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Nagib AM, Abbas MH, Abu-Elmagd MM, Denewar AAEF, Neamatalla AH, Refaie AF, Bakr MA. Long-term study of steroid avoidance in renal transplant patients: a single-center experience. Transplant Proc 2016; 47:1099-104. [PMID: 26036529 DOI: 10.1016/j.transproceed.2014.11.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/13/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Steroids have played a major role in renal transplantation for more than 4 decades. However, chronic use of steroids is associated with many comorbidities. This study aimed to assess the costs and benefits of a steroid-free immunosuppression regimen in a prospective randomized controlled study of living-donor renal transplantation, which was lacking in the literature. MATERIALS AND METHODS In our study, 428 patients were enrolled to receive tacrolimus (Tac), mycophenolic acid (MPA), basiliximab (Simulect, Novartis, Basel, Switzerland) induction and steroids only for 3 days (214 patients, study group) and steroid maintenance (214 patients, control group). Median follow-up was 66 ± 41 months. RESULTS We found that both groups showed comparable graft and patient survival, rejection episodes, and graft function. Posttransplantation hypertension was detected in 40% of the steroid-free group and 80% of the steroid maintenance group (P = .05), whereas posttransplantation diabetes mellitus was detected in 5% and 15% of these 2 groups, respectively (P = .3). CONCLUSIONS Among low-immunological-risk recipients of living-donor renal transplants, steroid avoidance was feasible, safe, and had less morbidity outcome using Simulect induction, then Tac and MPA as maintenance immunosuppression. Steroid avoidance was associated with a lower total cost despite comparable immunosuppression cost, which was attributed to the lower cost of associated morbidities.
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Affiliation(s)
- A M Nagib
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - M H Abbas
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M M Abu-Elmagd
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A A E F Denewar
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A H Neamatalla
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A F Refaie
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M A Bakr
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Abuelmagd MM, Nagib AM, Abuelmagd MM, Refaie AF, Elhindi YA, Ahmed MF, Ali MH, Elmaghrabi HM, Bakr MA. Study of the risk factors and complications of diabetes mellitus after live kidney donation. Transplant Proc 2015; 47:1152-7. [PMID: 26036542 DOI: 10.1016/j.transproceed.2014.11.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 11/13/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Kidney donors, similar to the general population, are at risk for developing type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been well studied. This work estimates the incidence of diabetes after kidney donation, and some risk factors and complications of diabetes mellitus postdonation. MATERIALS AND METHODS This study examined the records of 2267 donors who donated one of their kidneys between 1976 and 2014 at the Urology and Nephrology Center, Mansoura University, Egypt, and who were regularly followed up at its outpatient clinic. A total of 388 donors were included in the study, and their medical records were revised. RESULTS Postdonation weight gain and family history of diabetes mellitus were statistically significant for the development of diabetes mellitus, high or very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion and creatinine clearance decline in the studied group. CONCLUSIONS There is a significant impact of a family history of diabetes mellitus on the development of high or very high albuminuria and/or decreased creatinine clearance.
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Affiliation(s)
- Mohammed M Abuelmagd
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - A M Nagib
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Megahed M Abuelmagd
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A F Refaie
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Y A Elhindi
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M F Ahmed
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M H Ali
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - H M Elmaghrabi
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M A Bakr
- Department of Dialysis and Transplantation, the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Hamdy E, Abu Bakr M, Abd El-Hay A, Sisostris S, Anwar M, El Farouk O. Challenge and Successful Application for Scale Removal in Oil Field, Egypt: Field Study. All Days 2014. [DOI: 10.2523/iptc-18139-ms] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Water flooding is the hinge pin for Petrobel Oil Field. Water injection is supplied from shallow water supply wells. Compatibility tests, Petrographic Techniques and quantitative calculations of scale tendency using specific software had indicated probable deposition of calcium sulphate scale in the near-wellbore (Critical Matrix). Calcium sulphate scale, paraffin & was have been recognized to be a major operational problem. The bad consequences of scale formation& organic deposits comprised the contribution to flow restriction thus resulting in oil and gas production decrease. The nature of calcium sulphate scale is very hard and can't be dissolved with known dissolver. Sister companies that has similar problem were always going to the mechanical remover options which usually lead to further formation damage when invasion of formation rock by small particle sizes of the scale components.
Extensive lab and field work was conducted to determine the suitable chemicals to dissolve calcium sulphate scale.
The Production of Sidri formation which is currently contained 23 % of belayim land field OOIP (original oil in place) and currently contributes 27 % to the total oil production has been stopped dramatically in some wells.
Sidri formation exhibits a high degree of permeability, heterogeneity and increase water injection was done in some areas that lead to increase the possibility of forming scale, most of scale in Belayim onshore is calcium sulphate.
Precipitation of mixed organic/inorganic deposits (Calcium Sulfate Scale) resulted in decreasing the permeability in the critical matrix and perforation tunnels. Scale formed in the near-wellbore reduces oil production by blocking the narrow pore throats of the matrix itself
This paper highlights Petrobel first application by using the new innovation product SCSR in Belayim land field (Sidri formation), its success and results based on extensive lab studies, SCSR was tested and applied through an effective treatment strategy proposed to remove the scale efficiently; the program was designed taking into consideration the nature of the scale. Furthermore the proposed treatments were conducted and placed using coiled tubing (CT).
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Abstract
BACKGROUND The risk of skin infections in renal transplant recipients (RTRs) has been described previously; however, it differs markedly by ethnic groups, skin type, and geographical location. We investigated the prevalence and nature of skin infections in a large series of RTRs in our locality in Egypt. PATIENTS AND METHODS A total 302 RTRs (216 males and 86 females) were included in this study. They were screened for the presence of bacterial, fungal, and viral skin infections depending on clinical signs, Woods lamp examinations, culture, and biopsy if indicated. The patients were compared with 300 healthy controls matched for age and sex (200 males and 100 females). RESULTS We found 191 (63.25%) RTRs had some kind of skin infection. Folliculitis (10.3%), tinea versicolor (30.1%), dermatophytosis (19.5%), and onychomycosis (7.6%) were statistically significantly more common in RTRs compared with control subjects. CONCLUSION Our RTRs have higher prevalence rates of folliculitis and superficial fungal infections than the healthy population and they should be searched for in every patient with renal transplantation to ensure early treatment and avoid complications. Low-dose ketoconazole should be considered in renal transplant populations with high rates of superficial fungal infections, as it may reduce risk of such infections.
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Affiliation(s)
- N I Bakr
- Dermatology and Andrology Department, Students' Hospital, Mansoura University, Mansoura, Egypt
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5
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Ghanem ME, El-Baghdadi LA, Badawy AM, Bakr MA, Sobhe MA, Ghoneim MA. Pregnancy outcome after renal allograft transplantation: 15 years experience. Eur J Obstet Gynecol Reprod Biol 2005; 121:178-81. [PMID: 16009483 DOI: 10.1016/j.ejogrb.2004.11.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To present our 15 years' experience in the management of 67 pregnancies in renal allograft recipients in Egypt. METHODS A retrospective study of 67 pregnancies that occurred in 41 renal allograft recipients over the last 15 years. The study was performed in Department of Obstetrics & Gynecology, and Nephrology & Urology Center at Mansoura University, Egypt. RESULTS Gestational diabetes occurred in 5.7%, infection in 13.4% and proteinuric hypertension in 19.2% of pregnancies. Graft dysfunction and obstructive uropathy occurred in 30.7% and 9.6% of pregnancies, respectively, but no episodes of graft rejection were reported. Pre-term labour was found in 40.9% and fetal growth retardation occurred in 19.2% of pregnancies. Perinatal mortality was in the order of 9.6%. Pregnancy outcome was better in non-cyclosporine group, in non-proteinuric hypertensive groups and in repeated pregnancies compared to the counter groups. CONCLUSION Although pregnancy in renal transplant recipients is high-risk, successful outcome is expected for singleton pregnancy and is even better with repeated pregnancies in those cases with stable and good graft function. This satisfactory outcome is generally achieved if the graft is stable and the post-transplant interval is more than 2 years.
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Affiliation(s)
- M E Ghanem
- Department of Obstetrics & Gynaecology, Mansoura University Hospitals, Mansoura University, Egypt
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Abbas EE, Afioni N, Al Wakeel J, Bakr MA, Dham R, Donia A, Droubi N, Khidir E, Mathew CM, Mitwali AH, Naga S, Pingle A, Rashed A, Roshdy A, Shaheen F, Shaibani B, Shaibani FM, Shaker DS, Sheiban A, Solieman M. The new rHuEPO alpha (epotin) in the management of anemia of end-stage renal disease in patients on maintenance hemodialysis. Transplant Proc 2005; 36:1805-11. [PMID: 15350482 DOI: 10.1016/j.transproceed.2004.07.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Recombinant human erythropoietin has proved to be effective to treat anemia of end-stage renal disease (ESRD). The aim of this study was to assess the efficacy and safety profile of Epotin, a rHuEPO produced in the Middle East. One hundred thirty patients with Hct </= 27%; Hb </= 9 g/dL maintained on hemodialysis thrice weekly from 19centers in eight countries in the Middle East were recruited into this 13-week study. Depleted iron stores (TSTAT <20% and/or Serum ferritin < 100 microg/dL) were replenished prior to initiation of Epotin therapy, which was delivered intravenously in a dose of 150 U/kg body weight/week in three equal doses postdialysis and titrated according to hemoglobin (Hb) and hematocrit (Hct) response. Efficacy was assessed in terms of Hb/Hct response. Epotin raised the mean Hb level from 7.7 (+/- 1.2) g/dL to 12.0 (+/- 1.7) g/dL and Hct from 22.7 (+/- 4.1) % to 36.2 (+/- 5.7) % by week 13. The increase started to show significance at week 3. Targeting an absolute increase in Hb of 2.5 g/dL (Hct 7.5%) over a 13-week period, the success rate was of <85.71%. Segregating patients into subgroups of men and women and chronic ESRD versus recent ESRD failed to reveal a significant differences in either the severity of the anemia or the response to Epotin. Side effects were similar to other erythropoietins; no dropouts were reported. In conclusion, Epotin is effective to treat anemia in patients on maintenance hemodialysis with an acceptable safety profile. No difference in response was observed between men and women, nor between patients with different levels of chronicity of ESRD.
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Affiliation(s)
- E E Abbas
- SaifBin Gobash Hospital, Ras Alkhaima, UAE.
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7
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Ghoneim MA, Bakr MA, Hassan N, Wahba I, Fouda AS, Sobh MA, Shehab el-Dein AB, Shokeir AA, el-Mekresh MM, Ali-el-Dein B, Osman YM, Moustafa A, el-Chenawi F. Live-donor renal transplantation at the Urology & Nephrology Center of Mansoura: 1976-1998. Clin Transpl 2002:167-78. [PMID: 12211779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Based on more than 1,200 living donor transplants performed at the Urology & Nephrology Center at Mansoura University between 1976-1998, we report: 1. The overall graft survival rate was 75.8% and 51.9% at 5 and 10 years, respectively, with a projected half-life of 10.7 years. 2. Three factors acted as independent variables that significantly influenced graft survival: the number of HLA mismatches, the number of acute rejection episodes and the presence of posttransplant hypertension. a. Grafts with 2 or fewer HLA-A, -B and -DR mismatches had a significantly better survival rate. b. The incidence and the number of early acute rejection episodes had a significant negative impact on graft survival. c. A significant reduction in graft survival was associated with hypertension uncontrolled by or newly developed after transplantation. 3. Bilharziasis had no impact on the outcome. 4. Despite improvements in tissue matching and immunosuppression, an important proportion of grafts is still lost following living-donor kidney transplantation. 5. Efforts must be directed to identify better regimens, which can provide adequate immunosuppression and minimal nephrotoxicity.
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Affiliation(s)
- M A Ghoneim
- Department of Urology, Division of Nephrology, Division of Clinical Immunology, Urology & Nephrology Center, Mansoura, Egypt
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8
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Barsoum R, Bakr MA. The Egyptian renal transplant experience. Clin Transpl 2001:359-60. [PMID: 11512334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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9
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Sobh MA, Hamdy AF, El Agroudy AE, El Sayed K, El-Diasty T, Bakr MA, Ghoneim MA. Coadministration of ketoconazole and cyclosporine for kidney transplant recipients: long-term follow-up and study of metabolic consequences. Am J Kidney Dis 2001. [PMID: 11228175 DOI: 10.1053/ajkd.2001.22075] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In a prospective randomized study including 100 kidney transplant recipients, we previously reported on the safety and financial benefits of the coadministration of ketoconazole (keto) to cyclosporine (CsA)-treated kidney transplant recipients. In this study, we report on the long-term follow-up of these patients and their control group, as well as possible metabolic consequences of this drug combination. Evaluation of 51 keto-treated patients and their control group (49 patients) included graft function, lipogram, fasting blood glucose, liver function tests, serum calcium, phosphorus, and radiological and histopathologic assessments. Follow-up of these patients for 54 months showed that the CsA dose reduction was 72.9% at 12 months, decreased to 69.3% at the last follow-up. We also found that the mean keto dose required for CsA dose reduction decreased to 82.8 +/- 24.1 mg/d compared with the starting dose (100 mg/d). Diagnosis of acute rejection episodes was similar in both groups. However, in the control group, rejection episodes were more recurrent, with poorer response to treatment. Acute CsA nephrotoxicity was more common in the keto group, but this was encountered more at keto induction and was rapidly reversed on further reduction of CsA doses. Chronic graft dysfunction was statistically significantly less in the keto group during the first year. However, by the end of the study, the difference was not statistically significant. In this study, hepatotoxicity was similar in the two groups. On studying the metabolic consequences, we found that serum cholesterol, low-density lipoprotein, and triglyceride levels were lower in the keto group. Bone mineral contents in both groups were less than the mean values for age- and sex-matched healthy controls. From this study, we conclude that long-term use of low-dose keto in CsA-treated kidney transplant recipients is safe and cost-saving and may induce better graft function. Bone mineral contents, vitamin D blood levels, and lipid profiles are not affected by long-term keto coadministration in CsA-treated kidney transplant recipients.
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Affiliation(s)
- M A Sobh
- Urology and Nephrology Center, University of Mansoura, Mansoura, Egypt
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10
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Sobh MA, Hamdy AF, El Agroudy AE, El Sayed K, El-Diasty T, Bakr MA, Ghoneim MA. Coadministration of ketoconazole and cyclosporine for kidney transplant recipients: long-term follow-up and study of metabolic consequences. Am J Kidney Dis 2001; 37:510-7. [PMID: 11228175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In a prospective randomized study including 100 kidney transplant recipients, we previously reported on the safety and financial benefits of the coadministration of ketoconazole (keto) to cyclosporine (CsA)-treated kidney transplant recipients. In this study, we report on the long-term follow-up of these patients and their control group, as well as possible metabolic consequences of this drug combination. Evaluation of 51 keto-treated patients and their control group (49 patients) included graft function, lipogram, fasting blood glucose, liver function tests, serum calcium, phosphorus, and radiological and histopathologic assessments. Follow-up of these patients for 54 months showed that the CsA dose reduction was 72.9% at 12 months, decreased to 69.3% at the last follow-up. We also found that the mean keto dose required for CsA dose reduction decreased to 82.8 +/- 24.1 mg/d compared with the starting dose (100 mg/d). Diagnosis of acute rejection episodes was similar in both groups. However, in the control group, rejection episodes were more recurrent, with poorer response to treatment. Acute CsA nephrotoxicity was more common in the keto group, but this was encountered more at keto induction and was rapidly reversed on further reduction of CsA doses. Chronic graft dysfunction was statistically significantly less in the keto group during the first year. However, by the end of the study, the difference was not statistically significant. In this study, hepatotoxicity was similar in the two groups. On studying the metabolic consequences, we found that serum cholesterol, low-density lipoprotein, and triglyceride levels were lower in the keto group. Bone mineral contents in both groups were less than the mean values for age- and sex-matched healthy controls. From this study, we conclude that long-term use of low-dose keto in CsA-treated kidney transplant recipients is safe and cost-saving and may induce better graft function. Bone mineral contents, vitamin D blood levels, and lipid profiles are not affected by long-term keto coadministration in CsA-treated kidney transplant recipients.
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Affiliation(s)
- M A Sobh
- Urology and Nephrology Center, University of Mansoura, Mansoura, Egypt
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11
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Refaie A, Sobh M, Moustafa F, Bakr MA, El-Mekresh M, Farahat S, Ghoneim MA. Living-related-donor kidney transplantation outcome in recipients with primary focal-segmental glomerulosclerosis. Am J Nephrol 2000; 19:55-9. [PMID: 10085451 DOI: 10.1159/000013426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We studied the outcome of renal transplantation in 30 patients with primary focal-segmental glomerulosclerosis (FSGS) and in 30 controls in whom renal failure was secondary to nonglomerular renal diseases. All patients received living-related-donor kidneys, and the majority had one-haplotype HLA matching. Within the follow-up period, the mean serum creatinine values were significantly higher in FSGS recipients as compared with the control group (p = 0.02). However, the frequency of acute rejection episodes and the mean blood pressure values were not significantly different between the two groups. There was a tendency of a higher incidence of proteinuria among FSGS recipients in comparison with the controls. Moreover, nephrotic-range proteinuria occurred only in 3 recipients of the FSGS group. Recurrence of FSGS was morphologically documented in 2 recipients 7 and 18 months, respectively, after transplantation. It is concluded that FSGS as the primary disease has a negligible impact on the living-related-donor kidney transplantation in the Egyptian population. Therefore, this disease should not discourage transplantation for this group of patients.
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Affiliation(s)
- A Refaie
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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12
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Donia AF, Sobh MA, Moustafa FE, Bakr MA, Foda MA. Clinical significance and long-term evolution of minimal change histopathologic variants and of IGM nephropathy among Egyptians. J Nephrol 2000; 13:275-81. [PMID: 10946807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
In children, the most frequent idiopathic nephrotic syndrome is minimal change nephrotic syndrome (MCNS). Typically, MCNS shows no abnormalities by light microscopy: "nil disease". Beside this classic picture, there are other minor light microscopic abnormalities which are considered as MCNS variants. Our 172 MCNS patients were divided into a nil disease group, two groups of MCNS variants (mild mesangial hypercellularity and mild mesangial thickening) and a fourth group with normal light microscopy and diffuse IgM deposition (IgM nephropathy group). The relation of this fourth group to MCNS is controversial in the literature. Age and serum creatinine were significantly different in the four histologic groups (P=0.03 for age and 0.047 for serum creatinine). Comparing the groups in pairs, it appeared that these significant differences were due to significantly higher age and serum creatinine in the mild mesangial hypercellularity group than in the IgM nephropathy group (P = 0.02 for age and 0.01 for serum creatinine). The groups were similar as regards follow-up creatinine clearance and early and late steroid response. We concluded that mild mesangial hypercellularity may differ from other MCNS forms as regards age at presentation and renal function. We also suggest that IgM nephropathy with normal light microscopy is similar to MCNS.
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Affiliation(s)
- A F Donia
- Urology and Nephrology Center, University of Mansoura, Egypt
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13
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Khosh-Chashm K, Shabanah MH, Bakr MA, Menessy W, Mansour AO. Alexandria Healthy City and Women's Development Project. East Mediterr Health J 1999; 5:811-5. [PMID: 11338703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- K Khosh-Chashm
- Research Institute for Soil, Water and Environment, Alexandria, Egypt
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14
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Abstract
A high-performance liquid chromatographic system with automated precolumn extraction was developed for the determination of propofol in human serum. Propofol of directly injected serum sample was enriched on a protein-coated mu Bondapak phenyl precolumn while serum constituents such as proteins and salts were eluted to waste. Thereafter, using an on-line column-switching system, the drug was quantitatively transferred and separated on a second analytical column followed by spectrophotometric determination at 270 nm. Good precision, accuracy and linearity were obtained over a range of 30-3000 ng/mL propofol in human serum. The developed method proved to be fast, simple, reproducible, reliable and therefore convenient for propofol monitoring from serum. The recovery of propofol in serum samples from the lowest to the highest concentration ranged from 96.84 to 100.16% (n = 5). The assay was applied to study the pharmacokinetic of the drug in six women undergoing elective caesarean section under general anaesthesia induced with a single intravenous bolus dose of propofol (2.5 mg/kg).
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Affiliation(s)
- S Emara
- Department of Analytical Chemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
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15
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Fouda AM, Sobh MA, Moustafa F, Sally S, Bakr MA, Refaei A, EI-Mekresh MM, Azab ME, Ghoneim MA. Hyperechogenic renal parenchyma in potential live related kidney donors: Does it justify exclusion. AJN 1998. [DOI: 10.21804/2-1-857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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16
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Mahmoud IM, Gabr MM, Refaie AF, el-Baz MA, Bakr MA, Ghoneim MA. Purified murine islet allografts: islet engraftment as influenced by implantation site and glucotoxicity. Transplant Proc 1998; 30:369-72. [PMID: 9532085 DOI: 10.1016/s0041-1345(97)01313-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- I M Mahmoud
- Urology and Nephrology Center, Mansoura University, Egypt
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17
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Refaie A, Gabr M, Mahmoud I, Bakr MA, el-Baz M, Ghoneim MA. Experimental islet cell transplantation in rats: optimization of the transplantation site. Transplant Proc 1998; 30:400-3. [PMID: 9532101 DOI: 10.1016/s0041-1345(97)01328-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A Refaie
- Urology and Nephrology Center, Mansoura University, Egypt
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18
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Affiliation(s)
- M A Bakr
- Urology and Nephrology Center, Mansoura University, Egypt
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19
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Bakr MA, el Said Ghaneim M, Fouda MA, Sally S, Moustafa FE, Sobh MA, Ghoneim MA. Clinical course and outcome of pregnancies in recipients of renal allografts. Transplant Proc 1997; 29:2787-9. [PMID: 9365563 DOI: 10.1016/s0041-1345(97)00679-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M A Bakr
- Urology & Nephrology Center, Mansoura, Egypt
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Affiliation(s)
- M A Bakr
- Urology & Nephrology Center, Mansoura University, Egypt
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Bakr MA, Sobh M, el-Agroudy A, Sally S, Fouda MA, el-Mekresh M, Moustafa F, el-Baz M, Wafa E, Ghoneim MA. Study of malignancy among Egyptian kidney transplant recipients. Transplant Proc 1997; 29:3067-70. [PMID: 9365669 DOI: 10.1016/s0041-1345(97)00785-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M A Bakr
- Urology and Nephrology Center, Mansoura, Egypt
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22
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Affiliation(s)
- M A Bakr
- Urology & Nephrology Center, Mansoura University, Egypt
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23
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Bakr MA, Foda MA, Sally S, Sobh MA, Ghoneim MA. ATG in steroid-resistant acute rejection in living related kidney transplantation: long-term evaluation. Transplant Proc 1994; 26:3161-2. [PMID: 7998103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M A Bakr
- Urology & Nephrology Center, Mansoura, Egypt
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24
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Bakr MA, Sally S, Foda MA, Sobh MA, el-Sherif AK, Ghoneim MA. Different trends in immunosuppression: 10 years' experience with cyclosporine after living related donor renal transplantation. Transplant Proc 1994; 26:3163-6. [PMID: 7998104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M A Bakr
- Urology & Nephrology Center, Mansoura, Egypt
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25
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Shokeir AA, Shamaa MA, Bakr MA, el-Diasty TA, Ghoneim MA. Salvage of difficult transplant urinary fistulae by ileal substitution of the ureter. Scand J Urol Nephrol 1993; 27:537-40. [PMID: 8159928 DOI: 10.3109/00365599309182291] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report our experience with 4 cases of ileal substitution of the ureter after live-donor kidney transplantation and review the literature. The indications were recurrent ureteric fistula and obstruction in 3 cases and extensive necrosis of the ureter and renal pelvis in one case. Nephrostomy tube drainage was a useful adjunct to diagnosis and treatment of the 4 cases. No mortalities or graft losses were encountered and satisfactory graft function was maintained 2-14 years after ileal substitution of the ureter. Moreover, no electrolyte or acid-base disturbances were observed. One patient developed recurrent vesical stones 2 and 4 years after ileoureteral replacement secondary to bladder neck obstruction. Ileal substitution of the ureter seems a feasible operation to salvage difficult and recurrent transplant urinary fistulae in exceptional situations when it is impossible to restore urinary continuity using urinary tract tissues.
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Affiliation(s)
- A A Shokeir
- Urology & Nephrology Center, Mansoura, Egypt
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26
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Shokeir AA, Gad HM, Shaaban AA, el-Kenawy MR, el-Sherif A, Shamaa MA, Bakr MA, Ghoneim MA. Differential kidney scans in preoperative evaluation of kidney donors. Transplant Proc 1993; 25:2327-9. [PMID: 8516916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A A Shokeir
- Urology and Nephrology Center, Mansoura, Egypt
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27
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Bakr MA, Foda MA, Shokeir AA, Mostafa A, Sobh MA, Ghoneim MA. Haemolytic anaemia after ABO-mismatched living-donor kidney transplants. Transplant Proc 1993; 25:2297-8. [PMID: 8516906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M A Bakr
- Urology and Nephrology Center, Mansoura, Egypt
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28
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Shokeir AA, el-Diasty TA, Bakr MA, Eraky I, Shamaa MA, Ghoneim MA. Ureteric complications of renal transplantation: role of percutaneous techniques. Transplant Proc 1993; 25:2303-4. [PMID: 8516908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A A Shokeir
- Urology and Nephrology Center, Mansoura, Egypt
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29
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Ghoneim MA, Sobh MA, Shokeir AA, Bakr MA, el-Sherif A, Foda MA. Prospective randomized study of triple vs conventional immunosuppression in living donor kidney transplantation. Transplant Proc 1993; 25:2243-5. [PMID: 8516887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M A Ghoneim
- Urology and Nephrology Center, Mansoura University, Egypt
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30
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Shokeir AA, Shamaa MA, Bakr MA, Eraky I, Ghoneim MA. Ileal ureter in renal transplant recipients. Transplant Proc 1993; 25:2339-40. [PMID: 8516920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A A Shokeir
- Urology and Nephrology Center, Mansoura, Egypt
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31
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Ghoneim MA, Sobh MA, Shokeir AA, Bakr MA, el-Sherif AK, Fouda MA. Prospective randomized study of azathioprine versus cyclosporin in live-donor kidney transplantation. Am J Nephrol 1993; 13:437-41. [PMID: 8141177 DOI: 10.1159/000168660] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A total of 112 recipients of haploidentical live-related donor kidney transplants were assigned randomly prior to transplantation to two groups of immunosuppressive treatment. The first group (54 patients) received the conventional immunotherapy of azathioprine (AZA) and prednisolone (P; AZA-P group). In the second group, 58 patients were given cyclosporin (Cs) and P (Cs-P group). All patients had previous third-party blood transfusions. The follow-up period ranged from 3 to 6 years (mean 50 +/- 8 months) during which 13 patients (24%) in the AZA-P group and 6 (10%) in the Cs-P group were switched to the alternate immunotherapy (p > 0.05). Analysis of patient and graft survival along the follow-up period did not disclose significant differences between patients of the two groups. While the overall frequency of acute rejection episodes was not significantly different between the two treatment groups, the number of patients who had 2 or more rejection episodes was higher in the AZA-P group (p < 0.04). The mean serum creatinine levels were significantly higher in the Cs-P group than corresponding levels in the AZA-P group at 1, 12 and 24 months after transplantation. We have concluded that at least 75% of the haploidentical human lymphocyte antigen mismatched live-related donor renal transplants can be maintained on AZA-P immunotherapy with a comparable degree of success to those treated with Cs-P. However, in at least 15% of patients with conventional immunotherapy, Cs could reverse ongoing rejections, and therefore, it can be considered as a rescue treatment in AZA-treated patients with steroid-resistant or ongoing rejections.
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Affiliation(s)
- M A Ghoneim
- Urology and Nephrology Center, Mansoura University, Egypt
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Ghoneim MA, Sobh MA, Shokeir AA, Bakr MA, el-Sherif AK, Fouda MA. Cyclosporin in primary haploidentical live-donor kidney transplantation: is it worthwhile? Nephrol Dial Transplant 1993; 8:551-6. [PMID: 8394538 DOI: 10.1093/ndt/8.6.551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Two consecutive prospective randomized trials were performed to study three immunosuppressive protocols in 195 kidney transplant recipients. Only adult primary renal transplant recipients with one haplotype HLA mismatch were included. All patients received kidneys from living related donors and had previous donor non-specific blood transfusions. Study I included 112 recipients who were randomly assigned to receive either azathioprine (Aza) and prednisolone (P) (n = 54) or cyclosporin (CsA) and P (n = 58). Patients in this study were followed up for 3-6 years (mean 50 +/- 8 months). Study II included 83 recipients who were randomly assigned to receive either triple therapy of Aza-CsA-P (n = 41) or conventional therapy of Aza-P (n = 42). Patients in this study were followed up for a period of 32 +/- 10 (range 26-43) months. Analysis of data in the two studies demonstrated the absence of statistically significant differences in graft or patient survival rates over short- and long-term follow-up periods among recipients of the conventional immunotherapy and those receiving the CsA-P or the triple therapy. The overall frequency of acute rejection episodes was not significantly different between the two treatment groups of each study. Serum creatinine was significantly higher in the CsA-P group while the incidence of infection was significantly lower in the triple group. When switching from one regimen to another is considered, at least 75% of the one-haplotype HLA mismatched live-related donor renal transplants could be maintained on conventional immunotherapy with comparable degree of success to those treated with the CsA-P or the triple therapy. However, in at least 15% of patients with conventional immunotherapy, CsA could reverse ongoing rejections and can therefore be considered as a rescue treatment.
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Affiliation(s)
- M A Ghoneim
- Urology and Nephrology Center, Mansoura University, Egypt
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Shokeir AA, Bakr MA, el-Diasty TA, Sobh MA, Moustafa FE, el-Agroudi AE, Ghoneim MA. Urological complications following live donor kidney transplantation: effect of urinary schistosomiasis. Br J Urol 1992; 70:247-51. [PMID: 1422682 DOI: 10.1111/j.1464-410x.1992.tb15725.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Urological complications were studied in 310 live donor kidney transplants. All recipients and donors were investigated for urinary schistosomiasis by examining tissue obtained intra-operatively from the donor's ureter or the patient's bladder. Schistosomiasis was histologically documented in 76 cases (patient's bladder (46), donor's ureter (9), both (21)). The incidence of urological complications was 11/76 (15%) in the schistosomal group and 14/234 (6%) in the non-schistosomal group; this was statistically significant. Among the schistosomal patients, the site of infestation had no statistically significant effect on the incidence of urological complications. No deaths or graft losses were directly attributable either to these complications or to their surgical correction.
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Affiliation(s)
- A A Shokeir
- Urology and Nephrology Centre, Mansoura University, Egypt
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Shokeir AA, Sobh MA, Bakr MA, Ghoneim MA. [Vesico-ureteral reimplantation in kidney transplantation from living relative donor: extravesical or transvesical? Urologic complications and long-term results evaluation]. Prog Urol 1992; 2:241-8. [PMID: 1302060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Results of two techniques of ureteroneocystostomy were evaluated in a series of 400 consecutive living renal transplantations. In the first 150 patients (group A) PAQUIN ureteroneocystostomy was utilized and in the second 250 (group B) DE CAMPOS-FREIRE technique was performed. Significant urological complications were seen in 13 (8.6%) patients of group A and in 10 (4%) of group B. Bladder leak occurred in 5 patients of group A and in only 1 of group B (P < 0.05). Complications related to ureteral stenosis and ureteral necrosis were comparable in the two groups. High pressure vesicoureteral reflux was demonstrated in 2 of 85 patients of group A and in 15 of 160 of group B (P < 0.05). Abnormalities of intravenous urography were significantly higher in group A. The incidence of immediate and delayed post-transplant urinary infection was not statistically different among the two groups. We advocate the use of DE CAMPOS-FREIRE approach over the PAQUIN reimplantation, not only because of the marginal differences in the incidence of urological complications, but also because of the technical advantages offered by the former approach.
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Affiliation(s)
- A A Shokeir
- Urology & Nephrology Center, Mansoura, Egypte
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Pamfamirov IK, Rybalka AN, Kichikkhanov SS, Bakr MA. [Modification of the ovary demedullation method in sclerocystic ovary syndrome]. Akush Ginekol (Mosk) 1991:64-5. [PMID: 1746707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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