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Background: Reassurance is important because it influences lifestyle choices or fears of breast cancer in 70% of women of reproductive age who have breast discomfort and seek medical attention. Either cyclic or noncyclic mastalgia exists. Breast discomfort needs to be carefully evaluated and should be looked into the same way as any other breast symptom. Natural remedies like evening primrose oil and vitamin E are now being used as therapeutic options because of the undesirable side effects of other treatment approaches. Objective: In order to treat cyclic mastalgia, we compared the efficacy and adverse effects of vitamin E and evening primrose oil. Patients and Methods: We conducted a double-blind randomized controlled trial between February 2018 and February 2019 at Al-Jedaani Hospitals, KSA. A total of 160 women of reproductive age with a chief complaint of cyclic mastalgia were enrolled into this study. They were randomly assigned into 3 groups: group A of 55 patients (34.4%) received vitamin E, group B of 45 patients (28.1%) received evening primrose oil and group C of 60 patients (37.5%) received placebo. Overall pain severity and the effect of pain on patients' lifestyle were assessed at 1-month and 3-month follow-up visits. ResultsThe mean age of the patients was 31.23 ± 6.82 years. Highest respondents were aged between 30 and 38 years (34.5%). The median pain score and the effect of pain on patients' lifestyle were significantly decreased on successive follow-up visits. Although this decrease was significant in each individual group, it was not statistically significant compared to one another (P value = 0.619 and 0.621 respectively). Conclusion Vitamin E and evening primrose oil have a good impact on cyclic breast pain but their effect is not much different than placebo effect

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Background: Management of acute sigmoid volvulus was documented using a variety of surgical techniques. It has been established that mechanical bowel preparation is not required for elective colorectal surgery. To lower the risk of post-operative infectious complications and anastomotic dehiscence, one-stage primary resection and anastomosis of left sided colon blockage with on-table antegrade colonic lavage are becoming more and more popular. Objective: The aim of the current study was to assess the safety of single stage resection and anastomosis in the treatment of acute left sided colonic blockage brought on by acute sigmoid volvulus without intraoperative colonic lavage. Patients and methods: This study was conducted in the Department of Surgery, Ain shams University Hospitals (Cairo, Egypt) between June 2018 till June 2021. It included 37 patients who presented with acute sigmoid volvulus and managed by colonic resection and primary anastomosis then furtherly classified into two groups based on the usage of antegrade colonic lavage to evaluate their outcome. Results: Preoperative characteristics of the 2 studied groups were comparable. In terms of mortality, general morbidity, or significant morbidity, there was no difference between the 2 studied groups. Operative time was significantly higher in Group I where Intra-operative Antegrade Colonic lavage (IOACL) took place, which could be attributed to the extra step of setting the lavage system and colonic irrigation time. Of the studied 37 patients, superficial wound infection occurred in 12 patients and 3 of them progressed to develop complete wound dehiscence, however; neither required further surgery as no disruption and managed conservatively with antibiotics and wound dressing. Conclusion: Colonic resection and primary anastomosis can be used to safely treat left-sided colonic blockage brought on by acute sigmoid volvulus without the need for mechanical bowel preparation.

Background:The key to effective therapeutic endoscopic therapy is early dysplastic Barrett's oesophagus (BO) alteration detection. Oesophago-gastro-duodenoscopy (OGD) technical proficiency is quickly attained, but the diagnosis accuracy is still quite variable, especially in non-specialized endoscopic facilities. Objective: We aimed to evaluate the quality of endoscopic diagnosis and the adherence to guidelines of BO in our unit. Patients and Methods: A retrospective cohort analysis was done for 436 eligible endoscopic reports after independent review for confirmation of BO. Cohorts represent the complete audit cycle during the period from 01/01/2018 till 01/07/2022. Group A represented first audit data, and group B represented re-audit data. Results: A total eligible reports of 256 of BO in group A, and 180 reports in group B were reviewed. There was no significant difference between the groups regarding the age (62.7 ± 13.5 and 60.1 ± 15.1 years), male sex (68% and 70 %), and endoscopist specialty respectively. Surveillance was the most common indication (32.4% vs 35.5%), followed by Reflux (16.7% and 15%) in both groups respectively. Compliance with Prague, Paris, and Seattle protocol was significantly higher in group B (P value ≤0.05). Lack of awareness of the new guidelines, surgeon specialty, older age of the endoscopist, long segment of BO were the main factors of poor results in group A. Conclusions: In the absence of local standard protocol for endoscopic diagnosis of BO, the adherence to the guidelines was poor. Compliance with the guidelines after implementing new recommendations results in better outcomes. It is important to complete the audit cycle to ensure that the quality improvement was achieved.