Background: Anal stenosis may occur after anal surgery especially after surgical haemorrhoidectomy. Many types of flaps have been described for anal stenosis. We aimed to evaluate the outcome of dermal rhomboid island flap in treatment of post haemorroidectomy anal stenosis. Patients and methods: The current study included twenty patients with a clinical diagnosis of post hemorrhoidectomy anal stenosis underwent rhomboid island flap anoplasty. We assessed the caliber of the anal canal (measured with a conical calibrator), clinical improvement and postoperative complications for all patients. Results: There was high significant improvement in anal calibration with a mean difference obtained on comparing preoperative and 1 month' anal caliber, of 15.95± 1.88 (p < 0.001). Also, there was high significant improvement in CCIS with a mean difference obtained on comparing preoperative and 12 months' CCIS, of 7.55± 1.28 (p < 0.001). The majority of patients had no postoperative complications (85%). Conclusion: The use of Rhomboid Island Flap Anoplasty is a safe and suitable option for the treatment of mild, moderate and severe Post-Hemorrhoidectomy Anal Stenosis.

Background: The largest rotator cuff tendon, the subscapularis, rotates the glenohumeral joint internally. This study's objective was to compare the arthroscopic versus the open technique outcomes in subscapularis tear repair. Methods: This prospective study comprised 30 patients who had a subscapularis tear and needed either arthroscopic or open surgery for repair. The study was done in Benha university hospitals and Ahrar teaching hospital from November 2020 to February 2023. Patients were split into 2 groups: Arthroscopic group: 15 were treated by arthroscopic surgery. Open surgery group: 15 were treated with open surgery. Results: The arthroscopic group had a higher percentage of combined tears and affected the right side more often, while the open surgery group had a higher percentage of isolated tears and affected the left side more often. The arthroscopic group had more postoperative pain, but fewer complications than the open surgery group. Preoperative and postoperative clinical assessments showed substantial changes among groups of the study concerning the constant score, UCLA score, and results of belly press test. The arthroscopic group had more positive results in belly press tests and lift off after operation. The two groups had similar outcomes in terms of post-surgical complications and duration of follow up. Conclusions: In terms of motion range and functional results, arthroscopic treatment may be preferable to open repair. While there are still rare cases when open repair surgery makes sense, particularly when arthroscopic options are restricted.

Background: Differentiation of benign from malignant follicular thyroid lesions remains difficult and the ability of molecular markers to differentiate between them still unclear. The aim of this study was to evaluate the usefulness of IMP3 expression to distinguish benign from malignant thyroid lesions. Methods: This is a retrospective study upon selected 57 thyroid lesions designated as; 7 cases of Hashimoto thyroiditis (HT), 10 cases of hyperplastic nodules (HN), 15 cases of follicular thyroid adenoma (FTA), 13 cases of conventional papillary thyroid carcinoma (PTC), 6 cases of follicular variant of papillary thyroid carcinoma (FV-PTC), and 6 cases of follicular thyroid carcinoma (FTC). Immunohistochemistry was applied on formalin-fixed, paraffin-embeded tissue blocks using IMP3. clinicopathological data were reviewed from patients' pathological reports and correlated with IMP3 expression. Results: IMP3 positivity was seen in 1/7 cases (14.3%) of HT, 2/10 cases (20%) of HN, 4/15 cases (26.7%) of FTA, 12/13 cases of PTC, and in all (100%) FV-PTC & FTC cases. IMP3 staining was significantly increased from normal thyroid tissue up to malignant tumors (P<0.01). IMP3 showed 96% sensitivity and 78.1% specificity for malignant tumors. IMP3 expression was positively correlated with grade and tumor size in malignant cases (P<0.05). No significant correlation was found in IMP3 expression with patient age, sex, capsular invasion, lymphatic/vascular invasion, lymph node metastasis, distant metastasis and TNM stage. Conclusions: IMP3 is a potential diagnostic marker for thyroid cancer and can be a promising marker for distinguishing benign from malignant follicular patterned thyroid lesions.

Background: Achilles tendinopathy is a common hindfoot disorder which affects both the active and non-active population. It can be classified as insertional and non-insertional tendinopathy. Insertinal acilles tendinopathy presents 20% to 25% of total Achilles tendon related disorders. Operative treatment in cases of failure of conservative treatment for 6 months in the form of open surgery and minimally invasive endoscopic treatment. The aim of this study was to evaluate the outcome of endoscopic treatment of insertional Achilles tendinopathy. Methods: In our study we had 15 patients with endoscopic treatment of insertional achilles tendinopathy with mean Pre-operative AOFAS hindfoot scale was 58.2 (36-80) and mean postoperative AOFAS hindfoot scale after 6 months was 86.53 (67-97) with P value.001 which showed significant improvement. Results: In our study there were two cases showed non improvement of pain and function postoperatively which maybe due to high BMI (35.05 and 33.44), they were have triple pathology in the form of (haglund deformity, retrocalcaneal bursitis and retrocalcaneal exostosis) and more Achilles tendon degeneration. There were no postoperative complications in the form of deep venous thrombosis, sural nerve injury, Achilles tendon rupture and wound infection but only 3 cases have postoperative scar tenderness. Conclusion: Endoscopic technique for treatment of insertional achilles tendinopathy seemed to be a safe and efficient as the open technique and has the advantage of small incisions with better cosmetic scar, early wightbearing which decrease the risk of deep venous thrombosis, less risk to weaken the Achilles tendon insertion that can cause tendon rupture, and also fewer wound complications such as dehiscence, painful or ugly scars, nerve entrapment within the scar and hypoesthesia.AAA