Pelvic organ prolapse (POP) is the descent of one or more aspects of the vagina and uterus, while rectal prolapse (RP) is the protrusion of the rectum through the anal canal. Multiple POP is combined ...prolapse of more than one pelvic organ and it is ideally surgically treated. Vaginorectopexy is a modification of the classical ventral mesh rectopexy which may be used in case of combined prolapse of multiple pelvic organs where a polypropylene mesh is used to support pelvic tissues and repair prolapse.
To assess the feasibility of open abdominal mesh vaginorectopexy in the repair of multiple POP.
This study was carried out on 20 female patients who underwent open abdominal mesh vaginorectopexy for the repair of multiple POP.
All the cases who complained of complete RP and 90% of cases who complained of uterine prolapse were cured, while symptoms of obstructed defecation were significantly improved in 95% of cases, of which 35% were completely cured. Fecal incontinence was significantly improved in 100% and significantly cured in 80% of cases, urinary incontinence was significantly cured in 75% of cases, and 94.4% of the cases who presented with urinary symptoms (dysuria and urgency), were treated at 12 months post surgery. There was no statistically significant postoperative complications.
Abdominal mesh vaginorectopexy for the repair of multiple pelvic organ is feasible and can result in significant improvement of function and quality of life.
There have been numerous techniques used in laparoscopic appendectomy (LA) to divide the mesoappendix, including LigaSure, Harmonic scalpel, clips, endoloop ligatures, Endo GIA staplers, and bipolar ...coagulation. However, few studies have investigated monopolar diathermy for mesoappendix division. Therefore, this study aimed to assess both its safety and efficacy in LA.
In this prospective non-randomized study, patients (n = 87) who underwent LA for acute appendicitis were included. The bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar electrocautery was used in the next 54 patients (MC group).
The median operative time was significantly shorter in the MC group (42 min. vs 47 min. in BE group, p = 0.01). One patient converted to open surgery in the MC group due to uncontrollable bleeding. There were no significant differences between both groups regarding postoperative complications and hospital stay (p = 0.91, p = 0.13, respectively).
Monopolar electrocautery is safe and effective for mesoappendix division in LP in comparison to bipolar electrocautery. However, larger and multicentric studies are required to validate our results.
Through the past decades, various surgical methods have been introduced as new modalities for the management of grade III and IV hemorrhoidal disease HD, to provide an effective and less invasive ...operation in comparison with conventional haemorrhoidectomy which is the gold standard surgical treatment.
This study was conducted at Alexandria Main University Hospital. Ninety three patients with grade III and IV HD were enrolled in our study, thirty-one patients treated with diathermy hemorrhoidectomy DH (group A), thirty-one patients with LigaSure™ hemorrhoidectomy LH (group B),and thirty-one patients with Laser hemorrhoidoplasty LHP (group C). Assessment of postoperative pain, intra and postoperative bleeding, operative time, time to return to work, quality of life using Hemorrhoidal Disease Symptom Score HDSS, and Short Health Scale for hemorrhoidal disease SHSHD and patient satisfaction were recorded and analyzed.
The postoperative pain according to Visual analogue scale VAS scores from the evening of the procedure till the fourth week postoperatively were significantly higher in group A patients compared to group B and C patients, however, no significant statistical difference was found between group B and C patients. There was significant statistical difference between each group for intra-operative bleeding, operative time, and time to return to work with advantage for LHP. LH led to significant improvement in both HDSS, SHSHD when compared with LHP (p = 0.015*and p = p3<0.001*respectively) and when compared with DH, however, only SHSHD was statistical significance (p = 0.001*). The median score for patient satisfaction was 6 in the 3 groups (range: 3–7 group A, 3–7 group B and 2–6 group C) with no statistical significance.
LH and LHP are associated with significantly less postoperative pain and give superior results than DH in terms of less operative time, intraoperative blood loss, postoperative complications, and faster recovery time, with significantlys better health-related quality of life after LH.
Clinical Predictors of mortality in Acute Mesenteric Ischemia Elsharkawy, Nagat Moaz Hamza Youssef; Abu Zeid, Mostafa Mohamed; Ahmed, Mohamed El Said ...
The Egyptian journal of hospital medicine,
12/2021, Letnik:
82, Številka:
3
Journal Article
COVID-19, caused by the SARS-CoV-2 virus, is spreading rapidly worldwide, with devastating consequences for patients, healthcare workers, health systems, and economies. As it reaches low- and ...middle-income countries, the pandemic puts healthcare workers at high risk and challenges the abilities of healthcare systems to respond to the crisis. This study measured levels of knowledge and preparedness regarding COVID-19 among physicians and nurses. A cross-sectional survey was conducted among healthcare workers in Libya between February 26 and March 10, 2020. We obtained 1,572 valid responses of a possible 2,000 (78.6%) participants from 21 hospitals, of which 65.1% were from physicians and 34.9% from nurses. The majority of participants (70%) used social media as a source of information. A total of 47.3% of doctors and 54.7% of nurses received adequate training on how to effectively use personal protective equipment. Low confidence in managing suspected COVID-19 patients was reported by 83.8% of participants. Furthermore, 43.2% of healthcare workers were aware of proper hand hygiene techniques. Less than 7% of participants received training on how to manage COVID-19 cases, whereas 20.6% of doctors and 26.3% of nurses felt that they were personally prepared for the outbreak. Awareness and preparedness for the pandemic were low among frontline workers during the study. Therefore, an effective educational training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.
Herein, the chemical synthesis of new thiazole-based benzenesulfonamide-linked morpholine
4a,b-7
via
late-stage thiazolation of the corresponding thiosemicarbazone
3
is reported. The skeletal ...formulas of the new compounds were confirmed
via
instrumental analysis (FT-IR, NMR, and EI-MS). Their structural geometry optimization and the related quantum chemical descriptors were predicted
via
DFT-B3LYP/6-31G(d) calculations. Their antimicrobial screening demonstrated that all the tested compounds except
4a and b
showed antibacterial efficacy against multidrug-resistant
Klebsiella pneumoniae
with an inhibition zone ranging from 10 to 15 mm. Compound
7
, which bears a 4-thiazolone moiety, is the most potent towards
K. pneumoniae
with an inhibition zone diameter (IZD) of 15 mm and is the sole molecule that exhibited broad-spectrum antimicrobial activity against all pathogenic bacterial and fungal strains with an IZD spanning from 11 to 18 mm. Enzymatic
in vitro
bioassays indicated that
7
is more potent towards DHFR (IC
50
= 0.521 ± 0.027 μg mL
−1
) than DNA gyrase (IC
50
= 6.14 ± 0.27 μg mL
−1
). The best action mode
via
molecular docking disclosed that
7
is interlocked into the cavity centre of DHFR with a lower binding fitness (−123.615 kcal mol
−1
) than DNA gyrase (−112.537 kcal mol
−1
), validating the experimental results and showing that the 4-thiazolone-linked methyl ester and sulfonamide units are responsible for the hydrogen bonding interactions. Accordingly, thiazole
7
could be a promising antimicrobial lead candidate.
Herein, the chemical synthesis of new thiazole-based benzenesulfonamide-linked morpholine
4a,b-7
via
late-stage thiazolation of the corresponding thiosemicarbazone
3
is reported.
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