Multi-detector computed tomography and virtual bronchoscopy in children: uses and values over fibro-optic bronchoscopy

In the last 30 years, flexible Fibro-optic bronchoscopy has become a major tool for evaluating respiratory disorders in children. Nowadays different imaging modalities for pediatric rachea-bronchial lesions have vastly improved. To identify some potential clinical indications and advantages of Multi-detector Computed Tomography and Virtual Bronchoscopy over Fibro-optic Bronchoscopy in pediatric age group. 25 patients were included in this study 16 males and 9 females, mean age was [25.8 months] suffering from acute or chronic unexplained respiratory symptoms. They subjected to both Multi-detector Computed Tomography and Virtual Bronchoscopy and Fibro-optic Bronchoscopy. This comparative study showed that sensitivity of Multi-detector Computed Tomography and Virtual Bronchoscopy was 63-15% with positive predictive value of 80%, It is sensitive to detect external compression rather than airway malacia. It was sensitive to detect intra luminal obstruction without identifying the pathology which could be more determined by Fibro-optic Bronchoscopy. MDC T- VB may be considered a novel technique for noninvasive evaluation of the tracheobronchial tree in children especially in patients who were not suitable for Fibro-optic Bronchoscopy

Failure to pass urine following transurethral resection of the prostate [TURP]: does the patient's mode of presentation determine the outcome of TURP?

To elucidate possible predictive factors for failure to pass urine following transurethral resection of the prostate [TURP] in patients subjected to TURP for lower urinary tract symptoms [LUTS] secondary to benign prostatic hypertrophy [BPH]. Prospective Study. Urology Unit, Department of Surgery, Mubarak Hospital, Kuwait. Three hundred and fifteen consecutive patients who presented with LUTS secondary to BPH and underwent TURP were included in the study. TURP. Main Outcome Measure: Ability to void after TURP. Out of 315 patients, 26 [8.3%] failed to void after TURP. The mean age of patients was 67 [range 57-92] years. The causes of failure to void after the catheter removal were: hypotonic bladder [10 / 26, 38%], persistent infra-vesical obstruction [9/ 26, 35%], diabetic neuropathy [4/ 26, 15%], end stage renal failure neuropathy [1 /26, 4%] and old age [2/ 26, 8%]. 21 / 26 [80.7%] patients who failed to void presented with acute on chronic or chronic urinary retention. The etiology of failure to void post-TURP is multi-factorial but is more common in patients presenting with acute on chronic or chronic urinary retention secondary to hypotonic bladder, diabetic neuropathy and occasionally very old age. Careful pre-operative patient selection and counseling is required in patients with chronic urinary retention about to undergo TURP to minimize the frustrations associated with the management of patients failing to void post-TURP

twelve-year experience in the management of calciphylaxis resulting in penile gangrene

To analyze the mode of presentation of patients with calciphylaxis induced penile gangrene and the outcome of management of the disease Prospective study [1998 - 2010] Urology Unit, Mubarak Hospital, Kuwait Patients presenting with penile gangrene secondary to calciphylaxis were analyzed. Intervention[s]: Patients with moderate to severe penile gangrene had penile amputation Main Outcome Measure[s]: Etiological factors, mode of presentation, patient characteristics and the outcome of management Eleven patients were managed in the 12-year period. All patients [100%] had end stage renal failure [ESRF] and nine patients [81.8%] were on chronic dialysis at presentation. Poorly controlled diabetes mellitus was a co-morbidity in 10 patients [90.9%]. Areas of gangrene were limited to the glans penis in nine patients [81.8%] and extending to the scrotum in two patients [19.2%]. All patients had generalized calcified blood vessels on plain X-ray of the abdomen and pelvis. Eight patients [72.7%] required partial or total amputation of the penis. Three patients were successfully managed by debridement while one of them was too ill for surgical intervention. Seven patients [63.6%] were dead within three months of the diagnosis of penile gangrene. Penile gangrene due to calciphylaxis is a rare disease seen mostly in patients with ESRF on chronic dialysis. Poorly controlled diabetes is a risk factor for the onset of penile gangrene. The disease has a high mortality in older patients with other co-morbid medical diseases. Immediate penile amputation may result in a satisfactory outcome in less than 50% of all patients

Typhoid carriers among children in Sohag

Typhoid fever is still a major public health problem around the world especially in developing countries. In endemic areas, children aged 1-5 years are at the highest risk of infection. Between 1% and 5% of patients with acute typhoid infection have been reported to become chronic carriers, depending on age, sex and treatment regimen. In this work we study the prevalence of chronic typhoid carriers among children in Sohag. Five hundred children between 2-14 years [421 males and 79 females] attending outpatients pediatrics' clinic at Sohag University Hospital were examined for the existence of typhoid bacilli in their urine and stool. This study showed that typhoid bacilli were found in 18.7% stools and 3.1% were urinary carriers. Only 34.7% of the stool carriers had definite history of typhoid and 12.3% in the urinary carriers. The highest percentage of carriers was found at age above 12 years [40.2%]. Chronic stool and urinary carriers were more in rural than in urban areas. This high percentage was associated with bad water supply and poor hygienic measures. Symptoms suggesting typhoid fever were present in 58.6% of stool carriers and 18.2% in urinary carriers. Chronic typhoid carriers are present in considerable percentage of children in Sohag, and this was associated with bad water supply and bad hygiene especially in rural areas

Bronchial asthma among school students of Sohag district

Respiratory system diseases are common among school students but there were no previous community based studies conducted to show the prevalence of bronchial asthma among school students in sohag governorate, also for the assessment of the school classroom environment affecting those diseased students. A cross sectional study was done and randomly chosen classroom from each school from the 50 sampled schools was selected. This study in 2408 students from different grades who completed a prepaired questionnaire and went thorough history taking, physical examination and pulmonary function test for suspicious cases for bronchial asthma with special interest to FEV1 improvement of more than 15% after inhaled sulbutamol. Prevalence of bronchial asthma was [4.81%]; [3.40%] in urban schools and [1.41%] in rural schools with statistically highly significant difference between urban and rural [P<0.001 and 0.002 respectively]. The mean classroom density was [44.6 students per classroom]. About the classroom ventilation, windows area constitutes >/= 1/4-1/5 of the classroom area in [90%] of the schools; [95%] of urban schools and [86.7%] of rural schools. There was significant difference in the prevalence of asthma among urban and rural area school students. Prevalence was high among families with positive history of bronchial asthma. Most of school students who were diagnosed as bronchial asthma had other allergic diseases like eczema and allergic rhinitis and eye allergy

Anuria secondary to hot weather-induced hyperuricaemia: diagnosis and management

There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait. Patients and Patients presenting to our urology unit as an emergency during the hot summer months of April to October [average temperature 40-55oC] were suspected of having hot weather-induced anuria secondary to hyperuricemia if they had a history of working in the sun for 6 to 8 hours per day and a progressive decrease in urine output to complete anuria. The diagnosis was confirmed by demonstration of elevated serum creatinine and uric acid, ultrasound findings of normal kidneys, ureters, and bladder [KUB] or mild to moderate hydronephrosis, but no features of chronic renal disease and little or no urine in the bladder. Management consisted of emergency cystoscopy, retrograde pyelogram, ureterorenoscopy [URS], and

Chronic renal failure in adult Yemeni patients: Risk factors

This research was done to investigate some of the risk factors of chronic renal failure among adult Yemeni patients. A case-control study of two groups, each containing 140 patients, was designed. Cases were the patients with chronic renal failure in the dialysis center of Al-Thawra Modern General Hospital in Sana'a. The controls were selected from other departments: general surgery, orthopedics and gynecology. The groups were matched for age, sex and residence. Risk factors studied included previous renal calculi, urinary tract infections, diabetes mellitus, hypertension, prostatic enlargement, malaria, tuberculosis, family history, analgesic abuse and Khat chewing. Mean age of cases was 38.6 +/- 13.9 years and that of the controls was 39.7 +/- 12.6 years. Renal calculi were found to be the most common risk factor for chronic renal failure in Yemen, with odds ratio of 11.23. The second risk factor was hypertension with odds ratio of 8.33. Third was a history of urinary tract infection with odds ratio of 4.04. The family history of hereditary diseases was the fourth risk factor with odds ratio of 3.24, and last was analgesic abuse with odds ratio of 2.05. The other studied factors were found to be of no significance in relation to chronic renal failure. Renal calculi were the leading risk factor for chronic renal failure