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Search Results: 1 - 10 of 26 matches for " Ghnnam Wagih "
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Ghnnam Wagih
Journal of Cutaneous and Aesthetic Surgery , 2010,
Hypospadias algorithm: The way to propose
Ghnnam Wagih
Indian Journal of Plastic Surgery , 2010,
Rate of conversion and complications of laparoscopic cholecystectomy in a tertiary care center in Saudi Arabia
Ghnnam Wagih,Malek Jawid,Shebl Emad,Elbeshry Turky
Annals of Saudi Medicine , 2010,
Abstract: Background and Objectives : Problems during laparoscopic cholecystectomy include bile duct injury, conversion to open operation, and other postoperative complications. We retrospectively evaluated the causes for conversion and the rate of conversion from laparoscopic to open cholecystectomy and assessed the postoperative complications. Methods : Of 340 patients who presented with symptomatic gall bladder disease over a 2-year period, 290 (85%) patients were evaluated on an elective basis and scheduled for surgery, while the remaining 50 (14.7%) patients were admitted emergently with a diagnosis of acute cholecystitis. Results : The mean age of the patients was 41.9 (12.6) years. Conversion to laparotomy occurred in 17 patients (5%). The incidence of complications was 3.2%. The most common complication was postoperative transient pyrexia, which was seen in four patients (1.2%) followed by postoperative wound infection in three patients (0.9%), postoperative fluid collection and bile duct injury in two patients each (0.6%). Conclusion : Laparoscopic cholecystectomy remains the ′gold standard′ by which all other treatment modalities are judged. Conversion from laparoscopic to open cholecystectomy should be based on the sound clinical judgment of the surgeon and not be due to a lack of individual expertise.
Paraumbilical hernia repair during cesarean delivery.
Ghnnam Wagih,Helal Adel,Fawzy Muhammad,Ragab Ahmed
Annals of Saudi Medicine , 2009,
Abstract: Background and Objectives: Pregnant women with paraumbilical hernia usually postpone hernia repair until after delivery, but some patients request that it be done during cesarean delivery. Therefore, we evaluated the outcome of combined cesarean delivery and paraumbilical hernia repair in a prospective study at a tertiary referral university hospital. Patients and Methods: In a prospective study, we compared the outcome of 48 patients undergoing cesarean delivery combined with paraumbilical hernia repair versus 100 low-risk patients undergoing cesarean delivery alone. The main outcome measures were operation time, blood loss, severity of pain, peripartum com--plications, , hospital stay, hernia recurrence, and patient satisfaction. Results: The combined procedure took significantly longer than cesarean delivery alone (75.2 minutes versus 60.5 minutes, P< .001)). There were no major complications. Wound infection occurred in 6 patients (4.1%). Hospital stay did not differ significantly from those of controls. Pain at the hernia site repair occurred in two pa--tients, and one hernia recurred in the hernia repair group during a mean follow-up period of 22 months (range, 6-36 months). All hernia patients reported that they preferred the combined operation. Conclusions: Combined cesarean delivery and paraumbilical hernia repair had the advantage of a single in--cision, single anesthesia, and a single hospital stay while avoiding re-hospitalization for a separate hernia repair. Our results indicate that the combination approach is safe, effective, and well accepted.
Rhinolith: Delayed Presentation after Head Trauma—A Case Report
Ali S. Al Mastour,Wagih M. Ghnnam,Abdu H. Zubaidi
Case Reports in Otolaryngology , 2012, DOI: 10.1155/2012/492081
Rhinolith: Delayed Presentation after Head Trauma—A Case Report
Ali S. Al Mastour,Wagih M. Ghnnam,Abdu H. Zubaidi
Case Reports in Otolaryngology , 2012, DOI: 10.1155/2012/492081
Abstract: Rhinoliths are uncommon clinical entities reported in clinical practice as unusual cause of unilateral nasal obstruction and foul smell nasal discharge. Rhinolith is calcified material found in the nasal cavity incidentally or due to patient complaint. It should be suspected when patient presents with nasal symptoms and found to have stony mass showed radiologically. We reported a 28-year-old Saudi male with left sided (LT) nasal obstruction and foul smell discharge for 5 years suspected as being due to foreign body presence since childhood due to head trauma following car accident in sandy area. 1. Introduction Rhinoliths are calcified material around intranasal foreign body. They can be endogenous if occur around body tissues as tooth or exogenous if they occur around foreign subject as stones, cotton, or beads. They are found usually in anterior nasal cavity commonly associated with narrowing due to deviated septum, spurs, and/or turbinate hypertrophy. Endoscopic appearance is the main step in diagnosis which can be supported by radiology. Complete resolution of symptoms occurs after endoscopic surgical removal [1–3]. 2. Case History A 28-year-old Saudi male presented to ORL HNS clinic referred from another hospital for his complaint of left (LT) nasal obstruction and foul smell discharge for five years. Symptoms were progressively noticed and disturb the patient’s life in the last 3 years. He received multiple courses of antibiotics and nasal steroids with no benefit. He had no history of foreign body introduced into nasal cavity. He had history of head trauma after car accident at childhood in sandy area. Anterior rhinoscopy showed irregular hard material with crustations and thick secretions around, stuck between septal spur and inferior turbinate at LT anterior nasal cavity (Figure 1). Trials of removal in clinic failed causing epistaxis. Plain X-ray and CT scan showed dense irregular material at LT nasal cavity occupying floor without extension outside nasal cavity (Figure 2). Rhinolith was suspected then endoscopic removal done anteriorly after rhinolith was divided in two pieces and bleeding controlled (Figures 3 and 4). Then antibiotic ointment was applied in the place and patient given oral augmentin 625?mg three times daily along with nasal decongestant and analgesia for one week. Patient came to the clinic after one week later in better condition with dramatic improvement and resolution of symptoms. Figure 1: Rhinoscopy view of rhinolith (IT: inferior turbinate, S: septum, R: rhinolith). Figure 2: CT showing rhinolith. Figure 3: Rhinoscopy
Penetrating Neck Trauma in a Level II Trauma Hospital, Saudi Arabia
Wagih Mommtaz Ghnnam,Ali Saeed Al-Mastour,Mohamed Fayez Bazeed
ISRN Emergency Medicine , 2012, DOI: 10.5402/2012/672948
The Microbiology of Tonsils in Khamis Civil Hospital, Saudi Arabia
Mohammed S. Al Ahmary,Ali S. Al Mastour,Wagih M. Ghnnam
ISRN Otolaryngology , 2012, DOI: 10.5402/2012/813581
Abstract: Objectives. Tonsillitis is a common infection in all age groups, especially under the age of five. Organisms causing this condition vary from place to place. Our aim is to find out the main causative agents of this condition in our hospital. Patients and Methods. Fifty-two consenting patients who needed tonsillectomy in Khamis civil hospital, Kingdom of Saudi Arabia, between September 2006 and April 2007, were enrolled for the study. Swabs were taken from their inner surfaces and cultured for anaerobes and aerobes according to standard microbiological techniques. Results. Fifty-two patients, consisting of 30 males and 22 females were enrolled. Their mean age was . Nearly 65% of patients had positive cultures while 35% were negative. The commonest bacteria isolated were Staphylococcus aureus (44.1%); and Group B Streptococcus (35.3 %). Two Gram-negative bacteria, Klebsiella pneumoniae, (8.82%), and Pseudomonas aeruginosa (2.94 %), were also isolated. No anaerobe was isolated. Conclusion. Gram-positive cocci, consisting of Staphylococcus aureus and Group B Streptococcus (Streptococcus agalactiae), are the major causes of tonsillitis requiring surgery in our hospital. Antibiotic treatment of this condition should be directed largely against these organisms. 1. Introduction The lingual tonsils develop at 6.5 weeks between the second and third arches ventrally while palatine tonsils develop at 8 weeks from second pouch (ventral and dorsal) [1]. Tonsils are predominantly B-organs and B-lymphocytes comprise 50–60% of tonsillar lymphocytes [2]. T-cell lymphocytes comprise approximately 40% of adenoids and tonsillar lymphocytes [3]. Conversely, 70% of the lymphocytes in peripheral blood are T-cells [3]. Ample evidence shows that tonsils are involved in inducing secretory immunoglobulin production [4, 5]. Both adenoids and tonsils are favourably located to mediate immunologic protection of the upper aerodigestive tract as they are exposed to air borne antigens [2]. Tonsils are particularly designed for direct transport of foreign material from the exterior to the lymphoid cells [2]. The human tonsils are immunologically active between the ages of 4 and 10 years [2]. Involution of the tonsils begins after puberty, resulting in a decrease of the B cell population and a relative increase in the ratio of T to B cells [2]. The commonest indication for tonsillectomy is recurrent tonsillitis, which results in shedding the immunologically active cells and decreasing antigen transport function with subsequent replacement by stratified squamous epithelium [6, 7]. Recurrent
Elderly versus young patients with appendicitis 3 years experience
WM Ghnnam
Alexandria Journal of Medicine , 2012,
Abstract: Background: Appendicitis in the elderly continues to be a challenging surgical problem. Patients continued to present late with atypical presentations. Results might improve with earlier consideration of the diagnosis in elderly patients with abdominal pain, followed by prompt surgical operation. We aimed to present our experience with a series of elderly patients with acute appendicitis who were subjected to appendectomy to find out the difference in the course and outcome of acute appendicitis in elderly patients. Patients and methods: We reviewed medical records of elderly patients (aged >60 years) who underwent appendectomy for acute appendicitis at our hospital. Variables selected for analysis included age, sex, presenting symptoms, operative approach, operative findings, duration of hospitalization. Patients were compared to a control group, less than 31 years admitted during the same period. Results: Twenty-three patients’ records aged > 60 years with acute appendicitis were compared to a group of 40 patients aged< 30 years. There were significant differences between the two groups with regard to duration of symptoms preoperative hospital stay and total hospital stay. All young patients group had an uneventful postoperative recovery only two cases (5%) had wound infection. There was one death in the elderly group thus mortality rate was 4.3%. These two groups of patients showed significant differences in relation to the stage of disease at operation and postoperative complications. Elderly group of patients had perforated appendix in 16 cases (69.5%) while in group II patients eight cases (20%) had perforated appendix Conclusion: Acute appendicitis in the elderly remains a challenge for practicing surgeons and continues to be associated with high morbidity and mortality. Results might improve with earlier consideration of the use of CT abdomen for diagnosis in elderly patients with abdominal pain, followed by prompt surgical operation.
Fournier′s gangrene in Mansoura Egypt: A review of 74 cases
Ghnnam W
Journal of Postgraduate Medicine , 2008,
Abstract: Background: Fournier′s gangrene (FG), caused by synergistic aerobic and anaerobic organisms, is a life-threatening disorder in which infection of the perineum and scrotum (can affect penis alone) spreads along fascial planes, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. Materials and Methods: We analyzed 74 patients admitted to our institution′s emergency surgical unit presenting with FG between January 2002 and January 2007, considering the anatomical site of infective gangrene, predisposing factors, etiological agents, and outcomes. Results: All the 74 patients included in this study were males; their mean age was 51±10.8 years (21-72 years). The mean duration from the onset of symptoms to admission to the hospital was 3.74±2.09 days (1-8 days). The mean hospitalization time was 9.2± 6.6 days (1-31). Forty patients (54.05%) had FG secondary to anorectal conditions. No etiologic factors for FG were found in 27 patients (36.5%). Diabetes mellitus as a predisposing factor was found in 38 patients (51.35%). There was no definite predisposing factor in 24 patients (32.43%). The microbiological finding was polymicrobial in 48 patients (64.8%) and monomicrobial in 26 patients (35.1%). The most frequent bacterial organisms were Escherichia coli (75.6%). Simple sigmoid loop colostomy was done in one patient (1.4%). Unilateral orchidectomy was done in one case (1.4%). The overall mortality rate was 16 patients (21.6%). Conclusion: FG is a rapidly progressive, fulminant infection. Even with aggressive surgical and medical treatment, mortality of the disease is high. In the present cases, such a high ratio of 21.6% means that this disease is still serious and fatal in Egypt.
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