No abstract

Background The researchers are trying to evaluate the measurement of: Intact parathyroid hormone (iPTH) and serum total calcium (sCa) levels for predicting hypocalcemia after total thyroidectomy (TT). Methods The sample of this single center prospective study consists of (100) patients, where (77) females and (23) males with an age range between (28) and (65) (the mean level is, 48.17 ± 6.54). These selected patients underwent total thyroidectomy (TT) in the general surgery department, Benha university hospital from the period of June 2019 to February 2020. Levels of sCa and iPTH were measured aat several times preoperatively, 10 min, 48 h, 3, 6, 9 months, and 1 year after being after gone TT. Results Among the entire study sample, 23 patients (23%) developed transient hypoparathyroidism and hypocalcemia (˂8.5 mg/dl), none of them developed permanent hypoparathyroidism and hypocalcemia. The cut-off point of PTH has been 10 min after TT was at 23 pg/mL as it was the best compromise between sensitivity and specificity for predicting hypocalcaemia. It has been found that Patients who have a PTH greater than 23 pg/mL can be discharged safely after 24 h. Patients who have PTH of less than 23 pg/mL were observed for an additional 24 h, and the study found that timely treatment initiation is recommended. A PTH ˂ 10 pg/mL measured at 48 h after surgery had a sensitivity, specificity as well as an accuracy of 100%, for predicting hypocalcemia after TT. The accuracy of a single PTH concentration at 48 h was useful for predicting hypocalcemia [Area under receiver–operator characteristic curve (AUC) 1; confidence interval (CI), 95%, 0.85–0.94]. Conclusion Patients with iPTH ˂ 10 pg/mL, and sCa levels ˂ 7.4 mg/dL are at higher risk of developing hypoparathyroidism and hypocalcemia after TT.

No abstract

No abstract

Background: Anastomotic leakage (AL) considered as the most feared complication after colorectal resection surgery increasing morbidity, mortality and risk of recurrence among these patients. Therefore, early detection of AL is crucial. Biomarkers as procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WCC) provide an easy, safe and efficient methods for early detection of AL and follow up of the patients after discharge.Methods: This study included 130 patients presented with colonic or rectal cancer in the period from January 2018 to January 2021. This study was conducted in general surgery department, faculty of medicine, Benha university hospital. CRP, PCT and WBC count were measured pre-operatively, first, third, fifth and 7th day post-operative to detect the change in their levels when AL was diagnosed either by clinical, radiological or operative measures.Results: Among 130 patients, only 10 patients had AL. On POD-3, CRP and WCC values were significantly increased in AL patients while PCT was significantly elevated only from POD-5. The best cut-off value for CRP on POD-3 was >30.1 mg/l, reaching 90% sensitivity and 100% specificity for detecting AL while for WCC was >7.1× 109 cell/l, with 90% sensitivity and 72% specificity. The best cut-off value for PCT was in POD-5 which was >1.7 ng/ml with 100% sensitivity and 84% specificity.Conclusions: The analysis of CRP and WCC on POD-3 together with PCT serum concentrations on POD-5 is crucial for early detection of anastomotic leakage in either open or laparoscopic colorectal resection surgery.