Clinical and laboratory diagnosis of contagious caprine pleuropneumonia in Qassim region, Saudi Arabia: a comparative study

Diagnosis of contagious caprine pleuropneumonia (CCPP) in Saudi Arabia mainlydepends on clinical signs and post-mortem findings, in addition to limited usage of latexagglutination test (LAT). In this study, a PCR method specific for detection of Mycoplasmacapricolum subspecies capripneumoniae (Mccp) was used as a direct confirmatory methodand to compare it with clinical signs, necropsy lesions and LAT. During the 2016-2017 year,samples of serum, pleural fluid, lung tissue and nasal swab were collected from 40 goats withclinical signs of CCPP, which were selected from goats brought to the veterinary clinic ofQassim University from 18 goat herds and nine localities. Epidemiological data revealed34.1%, 27.8% and 81.6% morbidity, mortality and case fatality rates, respectively. At necropsy,31 of 40 goats (77.5%) were found with lesions matching those of CCPP. Molecular findingssupported the suitability and applicability of PCR as a reliable method to diagnose andconfirm CCPP directly from clinical samples. The disease was confirmed by PCR in 35 goatsout of 40 (87.5%), 15 herds out of 18 (83.3%) and in all localities. Sera of 32 goats (80%) werefound positive by LAT. Four of the five goats and two of the three herds negative by PCR werealso negative by LAT and necropsy examination. Therefore, PCR sensitivity was considered97.2% (35/36). Compared to the claimed high specificity and sensitivity of the used PCRmethod, diagnosis of CCPP based on clinical signs was found less specific and necropsyexamination and LAT were less sensitive. It was concluded that molecular detection of Mccpdirectly in clinical samples should routinely be used to confirm diagnosis of CCPP in theregion of study, prevent economic impact of wrong diagnosis and to hasten control process.

Prevalence of occult hepatitis C virus in patients with HCV-antibody positivity and serum HCV RNA negativity

Introduction and aim: chronic hepatitis C infection [CHC] is a global health-care problem with an increasing burden year-by-year, particularly in Egypt. Even with the advent of high sensitive techniques, a subset of patients with positive HCV-Ab and negative HCV-viremia remain challenging. Therefore, we herein tried to determine the prevalence of occult HCV infection in peripherd blood mononuclear cells [PBMCs] of Patients presented with positive serologic test for anti-HCV-Ab and negative serum HCV-RNA-PCR [spontaneously cleared-patients] and also, we followed up those patients

Patients and Methods: between March 2010 to March 2015, a prospective study was designed to include all consecutive patients with HCV-Ab positivity and HCV-RNA negativity who attended to Assiut unit for treatment of viral hepatitis; sector of national committee for contrbl of viral hepatitis. A total of 25 patients were recruited. Spontaneous clearance of serum HCV infection was approved by [HCV-Ab positive using two 3rd generation ELISA tests and serum HCV RNA negative in three consecutive occasion each six months apart]. Follow up serum HCV RNA for patients with Occult 1 HCV Infection every 6 months. The RNA extraction step was performed by a protocol modified from, that of the QIAamp viral RNA kits [Qiagen, courtaboeuf, France]. Blood samples for separation of I PBMCs were collected from all patients. PBMCs were obtained using Ficoll-Hypaque density gradient of EDTA anticoagulated blood according to the manufacturer's instructions [Lymphoflot, Biotest,Dreleich, Germany]. Detection of HCV viral load was performed by kit supplied by applied Biosystem [HCV RT-PCR Kit lot No.]

Results: a total of 25 [21 males, mean age 36.2 +/- 9.1] patients who cleared HCV spontaneously [HCV- Ab positive and serum HCV RNA negative]. The genomic HCV RNA was detected in PBMCs from 3 [12%] of 25 patients. Follow up for those three patients with occult HCV infection were done for 18 months by measuring serum HCV RNA by using highly sensitive real-time Polymerase Chain Reaction [RT-PCR] every 6 months, only single patient became overt HCV with low level of viremia

Conclusion: occult HCV infection was detected in a considerable prevalence in patients in whom apparent clearance of HCV-viral load occurred that entails corporations of HCV-viral assay in PBMCs into the diagnostic algorithm

Work-related hand injuries treated at a tertiary care hospital

The hands are known to be the most commonly injured body parts in traumatic occupational injuries. They can be disabling, leading to major adverse social and economic consequences for the worker and for his or her family. The aim of the study was to describe work-related hand injuries and their potential risk factors and also investigate lines of management in relation to the type of injury. Patients who presented to the emergency room of a tertiary hospital over a 6-month period with occupational hand injuries were interviewed using a predesigned questionnaire. It included questions pertaining to the sociodemographic, occupational, and medical aspects related to the injury. A total of 163 patients were interviewed. More than 50% had injuries from cuts. Almost 60% of work-related hand injuries occurred in the absence of machines. The most common causes of hand injuries mentioned by workers were lack of concentration [68.7%], wearing no or ill-fitting gloves [63.2%], and a defect in the work place [51.5%]. On examination, fingers were the most affected site [66.7%]. About half of the cases were managed in the emergency room, 28.8% were managed with minor procedures, and 21.9% were managed with major procedures. Work-related hand injuries have multifactorial causes; lack of concentration was the most common in this study. Injuries from cuts were the most common and fingers were the most affected part. Modifications of the possible risk factors may reduce the incidence of acute hand injury at work

Prevalence of urinary incontinence and probable risk factors in a sample of Kurdish women

The most common manifestation of pelvic floor dysfunction is urinary incontinence [UI] which affects 15-50% of adult women depending on the age and risk factors of the population studied. The aim of this study was to determine the probable risk factors associated with UI; the characteristics of women with UI; describe the types of UI, and determine its prevalence. A cross-sectional study was conducted between February and August 2011, in the Maternity Teaching Hospital of the Erbil Governorate, Kurdistan Region, northern Iraq. It included 1,107 women who were accompanying patients admitted to the hospital. A questionnaire designed by the researchers was used for data collection. A chi-square test was used to test the significance of the association between UI and different risk factors. Binary logistic regression was used, considering UI as the dependent variable. The overall prevalence of UI was 51.7%. The prevalence of stress, urgency, and mixed UI was 5.4%, 13.3% and 33%, respectively. There was a significant positive association between UI and menopause, multiparity, diabetes mellitus [DM], chronic cough, constipation, and a history of gynaecological surgery, while a significant negative association was detected between UI and a history of delivery by both vaginal delivery and Caesarean section. A high prevalence of UI was detected in the studied sample, and the most probable risk factors were multiparity, menopausal status, constipation, chronic cough, and DM

Dengue vector control and surveillance during a major outbreak in a coastal Red Sea area in Sudan

An unprecedented dengue outbreak occurred in 2010 in Port Sudan city, Sudan. Dengue incidence was 94 cases per 10 000 observed over 17 epidemiological weeks [total cases = 3 765]. We report here the impact of the vector control response plan to the outbreak, which mainly entailed house inspection and insecticide space spraying. In total 3 048 houses were inspected during vector surveillance and 19 794 larvae and 3 240 pupae of Aedes aegypti were collected. Entomological indices decreased during the period: house index declined from 100% to 16% [F= 57.8, P< 0.001] and pupal/person [P/P] index from 0.77 to 0.10 [F= 3.06, P< 0.01] in weeks 9 and 21 respectively. This decline was accompanied by a decrease in cases from a peak of 341 cases in week 13 to zero in week 29 and the end of the outbreak. There was a significant correlation between the entomological parameters and dengue incidence [R2 = 0.83, F= 23.9,P< 0.001]. Integrated epidemiological and vector surveillance is essential to an effective dengue control programme

Measuring of gastric emptying in Egyptian pediatric patients with portal hypertension by using real-time ultrasound

Among the various methods for evaluating gastric emptying, the real-time ultrasound is safe, does not require intubation, or rely on either radiologic or radionuclide technique. The aim of our work was to measure the gastric emptying in pediatric patients with portal hypertension by using the real-time ultrasound. Forty patients with portal hypertension with mean age 7 +/- 2.8 years and 20 healthy children as a control group underwent gastric emptying study by using real-time ultrasound. The cross-sectional area of the gastric antrum was measured in the fasting state and then each subject was allowed to drink tap water then calculated by using formula area [longitudinal anteroposterior diameter/4]. The intragastric volume was assumed to be directly proportional to the cross-sectional area of the antrum. The mean gastric emptying half-time volume was significantly delayed in portal hypertension patients [40 +/- 6.8 min] compared with the control subjects [27.1 +/- 3.6] min [P<0.05]. Patients with extrahepatic portal vein obstruction had significant delayed gastric emptying in comparison to patients with portal hypertension due to other etiologies [36.14 +/- 4.9 vs 44.41 +/- 6.04 min; P<0.01]. Ultrasound is a noninvasive and a reliable method for measuring gastric emptying in pediatric patients. Gastric emptying was significantly delayed in patients with portal hypertension. Etiology of portal hypertension may influence gastric emptying time in patients with chronic liver disease

Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery

This study was designed to evaluate the effect of intravenous dexmedetomidine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6, cortisol and blood glucose level. It also assessed its effect on recovery profile and postoperative pain. Thirty adult ASA I-III patients admitted to the surgery department of the Alexandria Main University Hospital scheduled for elective major abdominal surgery under general anaesthesia were included. They were randomly classified into two equal groups of 15 patients each, dexmedetomidine group [Group D] received intravenous dexmedetomidine infusion and placebo group [Group P] received intravenous infusion of normal saline. Haemodynamic parameters were recorded intra- and postoperatively. Interleukin-6, cortisol and blood glucose levels were measured. Recovery profile, postoperative pain score and analgesic requirement postoperatively were assessed. Heart rate and mean arterial pressure were significantly lower in group D relative to group P during most of the intra- and postoperative periods. Postoperatively, the levels of interleukin-6, cortisol and blood glucose were significantly lower in group D relative to group P. Recovery time was longer in group D than group P but with no significant difference. Postoperative pain score was significantly less in group D relative to group P during the early postoperative period with smaller amount of analgesic requirements in group D. Dexmedetomidine is safe and effective in blunting the postoperative rise of the proinflammatory cytokine interleukin-6 and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose. Dexmedetomidine also reduces the postoperative pain score without delaying recovery from anaesthesia

Multi-center study of wilms tumors treated by different therapeutic strategies in two different countries

According to the treatment of Wilims' tumours', two different therapeutic strategies were established in the 2[nd] half of the last century. Both NWTS and SIOP have helped to improve the clinical management and outcome of Wilms' tumour's patients. In this study we compared the 3 groups of Wilms' tumour patients with different racial backgrounds and therapeutic strategies. Clinicopathological review was performed for 40 patients treated at Kyushu University [KU] hospital in Japan from 1960 to 2006 according to NWTS and JWiTS [Japanese Wilms' tumour Study] protocols, and 79 patients treated at South Egypt Cancer Institute [SECI] from 2002 to 2009 according to SIOP protocol. Retrospective study of 33 patients treated at pediatric surgery department of Assiut University hospital, from 2000 to 2009 according to NWTS protocol In KU group, a favourable histology [FH] was diagnosed in 82.5% and an unfavourable histology [UH] in 17.5%. Distribution of the clinical stage: I = 40%, II = 22.5%, III = 22.5%, IV = 7.5%, V = 7.5%. Five year overall survival was 82.5% and 5 year stage related survival was as follows; I 93.7%, II 83.3%, III 62.5%, IV 33.3% and V 100%. In SECI group, FH was diagnosed in 89.9%, UH in 8.8% and benign disease in 1.3%. Distribution of the clinical stage [pre and post chemotherapy] was as follows: I = 25.3% 50%, II =19% 20%, III = 35.4 15%, IV = 12.5% 5%, V =7.6% 7.6%. No case of intra-operative tumour rupture was recorded. The overall 5 year survival rate 80% with 5 year stage related survival was as follows; 195%, 11 93%, III 75%, IV 50% and V 83%. In AU group a favourable histology [FH] was diagnosed in 79% and an unfavourable histology [UH] in 9%. Distribution of the clinical stage: I = 39.4%, II = 21.2%, III = 21.2%, IV = 12%, V = 6%. The overall 5 years survival rate was 78.8% and 5 year stage related survival was as follows; 192%, 11 86%, III 71%, IV 50% and V 50%. The KU and AU group results proved the advantages of primary surgery in which accurate staging information and unmodified tumour histology helped subsequent treatment by proper chemotherapy dose. The SECI group results proved that preoperative chemotherapy increased the rate of stage I disease and decreasing the incidence of intraoperative tumour rupture. However, there was a possibility that chemotherapy administered to benign disease or an inappropriately low dose led to unfavourable histology

study of patients with community acquired abscesses at Khartoum north teaching Hospital

Abscess incision and drainage [I and D] operation represents the bulk of surgical procedures in the emergency department [ED]. Nevertheless, epidemiological, clinical, and bacteriology data are lacking or non-existent on patients with abscesses. Information is also lacking on the magnitude of the problem of community acquired methicillin-resistant Staphylococcus aureus [CA-MRSA], and their susceptibility to the most commonly used antibiotics. To identify and document epidemiological and clinical variables of patients with superficial abscesses, and isolate the causative organism [s] in the pus and determine their antibiotic susceptibility. Also, to determine the prevalence of CA-MRSA and their antibiotic susceptibility and ao audit our practice of I and D of abscess. A prospective observational study, involving a convenience sample of patients who presented with community acquired skin and soft tissue [superficial] abscesses to a single unit at Khartoum North Teaching Hospital [KNTH] emergency department [ED], was done during the period 2009-2010.A pro-forma was designed to record the personal, epidemiological, and clinical data of each patient. The I and D of the abscesses was performed as a day case. Swabs of pus drained from the abscess were sent to the laboratory for culture. Micro-organisms isolates underwent susceptibility testing against a group of the most commonly used antibiotics. A total of 248 patients were included in the study. The majority [84%] were below the age of 40 years. Males [69%] were twice as many as females [31%]. The majority of patients did not have a known predisposing factor, but 13% had a previous history of an abscess. A history of trauma was found in 27% of the patients, whereas diabetes mellitus history was obtained in only 6%. The most common site of the abscess was the upper limb [46%] followed by the lower limb [20%]. The study showed that 85% of the abscesses were drained under local anaesthesia. Susceptibility tests were performed on 151 pus specimens using a group of commonly used antibiotics. 123 [81.5%] specimens grew micro-organisms. Of those, Staphylococcus aureus was the commonest organism grown [90%], followed by Klebsiella spp [6.5%]. The proportion of CAMRSA was 24%. High proportions of S. aureus were resistant to other antibiotics too. Lists of antibiotics and their efficacy in the treatment of S. aureus and Klebsiella were constructed. This study documents some epidemiological and bacteriological data on one of the most common surgical problems. The study showed the presence of a significant proportion of CAMRSA. This reflects the abuse of antibiotics in the community and stresses the importance of health education. Standardized surgical and anaesthetic guidelines on I and D of abscess should be followed to avoid recurrences. Further studies are urgently needed

One month outcome of ocular related emergencies in a tertiary hospital in Central Saudi Arabia

To investigate the number and characteristics of patients attending the Accident/Emergency [A/E] Department of a tertiary care hospital in Riyadh, and to determine their route of referral, and pattern of ocular emergency cases. A retrospective study was carried out using the records and history of all patients attending the A/E at King Abdulaziz University Hospital [KAUH] in Riyadh, Kingdom of Saudi Arabia in July 2010. Data collected included time of arrival, age, gender, source of referral, principal diagnosis, attending doctor, action taken, and discharge plan. A total of 1,412 patients were recruited in our study with an average daily attendance of 47 patients. A total of 863 [61%] patients were male, and their mean age was 28.2 years. The most frequent diagnosis in patients was trauma [382, 27%], followed by conjunctivitis [211, 14.9%], lids and lacrimal system [133, 9.4%], retina problems [51, 3.6%], glaucoma [30, 2.1%], neuro-ophthalmology [22, 1.6%], keratitis [20, 1.4%], uveitis [10, 0.7%], and episcleritis [5, 0.35%]. Most cases [77.5%] seen were self-referrals. Additionally, 712 [50.4%] of cases were considered as non-emergency, which are visiting the A/E for dry eye, chalazion, blepharitis, and allergy. Most cases seen at our ophthalmic A/E had non-urgent conditions that could be managed satisfactorily by trained ophthalmic assistants under supervision of an ophthalmologist

profile of glaucoma in a tertiary ophthalmic university center in Riyadh, Saudi Arabia

To report the pattern of glaucoma among Saudi patients who were presented to King Abdul Aziz University Hospital [KAUH]. All glaucoma or glaucoma suspect patients who were presented to KAUH from 2006 to 2008 were included; medical files of all patients were retrieved and evaluated through standardized international guidelines. Collected data included: age, sex, laterality, intraocular pressure, and cup/disk ratio. Prevalence of different glaucoma types [including 95% CI] was calculated, ANOVA and post hoc tests were applied to evaluate the difference in indices across different types. A total of 2296 eyes of 1236 patients were included. Primary angle closure glaucoma [PACG] was the predominant type [46.6%] followed by primary angle closure [PAC] [17.2%], then primary open angle glaucoma [POAG] [12.8%], and secondary glaucoma [13%]. Other types including [normal tension glaucoma [5.9%], childhood glaucoma [2.6%], and juvenile glaucoma [1.9%]] were also present but of lower prevalence. Primary angle closure glaucoma was the predominant form of glaucoma followed by PAC, and POAG suggesting that the pattern in Saudi Arabia could be quite different from that reported for primary glaucomas in the Western literature. In addition, pseudoexfoliation was the most common form of secondary open and closed angle glaucoma. These results indicate the need for a national intervention program for early detection and referral of glaucoma cases in order to prevent significant visual loss. There is also a need for a community based assessment to determine the prevalence of glaucoma as a baseline for future intervention

Immediate changes in pupil size following laser in situ keratomileusis [LASIK]: pupillometry study

To investigate the impact of laser in situ keratomileusis [LASIK] on the change in pupil size immediately after the procedure. In a prospective study, measurement of pupil size was assessed in 70 eyes of 35 consecutive patients using a hand-held pupillometer before and immediately after LASIK in mesopic condition at the refractive eye center, Riyadh, Saudi Arabia. The pupil showed mild dilation immediate after LASIK. Mean pupil size before LASIK was 4.10 +/- 0.74 and immediate after was 4.74 +/- 0.82, P value <0.0001. No association was found with age, sex, central corneal thickness or pre-operative refractive measurements [CCT]. There is a change in pupil size that immerses immediately after LASIK; postulations suggested for papillary dilation include the effect of suction ring, post-operative steroid eye drops, dark room, pain and anxiety

Psychiatric profiles in patients with liver cirrhosis

Psychiatric disorders are common comorbidities in patients with liver cirrhosis that may impair patients' quality of life. The purpose of this study was to evaluate the common psychiatric disorders in cirrhotic patients in our locality. Subjects and Psychiatric disorders were prospectively assessed by administration of Symptom Checklist-90 revised [SCL-90-R], Hamilton anxiety rating scale, and Hamilton Checklist of Symptoms of depressive illness to 200 patients with liver cirrhosis and 200 control volunteers of matched age. In addition, clinical data, abdominal ultrasonography and laboratory data [liver function tests for patients] were collected. Results. Compared with controls, cirrhotic patients were significantly more likely to have depression [43.5% versus 14%, P< 0.001], anxiety [16.5% versus 5.5% P< 0.001] and increased mean scores of SCL-90-R subscales ['e.g. somatizalion, depression and hostility,]. Increasing severity of liver cirrhosis [based on the Child-Pugh score] was associated with increased frequency of Psychiatric disorders. Compared with the control group, patients with liver cirrhosis showed significantly higher frequency of comorbid psychiatric disorders which is increased by worsening disease severity

Response of sumflower [helianthus annuus l] to phosphorus and nitrogenfertilization under different plant spacing at new valley

This ivestigatton was carried out the New Vanlley agricultural Research Station during the summer growing seasons 2007 and 2008 under drip irrigation system to study the effect of pllosplIoms and nitrogen fewer lsvels and plant spacing on growth yfefd and geld cornponants of suntaower [var. Elza 102]. The plant spacing of 10, 20 and 30 cm were used for the*tudy. Qbosphoms a and d Nitrogen and vela were 15.22.5 and 30 kg ROs fed" and 30.45 and 60 kg N feB1, respectively. The heobtained results reveated that increasing phosphorus fertlllzer lewels from 15 to 30 kg P205 fed.' si@fbcmtly increased all parameters Wder study. Plant spacing had significant effects on swflower gsowthcbaaactedsMes. The highest plaat height seed and of1 yields kg Pet1 obtalnad'komamnaFfow spacing bebareen plants [10 om]. The ltigltest stern and head @meter, 100-seed weight, seed husk, oil% and seed yield per plant recorded at wide spacing [30 em]. Nitrogen application rnarRedly eeplhanced growth and yield, bat resulted in decrease in seed on percentage. Application of 60 kg N Ketl produced the Bighest seed and of1 yields fed1. Gonsidehg the superiodty of 30 kg ROs fed", 10 cm plant spacing and 60 kg N RIed1for seed and oil yleld, it appears that it could be reeomended for produchg desirable yield under the New Valley soils coaaditions

Controlled Cyclophotocoagulation with diode laser in refractory glaucoma and long term follow up at King Abdulaziz University Hospital, Riyadh

To evaluate the clinical efficacy and safety of controlled contact transscleral diode laser Cyclophotocoagulation [COCO] procedure in reducing the Intraocular Pressure [IOP] among patients with refractory glaucoma. Thirty two patients [35 eyes] with refractory glaucoma in prospective clinical studies were treated with trans-sclera diode laser in a controlled manner. The energy power used was 5 W in adults and 3 W in children, exposure time was 0.5 s, a total of 16 shots were applied over ciliary body and four shots in each quadrant. Pre and postoperative IOP were measured at different postoperative visits. Snellen visual acuity, the number of anti-glaucoma medications and associated complications were also recorded. Student Ttest was used to compare the pre and post intervention lOPs, while Wilcoxon Signed Ranks test was used, to detect significance change in medication dependency. The mean [SD] follow up time was 80.2[ +/- 9.6] months, range [36-84] m, where the mean IOP was significantly reduced from 35.1 mm Hg [ +/- 10.7] before intervention to 18.8 mm Hg [ +/- 7.3] after intervention, in the final visit [P < 0.0001]. Complete success was achieved in seven eyes [20%], 22 eyes [62.8%] showed qualified successes and complete failure was reported in six eyes [17.1%]. The overall success rate was 82.8% [95% CI: 70.4-95.3]. Visual acuity improved

Response of sunflower [helianthus annuus L.] to phosphorus and nitrogen fertilization under different plant spacing at new valley

The investigation was carried out in the New Valley Agricultural Research Station during the summer growing seasons 2007 and 2008 under drip Irrigation system to study the effect of phosphorus and nitrogen fertilizer levels and plant spacing on growth, yield and yield components of sunflower [var. Giza 102]. The spacing of 10, 20 and 30 cm were used for the study, Phosphorus and Nitrogen levels were 15, 22.5 and 30 kg P[2]o[5]fed[-1] and 30, 45 and 60 kg N fed [-1], respectively. The obtained results revealed that increasing phosphorus fertilizer levels from 15 to 30 kg P205 fed [-1] significantly Increased all parameters under study. Plant spacing had significant effects on sunflower growth characteristics. The highest plant height seed and oil yields kg fed [-1] obtained from narrow spacing seed between plants [10 cm]. The highest stem and head diameter, 100seed weight, seed husk, oil% and seed yield per plant recorded at wide spacing [30 cm], Nitrogen application markedly enhanced growth and yield but resulted in decrease in seed oil percentage. Application of 60 kg N fed[-1] produced the highest seed and oil yields fed [-1]. Considering the superiority of 30 kg P[2]o[5] fed [-1], 10 cm plant spacing and 60 kg N fed [-1] for seed and oil yield, it appears that it could be recommended for producing desirable yield under the New Valley soils conditions

risk of venus thromboembolism among sudanese women using contraceptives

Contraceptives are known family planning tool and their side effects are well understood except on the coagulation system reactions. The study intended to identify the effect of the use of contraceptives on coagulation reactions in order to find out the risk of Venus Thromboembolism [VTE] among those who use these tools. A descriptive cross-sectional study designed and conducted between April 2008 and January 2009 in Al Taif, Abo-Hamama and Al maygoma family planning centers. Sixty venous blood samples from healthy non-pregnant women using contraceptives and 30 venous blood samples were collected from healthy women without contraception as control group. Citrated blood samples were then subjected for measurement of PT, APTT, TT and Fibrinogen concentration, using the conventional manual methods. The results of the study showed a shortening of PT [T:12.9/C:15.4] and TT [T:14.4/C:16.3] accompanied by an increase of Fibrinogen concentration [T:3.8/C:3.1] in females using contraceptives compared to control group. Also, age of tested women was significantly associated with the lowered TT as well as elevated Fibrinogen. Body weight was significantly correlated to the increased Fibrinogen; while, the injection method significantly shortened PT [Tab:15.2/Inj:13] and TT [Tab:13.7/Inj:12.2] more than tablet method. It was concluded that the use of contraceptives is significantly affect the coagulation system specially the Extrinsic pathway, increases the risk of VTE; thus, could lead to serious complications. The study recommended the use of tablets method and for separated short intervals as well as females using contraceptives should be subjected for regular and continuous coagulation screen

Comparative study between open anterior approaches using the prolene patch and open posterior [pre-peritoneal] using a configured prolene mesh in treatment of recurrent inguinal hernia

Recurrence of inguinal hernia is not an infrequent problem seen by the surgeon. Usually repair of such hernia is technically more demanding than a primary repair, with a potential for new recurrence and a high risk of complications. The objective of this study is to compare between the anterior approach using the prolene patch and a pre-peritoneal approach with prolene mesh configuration. A comparative study was done from June2004 to December 2006, at Assiut university hospital on thirty patients with recurrent inguinal hernia selected for this prospective comparative study. The studied patients were allocated into two groups: group A [anterior approach n=15 patients] and group B [posterior approach n= 15 patients]. Thirty patients with recurrent inguinal hernia were operated. All of them were males. Incidence of cord injury in group A was 6.6%, while no injury of the occurred in group B. the incidence of haematoma [6.6%], scrotal oedema [20%] and testicular atrophy [6.6%] were encountered in group A while no reported cases were seen in group B. Although both anterior and posterior approachs are effective treatment modalities for treatment of recurrent inguinal hernias, yet the open pre-peritoneal approach is technically easier, safer, cheaper, is followed by minimal morbidity and has a low re-recurrence rate