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Background: Breast conserving treatment (BCT) has become the standard treatment in early breast cancer; its goal is to provide a treatment as effective as mastectomy with the added benefit of a preserved breast. However, it is sometimes difficult to achieve good cosmetic results, particularly in patients with breast cancer located in the upper inner quadrant, for which the traditional conservative surgery results in a deformed breast. Aim of the work: To compare prospectively the oncoplastic results of inferior pedicle mammaplasty and doughnut mastopexy as techniques for early breast cancers located at the upper inner quadrant. Patients and Methods: This is a prospective randomized study on twenty female patients who were diagnosed to have early breast cancer located in the upper inner quadrant and are candidates for oncoplastic breast surgery. The study was conducted at Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants were obtained. Patient selection was achieved through a number of inclusion and exclusion criteria. Results: There is significant difference between the two groups as regards the operative time, intraoperative blood loss, hospital stay, total drainage volume, drainage days, postoperative complications, cosmetic outcome and the need for contralateral symmetrization. Inferior pedicle mammaplasty needs longer operative time and postoperative hospital stay and drainagy days with more intraoperative blood loss in comparison to Doughnut mastopexy. As regards the postoperative complications, we found that there are more complications in Inferior pedicle mammaplasty than Doughnut mastopexy as wound wound infection and dehiscence. Conclusion: Patients with early breast cancer located in the upper inner quadrant are candidate for either Inferior pedicle mammaplasty or Doughnut mastopexy. Doughnut mastopexy is better for them as there is less morbidity, better cosmesis, no need for contralateral symmetrization and fewer complications, so no delay in radiotherapy and Inferior pedicle mammaplasty needs more surgeon experience.

Background Amyotrophic lateral sclerosis (ALS) is the most common, fatal adult neuromuscular disease. It is a multi-system disorder characterized primarily by motor manifestations, but there is established evidence for cognitive and behavioral impairment, which is associated with poor prognosis, hence, the importance of tools for its assessment. The Edinburgh Cognitive and Behavioral Assessment Screen (ECAS) is an invaluable assessment tool for cognition in ALS-front temporal spectrum dementia (FTSD), as it accommodates physical challenges that usually confound traditional neuropsychological testing in those patients. Objective and methods To validate the Egyptian Arabic version of ECAS (ECAS-EG) based on the original English scale. This is a prospective study. The ECAS was adapted and administered to 62 Egyptian ALS patients and 60 healthy controls. Patients were recruited from the Neuromuscular Unit, Ain Shams University Hospital. The ECAS was adapted to Egyptian Arabic after being translated using the back translation method. Internal consistency of the test, inter-rater reliability, and construct validity were assessed. Results The Egyptian Arabic version of ECAS (ECAS-EG) showed good internal consistency using Cronbach’s alpha of 0.84. Inter-rater reliability was tested, values for all variables were compared, and no statistically significant differences were found (ICC = .997). ECAS-EG discriminated significantly between the patients from the control subjects (p-value of 0.001). There was a strong positive correlation between the ECAS-EG total score and the MoCA total score with a p-value of 0.001, thus indicating convergent validity. The test showed that 63% of Egyptian ALS patients were cognitively affected; most affected domains were executive functions and verbal fluency. Conclusion The current study proves that the Egyptian version of the ECAS (ECAS-EG) is valid and reliable among Egyptian ALS patients and it would be applicable to the general Arabic-speaking population.