Urethral stripping for delicate excision of dorsal accessory urethra

Duplication of the urethra is a rare anomaly. The accessory urethra may be dorsal or ventral, relative to the orthotopic urethra. Dorsal urethral duplication describes a normally located meatus and another accessory epispadiac meatus. Excision of the dorsal accessory urethra is usually curative, on the condition that the ventral  orthotopic urethra is normal. However, most reports recommend surgery only when there are significant functional or cosmetic problems, for fear of possible damage to the neurovascular bundle, or the continence mechanism during surgical excision. In this  report, we describe a modification for excising the dorsal accessory channel by stripping with minimal disturbance to the glans. With continuous refinement of the  surgical technique together with more reports confirming its safety, we believe that total excision of the dorsal accessory urethra can be offered to more patients as being the standard level of care.Keywords: accessory urethra, epispadias, urethral duplicatio

Knowledge Translation in Africa for 21(st) Century Integrative Biology: The "Know-Do Gap" in Family Planning with Contraceptive Use among Somali Women

Abstract An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st) century primary healthcare

Presacral tumors of the Currarino triad: teratomas or hamartomas?

Purpose: The aim was to elucidate the nature of the presacral tumors in the Currarino triad through studying their preoperative radiological anatomy and histopathology of excised specimens.Patients and methods: The study group included three operated cases of Currarino triad. All were women who presented with constipation and demonstrated the typical three components of the disease: anorectal anomaly, sacral bony defect, and presacral tumor. The histopathological slides of excised specimens (presacral tumors) were available for re-examination. For comparison, we included another ‘control’ group representing the standard sacrococcygeal teratomas (without vertebral or anorectal anomalies).Results: Histopathological examination of presacral tumors in the Currarino triad showed multicystic spaces lined by different types of epithelia mainly keratinized stratified squamous epithelium with focal areas of transitional epithelium. The underlying stroma showed fibrovascular connective tissue admixed with randomly arranged smooth muscle bundles. In contrast to the standard sacrococcygeal teratomas, neither skin adnexal structures nor heterologous mesenchymal tissues were observed; no immature elements could be detected.Conclusion: In the Currarino triad, several clinical and histopathological observations would suggest the excised presacral tumors to be developmental cysts (retrorectal hamartomas) rather than neoplastic teratomas.Keywords: Currarino triad, hamartoma, sacrococcygeal, tailgut, teratom

Biliary duodenostomy: a safe and easier biliary drainage procedure after choledochal cyst excision

Background/purpose: The treatment of choice for choledochal cyst (CC) is complete excision followed by biliary–enteric anastomosis. Roux-en-Y biliary jejunostomy has been favored by most surgeons for decades, with satisfying results. The use of biliary duodenostomy (BD) is another simple alternative for biliary drainage after CC excision. Our intermediate-term outcomes of both biliary drainage procedures after CC excision are presented.Methods: We carried out a retrospective analysis of the outcome of CC management in children operated at the Pediatric Surgery Department of Ain-Shams University over 5 years, from January 2010.Results: A total of 23 cases (16 females) were included in this study. The mean age at operation was 4.02 ± 2.52 years. Twenty-one cases had type I and two cases had type III CC. Complete excision of the CC was performed in 22 cases, and partial excision with mucosectomy was performed in one case. Biliary–enteric anastomosis was performed with the duodenum in 18 patients (group I, BD) and with the jejunum in five cases (group II, Roux-en-Y biliary jejunostomy). The mean follow-up period was 53± 4.48 months. A patient from group II suffered from ascending cholangitis 6 months postoperatively.Conclusion: BD is a simple technique for biliary drainage after CC excision with no major complications at intermediate-term follow-up.Keywords: biliary obstruction, choledochal cyst, hepaticoduodenostomy, jaundic

Properties of cellulosic fabrics treated by water-repellent emulsions

Water-repellent cotton, jute and linen fabrics have been prepared by treating them with emulsions made of beeswax/stearic acid (BW/SA) mixture. Different BW/SA ratios are tested to find out the best formulation recipe and different additives are incorporated in order to enhance emulsion stability and water repellency rating, such as alkali and metal salts. Triethanolamine (TEA) alkali has been selected for promoting the water repellency results. Cellulosic fabrics are pre-/post-treated with metal salts (aluminium chloride and zirconyl chloride) to enhance their physical attachment to the surfaces. Optimum emulsion ingredients for best results are found to be BW: SA (1:1), in presence of TEA (0.5 mole equivalent of SA) and zirconyl chloride concentration (1 g/L). Treated fabrics have been imparted with a water repellency characteristic, showing a value of 90, 80 and 80 for cotton, linen, and jute fabric respectively. Mechanical properties for treated fabrics are also demonstrated. FTIR spectra of treated fabric show no evidence of any chemical reactions between the substrate and the emulsion. Emulsions show stable rheological behavior upon storing for 3 months

On the energy-momentum tensor in non-commutative gauge theories

We study the properties of the energy-momentum tensor in non-commutative gauge theories by coupling them to a weak external gravitational field. In particular, we show that the stress tensor of such a theory coincides exactly with that derived from a theory where a Seiberg-Witten map has been implemented (namely, the procedure is commutative). Various other interesting features are also discussed.Comment: 3 page