Colorectal cancer in Egypt has no age predilection and more than one-third of tumors affects a young population. The high prevalence in young people can neither be explained on a hereditary basis nor can it be attributed to bilharziasis. The disease usually presents at an advanced stage, and predisposing adenomas are rare. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

Early oral feeding after colorectal surgery is safe and tolerated by the majority of patients. Operative time and amount of blood loss do, however, have an impact on the tolerability of early feeding.

Background This randomized clinical trial was conducted to assess the role of platelet-rich plasma (PRP) gel as a treatment of clean non-healing diabetic foot ulcer (DFU) in comparison with regular dressing with saline as a control. Methods Patients with DFU were randomly assigned to one of two equal groups: group I received dressing with PRP gel and group II received regular saline dressing. The main outcomes of the study were percent reduction in the dimensions of the DFU, healing of DFU, and complications at 20 weeks of follow-up. Results Twenty-four patients were included to the study. The mean age of patients was 55.2 ± 6.4 years. Only three (25%) patients in group I achieved complete healing versus none of group II patients. In total, 8.3% of group I and 41.6% of group II patients did not show any response to treatment. The percent of reduction in the longitudinal and horizontal dimensions of the DFU was significantly greater in group I than group II (43.2% vs 4.1%) and (42.3% vs 8.2%), respectively. The time required to maximum healing was significantly shorter in group I than group II (6.3 ± 2.1 vs 10.4 ± 1.7 weeks, P \ 0.0001). Conclusion The use of PRP gel as a dressing for chronic DFU resulted in a more significant reduction in the size of the ulcer when compared to regular saline dressing. Also the time to reach the point of maximal possible healing with the least wound dimensions was significantly shorter when using PRP as a dressing protocol.Ahmed Elsaid and Mohammed El-Said contributed equally to the study and both are considered co-first Author.

Biofeedback training has a limited therapeutic effect on patients suffering from anismus. BTX-A injection seems to be successful for temporary treatment of anismus.

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Background: The problem of substance use is becoming one of the most serious and rapidly growing phenomena all over the world. Efficient and well-designed prevalence studies for mental illnesses including substance use problems need to be regularly updated, in order to rearrange the prevention and management plans on a scientific basis. The aim of the study is to detect the prevalence of substance use and dependence among secondary school students, as they are one of the high-risk populations for drug use, targeting a representative sample of 10,648 of students. Results: The most commonly used substance was nicotine during lifetime (9%), last 12 months (4.9%), and last month (2.4%). After the exclusion of nicotine, benzodiazepines was the commonest substance abused (5.1%) followed by alcohol (3.3%) and organic solvents (3.1%). The most commonly used during the last 12 months was alcohol (2.9%) followed by organic solvents (2.7%) and cannabis (2.6%). The prevalence of the regular use of any substance was 1.5%, while the prevalence of the dependence syndrome was 0.9% (excluding nicotine dependence). The prevalence of intake, regular use, and dependence were all higher among males. Conclusion: The results of this study attract attention towards the substance abuse problem among adolescents in Egypt. Tobacco is the most commonly used substance followed by benzodiazepines which seemed to be used on a regular basis. Alcohol, organic solvents, and cannabis are also commonly used. Preventive services should be directed towards youth to combat these phenomena.

Sigmoid resection for cancer is associated with an increased risk of long-term bowel dysfunction; obstructed defaecation is prevalent and associated with substantial impairment of QoL.

Background  Fistula-in-ano commonly affects males more than females. Some differences in the characteristics of fistula-in-ano between both genders have been recognized, yet the impact of these differences on the outcomes of surgery for fistula-in-ano is still unclear. The present study conducted a gender-specific analysis aiming to assess the characteristics and the outcomes of surgery of fistula-in-ano in each gender. Patients and methods  The records of patients with fistula-in-ano were retrospectively reviewed and the following variables were extracted: patients’ demographics, type of fistula-in-ano, position of the external opening, operation performed, incidence of recurrence and complications, particularly fecal incontinence. Gender-based analysis of the characters and outcomes of surgery for fistula-in-ano was performed. Results  565 (491 males) patients of a mean age of 41.7 years were included. Females had a significantly higher percentage of low fistula-in-ano than males (70.2% vs. 50.3%, p = 0.002). Males had a significantly higher percentage of high trans-sphincteric fistula-in-ano (48.5% vs. 29.7%; p = 0.003). Anterior fistula-in-ano was more common in female patients (69% vs. 16.3%; p < 0.0001). Recurrence of fistula-in-ano was detected in 42 (7.4%) patients. Males had higher recurrence rate than females (7.9% vs. 4%; p = 0.34). Fecal incontinence developed in 1.7% of patients with higher incidence observed in females (4% vs. 1.4%). Conclusion  The majority of fistula-in-ano in males were posterior and high trans-sphincteric whereas most fistula-in-ano in females were low and anteriorly based. Despite the different characteristics of fistula-in-ano; no significant differences in the rates of fistula recurrence and fecal incontinence between males and females could be recorded.