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Objective. To determine whether there has been a change in mortality rates over the last 3 decades in patients with psoriatic arthritis (PsA) whose cases were followed prospectively.

Using a practical scoring system for diagnosing acute appendicitis can help reduce the rate of unnecessary surgery. This prospective study was carried out to evaluate Alvarado scoring system for diagnosing of acute appendicitis in our set up. Out of total 100 patients, appendicitis was confirmed in 80 patients, thus giving negative appendectomy rate of 20% (male 6%, female 14%). Perforation rate was 4%. Positive predictive value was 89%. The sensitivity was 54% and specificity 75%. Alvarado score is not a sensitive tool for aiding diagnosis of acute appendicitis.

Trocar site hernia (TSH) is an incisional hernia occurring at the trocar insertion sites after different types of laparoscopic surgeries. the aim of this study is to present characteristics of patient and surgery series with trocar site hernia after laparoscopic cholecystectomy. A 2930 consecutive patients underwent laparoscopic cholecystectomy in two major university-affiliated hospitals from April 2014 to March 2018 and the patient followed up for variable periods of time. Retrospective medical chart review to study trocar site hernia including patient, operation, instruments, and pathologic characteristics described. Six patients had trocar site hernia (incidence 0.20%), the hernias occurred mostly at the umbilical port site after using 10 mm trocar. Risk factors included mainly obesity, female gender and use of 10 mm trocars at midline sites. TSH is more described. It occurs mostly at the umbilical port site. Major risk factors include obesity, diabetes mellitus, lengthy procedure, extension of entry site, and wound infection. Closure of fascial defect is supposed to reduce the incidence despite weak evidence.Laparoscopic cholecystectomy (LC) was performed for the first time by Erich Mühe of Bo¨blingen, Germany on September 12, 1985 1 . It is now the standards surgical treatment for gallbladder stone disease (GBSD) and stood the test of time regarding reduced postoperative pain, decreased hospital stay, earlier return to work, and much more cosmetic scars. On the other hand, LC appeared progressively to have unprecedented complications such as complications related to the pneumoperitoneum and laparoscopic instruments in addition to the classical complications encountered in the open surgery such as bleeding, bile leak, and common bile duct injury.The trocar site hernia was reported for the first time in the late 1960s of the last century in a series of patients underwent laparoscopic gynecologic procedures 2 . The first case of TSH after LC was reported by Maio et al. in the USA in 1991in which they described the use of CT scan to diagnose the hernia 3 . Consequently, variable several studies were published addressing laparoscopic surgery complications including trocar site hernia. In this research, we present our observations regarding TSH after 2930 cases of LC.