BackgroundAlopecia areata (AA) is a common disease characterized by hair loss with an autoimmune background. There are many lines of therapy, but no standard line for all cases. Consequently, treating severe forms of AA is challenging.ObjectiveThis study aimed to compare the efficacy and safety of the combination of diphenylcyclopropenone (DPCP) and platelet‐rich plasma (PRP) with DPCP alone in treating patients with severe or refractory AA.Patients and methodsOur randomized clinical trial was conducted on patients with severe and recalcitrant AA. Group A included 13 patients who received only DPCP, while Group B included 11 patients who received both DPCP and PRP. After sensitization in both groups of patients, DPCP was applied to half the scalp weekly. In addition, PRP injection in all scalp was performed once a month in group B. The patients in both groups completed the study for six months.ResultsThe regrowth scale results were 53.85% and 54.5% for groups A and B, respectively. Although the response rate of group B was higher than that of group A, there is no statistically significant difference between the two groups.ConclusionFrom our clinical trial, it can be concluded that DPCP alone or combined with PRP is an effective and safe method for treating severe or recalcitrant AA.

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IntroductIonThe epidemic of obesity (having a body mass index [BMI] of 30 and above) and its related medical diseases has been recognized as one of the most common public health problems facing the world today. [1] According to the World Health Organization, around 2 billion adults (40%) are classified as overweight, of those 650 million (13% of the total population) are diagnosed with obesity worldwide in 2016. [1] Scotland is one of the most significantly affected countries. In 2018, the majority of adults in Scotland (65%) was overweight, around one-third of those were diagnosed with obesity (28%). [2] Among treatment modalities for obesity, bariatric surgery has been the most effective intervention for sustained weight loss. Bariatric surgery ameliorates obesity concurrent metabolic syndrome in the majority of patients. [3] Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is one of the bariatric procedures where restriction and malabsorption of food happen simultaneously. [4] Adequate preoperative workup is essential for the success of bariatric surgery. This workup is not only restricted to exercise, preoperative weight loss or attending a teaching program, but Background and Aims: Patients with obesity are known for higher chances of having upper gastrointestinal (UGI) pathology and diseases. Esophagogastroduodenoscopy (OGD) is considered the investigation of choice to detect and confirm UGI pathology in patient with obesity. The routine OGD as a preoperative workup remained controversial before gastric bypass surgery. The need for preoperative OGD on patients undergoing bariatric surgery has been a subject of debate among bariatric surgeons. The study's aim is to evaluate the impact of routine preoperative endoscopy on patients underwent gastric bypass surgery laparoscopic Roux-en-Y gastric bypass (LRYGB). Patients and Materials: Retrospective review of prospectively kept patients' records who underwent LRYGB in our unit from February 2009 to March 2020. Patients were divided into two groups according to the absence or presence of symptoms before their preoperative OGD: Group A (asymptomatic patients) and Group B (symptomatic patients). Further data on OGD reports, campylobacter-like organism test and histology results and changes in the management plan were collected and analyzed. Calculation of post hoc power and Fisher's exact test was to investigate the correlation between OGD indication and its findings. All analyses were conducted at a 5% critical level. Results: A total of 114 patients included in the analysis, 85 (74.56%) were in Group A and 29 in Group B. OGD detected pathology in 34 patients in Group A and 21 in Group B (P = 0.004). Those included hiatus hernia (HH) (17.65% Group A, 44.83% Group B, P = 0.006); stomach ulcer (7.06% Group A, 3.45% Group B, P = 0.676), Helicobacter pylori (H. pylori) infection (12.86% Group A, 29.41% Group B). This led to change of management in 22 patients in Group A and 12 in Group B (P = 0.157). Those changes included H. pylori eradication (10.59% Group A,...

Introduction: Textiloma or Gossypiboma is used to describe a foreign body composed of a compress (s) or surgical field (s) forgotten at an operating site. Case report: Authors reported two cases of intestinal migrant textiloma in patients all previously operated on by cesarean section. The two patients consulted for a chronic painful abdominal mass. Abdominal ultrasound showed a superficial anterior structure in favor of foreign body in the first patient. The second one concluded that there was a right ovarian cyst. The surgery discovered a greek mass in both cases. Resection of the intestinal mass was performed followed by end to end anastomosis. The enterostomy of hail mass revealed an abdominal compress in each case. Conclusion: Forgetting a compress or abdominal field during surgery is a tragedy for the surgeon not only because of its forensic aspect but also because of the suffering endured by the patient. Indeed, actions trying to prevent this type of error are implemented in most developed countries; it is time for each hospital to adopt preventive measures, even if just only the compresses counting during the procedure.

Aim Preoperative OGD in patients undergoing bariatric surgery, has been a subject for debate for decades. The aim of this study is to evaluate the pathology pick up rate in routine preoperative endoscopy in patients undergoing Gastric Bypass surgery (LRYGB) in our unit. Method Retrospective review of patients’ records who underwent LRYBG in our unit from February 2009 to March 2020. Patients were divided into two groups according to the presence or absence of symptoms prior to bariatric surgery: Group A (Asymptomatic) and Group B (Symptomatic). Data from prospectively kept electronic OGD reports, CLO test results, histology reports and the changes in management plan were collected and analysed. Results 114 patients were included in the analysis, 85 (74.56%) were in group A and 29 in group B. OGD detected pathology in 34 patients in group A and 21 in group B (p = 0.004). Those included hiatus hernia (HH) (17.65% group A, 44.83% group B, p = 0.006); stomach ulcer (7.06% group A, 3.45% group B, p = 0.676), H.pylori infection (12.86% group A, 29.41% group B). This led to change of management in 22 patients in group A and 12 of group B (p = 0.157) excluding PPI prescription. Those changes included H.pylori eradication (10.59% group A, 17.24% group B, p = 0.153), HH repair (3.53% group A, 24.14% group B, p = 0.002). There was no cancellation or change in bariatric surgery offered in both groups. Conclusions Preoperative OGD has only significantly impacted the bariatric patient’s pathway in symptomatic patients. However, in Asymptomatic patients, OGD could be replaced by cheaper and non-invasive alternatives.