Early and late outcomes of TEP and Lichtenstein repair for recurrent inguinal hernia repair in men: a comparative study

Background: Repair operation for recurrent inguinal hernia is a more exigent than the primary inguinal hernia. Open hernia repair associated with lower recurrence and fewer complications while the Laparoscopic repair associated with less pain postoperatively, early recovery time with subsequent earlier return to activity and better results regarding the wound.Methods: From November 2015 to March 2019, a total of 86 patients were randomized. 42 patients were recruited to total extra-peritoneal repair (TEP) group and 44 patients for Lichtenstein group. Overall, 86 were operated in general surgery department, Menoufia University hospitals.Results: The mean age of patients was 41.3±14.4, range from (25-55 years). One conversion occurred in the TEP group to Lichtenstein. Operative time was significantly low in TEP group (82.7 min) compared to Lichtenstein group (108 min). Hospital stay was significantly less in TEP group (1 day) compared to Lichtenstein group (1.8 days). Patients undergoing Lichtenstein repair have significant earlier oral intake than TEP group (3.7 vs. 6.6 hours). 12 cases developed seroma in Lichtenstein group with significant p value (0.001). This study showed less immediate and early VAS score in TEP group (2.3) versus high VAS score in Lichtenstein group (5.9) with highly significant p value (0.0001).Conclusions: TEP offer excellent results than LR for treatment of unilateral or bilateral recurrent inguinal hernia with lower morbidity and less incidence of post-operative pain with subsequent earlier return to normal activities.

Gas chromatography/mass spectrometry profiling of the costus plant Saussurea lappa (Decne.) C.B. Clarke root extracts and their anti-bacterial activity

The costus Saussurea lappa is a well-known medicinal plant that has been widely used in the traditional medicinesin many Asian countries. Here, we report on the chemistry of the ethanol and water extracts of S. lappa roots usinggas chromatography mass spectrometry (GC/MS) analysis. We further tested their antimicrobial activities againstStaphylococcus aureus (Gram +ve) and Salmonella sp. (Gram –ve) isolates. The GC/MS analysis indicate that theethanol extract has more compounds (37) than does the aqueous extract (18) with sesquiterpene lactones as the mostabundant compounds in both extracts. The results reveal that the ethanol extract has significant antimicrobial activityagainst S. aureus isolate with 18–20 mm zone of inhibition, while no effect was observed against Salmonella sp. Incontrast, weak effects were found in the water extract against S. aureus and no effect against Salmonella sp. isolate.Together with the GC/MS analyses, we conclude that the ethanol extract contains active secondary metabolites thatmay have a specific activity likely in a synergy effects with other metabolites against Gram +ve bacteria, but not Gram–ve isolate. Further experiments are needed to clarify the specific effects of S. lappa ethanol extracts against Gram+ve bacteria

Impact of Hemodialysis on Serum Zinc and Copper Level in CKD Patients.

The aim of this study was to assess the effect of HD on zinc and copper level among CKD patients. A cross-sectional study included 40 subjects (15 female and 25 male) from academic hospital aged (22-80 years old) were included, timed pre and post-hemodialysis samples were collected. Serum zinc, copper, urea and creatinine were measured by using atomic absorption spectroscopy 210-VGP® and Mindray Bs-200 respectively, and BMI was estimated. Paired t-test analyses showed significant decrease in mean copper, urea and creatinine with p-value (0.025, 0.000 and 0.000) respectively, while significant increase was observed in zinc level p-value 0.035. Person's correlation showed positive correlation between change in zinc level and reduction in urea, and no correlation noted between change in serum copper level and reduction in urea and creatinine. In conclusion HD decrease copper and increase zinc as both are antagonists, might play a vital role in pathogenesis of related disorders in CKD Patients.

Thermophilic bacteria in Moroccan hot springs, salt marshes and desert soils

The diversity of thermophilic bacteria was investigated in four hot springs, three salt marshes and 12 desert sites in Morocco. Two hundred and forty (240) thermophilic bacteria were recovered, identified and characterized. All isolates were Gram positive, rod-shaped, spore forming and halotolerant. Based on BOXA1R-PCR and 16S rRNA gene sequencing, the recovered isolates were dominated by the genus Bacillus (97.5%) represented by B. licheniformis (119), B. aerius (44), B. sonorensis (33), B. subtilis (subsp. spizizenii (2) and subsp. inaquosurum (6)), B. amyloliquefaciens (subsp. amyloliquefaciens (4) and subsp. plantarum (4)), B. tequilensis (3), B. pumilus (3) and Bacillus sp. (19). Only six isolates (2.5%) belonged to the genus Aeribacillus represented by A. pallidus (4) and Aeribacillus sp. (2). In this study, B. aerius and B. tequilensis are described for the first time as thermophilic bacteria. Moreover, 71.25%, 50.41% and 5.41% of total strains exhibited high amylolytic, proteolytic or cellulolytic activity respectively.

[Gaucher's disease uncovered late about two patients]

Gaucher's disease is an uncommon inborn recessive autosomal disease, due to a deficient activity of the lysosomal enzyme beta glucocerebrosidase. This disease is usually diagnosed in the first or second decade of life with the arising of bone pains, splenomegaly and hemorragic manifestations due to thrombocytopenia. When the enlarged spleen is not evident, or after splenectomy, patients may be mis-identified as having Gaucher's disease. We present here two cases of elderly patients aged 70 and 46 years respectively, in whom the disease was a surprising finding of bone marrow examination, during check up for pancytopenia