RESUMO
Hepatic encephalopathy is one of the complications of liver cirrhosis. Ammonia is implicated as a precipitating factor for HE, minimal hepatic encephalopathy cannot be detected clinically and impairs quality of life, indicated that H. pylori infection is associated with high blood ammonia levels by urease enzyme and can lead to causation of HE. This study evaluated the effect of H. pylori eradication therapy on MHE. A total of 60 cirrhotic patients were selected from al-Hussein University Hospital. They were GI: 30 patients with MHE and GII; 30 patients without MHE. All patients were subjected to H. pylori stool antigen and blood ammonia level. Positive H. pylori patients received triple therapy for 14 days, then 4 weeks later were revaluated regarding, H. pylori stool antigen, serum ammonia level and NCT. Helicobacter pylori infection was found 63.3% of GI versus 40% in GII; serum ammonia levels were significantly higher in patients with GI and H. pylori positive. Treatment was successful in 78.9% of GI patients versus 89.4% of GII. Number connection test and serum ammonia level were significantly improved in GI patients and positive H. pylori after eradication therapy
RESUMO
The outcome of the different surgical techniques used in our department for closure of urethrocutaneous fistulae [UCF complicating various types of hypospadias repair is evaluated. Simple, multi-layered closure and skin bridge operations were the commonest procedures used in this respect. The study comprised 120 patients undergoing UCF repair between 1998 and 2004. Out of the 120 patients, only 85 patients were available for postoperative follow up and evaluation. The median [range] age at primary fistula repair was 60 [30-180] months and the median follow up duration after the most recent repair was three years. Patients were categorized into 3 main groups; Group I included 28 patients [33.5% of the studied group] had simple closure of their UCF with successful outcome in 20 case [71%]. Group II involved 46 patients representing 54% of the studied group underwent multi-layered closure of their fistulae with successful results in 37 patients [82.5%]. Group III comprised 7 patients [8%] of the studied population for whom a skin bridge operation was done with successful outcome in 6 cases [85%]. The remaining 4 cases [4.5%] required repair of their fistulae using a Snodgrass technique with successful outcome. The overall success rate after primary fistula repair was reported in 63 cases [78%]. Fistulae larger than 2 mm [12 case] tended to re-fistulate in 50% of cases [6 cases]. Also multiple fistulae [14 case] showed greater tendency for recurrence as seen in 9 cases [65%]. After secondary repair for recurrent fistulae the success rate increased up to 22 case [78.5%] in Group I, up to 41 case [89%] in Group II and up to 7 patients [100%] in Group III. All failures, whether after primary or secondary repairs were caused by wound infection. From the above mentioned results it can be concluded that the overall success rate after multi-layer closure [89%] is much superior than the successful outcome after simple closure [78.5%] P < 0.05 while skin bridge oper