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Background: The mitral valve has been traditionally approached through a median sternotomy. However, significant advances in surgical optics, instrumentation, tissue tele ma-nipulation, and perfusion technology have allowed for mitral valve surgery to be performed using progressively smaller incisions including the minithoracotomy.Aim of Study: To compare the surgical outcome of right anterolateral minithoracotomy and median sternotomy in mitral valve replacement.Patients and Methods: This study was done in department of Cardiothoracic surgery at El-Hussen Hospital, Al-Azhar University, after approval of the local ethical committee in the period between December 2016 till December 2017.30 patients with MVD requiring mitral valve surgery were included in the study for operative and short term postoperative results to evaluate the impact of two approaches of replacement on functional status and Quality of Life of those patients who survived the operation will be studied.Results: The thirty patients were divided into two groups where fifteen patients underwent mitral valve surgery via Rt anterolateral minithoracotomy operations rely on direct vision (6-12cm) with femoral artery and vein cannulation, these patients had better cosmoses in the early and the short term postoperative period.Conclusion: It is obvious that not only better cosmoses drive surgeons to perform less invasive cardiac surgical procedures but the less invasive procedures are also intended to minimize harm to patients by reducing blood loss, reducing the amount of blood transfusion, reducing the danger of infection by minimizing wound dimensions, thereby shortening the patient's ICU and hospital stay.

Hepatitis C virus (HCV) is a major public health problem worldwide, which causes high rate of chronic liver disease such as liver cirrhosis and hepatocellular carcinoma. Plasma transforming growth factor Beta-1 (TGFB-1) is a member of large family of peptides, which has a major regulatory role in hepatic fibrosis and cirrhosis. The study evaluated the role of transforming growth factor Beta-1 (TGFB-1) in induction of fibrosis in liver parasites-free HCV patients with related steatohepatitis. Thirty HCV patients who were clinically and serologically positive were selected. They were diagnosed as fatty liver by abdominal ultrasonography; steatohepatitis and confirmed by histopathological biopsies examination. ELISA evaluated plasma transforming growth factor Beta-1 (TGFB-1) level. Also, 12 cross-matched subjects clinically, parasitologically and serologically free were used as a controls. The level of plasma transforming growth factor Beta-1 (TGFB-1) was highly elevated in the patients versus controls with mean +/- SD 18739.86 +/- 18539.46 and 6465 +/- 1142 respectively (P0.001). The TGFB-1 level in HCV related steato-hepatitis was elevated in all grades in contrast to controls (P0.05), without relation between the TGFB-1 levels and steatohepatitis severity. The TGFB-1 level showed high significant difference in all stages of fibrosis in patients in contrast to controls and the TGFB-1 level was very high when fibrosis started in stage I (P0.01) and tended to decrease in fibrosis of stage 23 (P0.05). There was highly significant positive correlation between TGFB-1 and body mass index (BMI) r = 0.774.

This work studied the role of parasitic infection among 85 chronic diarrheic patients in Delta region and cross-matched 20 normal controls. They were subjected to thorough history taking and clinical examination and stool examination by direct smear, formol-ether concentration, simple sedimentation, simple floatation and Kato-katz thick smear. Questionnaire sheet was obtained for each case included personal history, complaint, present as well as past history and family history. The results showed that 67.1% of patients suffered from parasites versus 20% in controls. They included giardiasis mixed with hymenolepiasis nana, ameobiasis, ascariaisis, S. mansoni, heterophyiasis, B. homninis, Taenia spp and enterobiasis respectively. Single infection represented 54.2 %, while mixed ones were 12.9% of total chronic diarrhea cases and non parasitic causes were responsible for 32.9%. Mixed infection was common in A. lumbricoides with E. histolytica (18.18%) and H. nana with G. lambia (27.28%). The diarrhea duration was longer in mixed infections (3 months), E. histolytica (2 months) and H. nana (1.5 months). Commonest symptom other than diarrhea was abdominal pain mainly in mixed parasitosis. Parasitic diarrhea was more common in males than females (1.28: 1). Chronic parasitic diarrhea was most prevalent among low social class (49 or 57.6%) followed by very low social class (20 or 23.5%), middle social class (10 or 11.7%) and finally high social class (6 or 7.1%) with significant increase in low social class as compared to high one, and most prevalent among positive cases in rural area than in urban area.