Is groin ultrasonic exploration necessary in infants and children with unilateral inguinal hernias?

Our study was carried on 393 infants and children at Pediatric Surgical Unit-Al Azhar University Hospitals in the period from January 1997 to January 1998. Their ages ranged from 0-12 years and followed for sixteen months. The need for contralateral inguinal exploration in children during unilateral inguinal hernia repair remains controversial. We questioned whether an elective preoperative sonographic examination of the contralateral inguinal canal was accurate enough to prevent unnecessary exploration of the asymptomatic side with no late appearance of a contralateral inguinal hernia. Sonograophy [US] of the groin was performed to 100 children [group I] awaiting unilateral hernia repair over a 1 year period during 1997-1998. 200 children [group II] with unilateral inguinal hernia underwent unilateral repair without preoperative groin US during the same period. Also groin US was done for 50 normal infants and children [group III] for measurement of the diameter of the internal inguinal ring. The two groups of patients [I and II] and their medical records were reviewed in April 1999, sixteen months following surgery. Of the group I, 87 patients had the clinical diagnosis of unilateral hernia confirmed by US. 13 patients with groin US evidence of a contralateral hernia based on the diameter of internal inguinal ring [> 3mm in infant below one year > 4 mm in children between 12-24 months and > 5 mm in children older than 24 months]. At the follow up 14 patients [7%] in group II presented with a hernia in the opposite groin 1 to 16 months following surgery. Non of the patients in group I presented with a clinically evident hernia during the follow-up period. These findings suggest that US is a readilyavailable, non invasive, and accurate method of preoperative evaluation of the groin. Our policy of contralateral exploration based on the US findings was shown to be reliable in preventing unnecessary surgical exploration of the unaffected inguinal canal

Monthly distribution and infection of the snails vectors of schistosomiasis with trematodes larvae in different agricultural water courses located in Beheira governorate

This study was monthly done for one year in small agricultural area in Behaira Governorate. Thirty permanent stations were chosen along primary, secondary and tertiary canals and drains, 5 stations for each. In the area of study, Biomphalaria alexandrina [B. alexandrina] snails were more prevalent than Bulinus truncatus [B. truncatus] snails, although the percentage of infected B. truncatus with different trematodes was 12 times the percentage of infected B. alexandrina snails. These two snail species of schistosomiasis were more dense from March until August during the year of study. B. alexandrina and B. truncatus seemed to be ideal intermediate hosts for holostome cercariae [about 55% of the total infected snails with different trematodes]. Schistosome was the second prevalent cercariae as well as amphistome, xiphidiocercariae, echinostome and monostome. Nevertheless, echinostome was the second prevalent cercariae in B. truncatus, in addition to amphistome, monostome and xiphidiocercariae but not schistosome cercariae. Old size snails of both kinds of schistosomiasis had a higher rate of infection with different trematodes cercariae, then medium followed by young size snails. Schistosoma mansoni [S. mansoni] cercariae were found only in old and medium size B. alexandrina snails. The highest infection with different trematodes larvae among the collected B. alexandrina snails was recorded in secondary and tertiary canals and drains, while for B. truncatus snails it was in primary and secondary canals. Also, the infected B. alexandrina snails with S. mansoni was found only in secondary and tertiary canals and drains. Conclusively, infection of both snails of schistosomiasis with different trematodes, suppress in one way or another the infection with S. mansoni and S. hematobium larvae. Suggestions of using these kinds of trematodes infection for biological control if the snails intermediate hosts of schistosomiasis were discussed

Classification and management of gastric varices

In this work eighty one patients with gastric varices alone or oesophagogastric varices were included for sclerotherapy of gastric varices. Gastric varices were classified to: 1- isolated gastric varices, fifty three patient 2- gastric extension twenty eight patients of them cord type included twenty five patients while the bulbous type included three patients. Gastric varices of the isolated type were injected histocary1 successfully. Gastric extension type was injected histoacry1 when presenting in active bleeding or when it is of the bulbous type. Complications were minimal in the form of recurrent bleeding, fever pleural reaction and pulmonary embolism. Recurrent gastric varices occurred in the patients during the period of follow up reaching 2 years we succeeded in controlling the bleeding in 92.85% of cases with early recurrence in 5.56% and late recurrence in 1.79% and the mortality due to rebleedig was 7.5%. this verify the crucial role of tissue adhesive in managing gastric varices

Effect of some insect growth regulators against housefly musca domestica vicina

Four JH-like compounds ZR-777, Altosid, Dimilin and Altozar were shown to be effective at concentrations considered promising against the house fly larvae. The average activity indices indicate that ZR-777 is the most active compound while Altozar is least active one. However, in all cases, records revealed that larval or pupal mortality and inhibition of adult emergence is not dose dependent. Also, data showed that the critical larval age which was mostly affected by such compounds application was 96 hours. No consistent relationship between the activity of these compound and reproductive capacity of female survivors following larval treatments, was proved.