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Aim The aim of this study is to show the efficacy of single crural artery angioplasty for diabetic wounds as regard to healing rate, patency rate, mean change in ankle brachial index (ABI), and limb salvage. Patients and methods A prospective observational cohort included diabetic patients with critical limb ischemia (Rutherford-5 and 6) who underwent percutaneous infrapopliteal angioplasty for single crural artery. Follow-up for complete wound healing, improving in ABI, patency rate, and limb salvage were done up to 1 year. Results In total, 42 patients with median age 56 years (interquartile range=0.06). In total, 27 patients had a diseased single crural artery and 15 patients had lesions in multiple crural arteries. The mean ABI for them was improved significantly after the procedure (P=0.0001). Complete wound healing occurred in 31 (73.8%) cases, patency rate at 12 months was 73.8%, and limb salvage rate was 88.1%, we found a significant difference in rate of change in ABI average between the healed group and nonhealed group (P=0.006), further analysis using receiver-operating characteristic curve found that the cutoff value of 0.2184 increase in ABI can predict complete wound healing (sensitivity=74.2% and specificity=72.7%). Conclusion Single crural artery angioplasty is a safe and effective procedure for management of diabetic patients with ischemic leg ulcers. [ABSTRACT FROM AUTHOR]

Aim: Anterior rectocele is usually an asymptomatic condition in many women, yet it can be associated with obstructed defaecation syndrome (ODS). Transperineal repair of rectocele (TPR) has been followed by variable rates of improvement in ODS. The present pilot randomized clinical trial aimed to evaluate the outcome of TPR with vertical plication (VP) of the rectovaginal septum compared to horizontal plication (HP). Methods: Adult women with anterior rectocele were recruited to the study and were randomly allocated to one of two equal groups. The first group underwent TPR with VP of the rectovaginal septum and the second group underwent TPR with HP. The main outcome measures were improvement in ODS, recurrence of rectocele, complications and dyspareunia. Results: The trial included 40 female patients with anterior rectocele. There was no significant difference between the two groups regarding the postoperative Wexner score. Complete cure and significant improvement in ODS symptoms were comparable after the two techniques. The reduction in rectocele size after HP was significantly greater than after VP (1.7 vs. 2.6, P < 0.0001). Significant improvement in dyspareunia was recorded after HP (P = 0.001) but not after VP (P = 0.1). There was no significant difference between the two groups with regard to operating time, complications and recurrence. Conclusion: VP and HP of the rectovaginal septum in TPR were associated with a comparable improvement in ODS symptoms and similar complication rates. HP was followed by a greater reduction in the rectocele size and greater improvement in dyspareunia than VP. [ABSTRACT FROM AUTHOR]

Background and aim Motorcycle accidents are one of the leading causes of road traffic injuries and mortality. The aim of this study was to determine the common patterns of major injuries associated with motorcycle accidents in patients attending Mansoura University Emergency Hospital in Egypt, and to measure the magnitude of the problem in our community. Patients and methods Patients involved in motorcycle crashes who were admitted to the hospital during August 2014 to April 2015 were retrospectively reviewed. All age groups and both genders were included. Results Two hundred patients (181 males) with a mean age of 30.7 ± 10.5 years were included with the majority of patients aged 20–40 years. Head injuries were the most frequent fatal injuries (9/61) patients; orthopedic injuries were the most common injuries, occurring in 78.5% of victims. Multisystem injuries occurred in 28% of patients. None of the motorcyclists involved in accidents wore helmets. Conclusion Motorcycle accidents are a common cause of road traffic injuries and mortalities in Egypt, occurring mainly in males aged 20–40 years. The majority of victims had an isolated trauma to single body system. Orthopedic injuries were the most common and least fatal type of injuries. The highest fatalities were among patients with chest injuries then patients with head injuries. None of the victims wore protective clothing or helmets at the time of accident. [ABSTRACT FROM AUTHOR]