Evaluation of the role of the hystrosalpingography in prediction of endometriosis in infertile females

Background: Hysterosalpingography is the testing the patency of the tubes and the uterine cavity by injecting urographin inside them. The purpose in this study was to evaluate 2 signs in hysterosalpingography (higher position of one or both tubes and S or C shape in the course of one or both tubes) in prediction of endometriosis. Methods: This was prospective cohort study that was done in El-Shatby Maternity University Hospital, Alexandria University. The study included eighty six infertile women who were assigned to do laparoscopy.  Recent hysterosalpingography was done within 3 months period before laparoscopy and comments were done on the position and S or C shape in the course of the tube then laparoscopy was done and document all findings including presence of endometriosis and biopsy was taken from atypical lesions.Results: All signs show high specificity in prediction of endometriosis although only 2 signs (higher level of left tube and bilateral tubal S or C shape) showed significantly high sensitivity in prediction of endometriosis.Conclusion: Careful examination of the HSG film and searching for the specific signs of endometriosis is a practical and simple method in prediction of endometriosis. These preliminary data suggest that HSG has a role in prediction of endometriosis

Laparoscopic appendectomy in the pediatric age group: comparative study between LigaSure and monopolar diathermy

Background Various techniques such as endoloops, endoscopic linear cutting staplers, electrothermal vesselsealing system (LigaSure), Harmonic scalpel, clips, and bipolar coagulation have been used for the division of the mesoappendix during laparoscopic appendectomy. This study was conducted to evaluate the potential benefits and limitation of LigaSure and electrocautery in laparoscopic appendectomy (LA).Patients and methods Forty patients with clinical diagnosis of acute appendicitis admitted to the Pediatric Surgery Unit at the Alexandria University Children’s Hospital between September 2008 and September 2010 were included in this study. The patients were assigned to two groups according to the mesoappendix dissection device: LigaSure and monopolar diathermy (MD) groups. The primary outcome measures (operating time, conversion rate, length of hospital stay, bleeding during dissection, port site infection, and readmissions) were compared.Results LA was performed in 40 patients with acute appendicitis. Twenty cases were in the LigaSure group and 20 cases were in the MD group. The mean operative times were 33.05 min and 43.80 min in the LigaSure and MD groups, respectively. Bleeding during appendicular dissection as roughly estimated by the mean number of needed irrigations were 1.60 and 1.95 for the LigaSure and MD groups, respectively. No statistically significant differences regarding hospital stay, rate of infection, readmissions, or conversion to open appendectomy were found, whereas significant differences were observed in operative time and bleeding.Conclusion The use of LigaSure for dissection of the mesoappendix shortens the operative time, and significantly decreases bleeding during LA. We believe that LigaSure is a safe and useful tool for mesoappendix dissection during LAKeywords: children, laparoscopic appendectomy, LigaSure, monopolar diatherm

Re-Thinking "Emotionally": Central of Business District (CBD) of Alexandria City as a Retailing Center

The decisions of the Alexandria Local Authorities would be a key motive power of the flourishing process in Alexandria City Center as a retailing center. The objective of this study is to pay more attention toward re-thinking "Emotionally" to identify any planning policies at various levels. This new tendency would be helpful for having a prosperous city center, after losing its significance as a retailing center. This degradation due to the presence of "Malls and Plazas" like 'City Center Mall," "Green Plaza," and "Down Town Plaza" lying on the peripheral of the city as well as many other reasons. Studying the Saad Zaghloul Street is part of this paper to prove that re-thinking "Emotionally" is the answer to the enhancement Alexandria City Center as a retailing center

What proportion of adult allergy referrals to secondary care could be dealt with in primary care by a GP with special interest?

Background: The concept of a General Practitioner with Special Interest (GPwSI) was first proposed in the 2000 National Health Service Plan, as a way of providing specialised treatment closer to the patient’s home and reducing hospital waiting times. Given the patchy and inadequate provision of allergy services in the UK the introduction of GPwSIs might reduce the pressure on existing specialist services. Objectives: This study assessed what proportion of referrals to a specialist allergy clinic could be managed in a GPwSI allergy service with a predefined range of facilities and expertise (accurate diagnosis and management of allergy; skin prick testing; provision of advice on allergen avoidance; ability to assess suitability for desensitisation). Methods: 100 consecutive GP referrals to a hospital allergy clinic were reviewed to determine whether patients could be seen in a community-based clinic led by a general practitioner with special interest (GPwSI) allergy. The documentation relating to each referral was independently assessed by three allergy specialists. The referrals were judged initially on the referral letter alone and then re-assessed with the benefit of information summarised in the clinic letter, to determine whether appropriate triage decisions could be made prospectively. The proportion of referrals suitable for a GPwSI was calculated and their referral characteristics identified. Results: 29 % referrals were judged unanimously appropriate for management by a GPwSI and an additional 30 % by 2 of the 3 reviewers. 18 % referrals were unsuitable for a GPwSI service because of the complexity of the presenting problem, patient co-morbidity or the need for specialist knowledge or facilities. Conclusions and clinical relevance: At least a quarter, and possibly half, of allergy referrals to our hospital-based service could be dealt with in a GPwSI clinic, thereby diversifying the patient pathway, allowing specialist services to focus on more complex cases and reducing the waiting time for first appointments

Postmenopausal Osteoporosis: Literature Review

Osteoporosis is a chronic condition, similar to heart disease, diabetes, or hypertension. A huge gap exists in the primary prevention of fractures, and studies show that an expected 80% to 90% of adults don't get proper osteoporosis managment even in the secondary prevention setting. Case finding strategies have been created and effective pharmacological mediations are accessible. This review tends to how ideal to utilize the pharmacological choices that anyone could hope to find for postmenopausal osteoporosis to give long lasting fracture protection in patients at high and extremely high risk of fracture. The advantage of osteoporosis treatments far outweighs the uncommon risks

Varicose Vein Therapy: Endovenous Laser Ablation

Endovenous laser ablation (EVA) is utilized in the therapy and the management of varicose veins from chronic venous disease. The fundamental sign for this treatment is disease that is refractory to conservative treatment with compression stockings. This activity audits the treatment of varicose veins with endovenous laser treatment and features the role of the interprofessional group being taken care of by patients that go through this method