ABSTRACT
Background: A pilonidal sinus [PNS] is a small cyst or abscess that occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. The exact cause of pilonidal sinuses is unclear. It is generally thought they are caused by loose hairs pushing into the skin. They could also be caused by deep layers of skin being stretched and moved, leading to a hair follicle rupturing
Aim of the Work: The prospective study aimed at evaluating the outcomes of management of recurrent pilonidal sinuses by rhomboid flap
Patients and Methods: A prospective study of cases with recurrent pilonidal sinus, was done at the department of general surgery at In Al-Azhar University hospitals over the period from July 2017 with medium follow up period of three months
Results: Age: ranged between 17 to 36 years with mean = 24.7+/-5.57. Sex: included 12 male and 8 female
Conclusion: Based on this study, it seems to us that the rhomboid flap is a good alternative for recurrent sacrococcygeal pilonidal sinus, especially for complex sinuses, and it could be appropriate for cases where simpler techniques have failed. It permits early return to complete activity, does not require prolonged postoperative attention, and has very low recurrence rate and postoperative morbidity which may compensate the inconveniences related to an unfavorable cosmetic look
ABSTRACT
Background: metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women
Objective: we performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women
Materials and Methods: we searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software [Version 5.3]. Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects [miscarriage, stillbirth and congenital anomalies]
Results: pooled data from two RCTs [n=843] showed that metformin caused a significant reduction in maternal gestational weight gain [MD-1.35, 95% CI: [2.08, -0.630]], compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score [MD-0.09, 95% CI: [0.23, 0.06]]. Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]]. None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10]] and congenital anomalies [RR= 1.36, 95% CI: [0.58, 3.21]] differed significantly between the two groups
Conclusion: for obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women
ABSTRACT
In this study, thirty adult male albino rats were used. They were classified into three groups; one control and two experimental groups [10 rats each]. Rats of the first experimental group [group I] had received 5.5 mg of the broad-spectrum antifungal Nizoral every day for two weeks. While rats of the second experimental group [group II] had received the same dose for four weeks. At the end of drug administration, animals of both control and experimental groups were anaesthetized and the kidneys were enucleated and processed for histological and ultrastructural studies. Light microscopic examination of all specimens of control rats was similar and had revealed normal structure for the kidney. Specimens of group I experimental rats showed hyper cellularity and hypertrophy of the capillary tuft of renal corpuscles, mild degree of degeneration affecting cells of the convoluted tubules, obliteration of tubular lumens, vascular congestion, presence of few scattered haemorrhagic spots and mild thickening of the basement membranes of the glomeruli and convoluted tubules as a result of deposition of extraordinary amount of collagen fibers. As regards group II experimental rats, the histological examination of rat kidney had revealed marked hyper cellularity and proliferation of glomerular capillary tuft, marked hydropic degeneration of the cellular cytoplasm of the convoluted tubules, partial destruction of the brush border, hyaline red casts, massive tubulo-interstitial haemorrhage and marked deposition of extraordinary amount of collagen fibers around glomerular and tubular basement membrane. At the electron microscopic level specimens of the control group revealed normal structure of the rat kidney. In group I experimental rats. It was observed that the ultrastructural changes were not symmetrical, the basement membrane thickening was the prominent finding as well as fusion of some minor foot processes with, obliteration of the filtration slits, and cellular degeneration of the convoluted tubules as evidenced from the presence of large number of degenerated mitochondria. Most of them lost their internal cristae. But few of them clarified a destruction of a local area of the outer membrane. In-group II experimental rats, focal widened areas of the glomerular basement membranes were observed with fusion of some minor and major foot processes which occurred at the expense of the filtration slits which were markedly reduced or completely obliterated. In conclusion, long-term administration of Nizoral induced variable degrees of renal damage
ABSTRACT
Unnecessary laparotomy was done for certain complications alter laparoscopic cholecystectomy [clips coming off cystic duct, bleeding from port site. or gallbladder fossa and subhepatic collections]. These complications can be managed by minimally invasive surgery, so we adopt the policy of relaparoscopy to deal with such complications. Fourteen patients were presented by jaundice, sepsis, pain, abdominal distension, and or persistent bile leak from the drain idler laparoscopic cholecystectomy. Relaparoscopy was done for such patients, one patient [7.1%] had clip obstructing common hepatic duct [CHD], two patients [14.3%] had subhepatic collection, five patients [35.7%] had bile leakage at the drain, three patients [21.4%] had biliary peritonitis at seventh day postoperatively and three patients [21.4%] had bleeding at drain, all the patients were managed laparoscopically except one patient required laparotomy. There was no mortality. Laparoscopy is useful in the management of post- laparoscopic cholecystectomy complications
ABSTRACT
Undescended testis is a common problem with high risk of infertility and cancer. Early surgical correction is important for prevention of those risks. In the last year 1999, multi-disciplinary projects were done between surgical, dermatological and pediatric departments aiming to re-explore the histological and morphological changes in cryptorchid testis and its relation to age. Twenty four [24] male patients were recruited from El-Minia University Hospital and were divided into 4 main groups. Group A included 6 infants under the age of 2 years; group B included 4 patients aged from 2-9 years [pre-pubertal]; group C included 6 patients aged from 9 to 14 years [pubertal]; and group D included 8 patients aged from 14 to 21 years [post-pubertal]. Orchiopexy was done for all patients in one stage and bilateral testicular biopsy was taken and fixed immediately in Baun's solution and then stained by H and E for histopathological preparations. Our results showed that, for boys under the age of 2 years, there was no change from the normal spermatogonia and Sertoli cells with no thickening of their basement membrane. In pre-pubertal children, we found that changes were evident by the age of 7 and 8 years in the form of decreased number of spermatogonia, delayed maturation of Sertoli cells, widening of interstitial spaces and increased number of fibroblasts in the interstitium. In pubertal patients, the spermatogonia became rare and Sertoli cells were immature. Biopsy specimens from post-pubertal patients showed marked reduction of spermatogonia and arrest of spermatogenesis at primary spermatocyte stage. We concluded that early correction of cryptorchidism is vital for preservation of testicular integrity and maintenance of fertility
Subject(s)
Humans , Male , Testis , Biopsy , Histology , Tomography, X-Ray Computed , Child , Infertility, Male , Cryptorchidism/complications , Spermatogonia , Sertoli Cells , SpermatogenesisABSTRACT
In the last year 1999, multi disciplinary projects were done between surgical, dermatological and pediatric departments aiming to re-explore the histological and morphological changes in cryptorchid testis and its relation to age. Twenty four male patients were divided into 4 main groups; group A included 6 infants under the age of 2 years, group B included 4 patients from 2-9 years [prepubertal], group C included 6 patients from 9 to 14 years [pubertal] and group D included patients from 14 to 21 years [postpubertal]. Orchidopexy was done for all patients in one stage and bilateral testicular biopsy was taken and fixed immediately in Baun's solution and then stained by H and E for histopathological preparations. The results showed that for boys under the age of 2 years, there was no change from the normal spermatogonia and sertoli cells with no thickening of their basement membrane. For prepubertal children, changes were evident by the age of 7 and 8 years in the form of decreased number of spermatogonia, delayed maturation of sertoli cells, widening of interstitial spaces and increased number of fibroblasts in the interstitium. In pubertal patients, the spermatogonia became rare and sertoli cells were immature. Biopsy specimens from post-pubertal patients showed marked reduction of spermatogonia and arrest of spermatogenesis at primary spermatocyte stage