Congenital urethrovaginal fistula is an extremely rare genitourinary anomaly. Literature search identified only five reported cases, all of which were associated with urogenital abnormalities. Transverse vaginal septum is another rare condition, resulting from abnormalities in the vertical fusion between the vaginal components of the Mullerian ducts and the urogenital sinus; and associated fistulous connection of the vagina with the urethra is even rarer. Herein we describe the case of a 35-year-old woman who presented with dyspareunia, and a 1-year history of infertility, who was found to have a urethrovaginal fistula with low transverse vaginal septum. The patient was successfully treated with excision of the septum and closure of the urethrovaginal fistula.

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality. Coronary atherosclerosis is a progressive disease with sudden destabilizing changes leading to plaque thrombosis and reorganization. Aim of work: Quantitatively characterize coronary atherosclerotic plaque composition in patients with CAD referred to Ain shams radiology department (El Demerdash Hospital) by using CT coronary angiography and compare prevalence of different plaque types. Patients and Methods: Seventy-eight patients of CAD symptoms (49 male, 29 female; mean age, 54.8 years) underwent CT coronary angiography (CTCA). Each patient underwent a non-contrast scan to determine the calcium score, then a contrast enhanced ECG gated scan. Coronary plaques were analysed as regard number, type, severity and plaque volumes by using semiautomated software. Results: 14 patients had normal CTCA, 37 patient had significant obstructive lesions, and 4 of them had a totally occluded coronary vessel. A total of 232 coronary vessel plaques were found. The number of patients with multi-vessel disease was significantly higher in diabetic patients verses non diabetics. Noncalcified plaques were more prevalent (than calcified plaques), in patients <55 years, where 56.4% of their plaques were noncalcified, however in patients >55 years only 39.3% of their plaques were noncalcified. Conclusion: Multi-slice CTCA is the non-invasive alternative to intravascular ultrasonography (IVUS) for plaque quantification, it is a reliable technique to detect CAD and estimate the degree of obstruction, number of affected vessels and the pattern of their affection. Using automated software provide the major advantage of higher reproducibility.

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Background Universally maximum standardized uptake value (SUVmax) and lactate dehydrogenase (LDH) are used as tools for response assessment in Hodgkin Lymphoma (HL) patients. Our objectives are to evaluate the predictive potential and response assessment of total lesion glycolysis (TLG) and metabolic tumor volume (MTV)—maximum three target lesions—as another alternatives and to investigate the correlation between TLG and MTV with LDH. Results Both initial SUVmax and TLG were significantly associated with early patient response (p value 0.03, 0.047, respectively). An optimal threshold for SUVmax and TLG less than or equal 19.52, and 158.6, respectively, correlated with better therapeutic response. Initial LDH was moderately correlated with initial values of TLG (rs = 0.4, p value 0.01), MTV (rs = 0.44, p value 0.01) and SUVmax (rs = 0.42, p value 0.01). Conclusion TLG in correlation with LDH can be significant prognostic factors of therapeutic response in HL. They can be used for the identification of a subset of HL patients with a better outcome.