impact of gender on difficulty of classical open cholecystectomy

Cholecystectomy demands attention, and expectation of abnormal anatomy in the veins, arteries or ducts. Prediction of difficult cholecystectomy does not only helpin patient counseling but also helps the surgeon to prepare better for the technical difficulties that may be encountered[1-3]. To find out whether there is impact of gender on the difficulty of surgery during open cholecystectomy. This is a prospective hospital based study. Patients who presented to Ibn Sina Hospital for open cholecystectomy during the period from April 2011 to April 2012 were included in this study. Special emphasis was put on gender, the operative time, difficulty of surgery and complications of open cholecystectomy. A pre-tested questionnaire was filled during interview of patients and operating surgeons. A total 327 operations were included in the study. Of them there were 34[64.2%] males and 99[36.1%] females presented early i.e. after the first diagnosis was made. The mean operative time was 44.6 min for males and 43.57 min for females. Difficult surgery was described in 6[11.3%] of male and 23[8.4%] females. There was no significant statistical difference in the operative time, difficulty of operation and complication rate between males and females

Impact of an educational programme on knowledge, beliefs, practices and expectations about care among adolescent glaucoma patients in Cairo

Glaucoma is a leading cause of blindness worldwide. The aim of the current study was to evaluate the impact of an educational programme on knowledge, beliefs, practices and expectations towards glaucoma and eye care among adolescent patients with glaucoma. A purposive sample of 50 patients with glaucoma aged 12-18 years, attending ophthalmology outpatient clinics in Cairo, Egypt, were given an educational programme focusing on information about glaucoma, correcting patients' incorrect beliefs and expectations, and demonstrations and retraining about eye care. A range of tools was used to assess patients before and after the programme: questionnaire, observation checklist, physical assessment sheet, childrens' depression scale, children manifest anxiety scale, self-esteem inventory and patients' expectations scale. The programme significantly improved patients' knowledge and beliefs about glaucoma and their practices and expectations concerning eye care. Innovative educational programmes about eye diseases are needed to improve patients' knowledge and practices

Prevalence of elevated hepatic transaminases among upper Egyptian patients with type 2 diabetes mellitus

The prevalence of liver transaminases in type 2 diabetics upper Egypt patients with type 2 diabetes is unknown. To estimate the prevalence of elevated liver transaminase levels among upper Egyptian patients with type 2 diabetes and to determine the associated risk factors. We recruited130 patients with type 2 diabetes from the diabetic outpatient clinic of internal medicine department, or those admitted in tropical medicine department, Assiut university hospital. For all participants, the following was recorded; body mass index, waist circumference, lipid profile, and hepatic transaminase levels. HBsAG, anti-HCV and abdominal US examination was done in all patients. Risk factors of raised transaminases were identified using univariate then multivariate analysis. Amoung the 130 patients enrolled in this study. 22.3% [n-29] were males and 77.7% [n=101] were females. The mean age was 47.35 +/- 9.36 years. One hundred and eighteen [90.8%] were obese. The prevalence of elevated AST was 7.7% [n=10] with the gender-wise prevalence of 13.8% [n=4] in men and 5.9% [n=6] in women, p value= 0.157, odds ratio - 0.39 [95% CI: 0.103-1.51]. The prevalence of elevated alanine transaminase [ALT] was 11.5% [n=15] with the gender-wise prevalence of 13.8% [n=4] in men, and 10.9% [n=11] in women, p value = 0.441, odds ratio=0.764 [95% confidence interval [CI]: 0.224-2.61]. Only 3.8% [n=5] showed elevated levels of both ALT and AST. Patients with high waist circumference had elevated ALT levels [13.8%] versus 4% only in those with normal waist circumference [odds ratio=3.6. 95%, CI: 0.462-29.49, and p value = 0.035]. Insulin use was associated with a high odds ratio for elevated ALT levels [OR=18.85. CI: 2.39-148.3]. High ALT levels were significantly associated with the duration of diabetes: 14.85% in those with DM dating to <10 years versus 0% in those with DM dating to >/= 10 [odds ratio= 0.748.CI: 0.673-0.832 and p value=0.018]. Younger patients [less than 45 old] and a higher tendency to have elevated ALT compared to those over 45 years [OR= 1.19. p value=0.003]. on multivariate analysis. Young age and insulin use was only independent predictor for isolated rise in ALT or AST were obese [P value= 00.043 and 0.045 respectively]. The risk factors for elevated levels of both ALT and AST in univariate analysis were male gender. Patients less than 45 years old and insulin use. Elevated ALT and AST levels are found in 11.5% and 7.7% of type 2 diabetic patients re-spectively. Elevated ALT level is observed more in relatively younger diabetic patients with isolated rise of either ALT or AST were obese. One multivariate analysis, young age and insulin use were only independent predictor for isolated rise in ALT levels. Hyperinsulinemia and insulin resistance should be considered as the key mechanism leading to hepatic steatosis

Secular trend is not only acused for the increased incidence of pet, but also for its severity

To determine the role of secular trend in preeclampsia. Both at puberty and in the 3rd trimester of 65 singleton-primigravid preeclapmtics [Group I] and 867 comparable healthy, pregnants [Group II], body mass index [BMI], serum testosterones [total and free], dehydroepiandrosterone sulfate, estradiol and sex hormone-binding globulin levels were measured. Also, the ages at menarche, umbilical S/D ratio, fetal sex and small muscular arteries/high power field [SMA/HPF] were detected. In group I menarche occurred earlier [p<0.001] with higher BMI [p<0.001]. Also, testosterones were significantly higher [p<0.001 for both] both at puberty and during pregnancy, irrespective of fetal sex. Also, S/D ratio was higher with smaller SMA/HPF [p<0.001 for both]. Also, BMI at puberty and testosterone levels; on one hand showed strong +ve correlation to diastolic blood pressure and S/D ratio and strong -ve correlation to SMA/HPF on the other hand. Preeclamptic primigravid showed earlier puberty, significant increase in BMI with significantly higher levels of testosterones than comparable normotensive women, which were associated with more severe disease. This may indicate a significant role for androgens both in the pathogenesis and the severity of PET