One-stage transanal Swenson procedure for rectosigmoid Hirschsprung’s disease in infants and children

Objective: This study aimed to present the outcome of transanal one-stage Swenson pull-through procedure in the management of rectosigmoid Hirschsprung’s disease (HD).Background: HD is a common cause of intestinal obstruction in pediatric age. Several pull-through procedures have been used to treat this pathology.Patients and methods: Between June 2008 and June 2015, 84 children with biopsy-proven HD underwent transanal one-stage Swenson pull-through procedure. Intraoperative details, postoperative complications, and bowel habits were recorded. Follow-up period ranged from 6 to 42 months.Results: The age at the time of surgery ranged from 3 months to 2 years. The length of the resected aganglionic segment ranged from 12 to 34 cm. The operating time ranged from 72 to 180 min. Postoperative hospital stay ranged from 3 to 6 days. There were no anastomotic leaks, no perianal infection, or postoperative bowel obstruction. Twelve patients (14.28%) developed postoperative enterocolitis. Six patients (7.14%) required a posterior internal sphincter myectomy despite repeated dilatations. All patients had less than four times bowel motions per  day, 3 months after surgery. No voiding disturbances were encountered at the end of the follow-up period and none of the patients complained of recurrent constipation. Six patients developed perianal dermatitis, which was treated conservatively within 3 months after surgery. Anastomotic circumference could not be felt at digital examination in 78 patients 3 months after surgery.Conclusion: One-stage transanal Swenson pull-through procedure is a safe alternative and simpler procedure for rectosigmoid HD with low morbidities and accepted outcome as regards postoperative bowel habits.Keywords: Hirschsprung’s disease, rectosigmoid Hirschsprung’s, Swenson procedure, transanal pull-throug

Using the renal pelvis flap to replace the whole hypoplastic ureter: a preliminary report

Background Hypoplastic ureter is a rare condition usually associated with hypoplastic kidney, and it ends with nephrectomy in most of the cases. Many techniques have been described as ureteric substitutes in the literature. Here, we describe a new technique using the renal pelvis flap to replace the whole hypoplastic ureter in two cases. Objective The aim of this study was to describe a new surgical technique in the management of ureteric hypoplasia.Patients and methods Of the two boys diagnosed antenatally, unilateral hydronephrosis was detected in one boy and a huge renal cyst was present in the other, with evidence of postnatal progressive obstruction necessitating surgical intervention. On exploration, hypoplastic ureter throughout its entire length was an accidental intraoperative finding. The renal pelvis flap was taken and tubularized to replace the entire ureter, and reimplanted into the urinary bladder. This technique was the primary procedure in one case, whereas it was the secondary procedure in the other case after failure of initial trial of pyeloplasty.Results The postoperative period was uneventful with adequate drainage of the renal pelvis in the short-term follow-up (6 and 3 months consecutively).Conclusion The renal pelvis flap is a new feasible alternative procedure for ureteric replacement in a hypoplastic ureter when there is preserved renal parenchyma.Keywords: renal pelvis flap, ureteral hypoplasia, ureteric replacemen

Quantum group symmetry of the Quantum Hall effect on the non-flat surfaces

After showing that the magnetic translation operators are not the symmetries of the QHE on non-flat surfaces , we show that there exist another set of operators which leads to the quantum group symmetries for some of these surfaces . As a first example we show that the $su(2)$ symmetry of the QHE on sphere leads to $su_q(2)$ algebra in the equator . We explain this result by a contraction of $su(2)$ . Secondly , with the help of the symmetry operators of QHE on the Pioncare upper half plane , we will show that the ground state wave functions form a representation of the $su_q(2)$ algebra .Comment: 8 pages,latex,no figur

Expression of transient receptor potential vanilloid (TRPV) channels in different passages of articular chondrocytes

Ion channels play important roles in chondrocyte mechanotransduction. The transient receptor potential vanilloid (TRPV) subfamily of ion channels consists of six members. TRPV1-4 are temperature sensitive calcium-permeable, relatively non-selective cation channels whereas TRPV5 and TRPV6 show high selectivity for calcium over other cations. In this study we investigated the effect of time in culture and passage number on the expression of TRPV4, TRPV5 and TRPV6 in articular chondrocytes isolated from equine metacarpophalangeal joints. Polyclonal antibodies raised against TRPV4, TRPV5 and TRPV6 were used to compare the expression of these channels in lysates from first expansion chondrocytes (P0) and cells from passages 1–3 (P1, P2 and P3) by western blotting. TRPV4, TRPV5 and TRPV6 were expressed in all passages examined. Immunohistochemistry and immunofluorescence confirmed the presence of these channels in sections of formalin fixed articular cartilage and monolayer cultures of methanol fixed P2 chondrocytes. TRPV5 and TRPV6 were upregulated with time and passage in culture suggesting that a shift in the phenotype of the cells in monolayer culture alters the expression of these channels. In conclusion, several TRPV channels are likely to be involved in calcium signaling and homeostasis in chondrocytes

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We investigate various classes of generalized closed fuzzy sets in [0,1]-topological spaces, namely, Wθg-closed fuzzy sets and Wδg-closed fuzzy sets. Also, we introduce a new separation axiom FT3/4∗ of the [0,1]-topological spaces, and we prove that every FT3/4∗-space is a FT3/4-space. Furthermore, we using the new generalized closed fuzzy sets to construct new types of fuzzy mappings

Repair of low anorectal anomalies in female patients: risk factors for wound dehiscence

Background/purpose: Wound dehiscence after rectoperineal/vestibular fistulae repair may have adverse effects on the continence mechanism with delayed functional sequels. We report the incidence of wound complications following the sagittal anorectoplasty in a group of female patients, in addition to studying the effect of some possible risk factors.Patients and methods: This is a prospective cohort study conducted on female patients with rectoperineal or rectovestibular fistula operated during the period from January 2011 to December 2015. Patients were divided into three groups: group A (no dehiscence); group B (minor dehiscence); and group C (major dehiscence). Patients were compared regarding their age at the time of repair, the type of anorectal anomaly, the degree of dilation of the colon, and the prevalence of covering colostomy.Results: The study included 63 female patients. Group A included 34 patients (those with no dehiscence, 52.4%), group B included 17 patients (minor wound dehiscence, 26.98%), and group C included 13 patients (major wound dehiscence, 20.6%). There was no statistically significant difference between the three groups regarding the studied risk factors.Conclusion: With regard to the wound complications following the repair of rectoperineal/vestibular fistulae in the female patients, none of the studied risk factors appear to have a significant effect on the outcome.Keywords: anterior sagittal anorectoplasty, colostomy, posterior sagittal anorectoplasty, rectoperineal fistula, rectovestibular fistula, wound dehiscenc

World Health Organization Surgical Safety Checklist with Addition of Infection Control Items: Intervention Study in Egypt

BACKGROUND: Surgical team is in command of the operating room (OR) and takes decisions regarding various patient care procedures. Educational programs directed to them, should be creative, provocative and tailored to their specific needs and the expected outcomes. AIM: This study aims to design and conduct an educational program of patient safety and infection control for the OR team based on the WHO surgical safety checklist and to assess their post-intervention knowledge and practices. METHODS: This interventional study was conducted at the ORs of Port-said general hospital. It passed through three stages; baseline assessment of knowledge and practice regarding patient safety and infection control among OR team (surgeons, anaesthetists and nurses), intervention stage in which an educational program based on the WHO surgical safety checklist with modifications and additions of more infection control items was conducted, then re-assessment of their post-intervention knowledge and practices. RESULTS: All the studied participants showed improvement in both knowledge and practices of patient safety and infection control after the educational program based on the WHO surgical safety checklist with modifications and additions of more infection control items and including not only practices but also knowledge as well, than before. CONCLUSION: The modification of the WHO surgical safety checklist to fit local knowledge and practices created a comprehensive tool that led to an improvement in both knowledge and practices of patient safety and infection control among the OR team

RANKL EXPRESSION AND METABOLIC CHANGES IN OVARIECTOMIZED RATS AND THE POSSIBLE PROTECTION BY VEGETABLE FORMULA.

 Objective: This study was to evaluate complications of osteoporosis in ovariectomized rats and the possibility to ameliorate these changes by consumption of vegetable formula. Furthermore, transcription of mRNA of RANKL gene was matched with bone mass density (BMD) and bone formation marker (human procollagen 1 N terminal peptide [PINP]).Methods: Thirty rats were divided into three groups. The first is non ovariectomized control group (NOVXC), the second is ovariectomized control group (OVXC), and the third is ovariectomized rats supplemented with the vegetable formula (OVXT). Animals were fed for 8 successive weeks. Animals were treated and sacrificed under the recommended ethics of laboratory animal's treatment. The vegetable mixture was formulated with the purpose to correct the bone compromise and supply all the presumed deficient elements and hormone.Results: Chemical analysis showed that the formulated vegetable mixture had a high amount of flavonoids as catechin (100 mg/100 g of dry weight) and polyphenols as tannic acid (1000 mg/100 g dry weight. Furthermore, it had high reducing power (1,1-diphenyl-2-picrylhydrazyl radical showed inhibition percentage of 91.81%.). Several phytochemicals necessary for bone health were demonstrated in the vegetable mixture using high-performance liquid chromatography. RANKL/GAPDH mRNA transcription ratio showed marked an increase in OVXC versus the control NOVXC rats (1.00 vs. 0.199, respectively) accompanied with a drop in BMD (0.157 vs. 0.25 mg/cm2, respectively) and PINP values (27.9±2.8 compared to NOVXC 34±2.4 μ/L, respectively). The vegetable mixture supplementation showed better values of BMD and PINP in OVXT group directed back toward normal (0.183 mg/cm2 and 29.35±3.4 μ/L, respectively). Furthermore, analysis of blood plasma of supplemented group showed lower blood glucose, lipid profile, and oxidative markers if compared to that in OVXC group.Conclusion: It may be concluded that the plant formula was effective to minimize health hazards in ovariectomized rats and maybe for postmenopause women. Perhaps longer time may be needed for more significant and clear effect

CYP1B1 and myocilin gene mutations in Egyptian patients with primary congenital glaucoma

Purpose: Primary congenital glaucoma (PCG) accounts for 26–29% of childhood blindness in Egypt. The identification of disease causing mutations has not been extensively investigated. We aimed to examine the frequency of CYP1B1 and MYOC mutations in PCG Egyptian patients, and study a possible genotype/phenotype correlation.Methods: Ninety-eight patients with PCG diagnosed at the Ophthalmology department ofAlexandria Main University Hospital were enrolled. Demographic and phenotypic characteristics were recorded. Patients and 100 healthy subjects (control group) were screened for two mutations in CYP1B1 gene (G61E, R368H) and one mutation in MYOC gene (Gln48His) using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). Phenotypic characteristics pertaining to disease severity were compared.Results: Nineteen patients (19%) with PCG were found positive for one or more of the mutations screened for. Seven patients (7%) were homozygous for the G61E mutation. Ten patients (10%) were heterozygous; 6 for the G61E mutation, 2 for the R368H mutation and 2 for the Gln48His mutation. Two patients (2%) were double heterozygotes harboring a R368H as well as a Gln48His mutation. The most common mutation observed was the G61E in 13 patients; 7 homozygotes and 6 heterozygotes for the mutation. The control group were negative for all mutations screened for. No significant correlations between the mutations and phenotype severity were detected. A statistically significant positive correlation however was found between the different mutations andeach of the IOP and the cup/disk ratio.Conclusion: The current study further endorses the role of CYP1B1 mutations in the etiology of PCG among Egyptian patients and is the first study to report MYOC gene mutation in Egyptian patients with PCG

ANTIBACTERIAL & ANTIFUNGAL POTENTIALITY OF RICINUS COMMUNIS & COLEUS FORSKOHLII ON SOME HUMAN PATHOGENIC MICROORGANISMS

The objective of the present study was to explore the antibacterial and antifungal activity of two plant extracts (Ricinus communis & Coleus forskohlii) against some selected pathogen (Staphylococcus aureus