ObjectiveTo evaluate and compare the clinical (patient’s morbidity, quality of life [QoL]) and economic impact of autologous vs synthetic slings in female stress urinary incontinence (SUI), as over the last decade, the introduction of synthetic vaginal tapes for managing SUI has gained wide acceptance being quicker with low morbidity. Synthetic vaginal tapes have been progressively replacing the use of autologous rectus fascia. However, the high cost of these synthetic tapes is almost always an obstacle for most patients of limited socio-economic resources in the Egyptian community.Patients and methodsThis retrospective study included 126 women with SUI. Data for patients that matched the study inclusion criteria were collected from the Urology Department of Ain-Shams University Hospitals from March 2011 to May 2013. Patients were categorised into two groups: Group I included 62 patients who underwent an autologous sling procedure using rectus sheath; and Group II included 64 patients that had a synthetic sling, using transobturator tape (TOT). The following variables were compared: operative time, postoperative pain scores, duration of indwelling urethral catheter, hospital stay, cost including the price of the synthetic tape when used, return to normal activity, and QoL assessment (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) before and after discharge from hospital.ResultsPatients amongst the two groups were normally distributed with no statistically significant differences in patient’s demographic data and comorbidities. The mean hospital stay was longer and the return to normal activity was delayed in Group I compared to Group II. The highest mean postoperative pain score was recorded in Group I. The overall morbidity was 12.9% and 4.68% in groups I and II, respectively. The mean (SD) overall cost was 2571.65 (254.8) and 3502.34 (196.9) Egyptian pounds (local currency) in groups I and II, respectively, being insignificantly lower in Group I when compared to Group II (P > 0.05). There were statistically significant differences between groups I and II for operative time, hospital stay, and postoperative pain scores. However, the differences in hospital cost amongst Group I and Group II were in favour of Group I. Post-surgical outcome was categorised into either complete cure (dry) or improved or failed with no significant differences in success rate and QoL amongst the study groups. The mean (SD) change in the QoL score was 10.95 (4.19) and 12.32 (4.1) in groups I and II, respectively. The higher success rate (complete cure) was in Group II, at 93.75%. Also, a statistically significant improvement of >70% of mean ICIQ-UI-SF score was shown in all groups when compared to baseline on both the 1- and 6-month follow-up visits.ConclusionAutologous grafts should be considered as a repair option in females with SUI in countries were health insurance policies do not cover the cost of synthetic materials in many instances. The cost-effectiveness of synthetic TOT...

BackgroundRetrobulbar regional eye block aims to ensure eye globe akinesia and anesthesia during ophthalmic surgery, and despite the rarity of occurrence of complications due to the blind needle passage while performing either peribulbar or retrobulbar block, some of them are serious and may be life threatening.AimThe aim of this study was to estimate the accuracy and safety of real-time ultrasound-guided retrobulbar regional anesthesia in comparison with the blind technique for cataract surgery.DesignThis was a prospective randomized controlled trial.MethodologyA total of 30 patients who met the inclusion criteria were registered in our research and were divided into two groups: 15 patients received real-time ultrasound-guided retrobulbar block compared to 15 patients who received the block using the blind technique.ResultsOne patient out of the 30 was excluded from the analysis, and no statistically significant differences were observed between the two groups regarding the onset of akinesia, numeric pain rating scores, rate of complications, and degree of patient and physician satisfaction.ConclusionThere were no statistically significant difference between real-time ultrasound-guided and blind retrobulbar regional eye blocks concerning the onset of action, total volume of injected local anesthetic solution, supplemental injection required, pain scores, and degree of patient satisfaction.

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Background portal vein thrombosis (PVT) is a common complication of end-stage liver disease with an incidence of 0.6–16% in patients with well-compensated disease (1–3), increasing up to 35% in cirrhotic patients with hepatocellular carcinoma. Aim of the Work the aim of the study is to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis, and post-operative complications. Patients and Methods This is a retrospective cohort study to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis & post-operative complications. The study was conducted as retrospective study of 33 adult patients who underwent LDLT at Ain Shams Specialized Hospital, Ain Shams University, Cairo, Egypt, between January 2016 and July 2018. Results the mean child score was 9.55 and the median hospital stay was 12 days. Based on review manager statics program, the PVT recurrence was non-significant (P = 0.295, Test value: 1.096). However, the blood loss was significant (p < 0.029, test value: -2.186) and the surgical time was significant (p = 0.013, test value: 2.633). Conclusion portal vein thrombosis (PVT) represents a significant technical challenge in liver transplantation and for many years was considered a relative contraindication. While advances in surgical techniques, axial imaging, and alternative inflow reconstruction options have made liver transplantation possible in transplant candidates with PVT.