The adoption of mini-bypass significantly reduces morbidity including donor blood usage and postoperative bleeding in routine CABG patients.

Objective:To demonstrate a benefit in diminished adverse events such as hypotension and hematuria with gradual drainage of the bladder when compared to rapid decompression in patients with acute urinary retention (AUR) due to benign prostatic hyperplasia in a case–control study.Methods:Sixty-two patients matched our selection criteria presenting with AUR. They were divided into two groups – the first was managed by rapid drainage of the bladder, the second was managed by gradual drainage through a urethral catheter (The first 100 mL immediately evacuated, then the rest evacuated gradually over 2 h).Results:The mean age was 64.4 and 63.2 years in the first and second group, respectively. Diagnosed cause was benign hyperplasia of the prostate. Hematuria occurred in two patients in the first group and none in the second group. The two cases of hematuria were mild and treated conservatively. After the relief of the obstruction, the mean blood pressure was noticed to decrease by 15 mmHg and 10 mmHg in the first and second group, respectively, however, no one developed significant hypotension. Pain relief was achieved after complete drainage in the first group and after the evacuation of 100 mL in the second group.Conclusions:We conclude that there is no significant difference between rapid and gradual decompression of the bladder in patients with AUR. Hematuria and hypotension may occur after rapid decompression of the obstructed urinary bladder, but these complications are rarely clinically significant.

Ectopic thyroid tissue (ETT) is a rare entity and a challenging differential diagnosis. This is a report of a case of a mediastinal mass that was found to be an ectopic mediastinal thyroid tissue, in a 77-year-old woman who was admitted to our hospital for breast cancer management. The mediastinal mass was identified in the postsurgical computed tomography (CT) scan of the chest and was suspected as mediastinal lymph node metastasis. A CT-guided percutaneous transthoracic punch biopsy (CT-TPB) proved to be an adequate diagnostic tool to exclude malignancy and provide a definite diagnosis of the mediastinal mass. We find that CT-guided punch biopsy as a useful diagnostic alternative enabling histopathological specimens to be obtained from mediastinal masses and lymph nodes suspected of malignancy.

Background:Organophosphate (OP) poisoning is an important reason for hospitals and intensive care units admission in the developing countries. OP poisonings are classically treated with atropine and oximes. These methods are sometimes shown to be of limited benefit. Objective: Assessment of the effectiveness of the management with fresh frozen plasma (FFP) in improving the outcome of patients with acute OP poisoning. Patient and Methods: A randomized clinical trial study was conducted upon 70 acute OP poisoning patients that were referred to the Emergency Department, Suez Canal University Hospital, Ismailia, Egypt. These patients were randomly divided into two groups (35 each); Control group: Treated with the traditional management protocol of OP (atropine and oximes). FFP group: Treated with the conventional management protocol of OP plus FFP. Results: No significant difference was found in cholinesterase level on admission between both groups, Serum cholinesterase level in the FFP group significantly increased after an hour of FFP infusion (2.48 iu/ml vs. 10.36 iu/ml p<0.0001). There is a significant difference between both groups regarding the duration of their hospital stay (2.43 ± 0.5 days for FFP group vs. 3.06 ± 1.4 days for control group; p<0.01) and intensive care unit admission (4 patients in FFP group vs. 12 patients in the control group; p<0.04). Conclusion Early management with FFP may be an effective method for the management of acute OP poisoning, as it can improve the clinical outcome through decreasing mortality, duration of hospital stay and the need for ICU admission.

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