ABSTRACT
Objective: The aim of this work is the presentation of a case of isolated renal hydatid cyst with novel findings and an unusual surgical scenario
Clinical Presentation and Intervention: A 54-year-old female patient presented with left loin pain and a palpable left renal mass. Imaging described a well-demarcated left renal cystic lesion with a double-layer wall. Radical nephrectomy was performed due to the possibility of malignancy. On retrograde revision, the double-layer
wall represented the detached germinative membrane of a hydatid cyst that was confirmed by histopathology
Conclusion: Isolated renal hydatid cyst could be misinterpreted as a renal tumor. It should be considered in the differential diagnosis of renal cystic lesions
ABSTRACT
Objective This study was designed to investigate and compare the possibility of reducing postoperative blood requirements by using Tranexamic acid TX either intravenously or topically in pediatric patients with cyanotic heart disease. Study Design Double-blind, r and omized fashion Setting Children's Hospital - Assiut University- Egypt Participants 120 children undergoing repair of cyanotic congenital heart disease. Measurements and Main Results: Patients were r and omized into three equal groups 40 patients in each one; Control C group did not receive either study drug, Intravenous Tranexamic acid ITX group received Intravenous TX 50 mg / kg at the induction of anesthesia followed by infusion of 1 mg/kg/hr. till 6 hours postoperatively while the topical Tranexamic acid group TTX received topical TX 50 mg / kg poured into the precordial cavity before sternal closure. Total blood loss and transfusion requirement within the first 24 hours postoperatively were recorded together with hematocrit percentage, platelet counts and coagulation studies. In addition; chest closure time, duration of mechanical ventilation, length of Intensive Care Unit ICU stay and length of hospital stay were recorded and the occurrence of re-exploration for excess bleeding, or any other thrombotic or adverse events were recorded. Postoperative blood loss during the first 24 h was significantly higher in the C group 29.13 +/- 8.69 ml/kg compared to the other two groups who were treated with Tranexamic acid either intravenously or topically. ITX group patientrecorded less blood loss 13.05 +/- 7.88 ml/kg in comparison to TTX group 17.40 +/- 8.117 ml/kg. The amount of packed red blood cells and Fresh Frozen Plasma FFP transfusion in the first 24 hours administrated were significantly less in the ITX group patients 10.75 +/- 6.53, 12.00 +/- 5.86 ml/kg followed by TTX group patients 12.60 +/- 6.90, 10.50 +/- 6.77 ml/kg compared to control group of patients 25.00 +/- 6.53, 25.95 +/- 8.05 ml/kg. The control group had the largest re-exploration rate. ITX group had the shortest ventilation time, ICU and hospital stay. No significant difference between the three groups as regard the coagulation parameters except for significant lowest level of fibrin degradation product in ITX group. No side effects were recorded among the three groups. Conclusion: Tranexamic acid effectively reduces postoperative blood loss and the need for transfusion of allogeneic blood products in patients with cyanotic congenital heart disease. However, the intravenous regimen seems to be more effective than the topical one. Key words: Pediatric cyanotic heart disease; Tranexamic acid; Postoperative; Blood transfusion
ABSTRACT
Most patients with asthma also have rhinitis, and the same inflammatory cells and mechanisms are present in bronchial and nasal mucosa, thus leading to the concept of "one airway, one disease". The aim of the present study was to determine the prevalence of rhinitis and sinusitis in children with varying severities of bronchial asthma and its relation to the degree of asthma severity among children residing in semi urban semi rural areas in Behira, Egypt. Our study was a matched case control cross sectional study. It included one hundred asthmatic children whose ages ranged from 5-12 years, attendants of the allergy and chest diseases, pediatric outpatient clinic, and 100 matched controls, attending pediatric outpatient clinic in Damanhour Medical National Institute during the period from the first of February 2004 to 31[st]of August 2004. Asthmatic children were judged atopic or non atopic on the basis of skin tests to common allergens and were graded as having mild, moderate and severe asthma. All children were subjected to complete physical and medical examinations, radiography of chest and paranasal sinuses, pulmonary function test. Laboratory investigations included complete blood picture and examination of nasal secretions for eosinophils. In the present study, there was significantly higher prevalence of both allergic rhinitis [63%] and sinusitis [19%] among allergic asthmatic children than controls [9% and 6% respectively] with a statistically significant difference at p< 0.01. Other nasal diseases among asthmatics were insignificantly different from controls. The chronic severe asthmatics had higher rate of sinusitis [62.5%] than other asthmatic children [12%] in children with frequent moderate and 8.8% in those with mild asthma with a statistically significant difference at p< 0.01. Proper examination of the upper airways including nose and paranasal sinus should be an essential and routine part when evaluating a child with bronchial asthma, even if symptoms of the upper respiratory tract diseases are not present