Stoppa preperitoneal approach [GPRVS] versus laparoscopic TAPP approach in management of bilateral inguinal hernia: a multicenter study

The preperitoneal approach for inguinal hernia avoids distorting the inguinal anatomy, markedly reducing the risk of damage to the testicular vessels and permits inspection of all potential groin hernia sites. In this, study we are trying to validate and compare two preperitoneal approaches used for repairing bilateral inguinal hernias; the Stoppa [GPRVS, giant prosthetic reinforcement of the visceral sac] and the laparoscopic transabdominal approach [TAPP]. Two hundred forty two [242] patients with bilateral inguinal hernia were treated at 3 University hospitals. They were randomly divided into two groups the first group [gp I] was 97 patients and underwent laparoscopic TAPP repair while the second group [gp II] was 143 patients and submitted for Stoppa preperitoneal repair [5 patients were turned from TAPP to Stoppa repair due to instrument failure in 2 patients, adherent intestinal loops with difficult reduction of the contents in 2 patients and bleeding from inferior epigastric vessel in l patient]. Operative time was 110 +/- 65 min in TAPP group and 90 +/- 20 min in Stoppa group. Hospital stay and need for analgesics were less with TAPP group than Stoppa group. Recurrence rate was- 5.1% in TAPP group and 2.1% in Stoppa group. Complications were slightly higher with Stoppa group except for chronic groin pain which was higher with TAPP. Both Stoppa and TAPP are valid preperitoneal repairs for bilateral inguinal hernias. Both are techniqually demanding operations. Stoppa has fewer recurrences but has slightly higher complication rate except for chronic groin pain which is more reported after TAPP. TAPP has the advantages of posing smoother postoperative course with shorter hospital stay

Role of vitamin [E] against immunotoxic and genotoxic effects of hexavalent chromium in albino rats

Sine chormium is one of the most important pollutants present in the general and industrial environment that induce health hazards, it was the aim of the present study to shed light on the role of antioxidant as vitamin [E] in the protection against immunotoxic and genotoxic effects of chromium in adult albino rats. Rats were divided into four groups, the first group was given 1/10 LD 50 of sodium dichromate, the second group was given sodium dichromate with vitamin E, the third group was given vitamin E alone in addition to the control group as a fourth group. After three weeks serum immunoglobulin [IgG and IgM] with immunohistochemical change in T-lymphocytes in bone marrow and spleen were detected and chromosomal pattern in rats bone marrow were examined. Results showed a significant decrease in serum immunoglobulin [IgG and IgM] and decrease in the number of CD4 helper T-lymphocytes with some increase in the number of CD8 supressors T-Iymphocytes and abnormalities in chromosomal pattern in the first group while the other groups showed no changes in serum immunoglobulins, T -lymphocytes or chromosomal pattern vitamin E administration can be a promising solution to ameliorate the chromium-induced immunotoxic and genotoxic effect. So, further studies on individuals exposed to chromium regarding its immunotoxicity and genotoxicity is recommended

Intestinal and urinary parasitosis in children with acute leukemia and lymphoma

The present study was conducted on 50 patients [37 with acute leukemia, 13 with lymphomas] attending the Hematology/Oncology Clinic, Children's Hospital, Ain Shams University. Fifty normal children were studied as controls. Patients and controls were subjected to laboratory investigations including a complete hemogram, red cell indices, urine and stool analysis for parasites. The results of this study revealed that, 13 out of 50 [26%] patients with acute leukemia and lymphoma were positive for parasitic infection, while 15 out of 50 [30%] of the control subjects were positive. The difference between the two groups was not statistically significant. Giardiasis was the commonest infection. It has been found in 16% of patients' group and 20% of controls. Among the patients' group, there was no correlation between the prevalence of parasitosis and the duration of therapy. As regards the hematological data, it has been found that, there was a statistically significant increase in RBCs count, Hb and Hct values in patients with acute leukemia and positive parasitosis than in those with negative parasitosis. Although there was a statistically significant increase in the absolute eosinophil count in controls with positive parasitosis than those with negative results, this finding was not observed in the patients group