Evaluation of Topical Capislow Extract and Long Pulsed Nd-YAG Laser in the Treatment of Idiopathic Hirsutism

Introduction: Hirsutism is a condition that affects 10% of women worldwide. In many cultures, hirsutism is regarded as loss of femininity and can be psychologically traumatizing to the suffering females. The aim of the present study was to evaluate how topical capislow would affect or enhance the efficacy of laser hair removal.Methods: A randomized, monoblinded, placebo controlled split face study of combined topical capislow and long pulsed Nd-YAG laser on one side of the face versus long pulsed Nd-YAG laser alone on the opposite side of the face. Laser sessions were done at 4 weeks interval for maximum seven sessions. Topical capislow and placebo were applied once daily from the day of the first laser session to the day of the last laser session. Patients were evaluated both subjectively and objectively in each laser session and for six months after the last laser session.Results: Both treatment modalities were well tolerated and accepted with significantly better results in combined capislow and laser group versus laser alone.Conclusion: Topical capislow can represent a safe and effective synergistic method for laser with faster results but this is a temporary effect retained only to the time of its application

Vascular complications in adults and pediatrics live-donor renal transplantation: 3 decades of single centre experience

We analyzed the incidence of vascular complications in adults and pediatrics live donor renal transplantations over 3 decades and compared its impact upon patient and graft survival in both groups.Material and methods: Between March 1976 and December 2005, 1785 live-donor renal transplantswere performed in a single institute, of the 1546 adults and 239 pediatric (age ≤18 years). The incidence of different types of vascular complications were determined in both groups. Long term patient and graft survival in patients with or without vascular complications and in various types of vascular complications were calculated & compared in both groups.Results: The overall incidence of vascular complications was 2.9%, it was equally 2.9% in both groups. In adults, 46 complications in 45 patients included 16 arterial, 10 renal artery thrombosis (0.6%), 2 cases of spasm in renal artery(0.1%), renal artery stenosis in 5 (0.3%), renal vein thrombosis in one (0.06%) and hemorrhagic complications in 28 patients whereas there were no thrombotic complications in the pediatric group, 6 case of hemorrhage (2.5%) and one case of renal artery stenosis (0.4%). There is steady decrease of vascular complications over the last 3 decades. The vascular complications significantly adverse patient and graft survival in both groups (p<0.001). The 5-years patient and graft survival in adults and pediatrics with or without vascular complications were 59.5 ± 9.2%, 89.14 ± 0.89%, 57.5 ± 18.7% and 90.18 ± 2.2% for the patient and 40.14 ± 7.75%, 97.79 ± 1.14%, 28.57 ± 17.07% and 77.18 ± 3.02% for the graft. There is no statistical significant difference in either patient or graft survival in thrombotic, stenotic or hemorrhagic complications in adult or hemorrhagic complications in the pediatric group (p=0.22 and p=0.142 respectively).Conclusions: There is no increase in incidence of vascular complications in pediatrics than adult transplants. The survival either graft or patient is comparable between adult and pediatric with or without vascular complications and the subgroups of vascular complications

Post-transplant anemia in pediatric patients and its impact on patient and graft survival: single center experience

Introduction: Post-transplantation anemia (PTA)occurs frequently, with prevalence rates between 20and 60% depending on the criteria used for defininganemia.Aim of the work: We aimed to assess the prevalenceof anemia after 6 months of transplantation inpediatric renal transplant patients under differentprotocols of immunosuppression, and to determinethe impact of anemia upon long-term patient andgraft survival.Patients and methods: Based on the data of 108renal transplants performed in our center, patientswere categorized after 6 months according to theirhemoglobin (Hb) levels into two groups. The firstgroup with Hb more than 11gm/dl (group I, 29cases) and the second group with Hb lessthan11gm/dl (group II, 79cases). We compared thetwo groups regarding post transplant complications(rejection episodes, hypertension, diabetes mellitus,infections, hepatic dysfunction, and patient andgraft survival.Results: we found no significant difference betweenthe two groups regarding rejection episodes.However, the percentage of cases with chronicallograft nephropathy was significantly higher in the anemic group. The survivors with functioning graftswere significantly higher in cases with normal Hb.Moreover, living cases with graft failure weresignificantly higher in anemic group. Graft survivalrate was better in the non anemic group. However,no difference in patient survival was detected. Also,we found no difference between the two groupsregarding post-transplant complications.Conclusions: From this study, we can conclude thatthe prevalence of post-transplant anemia is highpediatric renal transplant patients especially thosereceiving CNI and MMF, and it was associated withpoorer graft outcome but no effect on patientsurvival

Static T2w MRU in Noncalcular Urinary Obstruction: Comparison of Its Two Techniques

The purpose of this study was to compare the diagnostic accuracy of T2-weighted (T2w) MR urography (MRU) techniques — the standard MRU using fast spin echo (FSE) and postprocessing maximum intensity projection (MIP) and the single-shot MRU — in the diagnosis of ureteric obstruction in patients with noncalcular urinary obstruction. The study included 150 patients admitted to our center between January 2005 and December 2006. There were 203 renal units with noncalcular obstruction; 53 patients had bilateral obstruction. Patients with calcular obstruction were excluded. There were 85 males and 65 females with a mean age of 50 (range: 5–83) years. All patients were examined with static MRU using both single-shot (thick slab) and multisection MRU. Using single-shot MRU, we obtained images at the direct coronal and oblique coronal, as well as sagittal, planes for each renal unit. Postprocessing MIP for the standard coronal heavy T2 source images to obtain coronal and oblique images was done. Among the obstructed 203 units, the intrinsic causes were present in 157 units (151 were stricture and six were ureteric tumors), while the extrinsic causes were present in 46 units (35 bladder tumor, four ureterocele, five retroperitoneal fibrosis, one prostatic tumor, and one local pelvic recurrence after radical cystectomy for bladder cancer). The overall accuracy of single-shot MRU was 89% and was 93% for the multisection MRU in cases of intrinsic ureteric obstruction, while in cases of extrinsic obstruction, it was 20% for single-shot MRU and 96% for multisection MRU. T2w static MRU is a very useful technique in diagnosing noncalcular ureteric obstruction. Multisection MRU has a high diagnostic accuracy and reliability over that of the single-shot technique. The single-section technique is very rapid and useful in diagnosing ureteric stricture so it could be used as a localizer, while multisection images with postprocessing MIP is mandatory, especially in cases of suspected ureteric tumors or extraureteric causes

[44] Long-term outcome of shockwave lithotripsy in the management of patients presenting with calcular acute urinary retention

Objective: To evaluate the efficacy of shockwave lithotripsy in the long-term in the treatment of calcular acute urinary retention (AUR). Methods: From March 2015 to February 2017, a prospective study was conducted, and included a total of 50 male patients who were diagnosed with AUR as a result of urethral or vesical radio-opaque stone(s) at the Mansoura Urology and Nephrology Center. All patients underwent extracorporeal shockwave therapy. Results: A total of 47 of 50 patients (94%) were included, as only they underwent an initial successful treatment by shockwave lithotripsy. The mean (SD) age was 44.5 (11.8) years, the mean (SD) stone greatest dimension was 12.2 (3) mm, 33 stones (70.2%) were migratory and 14 stones (27.6%) were secondary in nature. At long-term follow-up of this patient cohort, there was recurrence of vesical stones in none, two (4%), and seven (15%) at 6-, 12- and 18-month intervals, respectively. The mean (SD) age of the nine recurrent cases (19%) was 52.3 (5.7) years and eight were secondary with one migratory in nature. Conclusion: Shockwave lithotripsy is a successful modality of treatment in vesical stones; however, it should be used with caution in patients aged >50 years and with a history suggestive of infravesical obstruction