Background: Septate uterus is a common congenital uterine malformation. It is due to abnormal resorption of the Mullerian canal in embryonic life. Poor reproductive outcomes (e.g., abortion and preterm births) are associated with septate uterus. Aim of the work: The present study aimed to compare scissors and resectoscope regarding the efficacy and safety in resection of uterine septum. Patients and Methods: This study was conducted in the outpatient clinic of Al-Azhar University Hospital (New Damietta) from December 2017 to October 2020. Women were assigned into one of the two groups. The first included fifteen women, who underwent septoplasty by scissor and the Group II included fifteen women who were submitted to septoplasty by bipolar resectoscope. Results: Group (I) had a higher pain score in group I than group II with a significant difference. Mild pain was reported in 10 cases (66.7%) in group I and 4 (26.7%) in group II. However, moderate pain was reported for 5 cases (33.3%) and 11 cases (73.3%) in groups I and II, respectively, with a statistically significant difference. However, both groups were comparable regarding patient characteristics, operative data, postoperative complications and postoperative results of hysteroscopy, three months after the resection of the uterine septum. Conclusion: Scissor is preferred over the bipolar resectoscope especially in thin septum. It is associated with comparable outcome to the bipolar resectoscope. However, bipolar resectoscope was associated with significantly higher pain scores than scissors.
Purpose: To determine the clinical profile of various subtypes of Duane retraction syndrome patients and to evaluate different surgical strategies in correction of different clinical signs. Patients and Methods: This was a hospital-based prospective interventional study conducted at the Ophthalmology department, Al-Azhar university hospital in Assiut over a duration of two years from October 2017 to October 2019. Thirty one patients of DRS were scheduled to be included in this study. They were divided into three groups; Group I: 21 patients of DRS type I, Group II: 4 patients of DRS type II and Group III: 6 patients of DRS type III. Age of patients ranged from 9 months to 28 yrs old. Postoperative results were evaluated over 6 th months follow-up period. Results: Thirteen patients were left without surgical intervention, they were orthophoric or with minimal misalignment in PP with mild retraction of the globe on attempted adduction and none of them had any vertical shoot nor abnormal head position, eighteen patients of DRS had surgical intervention. Nine cases were exotropic, 8 cases were esotropic & 1 case was orthophoric. Horizontal deviations were managed with unilateral or bilateral muscle recession& simultaneous recession of MR & LR. Retraction of the globe was managed with single muscle recession or simultaneous recession of both MR & LR. Vertical shoots were managed with LR Y-splitting, IO recession& simultaneous recession of both MR& LR. Conclusion: Every patient of Duane retraction syndrome has an individual story, with good diagnosis & accurate grading to different signs we can determine the best surgical technique for the correctable signs. Single muscle recession & simultaneous recession of both MR & LR can correct horizontal strabismus in PP, the retraction of the globe on attempted adduction & the abnormal head position effectively. Overshoots can be corrected by LR Y-splitting, simultaneous recession of both MR& LR IO anteriorisation surgery is the best choice in cases with HT in PP & slow upshoot. Small LR resection can be done in esotropic cases with mild retraction (grade 1).
Objective to compare the results of using Dapoxetine and HA (hyaluronic acid) gel injection by Five puncture technique in the treatment of premature ejaculation (PE). Methods 100 sexually active heterosexuals circumcised males with lifelong PE were included in the study. Group A patients were treated with on-demand Dapoxetine, while group B was treated with HA gel glans penis injection using a five-puncture technique. Both groups were evaluated at 1 st ,3 rd and 6 th months post-treatment using IELT. Results There were no significant differences between both groups regarding patient demographic. Mean pretreatment IELT in groups A and B were 45.82 ± 7.44 and 46.18 ± 7.82 receptively. There was no significant difference between both groups. After treatment, both groups show significant ILET improvement during the 1 st ,3 rd , and 6 th months follow-up with a P value < 0.001. However, when comparing the improvement of ILET in group A (Dapoxetine) and group B (HA injection), there were high significance differences in favor of group B in the 1st,3rd, and 6th-month follow-up. Conclusion Although both treatment modalities have improved IELT and premature ejaculation, but HA injection with five punctures technique was significantly better than oral Dapoxetine with self-limited side effects.
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