Background: the retrograde flow of urine from the bladder into the upper urinary tract is known as vesicoureteral reflux (VUR). Aim of The Work: to compare laparoscopic and open transvesical ureteral reimplantation for the VUR correction in children as regards the average surgery time in minutes (from the beginning of the skin incision to the finish of the wound closing), hospital stay in hours, complications, successful rate, recurrence rate, and follow-up by ultrasound every 1 month, Voiding cystourethrogram (VCUG) every 3 month and DMSA scan after 6 month. Patients and Methods: This is a prospective comparative study between laparoscopic and open transvesical ureteric reimplantation for the correction of VUR in pediatric patients. It was done at Pediatric Surgical Department, Al-Azhar University Hospitals, and others Governmental and Private Hospitals over a period of 2 years. This study was done on (20) children. Results: Urinary extravasation and growth hematuria varied significantly between the groups. Thus, they were significantly more common in Group B than in Group A. Conclusion: : In unilateral and bilateral VUR, the minimally invasive laparoscopic method has a comparable rate of success to open surgery. The laparoscopic method decreases the need for pain medication after surgery and allows for a quicker return to normal activities. Keep in mind the neuroanatomy of the bladder, ureters, and VUJ for this approach. The limitation of our study, further comparative studies with larger sample sizes were needed to strength the present results
A motor vehicle accident is a major public health problem with increasing incidence of mortality and morbidity. Psychoactive drugs, such as amphetamine, cocaine and medicinal drugs increase the risk of road traffic injuries (RTIs). The present work studied the relationship between illicit and non-illicit psychoactive drugs administration and head trauma in motor car accidents in Damietta governorate. The study was conducted from the 1st of January 2008 to 1st of July 2009 and involved 80 cases recruited from the Emergency Department of Al-Azhar University Hospital (New Damietta),in addition to 60 cases as a control group among those admitted to the neurosurgery department with no history of RTIs within the past 6 months. Within one hour after arrival to the emergency room,5ml urine and blood samples were drawn in a sodium fluoride (NaF) contained tubes. Then they were kept at 4-8 o C for subsequent tests, using radioimmunoassay strips as a preliminary test and a thin layer chromatography (TLC) as a confirmatory tests in the Clinical Toxicology Unit.. Cases and controls were subjected to a standardized questionnaire. Major variables included in the interview were age, sex, smoking, driving behaviors, wearing a protective gear and psychoactive drugs used during the previous month. In each case, all medications administered prior to urine and blood sample collection were recorded. Drug abuse in the present study, was positive in 52 cases (65.0%) of the studied group compared to 14 cases (23.3%) of the control group; in the study group, opiates are the most commonly abused (45.0%) followed by psychoactive drugs (37.5%), then cannabis (20.0%) and benzodiazepine (18.8%), while in the control group, opiates and antihistamines are the most common (8.3% for each one) followed by cannabis and benzodiazepine (5.0% for each one) and there is a significant difference in the use of cough suppressants, cannabis, opiates, benzodiazepine, psychoactive drugs and drugs co-administration in the study group in comparison to the control group. In conclusion, the present study revealed that illicit and non-illicit drug abuse was associated with motor car accidents regardless the type of the victim (driver, occupant or pedestrian), and the most common drugs used were opiates, psychoactive drugs, cannabis and benzodiazepine.
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