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International Journal of Advanced Biomedicine



Can Variceal Band Ligation (VBL) Improve MELD Score for patients awaiting for liver transplantation?

Ali Ismael, Elsayed A. El Gohary, Abdallah Nawara, Mohammad M. Sallam, Khaled Abdel-Azeem, Abd Elrazek Abd Elrazek,
Abstract :
Background: Esophago-gastric varices are abnormal distended veins usually seen in the esophagus (esophageal varices) and less commonly in the stomach (gastric varices) or in other sites (ectopic varices), bleeding such varices prior to liver transplantation may increase the MELD associated co-morbidities and even mortalities, hence Liver operation may cancelled in different situations, Nevertheless (VBL) should be optimized critically to improve overall success. Aim: Evaluated prophylactic (VBL) may have a beneficial role improving MELD score for those awaiting for Liver Transplantation. Methods: prospectively 70 patients; 53 male and 17 female awaiting for liver transplantation aged (18 to 63) year- old (MELD score ranged between 16 to 38, presented with esophageal/ gastric varices with different grades, VBL was done as primary prophylaxis and comparative MELD score was calculated at the time of VBL and 2 weeks further on. Children was excluded from the study, additionally patients beyond Milan HCC criteria and those with contraindication for major surgery were excluded also. Results: MELD score improved post VBL without reported complications, additionally VBL as a primary prophylaxis was a corner stone procedure saving those with large varices against bleeding may affect the overall operation prognosis, Mean, Median and SD before and after VBL was; (18.9,19.2, 6.02) and (16.9,15.9,6.5) respectively. Conclusion: Cirrhotic patients presented with large esophageal varices (LEVs) prepared for liver transplantation should receive variceal band ligation (VBL) prior to surgery, should decrease associated co-morbidities. MELD score have been improved totally post (VBL), but statistically showed no significant importance.


Personalised cancers treatment for Children, Teenagers and Young Adults (CTYA).

Hisham Morsi,
Abstract :
Cancer treatment has gone through several decades of treatment strategies of phase I, phase II and randomized controlled trials until reaching the current phase of successful treatment that approaches >95% cure rates in some paediatric based chemotherapy protocols. However some diseased are still not curable despite the use of combinations of surgery, chemotherapy, radiotherapy, immunotherapy, hormonal treatments, biological modifiers, novel agents and stem cell transplants (autologous and allogeneic). Such diseases are demanding alternative approaches and hence the oncology community is heading towards personalized management approaches. Here we present an overview of the precise medications approaches that have been tried by different teams. The near future would include combinations of these approaches to gain better understanding of the disease and achieve better outcomes.

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