Non-Reversed Appendicostomy for Antegrade Continence Enema in the Treatment of Encopresis

Background/Purpose: Constipation in children is considered when stool frequency is less than three times per week. Encopresis represents 80-90% of children with fecal incontinence. Operative strategy for management of encopresis ranges from resectional surgery to myotomy. The objective of the study was to evaluate the efficacy of non-reversed appendicostomy without antireflux mechanism for management of encopresis in children. Materials & Methods: The study included 35 patients with severe idiopathic constipation and encopresis with failure of conservative measures. They were subjected to non-reversed appendicostomy without anti-reflux procedures. Results: The incidence of complications was 22.8% and included stomal leak, stricture, retraction and granulation tissue formation. False passage during dilatation occurred in one case. Antegrade continence enema effectively controlled constipation and encopresis. Conclusion: Non-reversed appendicostomy without antireflux mechanism is safe and rapid with minimal incidence of leakage. Constipation and encopresis was effectively controlled with this simple procedure.Index Word: Constipation, encopresis, antegrade continence enema

Phase II, Double-Blinded, Randomized, Placebo-Controlled Clinical Trial Investigating the Efficacy of Mebendazole in the Management of Symptomatic COVID-19 Patients

The outbreak of the COVID-19 pandemic has spread throughout the world, affecting almost all nations and territories. The current double-blind, randomized, placebo-controlled, phase II clinical trial sought to evaluate the clinical efficacy and safety of mebendazole as an adjuvant therapy for outpatients with COVID-19. The patients were recruited and divided into two groups: a Mebendazole-treated group and placebo group. The mebendazole and placebo groups were matched for age, sex, and complete blood count (CBC) with differential and liver and kidney function tests at baseline. On the third day, the C-reactive protein (CRP) levels were lower (2.03 ± 1.45 vs. 5.45 ± 3.95, p p = 0.046) significantly in the mebendazole group than in the placebo group on the third day. Furthermore, CRP decreased and CT dramatically increased on day three compared to the baseline day in the mebendazole group (p p = 0.008, respectively). There was a significant inverse correlation between lymphocytes and CT levels in the mebendazole group (r = −0.491, p = 0.039) but not in the placebo group (r = 0.051, p = 0.888). Mebendazole therapy increased innate immunity and returned inflammation to normal levels in COVID-19 outpatients faster than it did in the placebo group in this clinical trial. Our findings add to the growing body of research on the clinical and microbiological benefits of repurposing antiparasitic therapy, specifically mebendazole, for SARS-CoV-2 infection and other viral infections