Impact of irregular marital cohabitation on quality of life and sexual dysfunction in infertile men from upper Egypt / 대한생식의학회지

Objective@#Irregular patterns of marital cohabitation are a common problem in upper Egypt due to employment conditions. The objective of this study was to investigate the effect of irregular marital cohabitation on the quality of life and sexual function of infertile men. @*Methods@#In total, 208 infertile men were included and divided into two groups. The first group included 134 infertile men with an irregular pattern of marital cohabitation and the second group included 74 infertile men with a regular pattern of marital cohabitation. All subjects were assessed through a clinical evaluation, conventional semen analysis, the fertility quality of life (FertiQoL) questionnaire, the International Index of Erectile Function (IIEF-5) score, and the premature ejaculation diagnostic tool (PMEDT). @*Results@#The two groups were compared in terms of conventional semen parameters, FertiQoL, IIEF-5 score, and PMEDT. Infertile men with an irregular pattern of marital cohabitation had significantly lower subscale and total FertiQoL and IIEF-5 scores. Additionally, they had significantly higher PMEDT scores. Erectile dysfunction and premature ejaculation were more common in them than in infertile men with a regular pattern of marital cohabitation. @*Conclusion@#Irregular patterns of marital cohabitation had an adverse effect on quality of life and sexual function in infertile men.

Comparative study between laparoscopic assisted versus open left sided hemicolectomy and sigmoidectomy for cancer colon

Background: Traditionally, open procedure through exploratory incisions remains the gold standard approach for treating colorectal [CRC]. Laparoscopic colectomy was proved to be a better alternative to the open approach. Though in some studies, it was found that the length of the operation tends to be somehow longer. However, in experienced hands it has comparable oncologic outcomes. Moreover, the laparoscopic approach is associated with less postoperative pain, faster return of bowel activity, earlier resumption of oral intake and lesser hospital stay

Aim of the Study: to study and evaluate the effectiveness of laparoscopic left hemicolectomy and sigmoidectomy compared to the open left sided colectomy and sigmoidectomy for malignancy regarding operative time, length of hospital stay, return of bowel function, resumption of oral intake, postoperative pain perception, general postoperative complications, surgical site infections and early recurrence

Patients and methods: This comparative study has been conducted in El-Demerdash hospital, Ain Shams University - Cairo, Egypt and has included 60 patients where half of the patients underwent open left hemicolectomy or sigmoidectomy and the other half underwent laparoscopic left hemicolectomy or simoidectomy. We performed both procedures during the period between 1[st] of January 2016 and 1[st] of January 2017 with 12 months of follow up post-operatively

Results: In our study, the laparoscopic operation was associated with less hospital stay, earlier return of bowel activity, earlier resumption of oral intake without the use of the regular anti-emetics with better pain control and perception postoperatively. Moreover, it was associated with less surgical site infections and general complications including the respiratory ones than the open operation. We had similar anastomotic leak rates and early recurrence rate between both operations. Finally, the laparoscopic operation was associated with more operative time compared to the open operation

Conclusion: Laparoscopic left hemicolectomy and sigmoidectomy are oncologically sound when compared to the open left hemicolectomy and sigmoidectomy for treating left sided and sigmoid cancers. Moreover the laparoscopic approach yielded better outcomes regarding the postoperative recovery compared to the open approach

Recommendation: A further high volume study is needed to assess the long term effects of both procedures in our hospital

Analgesic efficacy of intraperitoneal ropivacaine or combined with intravenous paracetamol for laparoscopic cholecystectomy

Intraperitoneal instillation of ropivacaine 0.25% immediately before and after surgery and intravenous [IV] administration of paracetamol at the end of surgery may reduce postoperative pain after laparoscopic cholecystectomy. The aim of the study was to examine whether intraperitoneal instillation of ropivacaine with or without IV paracetamol improves postoperative pain after laparoscopic cholecystectomy. After standardized general anesthetic, total of 60 patients were randomly assigned to one of three groups, 20 patients each. Group 1 received intraperitoneal instillation of 20 ml 0.9% saline before and after surgery and IV 100 ml 0.9% saline at the end of surgery [Placebo group]. Group 2 received intraperitoneal instillation of 20 ml ropivacaine 0.25% before and after surgery [total 100 mg ropivacaine] and IV 100 ml 0.9% saline at the end of surgery [Ropi group]. Group 3 received intraperitoneal instillation of 20 ml ropivacaine 0.25% before and after surgery and IV paracetamol 1 gm [in 100 ml bottle] at the end of surgery [Ropi-Para group]. Postoperative pain was rated at 0, 3, 6, 12, and 24 h postoperatively by visual analogue scale scores [VAS]. Total rescue analgesic consumption of morphine during the first 24 h after surgery and time until first analgesic request were recorded. Patients in Placebo group experienced visceral pain mainly and to a lesser extent incisional pain during the first 24 h after surgery. Patients in Ropi group experienced significantly less visceral pain than patients in Placebo group at 3 h after surgery [p < 0.05]. However, there was no significant difference in the intensity of the incisional pain between Ropi and Placebo group at any time after surgery. Patients in Ropi-Para group experienced significantly less visceral and incisional pain than patients in Placebo group at 3 and 6 h after surgery. Patients in Ropi-Para group experienced significantly less incisional pain than patients in Ropi group at 3 and 6 h after surgery. Also, patients in Ropi-Para group experienced significantly less visceral pain than patients in Ropi group at 6 h after surgery. Rescue morphine consumption was significantly less in Ropi-Para group [13 +/- 3 mg] compared to Placebo group [37 +/- 9 mg] [p < 0.001] and Ropi group [21 +/- 5 mg] [p < 0.05]. Also, rescue morphine consumption was significantly less in Ropi group compared to Placebo group [p < 0.05]. Time to first request for analgesia was significantly longer in Ropi-Para group [369 +/- 81 min] compared to Placebo group [35 +/- 29 min] [p < 0.01] and Ropi group [192 +/- 65 min] [p < 0.05]. Also, time to first request for analgesia was significantly longer in Ropi group compared to Placebo group [p<0.05] Intraperitoneal instillation of 20 ml ropivacaine 0.25% before and after surgery [total 100 mg ropivacaine] in addition to IV administration of paracetamol at the end of surgery provides better analgesia after laparoscopic cholecystectomy than that produced by intraperitoneal instillation of ropivacaine alone

Unilateral humeral lengthening in children and adolescents

This study evaluated the early experience with unilateral humeral lengthening in children and adolescents. Sixteen cases with unilateral humeral shortening ranged from 5.5-15 cm were studied. The etiology was Erb's palsy in eight cases, epiphyseal injury in five cases and infection in three cases. Hybrid fixation using wires and half pins was applied to all cases to minimize the risk of operative neurovascular complications. Osteotomy was performed in the middle 1/3 of the humerus through a posterior approach. After a latent period of 5-7 days, lengthening started at a rate of 1/3 mm every 8 hours. At an average follow up of 3 years and 2 months, ten excellent and six good results were achieved. The average healing index was 28 days/cm. The complications included pin tract infection in all cases, radial nerve palsy in one case and fracture of the regenerate in two cases

Forearm lengthening

In this study, 11 cases of forearm shortening underwent lengthening using Ilizarov principles. The etiology was hereditary multiple exostosis in six cases, radial club hand in two cases and traumatic in three cases. The average age at operation was 15.5 years [range 9-40 years]. The average follow up period was 3.5 years [range 2-6 years]. Eight good results, two fair results and one poor result were obtained. The area of lengthening achieved ranged from 2-11 cm of the original bone length. The average healing index was 40 days/cm. There were no neurovascular problems. Complications comprised some sort of pin tract infection in all cases, fracture of the regenerate in one case, breakage of a half pin in one case and increased carpal subluxation in another case. The combination of Ilizarov method and hybrid fixation provides a relatively safe method of forearm lengthening with the possibility of deformity correction and gradual reduction of chronic dislocations

Evaluation of different guide methods for the selection of artificial maxillary anterior teeth

The selection and arangement of maxillary anterior teeth for edentulous patient have long been recognized as a clinical problem in prosthodontic practice. So this study was directed to evaluate some different guide methods used for the selection of maxillary anterior teeth and to find the correlation between anatomical landmarks with the maxillary anterior teeth in dentulous subject. A specially designed tool was used to represent the Frankfort horizontal plane and the orbital plane on both sides of the face. A lateral right and anterposterior cephalometric radiographs were taken for each subject with the teeth in centric occlusion and the lip in repose. The Frankfort and orbital planes, the long axis of the maxillary canine and the most protruding central incisor were drawn. The Bizygomatic width was measured cilnically and cephalometrically. The results showed that there were significant correlations between the width of the 6 anterior teeth with both Bizygomatic width clinically and interorbital plan distance at Orbitale clinically and cephalometrically

Role of chest ultrasound in determining the nature of pleural effusion in children

Because of its ready availability and ability for bed side imaging, sonography has become a major imaging modality not only in determining the presence of pleural fluid and its nature, but also as a guide to aspiration. The pleura is a relatively superficial structure and therefore, it is accessible to sonography. The aim of our work was to investigate the usefulness of sonographic findings, including the internal echegenicity and associated changes in the pleura and lung parenchyma, in determining the nature of pleural effusion, and to compare the results with the CT findings, and those of pleural aspirate. This study was conducted on 50 children suffering from pleural effusion ranging in age between 2 months and 13 years. They were subjected to full history taking, clinical examination, laboratory investigations, laboratory analysis of pleural aspirate, chest Xray, CT chest [if needed] and chest ultrasound. The results of our study revealed that pleural fluid appearance in chest ultrasonography was classified into four main categories: anechoic in 50%; complex non septated in 16.7%; complex septated in 8.3%; and homogeneously echogenic in 25% of cases. We regarded transudates [45.8%] as usually anechoic. Exudates [28.2%] were considered when the pleural effusion was complex septated and non septated. Empyema [20.8%] was considered in our study in cases with homogeneously echogenic pleural effusion. Chest ultrasonography detected 91% of transudates, 80% of empyema, and all cases with inflammatory exudates

Conclusion : We concluded that chest ultrasonography is a valuable method in assessing the nature of pleural effusion and it seems to give additional information over chest x-ray and CT chest

Long-term administration of warfarn versus aspirin for improving the patency of infra-genicular bypass grafts

Fifty patients having infra-genicular bypass grafting were grouped into two groups: group [A] 25 patients were given Warfarin post-operatively, monitoring the dose by I.N.R estimation [target I.N.R: 2-3]; and Group B: 25 patients given aspirin 500 mg/day post operatively. The study has clarified that Warfarin therapy-compared with the aspirin therapy-does not increase the early, intermediate nor the late graft patency rate, and that Warfarin therapy is associated with increased hemorrhagic events, and necessitates life long regular dose monitoring [I. N. R]