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12.3±3.6 ml /second (P <0.05) and adequate caliber urethra in retrograde urethrogram (RUG) 6 months after operation.Three patients (15%) showed narrow stream of urine) Qave) average urine flow Conclusion: We demonstrated that thulium laser endourethrotomy was a reliable and safe therapy with minimal invasive therapeutic modality for urethral strictures.]]>
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0.05). Group ketofol and midazolam patients were sedated deeper after the start of the study drugs than group DEX and none of the patients were sedated to a score of < 2 (modified OAA/S score) in either of the groups. Group magnesium showed lighter sedation level significantly different with other groups. Conclusion: Study showed DEX provides optimum sedation without compromising airway or hemodynamic stability with favorable intubation time and less intubation attempts during AFOI in comparison to magnesium sulphate, ketofol and midazolam patients with better patient tolerance and satisfaction. ]]>
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5 million Egyptian yearly and causes high economic burden around the world. Gallstones are the major contributor to acute cholecystitis. Laparoscopic cholecystectomy (LC) is an important approach for treating acute cholecystitis nowadays. Issued data indicated that approximately 600,000 LCs and >30,000 LCs were annually performed to treat acute cholecystitis in the Egypt. Although LCs have been extensively performed to manage acute cholecystitis, the optimal timing of LC for this given condition is inconclusive.
Aim of the Study: To highlight the optimal time for LC in acute cholecystitis, comparing ELC or DLC is better in terms of surgical complications as bile duct injury, bile leakage, cystic artery bleeding, conversion to open surgery, duration of the surgery.
Patients and Methods: This study was done on 30 patients in Ain Shams University Hospitals in 12 months duration starting from June 2017 to June 2018 reviewing reports on ELC vs. DLC with all patients received medical treatment as antibiotics (3rd generation cephalosporins) and proper analgesia for 48-72 hours and if the patient responded to medical treatment so he/she was go with DLC group and if no response, he/she was go ELC group. This study was classified into two groups: Group (A) underwent laparoscopic cholecystectomy in the first seventy two hours from the onset of symptoms. Group (B) underwent laparoscopic cholecystectomy after delayed interval of six to eight weeks after initial period of conservative treatment.
Results: The mean operative time (100.3 ± 14.75 minutes) in the early group was more than the mean operative time (80.3 ± 12.4 minutes) in the delayed group. The conversion rate to open cholecystectomy (6.7%) in the early group was less than the conversion rate (13.3%) in the delayed group. The mean total hospital stay (4.8 ± 0.91 days) in the early group was less than the mean total hospital stay (9.2 ± 1.61days) in the delayed group. Finally, the overall complications in (53%) the early group were slightly more than complications occurred (47%) in the delayed group.
Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis within 72 hours has been shown to be superior to late or delayed cholecystectomy as regard the outcome and cost of treatment. Laparoscopic cholecystectomy should be carried out as soon as the diagnosis of acute cholecystitis is established and preferably before 3 days following the onset of symptoms. Early laparoscopic cholecystectomy can reduce both the conversion rate and the total hospital stay as medical and economic benefits.]]>
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0.05). Conclusion: In conclusion, osteoporosis is a common health problem (24.5%) in the elderly population in Arar city, KSA. Conclusion: Osteoporosis is significantly higher in elderly females. Health education and preventive programs are highly recommended to protect and treat that vulnerable group. ]]>
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0.05), except at the first 10 minutes and 20 minutes time periods after starting the epidural analgesia and application of the TAP block, highest readings were realized among the control group at these two time periods in comparison with the other two groups with P<0.05. Patients of the control group were the first to ask for rescue analgesia. Rate of administration of the rescue analgesia was seen to be more frequent among patients of the control group rather than the other two groups with (P<0.05).Postoperative complications as, (nausea and vomiting) which occurred due to systemic use of opioids were mostly seen among the control group rather than the other two groups with (P<0.05) Conclusion: Use of the TAP block proved to be a simple and safe procedure in providing effective reliable analgesia, together with reduction of postoperative pain scores, both at rest and knee flexion, and postoperative opioid requirements thus avoided any of the systemic side effect of opioid such as PONA as seen among the control group. Recommendations: The blind application of this technique might have been associated with major complication although we didn’t experienced any, yet performing this block under ultrasound guidance facilitates identification of the needle tip in the TAP, and may result in reduced risk, particularly in obese patient with BMI > 30 kg/m2.]]>
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