Risk factors for breast cancer in Egyptian postmenopausal females in Alexandria

Obesity is a modifiable risk factor for breast cancer in postmenopausal females. This study was conducted to investigate the association between obesity and breast cancer risk among Egyptian postmenopausal females in Alexandria. This study included 100 Egyptian postmenopausal females, 50 of them were breast cancer patients with mean age [54.6 years +/- 9.6] and the other 50 were controls with mean age [53.9 years! 2.5]. Standardized questionnaires concerning age, anthropometric, menstrual and reproductive information, family history of breast cancer in first degree relatives and history of hypertension were completed by the same researcher. Fasting blood samples were withdrawn from all participating females to separate sera in which total estradiol, insulin and glucose levels were measured. Univariate analysis showed that age at presentation > 60 years, delayed menopause > 50 years, family history of breast cancer in first degree relatives, oral contraceptive use, body mass index [BMI], waist circumference [WC] and serum levels of total estradiol were found to be significantly associated with higher risk of breast cancer in postmenopausal females. Multivariate logistic regression analysis showed that old age at presentation > 60 years and late menopause >50 years were the strongest risk factors, while oral contraceptive use and increased WC >100 cm showed border line significance. Based on the results obtained from this study, we advice Egyptian postmenopausal females of Alexandria to control weight by decreasing dietary caloric intake, maintain physical activity and breast self-examination continuously in order to decrease the risk of breast carcinoma

Long-term clinical and manometric comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure

Comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure. 160 patients were equally randomly divided into 4 groups treated by: lateral internal sphincterotomy [Group], local Diltiazem ointment [Group[22]], local Glyceryl trinitrate ointment [Group[222]], or injection of Botulinum toxin into the internal anal sphincter [Group 2V]. Anal manometry was measured before and 3 months after treatment. Patients were followed up for 5 years. Mean time for complete pain relief was 5.68 +/- 7.77 days [Group I], 15.7 +/- 5.87 days [Group II], 15.6 +/- 5.90 days [Group III] and 2.67 +/- 3.60 days [Group IV]. Mean healing time was 4.48 +/- 1.20 weeks [Group I], 5.12 +/- 1.13 weeks [Group II], 5.00 +/- 1.12 weeks [Group III] and 5.06 +/- 1.31 weeks [Group IV]. Mean resting and squeeze anal pressures decreased significantly after sphincterotomy. Recurrence rate was 10% in Group I, 65% in Group II, 57.5% in Group III and 52.5% in Group IV. Lateral internal sphincterotomy is easy and satisfactory, with minimal complications and recurrence. Medical sphincterotomy is safe, and easy, with mild complications. Its effect is reversible. Relapse after it is common. It is worth trial before surgery or in patients that cannot or unwilling to undergo surgery

Evaluation of laparoscopic trans-abdominal preperitoneal repair of recurrent inguinal hernia

Fifteen adult male patients with recurrent inguinal hernia were treated with laparoscopic transabdominal preperitorteal repair [TAPP]. Controllable intraoperative complications were recorded in 3 patients [20%] with no conversion to open. No major postoperative complications were encountered. The mean operative time was 77.3 minutes. The mean time of ambulation out of the bed was 10.3 hours and the mean hospital stay was 19.8 hours. The mean time to return to usual social activity was 8.5 days. During the short period of follow up [6-24 months] no recurrence was reported. Long term follow up is needed for proper evaluation of this new procedure