Comparative study between cases of previous one cesarean section delivered at Kafr El-Sheikh hospitals, versus those delivered at Tanta Uniersity Hospital

Background: Many factors have contributed to the increasing rates of CSs, including increases in maternal age, BMI, and changes in obstetric practices and technologies. CSs requested by the mother and fear of litigation among caregivers have now become one of the most common indications of CS. Aim of this study was to compare between conditions of previous one caesarean section subjects delivered at Kafr El-Sheikh general hospitals, versus those delivered at Tanta University hospital as regard integrity of the uterine scars, presence of adhesions, time of termination, and fetal outcomes.Methods: This study was an observational study that was carried out on 100 pregnant ladies with history of previous one caesarean section. Participants were divided into two groups: group I included 50 pregnant women selected from Tanta University hospitals, group II included 50 pregnant women selected from Kafr El-Sheikh General hospital.Results: The estimated blood loss was significantly higher in cases selected from Kafr El-Sheikh hospitals compared to that lost from cases selected from Tanta University hospitals. Furthermore, operation time was significantly longer in patients selected from Kafr El-Sheikh hospitals than those selected from Tanta University hospitals. Additionally, omental adhesion was observed in 5 cases (5%); 3 (6%) from those selected from Kafr El-sheikh hospitals and 2 (4%) from those selected from Tanta University hospitals. As regard post-operative blood transfusion, there were increase in the incidence of post-operative blood transfusion in pregnant women selected from Kafr El-Sheikh hospitals (8%) compared to those selected from Tanta University hospitals (4%), but without statistically significant difference (p=0.678).Conclusions: There is high rate of caesarean section in our country. But satisfactory results were present in both Tanta university hospitals and Kafr El-Sheikh general hospital with few complication rates found special in cases priory delivered at Tanta University hospitals including less adhesion finding and thus less intra and post-operative complications

Ataxia in Multiple Sclerosis: From Current Understanding to Therapy

Ataxia is a type of neurological disorder that affects the ability to coordinate voluntary movements, such as walking, balance, and speech. In people with multiple sclerosis (MS), ataxia is a common symptom, affecting around 80% of people with the condition. The cause of ataxia in MS is still unknown; however, it is thought to be due to damage to the part of the central nervous system (CNS) that controls balance, coordination, and movement, especially the cerebellum. Symptoms of ataxia in people with MS can range from mild to severe, and can include a lack of coordination, difficulty speaking, difficulty walking, and gait. Ataxia management in MS typically involves pharmacotherapy to improve coordination, physiotherapy to enhance strength and balance, surgical procedures to alleviate tremor as well as occupational therapy to help with everyday activities

Surgical Management of Ejaculatory Duct Obstruction

Objective: The aim of this work is to evaluate the efficiency of transurethral resection (unroofing) of the obstructed ejaculatory ducts (TURED) as a treatment alternative for cases of obstructive ductal azoo-/ oligozoospermia. Patients and Methods: Thirty-two patients, aged 26 to 45 (mean age 34 years) with varying degrees of ejaculatory duct obstruction (EDO) were selected from a large pool of infertile patients with low semen volume presenting to the outpatient clinic of the Andrology Department of Kasr el Aini Hospital, Cairo, Egypt. The patients (24 with complete and 8 with partial EDO) were then transferred to the Urology Department of the same hospital for surgical treatment performed by one surgeon. The treated patients were sent back to the Andrology Department for follow-up lasting 6 to 30 months (mean 18 months). Follow-up included history taking, physical examination and repeated semen analysis. Results: There was a statistically significant improvement in all “mean” semen parame-ters following TURED. Furthermore, 42% of the azoospermic (bilateral complete EDO) and 63% of the oligozoospermic patients (partial EDO) showed improvement in their semen parameters after TURED yielding an overall improvement rate of 47% among treated patients. Pregnancy was achieved in about 17% of the azoospermic and in 25% of the oligozoospermic patients. The overall pregnancy rate was 19%. Prolonged hematuria was the only complication, encountered in only 2 patients, and was managed conservatively. Conclusion: TURED is an effective line of treatment for cases of EDO. Used judiciously, this technique can yield satisfactory results with limited morbidity in this challenging patient population. The better response of partial EDO as compared to TURED warrants further studies involving a larger number of patients. Le traitement chirurgical de l\'obstruction des voies éjaculatoires Objectifs: Le but de ce travail est d'évaluer l\'efficacité de la résection transuréthrale (unroofing) des conduits éjaculatoires obstrués (TURED) comme une alternative thérapeutique des cas d\'azoo / oligozoospermie d'origine obstructive. Patients et Méthodes: Trente-deux patients, âgés de 26 à 45 (âge moyen de 34 années), présentant des degrés variables d\'obstruction du conduit éjaculatoire (EDO) ont été sélectionnés parmi une grande population de patients consultant pour stérilité avec un volume éjaculatoire bas à la consultation externe du Département d'Andrologie de l'Hôpital Kasr El Aini. Les patients (24 EDO complète et 8 EDO partielle) ont été transférés au Département d\'Urologie du même hôpital pour traitement chirurgical réalisé par un urologue. Les malades traités ont été renvoyés au Département d'Andrologie pour suivi qui a duré 6 à 30 mois (moyenne 18 mois). Le suivi a inclu un intérrogatoire, un examen physique et une analyse du sperme répétée. Résultats: Il y avait une amélioration statistiquement significative de tous les paramètres du spermogramme en moyenne. En outre, 42% des patients azoospermiques (EDO complet bilatéral) et 63% d\'oligozoospermiques (EDO partiel) ont présenté une amélioration dans leurs paramètres du spermogramme après TURED avec un taux d\'amélioration total de 47% parmi les patients traités. La grossesse a été obtenue dans approximativement 17% des couples avec azoospermie et dans 25% des couples avec oligozoospermie. Le taux de grossesses total était de 19%. Une hématurie prolongée était la seule complication rencontrée dans seulement 2 cas et a été traitée d\'une manière conservatrice. Conclusion: TURED est une alternative efficace dans le traitement des cas d\'EDO. Utilisé judicieusement, cette technique peut donner de bons résultats avec une morbidité limitée dans cette population de patients. La meilleure réponse est notée dans les cas d\'EDO partiel. African Journal of Urology Vol.11(1) 2005: 6-1