Short-term outcome of posterior anorectal myectomy for treatment of children with intractable idiopathic constipation

Purpose: Many children with idiopathic constipation (IC) fail to improve with bowel management program. The role of surgical treatment in this subset of patients with intractable IC is still controversial. The aim of this study was to assess the outcome of anorectal myectomy in treatment of intractable IC.Patients and methods: Twenty-five patients with intractable IC were included in this study after failure of bowel management program for at least 1 year. Work-up was made to exclude all other causes of chronic constipation. All patients were selected for internal sphincter myectomy. Patients were followed for at least 6 months postoperatively. Clinical improvement was evaluated by number of bowel motions per week, weaning of laxatives, soiling, child’s own feedback, and overall parent satisfaction.Results: Study included 25 children with a mean age of 6.3 ±1.6 years, suffering from constipation for a mean of 32.9 ± 8.5 months, with failed trails of bowel management program for at least 12 months. All children were subjected to anorectal myectomy with a mean follow-up of 12.4 months. Children’s feedback showed a mean of 79.1% improvement. Postoperative parent satisfaction had a mean of 75.9%.Conclusion: Anorectal myectomy is an effective and technically simple procedure in selected patients with intractable IC.Keywords: anorectal myectomy, children, idiopathic constipatio

Urethral advancement procedure in the treatment of primary distal hypospadias: a series of 20 cases

Introduction: Distal hypospadias is the most common genital anomaly, occurring in almost 65% of all hypospadias cases. Although there are several surgical techniques for the treatment of distal hypospadias, it is clear that none can be used to correct all forms of hypospadias. The aim of the study was to evaluate urethral advancement in the repair of primary distal penile hypospadias with regard to feasibility, complication rates and the final cosmetic outcome.Patients and methods: Between October 2014 and June 2015, the urethral mobilization technique was used in 20 patients who presented at the Pediatric Surgery Unit, Tanta University Hospital, with primary distal hypospadias. A submeatal crescent-like incision was performed a few millimeters proximal to the meatus with two vertical incisions from the lateral ends of the submeatal incisions. The urethra within the corpus spongiosum was dissected from the skin of the ventral surface and from the glans and corpora cavernosa for a distance of ~ 4 : 1. The urethra was advanced till the urethral meatus reached its normal position without any tension. Spongioplsty can be performed, and covering Buck’s or Dartos’ layers can be used. The follow-up was conducted on a weekly basis in the outpatient clinic in the first month, and then every month for 6 months.Results: The age of the patient at the time of operation ranged from 6 to 24 months, with a mean age of 10.5 months. The operative time ranged from 60 to 90 min, with a mean time of 73.5 min. Intraoperative urethral injury occurred only in one patient. In all patients, the catheter was removed immediately postoperatively except for one patient who had operative urethral injury. Deep wound infection was noticed in only one patient, followed by partial glanular disruption. Only one patient had urethrocutaneous fistula and two patients had meatal retraction.Conclusion: Urethral advancement can be used safely in the mobilization of the distal urethra with wide glanular dissection and wide lateral mobilization of glanular wings. However, it should be stressed that in the presence of hypoplastic distal urethra and/or persistent ventral curvature, another technique should be adopted. The majority of our patients had very good cosmetic results and minimal complication. However, the technique requires further studies with a larger number of patients and longer follow-up periods to draw more precise and final conclusions.Keywords: distal hypospidaus, primary, urethral advancemen

Virtual integration platform for computational fluid dynamics

Computational Fluid Dynamics (CFD) tools used in shipbuilding industry involve multiple disciplines, such as resistance, manoeuvring, and cavitation. Traditionally, the analysis was performed separately and sequentially in each discipline, which often resulted in conflict and inconsistency of hydrodynamic prediction. In an effort to solve such problems for future CFD computations, a Virtual Integration Platform (VIP) has been developed in the University of Strathclyde within two EU FP6 projects - VIRTUE and SAFEDOR1. The VIP provides a holistic collaborative environment for designers with features such as Project/Process Management, Distributed Tools Integration, Global Optimisation, Version Management, and Knowledge Management. These features enhance collaboration among customers, ship design companies, shipyards, and consultancies not least because they bring together the best expertise and resources around the world. The platform has been tested in seven European ship design companies including consultancies. Its main functionalities along with advances are presented in this paper with two industrial applications

Performance evaluation of MANET routing protocols based on QoS and energy parameters

Routing selection and supporting Quality of Service (QoS) are fundamental problems in Mobile Ad Hoc Network (MANET). Many different protocols have been proposed in the literature and some performance simulations are made to address this challenging task. This paper discusses the performance evaluation and comparison of two typical routing protocols; Ad Hoc On-Demand Distance Vector (AODV) and Destination-Sequenced Distance-Vector (DSDV) based on measuring the power consumption in network with varing of the QoS parameters. In this paper, we have studied and analyzed the impact of variations in QoS parameter combined with the choice of routing protocol, on network performance. The network performance is measured in terms of average throughput, packet delivery ratio (PDR), average jitter and energy consumption. The simulations are carried out in NS-3. The simulation results show that DSDV and AODV routing protocols are less energy efficient. The main aim of this paper is to highlight the directions for the future design of routing protocol which would be better than the existing ones in terms of energy utilization and delivery ratio

N-particle nonclassicality without N-particle correlations

Most of known multipartite Bell inequalities involve correlation functions for all subsystems. They are useless for entangled states without such correlations. We give a method of derivation of families of Bell inequalities for N parties, which involve, e.g., only (N-1)-partite correlations, but still are able to detect proper N-partite entanglement. We present an inequality which reveals five-partite entanglement despite only four-partite correlations. Classes of inequalities introduced here can be put into a handy form of a single non-linear inequality. An example is given of an N qubit state, which strongly violates such an inequality, despite having no N-qubit correlations. This surprising property might be of potential value for quantum information tasks.Comment: 5 page

A new clustering technique based on replication for MANET routing protocols

The cluster head nodes in most mobile ad hoc networks (MANET) clustering protocols take on an extraordinary role in managing routing information. The reliability, efficiency and scalability of the clustering in MANET will ultimately be dramatically impacted. In this work we establish a new approach to form the clusters in MANET called the square cluster-based routing protocol (SCBRP). That protocol is based on the theory of replication. The goal of the protocol is to achieve reliability, availability and scalability with in the MANET. The proposed protocol is evaluated by caring the performance analysis using the NS-3 simulator. The performance shows 50% improvementin data delivering ratio in large network size, also shows an improvement in network stability and availability which is reflected in energy consumption measurements and increase in the system lifetime to 20%

Calli Essential Oils Synergize with Lawsone against Multidrug Resistant Pathogens.

The fast development of multi-drug resistant (MDR) organisms increasingly threatens global health and well-being. Plant natural products have been known for centuries as alternative medicines that can possess pharmacological characteristics, including antimicrobial activities. The antimicrobial activities of essential oil (Calli oil) extracted from the Calligonum comosum plant by hydro-steam distillation was tested either alone or when combined with lawsone, a henna plant naphthoquinone, against MDR microbes. Lawsone showed significant antimicrobial activities against MDR pathogens in the range of 200-300 µg/mL. Furthermore, Calli oil showed significant antimicrobial activities against MDR bacteria in the range of 180-200 µg/mL, Candida at 220-240 µg/mL and spore-forming Rhizopus fungus at 250 µg/mL. Calli oil's inhibition effect on Rhizopus, the major cause of the lethal infection mucormycosis, stands for 72 h, followed by an extended irreversible white sporulation effect. The combination of Calli oil with lawsone enhanced the antimicrobial activities of each individual alone by at least three-fold, while incorporation of both natural products in a liposome reduced their toxicity by four- to eight-fold, while maintaining the augmented efficacy of the combination treatment. We map the antimicrobial activity of Calli oil to its major component, a benzaldehyde derivative. The findings from this study demonstrate that formulations containing essential oils have the potential in the future to overcome antimicrobial resistance