Predictive factors for success and failure of pegylated interferon/ribavirin therapy in chronic hepatitis C patients

The aim of this study was to determine the clinical, biological, virological and histological predictive factors for success and failure of pegylated interferon/Ribavirin therapy among Egyptian patients infected by hepatitis C virus [HCV]. This retrospective study included 100 patients with HCV infection who underwent clinical, biochemical and virological assessments before treatment and at 12, 24 and 48 weeks from the start of treatment. The selected patients were divided equally into two groups according to the seroconversion state after receiving a course of pegylated interferon and ribavirin. Group I: 50 patients with CHC who show seroconversion after 12, 24 and 48 weeks of treatment. Group II: 50 patients with CHC who did not show good virological response after 12 and 24 weeks of treatment and they further divided into two groups: Group II A: 25 patients who stop treatment at 12 weeks due to absence of virological response [S 2 log decline in HCV RNA by Quantitative PCR] and Group II B: 25 patients who siop treatment at 24 weeks due to presence of detected HCV RNA by Qualitative PCR. At the end of this study we found that the best positive predictor factors that associated with good virological response before treatment are male sex, younger patients, low BMI, low APP, low viremia and low grade of activity and fibrosis in liver biopsy. The positive predictive factors that associated with good virological response after 12 weeks of treatment are low liver enzymes low viremia and early virological response

Primary repair versus colostomy in management of penetrating colonic injuries

There has been a change in perspective in the treatment of penetrating injuries of the colon. The aim of the study is to compare between colostomy and primary repair and in particular to determine whether the latter is safe when there is operative delay, in the presence of intra-abdominal contamination, associated injuries and/or shock. Forty-eight patients with penetrating colonic injuries were randomly treated by primary closure or colostomy. There were significant differences between the two treatment groups as regards the operating time [primary repair; mean 132.2 mm, range 65-220 and colostomy; mean 148.7 mm, range 71-288] and the time of hospital stay [primary repair; mean 10 days, range 7-52 and colostomy; mean 29 days, range 21-63]. There were no significant difference between the two treatment groups as regards the operative delay and the postoperative complications. It is concluded that primary repair is a safe procedure in managing penetrating colonic injuries irrespective of delay, or other adverse circumstances

Laparoscopic simple nephrectomy: preliminary experience in theodor bilharz research institute

Aim: The open simple nephrectomy is associated with significant mobidity and laparoscopic nephrectomy is now becoming the standared of care in many centers. In this study we will try to evaluate the actual results of laparoscpic nephrectomy for benign renal lesions in comparison to open nephrectomy

Methods: 17 patients were divided into 2 groups in a non-randomized trial. 8 patients 5 males and 3 females, aged 19-56 underwent open simple nephrectomy. 9 patients, 3 males and 6 females, aged 16-53, underwent laparoscopic simple nephrectomy [3 retroperitoneal and 6 transperitoneal]

Results: In spite of the high conversion rate [4 out of 9 cases] the laparoscopic simple nephrectomy was superior to the open technique in terms of intraoperative complications [0 versus 2 patients who needed blood transfusion and another with pleural injury], duration of analgesia requirements [2 versus 4.5 days post operative], starting oral feeding [1 versus 3 days post operative], wound infection [0 versus 2 cases], hospital stay [3 versus 7.5 days] and time for full recovery [22 versus 40 days] The superiority of the laparoscopic simple nephrectomy in terms of analgesia requirement, post operative oral feeding, hospital stay and time for complete recovery were all statistically significant

Conclusion: In spite of this being a preliminary experience of the Urology Department started in association with the General Surgery Department in TBRI, laparoscopic simple nephrectomy was not only found to be a safe procedure but also other all parameters were in favor of the laparoscopic versus the open simple nephrectomy. The conversion rate was expectedly high but it is not until the learning curve peaks up before the true rate appear and properly judged

Clinical, sonographic, histopatholgical and DNA study of predictors for malignancy in chronic calcular cholecystitis

In 31 patients with dyspepsia sonographic examination showed thick wall gallbladder in 26 [83.9%], multiple stones in 21 [67.7%] and single stone in 10 cases [32.2%]. Mucosal chronic inflammatory infiltration and mucosal ulceration were the most common lesions [87.1% and 67.7% respectively]. Dysplasia was found in 3 gallbladders [9.7%], with DNA changes showing aneuploid histogram pattern and higher values of S phase percent of cellular population. Hyperplasia was associated with increased percentage of cells occupying the S phase and increased values of 2C-deviation index and 5C exceeding rate percentage. The DNA changes were more associated with multiple stones with significant differences in S phase percentage cellular population between multiple and single stones. Thus, it is concluded that multiple gallstones is an indicator for preference of cholecystectomy to avoid development difficulty predicting malignancy of gallbladder

Electrotherapy in management of spasticity by tonolyse in relation to the muscles of different joints of the limbs

Out of 32 patients with thrombotic hemiplegia, 12 patients considered as controls were treated by muscular exercise. Twenty patients were treated by electrotherapy using tonolyse method to the antagonostic muscle groups of each joint of the affected limb followed by muscular exercise. The clinical evaluation in relation to the tone and active range of joint motion were performed before and after 2 months treatment. The results of this work for management of spasticity proved that, the tonolyse method followed by muscular exercise was superior than muscular exercise only, however, the improvement was much better in the knee and elbow than in the wrist and ankle joints