islam’s sources: The Holly Quran and Prophet Mohamed (PBUH) Hadiths. In the case of Islamic religion’s sources, and specially in Holly Quran and Prophet Mohamed (PBUH) Hadiths we found many similarities with marketing strategy notably in the choice of promotional variables and the insistence on the importance of religious promotion or Islamic Daawah. So we suggest that the use of marketing techniques is possible and would have two major purposes: Developing Islamic religiousness and repositioning Islam’s image as an opened, tolerant and modern religion.
Structural System to Resist Seismic Loads on High Rise Reinforced Concrete Structures  [PDF]
Ramy Morsy Elkholy
Open Journal of Civil Engineering (OJCE) , 2017, DOI: 10.4236/ojce.2017.72019
Abstract: The forces of nature represent the biggest challenge for engineering work in general and perhaps the most prominent of these forces. This generated by earthquake where engineering structure is exposed abnormal loads and stresses which places areal burden on structural engineers to find solutions and structural systems to increase resistance and effectiveness of engineering structure especially high rise concrete structures.
A New Algorithm for Automatic Double Bright Fringe of Multiple-Beam Fizeau Fringe Skeletonization Using Fourier Transform Method of Fringe Pattern Analysis  [PDF]
Mohamed A. EL-Morsy
Journal of Signal and Information Processing (JSIP) , 2012, DOI: 10.4236/jsip.2012.33054
Abstract: The interferogram of multiple-beam Fizeau fringe technique plays an important role to investigate the optical properties of fiber because this interferogram provides us with useful information which can used to determine the dispersion curve of the fiber sample. A common problem in any interferogram analysis is the accuracy in locating fringe centers (fringe skeleton). There are a lot of computer-aided algorithms, which depend on the interferogram types, used to fringe skeleton extraction of various digital interferogram. In this paper, as far as I know, a novel algorithm for fringe skeleton extraction of double bright fringe of multiple-beam Fizeau fringe is presented. The proposed algorithm based on using the different order of Fourier transform and the derivative-sign binary image. Also the proposed algorithm has been successfully tested by using a computer simulation fringe and an experimental pattern. The results are compared with the original interferogram and shown a good agreement.
Mode of delivery and its associated maternal and neonatal outcomes  [PDF]
Aiat Shamsa, Jun Bai, Padmini Raviraj, Rajanishwar Gyaneshwar
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.33057

Aim: To determine the association between the mode of delivery and selected neonatal and maternal morbidities and outcomes in NSW, during 1998-2008. Methods: This study is a retrospective review of NSW Midwives Data Collection (MDC) of 981,178 deliveries during 1998-2008. Maternal condition and neonatal outcomes were compared for different modes of delivery. Results: The annual rate of caesarean section has steadily increased from 19% to 31.1% with a mean of 25.9% during the study period. The risk of neonatal death was higher for forceps-assisted delivery compared to vacuum-assisted delivery (adjusted odds ratio 0.85%, 95% CI 0.52 - 1.37), caesarean section (adjusted odds ratio 1.14%, 95% CI 1.01 - 1.3) and normal vaginal delivery. Operative vaginal delivery and caesarean section had significantly increased risk for maternal mortality compared to normal vaginal delivery. Conclusions: There is an association between maternal and neonatal outcome and mode of delivery. Mothers and babies with normal vaginal delivery achieved better outcomes in this community. Caesarean section and operative vaginal delivery are associated with significant maternal and neonatal risk. Breech vaginal delivery carries a significant neonatal risk. More future prospective analyses, such as multicentre controlled studies, should be designed to determine whether and how much the adverse pregnancy outcomes were caused by unnecessary surgical and operative vaginal delivery.

Acute Correction of Varus Knee by Biplanar Medial Opening-Wedge High Tibial Osteotomy and Fixation with TomoFix Plate  [PDF]
Elsayed Shaheen, Mohamed Abdel-Aal Morsy
Open Journal of Orthopedics (OJO) , 2019, DOI: 10.4236/ojo.2019.94009
Abstract: Background: Biplanar medial opening wedge high tibial osteotomy (MOWHTO) is a treatment method that allows adequate correction of symptomatic varus knee deformity. However, MOWHTO tends to decrease patellar height and increase the posterior tibial slope, which can affect the knee joint stability. Objective: The aim of this study was to describe the technique of biplanar MOWHTO and fixation by TomoFix plate, as well as to evaluate the accuracy of the planned correction and the postoperative tibial slope. Patients and Methods: This prospective cohort study was conducted on patients who presented with varus knee deformity and underwent biplanar MOWHTO and fixation by TomoFix plate during the period from March 2016 to March 2017. Assessment of patients included pre- and postoperative Knee and function scores, mechanical femorotibial angle (mFTA), posterior tibial slope angle (pTSA), range of motion (ROM) and radiological evaluation of the healing of the osteotomy site. Results: The recruited patients were 13 (8 men and 5 women), with average age 31.7 years old. The knee and functional scores improved from the preoperative mean of 45 and 41 to the postoperative mean of 85 and 72 points, respectively. The average knee flexion was 115 degrees, which at the final follow-up remained unchanged except for one case. The mean preoperative mFTA was 13.5° varus and decreased post-operatively to a mean of 3° valgus. The average postoperative follow-up period was 12 months (10 - 18 M). Conclusion: The biplanar MOWHTO allows preservation of posterior tibial slope while correcting the varus knee adequately.
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