Our major aim was to systematically study the effectiveness of phosphodiesterase type 5 inhibitors in treating chronic prostatitis stage III and performed meta-analysis to evaluate the changes occurred in posttreatment scores of National Institutes of Health chronic prostatitis symptom index, international index of erectile function and international prostate symptom score. This meta-analysis was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Comprehensive research was performed by using online resources like PubMed and the Wiley online library database to gather the relevant literature produced from the y 2010 to 2022. Two authors were assigned to independently collect the relevant information including author name, region of study, study design, treatment, publication year, sample size, voiding parameters, study inclusion and exclusion criteria, urological conditions, drug type, international prostate symptom score, international index of erectile function score, etc. In final screening 17 relevant studies were found. Out of these 17, 5 contained surgical procedure while 4 were narrative analysis. One study was incomplete regarding information. Finally, 7 studies were included for analysis. Total of 584 patients were involved in the selected studies. Three out of seven are from Italy region while two are from Japan and one was from Korea and Egypt respectively. Most of these studies used tadalafil monotherapy while one placebo-controlled trial. A significant difference in pain score, international prostate symptom score domain and National Institutes of Health chronic prostatitis symptom index were observed after consuming 5 mg tadalafil monotherapy. Everyday consumption of oral phosphodiesterase type 5 gave positive outcomes in terms of voiding. A significant difference was observed after using tadalafil monotherapy in the majority of the studies. Hence, tadalafil alone can be used to treat the type III chronic prostatitis.

• Although the current incidence of complications of thyroid surgery in good hands is acceptably low, the impact of complications can be signifi cant.• Literature clearly shows a direct correlation between experience and rate of complications, a fi nding that supports a dedicated subspecialty training. Hematoma• Incidence is low (0-3 %).• Typically results from venous bleeding from small veins.• Usually presents during the initial 4-8 h postoperative period but may have a delayed presentation up to several days, which makes it challenging to make an evidence-based recommendation regarding length of "safe" hospital stay.• Current literature shows no signifi cant value of placing drains after thyroid surgery, and pressure dressing does not seem to prevent hematoma formation.• Venous pressure can be reduced during and after surgery by obtaining reverse Trendelenburg position (head and back up).• At the conclusion of the procedure and prior to closure, a fi nal check for hemostasis should be confi rmed by asking the anesthetist to perform a Valsalva maneuver which increases the venous pressure. This should be performed with a careful reinspection of the operative fi eld.

Background: Morgagni hernia (MH) is a rare congenital anomaly of the diaphragm. It is a birth defect characterized by herniation of abdominal organs into the thoracic cavity through a retrosternal diaphragmatic defect which inhibits proper lung formation. Case presentation: We report two cases of MH in a set of premature twins aged 9 days, who presented with respiratory distress at King Abdulaziz Medical City, Jeddah. The diagnosis was confirmed by imaging of chest X-ray and CT scan. Both cases were successfully managed through abdominal approach i.e. laparotomy with surgical treatment of the diaphragmatic deformity. Conclusion: The exact pathogenesis of most cases of congenital diaphragmatic hernia (CDH) remains unknown, however there is an increasing evidence indicating that genetic factors play a pivotal role in formation of CDH. Moreover, its occurrence in a set of twins further supports the genetical theory.

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