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

The School Improvement and the Role of Principal on Enhancing Student Learning Outcomes

This article reviews literature related to school principals and their role in improving student learning outcomes, by presenting and providing many information and evidence provided by academic research related to the principals and their role in student achievement. The article emphasizes that the managers are able to play a positive role in improving students’ achievement and results. Although the academic materials indicate indirect influence of managers on student achievement, this indirect influence is important and necessary and contributes greatly to the development of the students and to raising their achievements

Anti-hepatotoxic effect of Casuarina stricta and Casuarina suberosa extracts on alcohol-induced liver toxicity in rats

In recent years, there has been a global trend toward the use of natural phytochemicals present in natural resources, such as fruits, vegetables, oilseeds, and herbs, as antioxidants and functional foods. The aim of the present study was to investigate the protective and antioxidant effects of methanolic extract of Casuarina stricta and Casuarina suberosa leaves on ethanol induced hepatotoxicity in rats. The ethanol intoxication (1 ml of 40 % ethanol for 100 gm body weight for 6 weeks) to rats resulted in a significant increase in serum ALT, AST, ã glutamyl transferase (ã GT), hydroxyproline, MDA level and a significant decrease in serum albumin, total protein, A/G ratio, total antioxidant capacity, SOD, catalase activities and GSH level, P < 0.05. The treatment with Casuarina stricta and Casuarina suberosa extract at a dose of 250 mg/Kg body weight together with ethanol for 6 weeks successfully prevented the alterations of studied parameters in the treated groups. Both extracts significantly increased the total antioxidant capacity. The experimental results indicate that, both Casuarina extracts have excellent hepatoprotective effect.KEYWORDS: Casuarina stricta, Casuarina suberosa, liver, antioxidants, ethano

Modified Koyanagi Technique in Management of Proximal Hypospadias

Background/Purpose: One stage urethroplasty with parameatal foreskin flap (OUPF) applicable to all types of hypospadias was first described by Tomohiko Koyanagi, however high complication rates were reported.The aim of this study is to analyze the results of a modification of the Koyanagi technique as a one-stage repair of proximal hypospadias. Patients and Methods: During the period of from March 2008 to March 2009, 30 patients underwent treatment of proximal hypospadias using the modified Koyanagi technique. Patient age at the time of surgery ranged from 6 to 24 months. In all cases, the urethral opening was at or just proximal to the penoscrotal junction. Follow up ranged from 3 months to 1 year. Results: Primary success occurred in 27 cases (90%) with accepted cosmetic appearance. Complications occurred in 3 cases (10%). Urethrocutaneous fistula occurred in 2 cases (6.7%). Meatal recession occurred in 1 case (3.3%). There was no incidence of meatal stenosis, urethral stricture, residual chordee or complete flap necrosis. Conclusion: The modified technique permits one-stage repair of proximal hypospadias with low complication rates. Keywords: Hypospadias, Koyanagi, One stage urethroplasty