Surgical repair of penile fracture

To evaluate the preoperative diagnostic methods and the outcome of surgical treatment of penile fractures in patients treated at our institution. Retrospective study. Department of Surgery, Urology Unit, Al-Jahra Hospital, Kuwait. Eighteen patients treated surgically for penile fracture during the period from October 2007 to June 2012 were included. The diagnosis of penile fracture was made on clinical grounds and penile ultrasonography. Patients were treated by immediate surgery. Corpus cavernosum tear was repaired with absorbable sutures. Surgical repair with absorbable sutures. Evaluation of preoperative diagnostic methods and the results of early surgical treatment. Patients presented within 6 - 20 hours [median time 16 hours] after injury. With a mean follow-up of 18 months [range 12 to 24 months], all patients were able to achieve full erection. No penile deformities or penile plaques were reported. Penile fracture represents a true urological emergency. In nearly all cases diagnosis can be made on typical history and clinical examination. Early surgical exploration and repair of tunica albuginea can result in good functional outcome

Effect of exposure to X-ray radiation on the hematological system and immunoglobulin concentration of customs clearance workers in Alexandria port

Based on scientific evidence, any exposure to radiation can be harmful; there is no safe dose, i.e. no threshold-dose. This study was conducted to reveal the effect of low dose radiation on the haematological system, as the blood cells are classified as the most radiosensitive tissue in the human body. The inference population included 40 male Customs Clearance Workers [CCWs] from Alexandria seaport; they were exposed to low doses of ionizing radiation while using various types of electronic and imaging machines for security purposes. .The comparative population included 40 male workers; they were not exposed to ionizing radiation or radioactive hazardous materials in their work environment. All CCWs and unexposed workers were subjected to an interviewing schedule, physical examination, and haematological investigations, which included a complete blood count and IgG, IgA and IgM concentrations. In the present study the prevalence of general manifestations such as pallor, hair loss, repeated infections and bouts of fever were higher among CCWs compared with unexposed workers. Neurological manifestations namely, headache and fatigue were prevailing among CCWs. Haematological investigations revealed that the mean total leucocytic count was significantly decreased among CCWs. On the other hand the mean values of RBC and platelet counts were not significantly lowered among CCWs. Moreover, the differential picture showed a significant depression in the mean percent of circulating lymphocytes among CCWs. Regarding the immunoglobulin concentrations, the present study revealed no significant difference between CCWs and unexposed workers regarding their serum IgG, IgM and IgA concentrations, Furthermore, there were significant negative correlations between the total leucocytic count and both the duration of occupation and smoking index, and between the mean percent of circulating lymphocytes and duration of occupation. CCWs at Alexandria seaport although assumed to be exposed to low doses of ionizing radiation, yet significant affection of some basic blood parameters was evident. Thus, personal monitoring for X-ray radiation and increasing the level of protection for CCWs is of utmost importance

Morbidity, age and sex distribution, and complications in symptomatic urinary tract infection in childhood

This study aims at identifying major causes of Urinary Tract Infection [UTI] in different pediatric populations in Jordan. It also compares UTI complications in Jordanian children with what is reported in the world literature. We prospectively studied 140 patients, 53 males and 87 females. The age of these patients ranged from 1 month to 12 years. This included 17 males and 7 female infants. All patients were investigated for the purpose of revealing the causes of UTI and were followed up for a period of 6 months to 4.5 years. The most common abnormality in UTI patients was Vesicoureteral Reflux [VUR]. Female patients had a high incidence of cystitis [34.4%]. Male subjects were found to have more serious underlying disorders and required more surgical procedures compared to females. More males than females had their first UTI in infancy. The most common complications were Chronic Renal Failure [CRF] [14.3%], renal scars [27.1%] and Hypertension [HTN] [6.4%]. All hypertensive patients were found to have renal scars. UTI in infancy and childhood, carriers a significant risk of renal injury. Consequently a careful urological evaluation at an early stage following the first UTI is mandatory. A careful follow up is also helpful in detecting complications in susceptible patients

Assessment of serum iron, TIBC and serum ferritin in end stage renal disease and the effect of hemodialysis

Because of the variability in the pathogenesis of anemia in CRF and the accepted usage of iron supplmentation, we attempted to evaluate the importance of blood indices, serum iron and serum ferritin in such conditions as serum ferritin is generally considered as the best indirect index of body iron stores. This work included 52 uremic patients besides 6 control subjects. The patients were grouped into predialysis and dialysis groups.The later were further subdivided into 3 subgroups according to the duration of dialysis. Biochemical tests, complete hemogram including erythrocyte indices, serum iron, TIBC and serum ferritin had been carried out for all subjects. All uremic patientsúirrespective of dialysis were suffering from microcytic hypochromic anemia with marked iron deficiency and low serum ferritin. There was a statigtically insignificant change of iron status in dialysis groups irrespective the variable duration of dialysis. We came to the conclusion that evaluation of serum ferritin is essential to assess the body iron stores and to evaluate the indication of iron supplementation in CRF and [dialysis patients because the hematological indices alone can not point to the actual iron stores. Reevaluation of the adequacy of hemodialysis procedure can be garanteed with the improvement of iron parameters. Moreover, iron supplementation in CRF should be cautiously used after investigating the iron status in such patients. An extension of this work could be suggested to investigate the erythrocyte ferritin, bone marrow iron in CRF and a trial to use RHuEpo in those patients

Plasma fibronectin concentrations in bleeder and non bleeder patients with hepatosplenic schistosomiasis

This study was conducted on 40 patients with schistosomal hepatosplenomegaly and oesophageal varices "O.V.". They were divided into two groups : Group A were suffering form bleeding O.V and group B were non bleeders. Ten Healthy individuals were also included in the study as control group. Plasma fibronectin concentration was estimated in each subject using quantitative single radial immuno-diffusion technique. The results of the study showed that plasma fibronectin concentrations were significantly decreased in both group of patients, bleeders [354.5 Mg/dl +/- 109.2] and non bleeders [307 +/- 103.5] compared to the control group [514 +/- 57.9]. However, there was no significant difference in fibronectin concentration between group A and group B [p > 0.05]. There was insignificant correlation between plasma fibronectin and some haemostatic estimations [clotting time, bleeding time and platelet count] in the studied groups [p > 0.05]. Also, there was insignificant difference in fibronectin concentration in patients with [312 Mg +/- 116.4] and without [368.6 +/- 106.9] liver cell failure

Renal handling of salt and water in myxedema

The response to acute water ingestion was determined in 10 patients with untreated myxedema and another 10 control subjects. Comparison of the results in the two groups indicated an abnormality in water excretion in the myxedematous patients. The imparied water diuresis in patients with myxedema including those with significant hyponatremia appeared to be multifactorial in origin. Impaired sodium transport, altered antiduiretic hormone metabolism and diminished volume delivery to the distal diluting segments are all present in hypothyroidism and may operate in combination in the pathogenesis of the impaired renal handling of salt and water in this disorder

Pentoxifylline [RBC deformability modulator] and glucose homeostasis

Oral glucose tolerance test with the estimation of S. glucose S. insulin, and S. C-peptide was carried out in 10 non-insulin dependent patients and 8 healthy control patient before and after the administration of oral dose of 400 mg pentoxifylline twice daily for 2 weeks. The diabetic patients were controlled by glibenclamide. Statistical analysis of the results revealed that pentoxifylline caused increase in the serum glucose which persisted inspite of the simultaneous increased levels of serum insulin and c-peptide all through the curve both in the control and diabetics. There could be two possible explanations for these results either pentoxifylline causes release of other diabetogenic hormones which neutralizes the insulin effect, or pentoxifylline blocks or decreases the post-receptor action of insulin by increasing the level of CAMP intracellularly and hence glucose utilization at cellular level

need for routine cytologic screening in Egyptian females

The results of a five-year study during the period of 1981-1985 in the cytology division of the OB./GYN., Cairo University hospitals were reviewed. A total number of 4458 smears were studied. Forty-eight shears showed abnormal cytology, with a general incidence of 1.07%. There were 43 smears showing various grades of cervical intraepithelial neoplasia [CIN] and five smears were positive for invasive cancer. Although this is a remarkably how incidence, if compared to other reports in Europe and USA, yet, the fact than 19 smears of those positive for CIN were collected from clinically free patients may raise the question of the need for routine screening for Egyptian females. The particular age group of patients to be screened is defined in the present study. The prevalence incidence of CIN [cervical intraepithehial neoplasia] a mong Egyptian females has been recently mentioned to be 7.03/1000 [5]. Since this is a rather low incidence when compared to other reports [1, 2, 4, 8, 11] the following question may he raised. Do we really need to establish routine cytology screening programs in Egypt for the early diagnosis of cervical cancer procursors ? This work is an attempt to answer this important question, and to define a particular high-risk age group for CIN in Egyptian women