Background: It is unknown whether stapling the mesh affects recurrence rate, incidence of neuralgia, and port-site hernia. We chose to fix it to the exterior reducing port size, cost and pain, at the same comparing this with traditional mesh stapling. Methods: We conducted a prospective trial for laparoscopic TAPP inguinal hernia repair on 120 patients in which we fixed the mesh to the anterior abdominal wall using either two prolene threads that passed to the exterior and tied in place or traditional mesh stapling. Results: The operative time is ranged from 35 to 70 minutes for external fixation, 30 to 60 minutes for mesh stapling, and 4 to 51 months for follow-up, and no recurrence occurred in both groups during the procedure. Two cases with post TAPP pain in mesh stapling patients are discussed with reduction of the cost and port size in external fixation patients. Conclusion: It is not necessary to secure the mesh during laparoscopic TAPP inguinal hernia repair from the interior and it is fixed only to the exterior allowing a reduction in size of the ports and considerable reduction in cost with elimination of TAPP associated post operative pain.

The goal of this study is comparison between the using of ultrasound guidance versus anatomical guidance in femoral artery access for endovascular treatment of chronic lower limb ischemia, by assessment of first pass success rate, total number of attempts required for access, rate of accidental venipunctures, rate of PFA puncture and time to sheath insertion, and assessment of post procedural puncture site complications defined as bruises or hematoma formation.The study found that US guidance is superior to anatomical guidance in femoral artery access in endovascular treatment of chronic lower limb ischemia in reducing access time, total number of punctures, and number of incidental venipuncture, the incidence of PFA access and incidence of local bruises.

HER-2/neu over expression is associated with increased tumor aggressiveness, increased rates of recurrence, and increased mortality in node positive patients. It is amplified and/or over expressed in approximately 30% of female breast cancers. This study was to detect the relation between HER-2/neu over expression and steroid hormone receptor status. It was conducted at Cairo and Bani Suif university hospitals between February 2012 to February 2014. HER-2/neu over expression was found to be positive in thirteen patients (41%) out of the thirty two patients included in the study, more positive (52%) HER-2/neu was found among estrogen receptor (ER) positive patients, on the other hand, only 18% positive HER-2/neu was detected among ER negative patients. This difference was statistically significant (P < 0.03). The same outcome was with progesterone receptors (PR) and HER-2/neu with statistically significant difference also (P = 0.02).