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Background: The evolving thoracoscopy approach enhanced the thoracoscopic sympathectomy to become the surgical technique of choice for treating primary hyperhidrosis. Objective: To compare the results of 1ry hyperhidrosis patients treated by uniportal and biportal sympathectomy. Methods: In a Randomized control study, 36 cases were included complaining of signs and symptoms of hyperhidrosis, 18 of them underwent uniportal sympathectomy and 18 were managed by biportal sympathectomy in Cardio-thoracic Surgery Department, Faculty of Medicine, Zagazig University Hospitals. Results: There is a significant increase in operative time in the biportal group as compared to the uniportal one with p p-value < 0.0001. There is a significant increase in postoperative pneumothorax with p value = 0.0191 and intercostal chest tube insertion with p value= 0.0455 in the bipotal group. There is a significant increase in pain scores in the biportal group in comparison with the uniportal group. There is no significant difference in pain score between both groups after 3 months of the operation. There are no patients with pain scores of more than 1 after 3 months of the operation. There is a significant increase in patient satisfaction with the scar in the uniportal group compared to the biportal group with p value <0.0001 regarding the mean of both groups. Conclusion: Uniportal Video-Assisted Thoracoscopic Sympathectomy (VATS) sympathectomy may be better than biportal VATS sympathectomy in the management of primary Palmar hyperhidrosis as it takes less operative time with more patient satisfaction and minimal scar with minimal complication compared to biportal VATS sympathectomy. [ABSTRACT FROM AUTHOR]

Background: Diabetics represent an increasing proportion of patients undergoing coronary artery bypass graft (CABG). Glycosylated hemoglobin (HbA1C) is a key indicator for glycemic control. The degree of glycemic control is directly reflected in the outcome after CABG. Our study aims to analyze the early outcome concerning preoperative HbA1C levels. Methods: This prospective study evaluated the early outcome of 623 isolated elective CABG patients over 19 months. The patients were divided into group A (347 patients) with HbA1C < 7% and group B (276 patients) with HbA1C ≥ 7%. Postoperative renal failure, myocardial infarction, atrial fibrillation (AF), wound infection, cerebrovascular accidents, and 30-day mortality were recorded. Results: Baseline characteristics showed a non-significant difference between both groups. The mean age of patients in group A was 59.6 years, and in group B it was 59.5 years. The mean graft number was 3.35 and 3.32 for groups A and B, respectively. First-month death was 0.9% in group A and 1.4% in group B without a significant difference. The incidence of AF, superficial wound infection, and other site infections showed a statistically substantial difference between both groups. Conclusions: Increased levels of HbA1c, more than 7%, may be a potential risk factor for postoperative complications with a substantial rise in the risk of wound infections (superficial sternal and non-sternal surgical) and AF. [ABSTRACT FROM AUTHOR]

Background: The standard of treatment for treating individuals with severe left main stem and three-vessel coronary artery disease (CAD) is coronary artery bypass graft (CABG) surgery. Compared to medical care, it is linked to better survival. Objective: To compare the early effects of coronary artery bypass grafting on individuals with borderline vs decreased ejection fraction (EF). Patients and methods: This is a prospective study that included 61 patients with CAD who were subjected for CABG. The included patients were divided into 2 groups; HF with border line EF (HFbEF) group included 29 patients with borderline ejection fraction and HF with reduced EF (HFrEF) group included 32 patients in reduced ejection fraction. All patients were operated upon in Zagazig University Hospitals, Egypt and followed up during the period from September 2018 till September 2021. Each patient underwent: full history taking, thorough clinical examination, laboratory investigations and echocardiographic assessment. Results: There was great improvement of EF in HFrEF group exceeding HFbEF group. The EF at 6 months postoperative EF was 40.5±9.5% versus 43.2±7.85% in the HFbEF group versus in the HFrEF group respectively (p=0.151). Among borderline EF group there was no significant difference regarding EF before and after coronary artery revascularization (P-value= 0.34). There was a statistically significant improvement post-CABG regarding New York Heart Association (NYHA) classification among HFbEF group and HFrEF (P-value = 0.00004 and <0.0001, respectively). Conclusion: There was great improvement of systolic left ventricular EF in reduced ejection fraction group exceeding borderline EF group. [ABSTRACT FROM AUTHOR]