Comparative study between sapherio-femoral disconnection and low molecular weight heparin in management of above knee great saphenous vein superficial thrombophlebitis

The aim of this work is to assess the safety and efficacy of saphenofemoral disconnection [SFD] in comparison to low molecular weight heparin [LMWH] in cases of above knee great saphenous superficial thrombophlebitis [STP] without involvement of the deep venous system. 40 patients who completed the study period with mean age 37.5 years, were diagnosed as having above knee great saphenous STP without involvement of the deep venous system clinically and with duplex examination. Blood tests for hypercoagulable state was done They were divided into two comparable groups each group was 20 patients: the first group was treated with SFD and the second group was treated with LMWH for 3 weeks [The first week: the recommended therapeutic dose, and prophylactic dose in the remaining two weeks] and following both groups of patients clinically and with duplex at one week, 1, 3, 6, months for complications, -resolution, recurrence and occurrence DVT [Deep Vein Thrombosis]. Minor complications and resolution of the symptoms in the first week were equal in both "' groups but the rate of first month recurrence of STP is higher in surgically treated group [statistically non-significant]. Detection of DVT in follow up period is higher in the first 3 months of follow up in the surgically treated group [statistically non-significant] after that it was the same in both groups where no DVT was observed with either therapeutic method after 3 months to 6 months. Neither pulmonary embolism [PE] nor mortality was recorded in this work. DVT was treated medically. No abnormal blood test for hypercagulable state was found before inclusion or during the study in any patient. STP of the lower limb is easy to diagnose but till now there is no standard management because the etiology is not clear, it shares DVT in some etiological factors but not all factors. Routine survey for thrombophylia is not recommended in the first attack of STP. SFD was stressed as an emergency operation in cases of above knee great saphenous vein [CSV] STP without involvement of ' the deep venous system. In this study it is found that no statistically significant difference between the groups of SFD and LMWH group in aspects of resolution, recurrence, and onset of DVT during the period of the study

Randomized clinical study of gastrografin[R] administration in patients with adhesive small bowel obstruction

Oral Gastrografin[R] has been used to differentiate partial from complete small bowel obstruction [SBO]. It may have a therapeutic effect and predict the need for early surgery in adhesive SBO. The aim of this study was to determine whether contrast examination in the management of SBO allows an early intake and reduces hospital stay. Thirty patients admitted in Department of General surgery, Tanta university hospital between January 2004 and February 2006 with symptoms and signs suggestive of postoperative adhesive SBO were randomized into two groups, a control group and Gastrografin[R] group. Patients in the control group were treated conservatively. If symptoms of strangulation developed or the obstruction did not resolve spontaneously after 4-5 days, a laparotomy was performed. Patients in the Gastrografin[R] group received 100 ml Gastrografin[R]. Those in whom the contrast medium reached the colon in 24 h were considered to have partial SBO, and were fed orally. If Gastrografin[R] failed to reach the colon and the patient did not improve in the following 24 h a laparotomy was performed. Conservative treatment was successful in 26 patients [86.67 percent] and 4 [13.33 percent] required operation. Among patients treated conservatively, hospital stay was shorter in the Gastrografin[R] group [P < 0.001]. All patients in whom contrast medium reached the colon tolerated an early oral diet. Gastrografin[R] did not reduce the need for operation [P=1.000]. No patient died in either group. Oral Gastrografin[R] helps in the management of patients with adhesive SBO and allows a shorter hospital stay

Post operative changes in sinus mucosa after endoscopic sinus surgery

This study was performed on 30 patients with chronic sinusitis from outpatient clinics, AlAzhar University Hospitals. Biopsies from the sinus mucosa and turbinates were studied by light microscopy. transmission and scanning electron microscopy. These biopsies were obtained before and after functional endoscopic sinus surgery [FESS]. The present investigation led to the following findings. The microscopic pictures showed that goblet cells, inflammatory cells and oedaema were less postoperatively but fibrosis was more than before the operation. In chronic sinusitis treated by FESS. the mucosa showed ultrastructural changes caused by acute and chronic infections. In chronic sinusitis, morphological changes such as swelling of the ciliary membrane, formation of compound cilia, loss of epithelial cells, ciliary disorientation dilated glands and cells distended with secretory granules were recorded. Swelling of endothelial cells of the blood vessels was observed. Healing of mucosal pathology evaluated radiologically and by electron microscopy took up to six months despite the seemingly early symptomatic improvement

Squamous cell carcinoma and tissue polypeptide antigens as tumor markers in pharyngeal carcinoma

To evaluate the squamous cell carcinoma antigen [SCCA] and tissue polypeptide antigen [TPA] in pharyngeal carcinoma, the serum concentration in 30 patients and ten apparently healthy controls were studied. The results of pre-treatment pharyngeal carcinoma patients were compared with both controls and 1, 6 and 12 months post- treatment. Also, pre- treatment results were correlated to the primary tumor, lymph node, clinical stages and histologic grades. SCCA was sensitive in 50% of the patients, while TPA was sensitive in 63.3%. The combined determination of the two markers increased the sensitivity to 76.6%. Thus, the two markers had a good monitoring value in the follow up of patients with pharyngeal carcinoma and they can extend and expand the diagnostic possibilities for therapy monitoring and early detection of recurrence