Management of recurrent rectal prolapse using Notaras technique

Twenty one patients with recurrent rectal prolapse were treated via transabdominal rectopexy, using a prolene mesh applied to the back of rectum and fixed to the promontory of sacrum [Notars Technique, 1973]. Seventeen patients [80.9%] passed smooth, nice postoperative period with good satisfactory results postoperatively. Three patients [14.3%] got severe intraabdominal sepsis and the mesh was removed. One patient [4.8%] got recurrence after 3 months, he needed reoperation with resection of the rectosigmoid colon and refixation again. The satisfactory results obtained in the 17 patients [80.9%] encourage the use of this technique in comparison to other techniques and satisfactory postoperative observation and follow-up of patients for two years encourages the use of this technique, we prefer the use of prolene mesh instead of mersilene mesh used by Notaras to avoid severe infection

Emergency treatment of blunt and penetrating injuries of colon

Twenty three patients with traumatic injuries of the colon were received in the emergency departments of Ain Shams University, Abd El-Kader Fahmy and Al Nozha Hospital. 11 patients had blunt trauma [47.8%], 12 patients experienced penetrating trauma [52.2%]. Blunt trauma commonly involved left colon in 9 patients out of 11 patients [81.8%] while penetrating trauma involved right or transverse colon II patients out of 12. [91.6%]. All patients with blunt injuries were treated with Iry repair of the colon. Ten patients with penetrating injuries were treated with primary colonic repair after resection of the affected segment, resection with proximal colostomy was done in two patients with penetrating injuries. Post-operative mortality was 2 patients [1.9%] on top of associated injuries, and postoperative chest infections. Morbidity was very low in patients with blunt injuries of colon, which encourage primary repair of colon in blunt and penetrating trauma

Venous surgery in erectile dysfunction Therapeutic strategy and results

Fifty seven [57] patients with venogenic impotence -were treated from period of 1989 to 1993. Their corporal veno-occlusive functions was evaluated by dynamic infusion cavernosography and cavernosometery [DICC]. Patients were divided into two groups on the basis of the type of venous operation performed. Thirty [30] patients were subjected to dorsal vein ligation with resection of 1.5 cm of deep dorsal vein. While 27 patients were subjected to deep dorsal vein ligation plus ligation of the proximal parts of both corporae The overall success rate in both groups was [38.7%] [22 patients out of 57]. Success rate was more in patients with dorsal vein ligation plus spongiolysis than in patients with dorsal vein ligation plus ligation of crorae. Data obtained in our series suggest that venous surgery should only be offered to a selected group of patients comprising young impotent males with venous leakage

Combined medical and surgical treatment of Rydatid disease of liver

This study was carried out on 31 patients [20 males, 11 females] with hydatid disease of liver. Mean age of males was 35 +/- 4 years while that of females was 28 +/- 5. Sixteen patients of the male group M solitary cyst of the liver, 90% of them were in the right lobe. Four patients had multiple cysts. Eight of females patients had solitary cyst of the liver, all of them were in the right lobe while 3 female patients had multiple cysts in the right and left lobe. all patients were subjected to elective surgical excision of hydatid disease after 1 month of medical treatment with Albendazole. They were followed postoperatively for 6-12 months with abdominal ultrasonography and computed tomography. No recurrence was obtained, the percentage of success of medical treatment combined with surgery was 100%. No medical treatment was given to those patients with calcified cysts

Effect of bilateral high ligation on ultrastructure of sperms by electromicroscopic examination

One hundred and three patients with primary varicocele more on left side than right side presented to out patient clinics of many hospitals in the age range from 25 years to 55 years [average age 30 +/- 4]. Diagnosis of varicocele was evaluated by clinical examination, ultrasonography, Doppler flowmetery and Testicular vein venography. All patients were subjected to bilateral retroperitoneal ligation of testicular veins and inguinal ligation of testicular veins. They were followed for 12 month to 39 months. Electron microscopic examination of seminal fluid, was done before and after surgery 3, 6, 12 months, to see the effect of highligation on ultra structure of sperms. Success was achieved in 40% of patients in excellent manner [increase in number of sperms, decrease in percentage of abnormal forms, increase in mothility of sperms] about 50% of patients showed mild improvement [mild increase in number of sperms, percentage of abnormal forms was still high, motility of sperms remained minimal]. Ten percent showed no improvement at all, even some of them schieved worse results. In our series, bilateral high ligation showed better results than unilateral ligation of left testicular vein alone and it remains the operation of choice in the treatment of varicocele with oligoathenospermia especially in selected young aged patient

Management of common bile duct stones endoscopy versus surgical treatment

Fifty three patients with common bile duct stones were treated. According to their investigations, they were divided into 3 groups. Group A, 18 patients with stones in common bile duct and in gallbladder, they were not jaundiced. Group B, 12 patients with retained stones in common bile duct after cholecystectomy. Group C, 23 patients with common bile duct stones and obstructive jaundice. Endoscopic sphincterotomy succeeded in extraction of stones from common bile duct in the three groups with a success rate 75%, 83.3% and 69.5%, respectively. Endoscopic sphincterotomy by an expert endoscopist proved to be very valuable line of treatment either alone or ancillary to surgery of common bile duct stones. It helped in the clearance of common bile duct before surgery or it helped in converting a seriously ill patient to a safe elective situation before surgery

Reconstruction of mandible after excision of primary malignant tumors

Seventeen patients with primary malignant tumor of mandible adamantionoma were treated with surgical excision of the tumor with safety margin. Wedge resection was done in small sized tumors, while hemimandibulectomy was achieved in large sized tumors affecting ramus or encroaching on temporomandibular joint. Immediate mandibular reconstruction was achieved in 9 patients using rib grafts and meshed trays or synthetic plates according to the defect. Eight patients underwent delayed reconstruction after 3-6 months of primary tumor excision using rib-bone grafts and meshed trays. Four patients out of 9 patients, who underwent immediate primary reconstruction of mandible, developed wound infection and rib graft was absorbed in 3 of them and plate graft was rejected in one of them. All patients who underwent delayed repair of mandible got excellent results. The cosmetic results were excellent [55% of primary repair and 88% in secondary repair]

Fine needle aspiration biopsy versus excision biopsy of cervical lymphadenopathy in children between ages of 10 and 16 Years

One hundred two children aging between 10-16 years, were subjected to fine needle aspiration technique for their cervical lymph node enlargement. The results obtained were compared to the results of surgical excision biopsy of these lymph nodes. The fine needle aspiration biopsy results proved to be accurate in diagnosis of tuberculous lymphadenitis, Hodgkin lymphoma, non Hodgkin lymphoma and metastatic lymph node enlargement with a percentage of 90%, 93%, 73%, 50%, respectively. It is a simple rapid technique that can be used as a routine clinical work-up in diagnosis of patients with cervical lymphadenopathy. The suspected cases of malignancy is a specific problem that can be solved completely by excision biopsy

Synthesis of some pyrazolone derivatives of expected pharmacological activity

The synthesis of some substituted pyrazolone derivatives having in position-4 an imidazole ring in which the isoureido moiety is partially featured. The analgesic activity of some of these compounds were tested in mice and results are included

Management of ocular mycosis

Ten cases of ocular fungal infection have been treated with topical and subconjunctival injection of either Amphotericin B [Fungizone] or by miconazole [Daktarin] both are in diluted solution and other cases were treated by oral ketoconazole [Nizoral], in two cases we resorted to surgical interference in the from of therapeutic keratoplasty and pars plana vitrectomy with use of antifungal therapy post-operative

Long term experience with buphthalmos in Egypt

Patients with buphthalmos creates a real challenge to ophthalmologist in most of countries, particularly, in the third world. Egypt is a country that lies within in the domain of the third world, and is not exempted from this difficulty. For the last 15 years we tried to adopt a one stage operative technique for the control of buphthalmos in Egypt. One hundred and three eyes with buphthalmos were operated upon by subscleral trabeculectomy, 61.5% of eyes studied were controlled by one set surgery, 23.0% needed a second trabeculectomy and only 18 eyes [l5.3%] neccessitated a third surgical interference