Percutaneous high tibial closed-wedge corticotomy and casting for treating genu varum in adolescents.

PURPOSE: Diverse surgical modalities have been designated for the treatment of genu varum deformity. However, other studies have not constantly confirmed which technique to be better than the other. The use of hardware, bone graft or bone substitute have their own risks. In this study, simple technique of percutaneous high tibial closed-wedge corticotomy and casting for treating genu varum in average body-built adolescents without hardware fixation was reported. METHODS: An overall 22 knees of 16 average-weight adolescents having genu varum with a mean age of 14.8 years (range, 12-18 years) underwent percutaneous high tibial closed-wedge corticotomy and casting. The study was conducted between May 2017 and January 2020. The typical follow-up duration was ten months (range, 8-22 months). Clinical and radiological evaluation for all patients was implemented. RESULTS: Mean postoperative Rasmussen clinical score was 27 (range, 24-30), with 16 excellent and six good results. The tibiofemoral angle improved from a mean of 18.2 degree varus (range, 14-25 degree varus) preoperatively to 1.3 degree valgus (range, 0-8 degree valgus) postoperatively, indicating a significant improvement (P < 0.05). Bone union was achieved at a mean of ten weeks (range, 8-14 weeks). None of the patients sustained nonunion, delayed union, infection, or knee stiffness. CONCLUSIONS: Percutaneous high tibial closed-wedge corticotomy and casting is a minimally invasive procedure for treating genu varum in adolescents. Good results are able to be attained with proper patient selection and meticulous surgical technique.

Clove oil cream: a new effective treatment for chronic anal fissure.

OBJECTIVE: Anal fissure is a common painful condition affecting the anal canal and causes considerable morbidity and reduction in quality of life. Surgical treatment has been associated with a degree of incontinence in up to 30% of patients. This study discussed the results of clove oil 1% cream in healing of chronic anal fissure. METHOD: A single-blind randomized comparative trial was setup to compare traditional treatment with stool softeners and lignocaine cream 5% against clove oil 1% cream for 6 weeks. RESULTS: 55 patients were included in this study, 30 patients in clove oil group and 25 patients in control group. Healing had occurred in 60% of patients in clove oil group and in 12% of patients in the control group after 3-month follow up (P < 0.001). Patients in clove oil group showed significant reduction in resting anal pressure and almost all other anorectal manometric pressures compared with patients in control group. CONCLUSION: Topical application of clove oil cream demonstrated a significant beneficial effect when applied to patients suffering from chronic anal fissure.

Augmented unilateral gluteoplasty with fascia lata graft in fecal incontinence.

BACKGROUND: This study was undertaken to evaluate the results of augmented unilateral gluteoplasty with fascia lata graft in patients with fecal incontinence due to congenital or neurologic disorders. METHODS: Between January 2000 and January 2001, we performed a prospective study of 11 patients with longstanding fecal incontinence (stage C3 according to Pescatori scoring system for fecal incontinence). The patients included one girl and 10 boys aged 5-19 years who had already undergone Swenson's operation for congenital megacolon (7 patients) or abdominoperineal pull-through for high imperforate anus (4 patients). Preoperative anorectal manometric studies (maximum resting pressure, maximum squeeze pressure, rectoanal inhibitory reflex and functional anal canal length), saline enema test and magnetic resonance imaging (MRI) studies were done. Unilateral gluteoplasty augmented with fascia lata graft was wrapped around the anal canal. Biofeedback retraining was started at the beginning of the fourth postoperative week. Patients were followed both objectively and subjectively for about 6-18 months. RESULTS: Eight of 11 patients (72.7%) were clinically improved, as shown by the change in incontinence score ( p=0.01). this was confirmed by the significant changes in manometric studies, functional anal canal length, rectoanal inhibitory reflex and saline enema test. MRI done one month postoperatively showed disruption in one patient. CONCLUSIONS: Unilateral gluteoplasty augmented with fascia lata graft leads to encouraging results in patients with end-stage anal incontinence due to irreversible damage to anal sphincter with less incidence of morbidity that could be related to tension on either the muscle flap or its neurovascular bundle.

Use of psychoactive substances among male secondary school pupils in Egypt: a study on a nationwide representative sample.

The present work is part of a series of epidemiological studies the main aim of which is to shed light on the extent and patterns of the use of substances among various sectors of the Egyptian population. A standardized questionnaire with established item re-take reliabilities was administered to 14,656 male secondary school pupils constituting a 4% representative sample of the whole population of Egyptian secondary school boys. Demographic and drug-related findings are discussed. Among the reported results the following are deemed of special interest: (1) Percentages of arts students who smoke tobacco, ever use prescription psychotropic substances, narcotics and alcohol consistently exceed their counterparts studying science and mathematics. (2) Ages of onset for the whole menu of substances range between 12 and 16 years. (3) Those among the experimenters who admitted continuing to take drugs ranged between 8% (for alcohol) and 21.41% (for synthetic drugs). (4) Significantly more urban than rural students smoke tobacco, and try cannabis and alcoholic beverages. (5) There is a strong association between exposure to drug culture and drug taking, confirming what we repeatedly reported previously. (6) More users than non-users tend to see drug consumption as either harmless or even useful. (7) Differentiation should be made between vulnerable and non-vulnerable non-users. Vulnerable non-users share with actual users a number of components of a common "drug ideology". (8) There are very significant correlations between drug taking and various aspects of misconduct verging on delinquency.

The use of psychoactive substances among Egyptian males working in the manufacturing industries.

The current work is part of a series of epidemiological studies on the extent and patterns of the non-medical use of psychoactive substances by significant sectors of the Egyptian population. A standardized interviewing schedule was especially constructed for the present survey and item re-take reliabilities were established. The interview was conducted on 5108 men working in the manufacturing industries. Findings are discussed and comparisons made between these results and the corresponding data obtained in our previous investigations on other sectors of the society. Egyptian industrial workers, compared with male university students seem to have a rather late age of onset of drug use, and to go for natural narcotics rather than prescription psychotropic drugs and alcohol. Much more workers than students take alcohol as an analgesic. There were, however, a number of commonalities among workers and various types of students concerning drug-related behaviour.