Hypospadias is a common congenital anomaly that affects the male genitalia. This research paper aims to investigate the incidence of hypospadias in Libya by analyzing existing literature, statistical data, and medical records.

 The study will explore the prevalence of hypospadias among newborn boys in various regions of Libya, as well as the factors that may contribute to the development of this condition.

 Additionally, the paper will discuss the current treatment options available for hypospadias patients in Libya and the challenges faced by healthcare providers in managing this condition. By providing a comprehensive overview of hypospadias incidence in Libya, this research paper will contribute to the understanding and improvement of care for individuals with this congenital anomaly.

Background

Safe anaesthesia and surgery are a public health imperative. There are few data describing outcomes for children undergoing anesthesia and surgery in Africa. We aimed to get robust epidemiological data to describe patient care and outcomes for children undergoing anesthesia and surgery in hospitals in Africa.

Methods

This study was a 14-day, international, prospective, observational cohort study of children (aged <18 years) undergoing surgery in Africa. We recruited as many hospitals as possible across all levels of care (first, second, and third) providing surgical treatment. Each hospital recruited all eligible children for a 14-day period commencing on the date chosen by each participating hospital within the study recruitment period from Jan 15 to Dec 23, 2022. Data were collected prospectively for consecutive patients on paper case record forms. The primary outcome was in-hospital postoperative complications within 30 days of surgery and the secondary outcome was in-hospital mortality within 30 days after surgery. We also collected hospital-level data describing equipment, facilities, and protocols available. This study is registered with ClinicalTrials.gov, NCT05061407.

Findings

We recruited 8625 children from 249 hospitals in 31 African countries. The mean age was 6·1 (SD 4·9) years, with 5675 (66·0%) of 8600 children being male. Most children (6110 [71·2%] of 8579 patients) were from category 1 of the American Society of Anesthesiologists Physical Status score undergoing elective surgery (5325 [61·9%] of 8604 patients). Postoperative complications occurred in 1532 (18·0%) of 8515 children, predominated by infections (971 [11·4%] of 8538 children). Deaths occurred in 199 (2·3%) of 8596 patients, 169 (84·9%) of 199 patients following emergency surgeries. Deaths following postoperative complications occurred in 166 (10·8%) of 1530 complications. Operating rooms were reported as safe for anaesthesia and surgery for neonates (121 [54·3%] of 223 hospitals), infants (147 [65·9%] of 223 hospitals), and children younger than 6 years (188 [84·3%] of 223 hospitals).

Background: Enlargement of inferior nasal turbinates is a common cause of nasal obstruction. There are many surgical methods used to treat hypertrophied inferior turbinates such as electrocautery, partial turbinectomy, microdebrider reduction and radiofrequency thermal ablation (RFTA). The mucosal condition after surgery is an important factor that should be considered in evaluation of different techniques. Objective: This study aimed to examine the microstructural appearance of the ciliated epithelial tissues of inferior turbinates by light microscope. It was done by cytological examination of inferior turbinate mucosa in patients treated by radiofrequency thermal ablation (RFTA) and bipolar electro cautery (BEC) for hypertrophied inferior turbinates. Methods: A prospective study performed on 36 patients with hypertrophied inferior turbinates causing nasal obstruction. Patients were divided into two groups: group (A) were managed with radiofrequency thermal ablation (RFTA) and group (B) were managed with bipolar electro cautery (BEC). Cytological examination of nasal mucosa was done 3 months postoperatively. Results: by cytological microscopic examination, 88% of cases of group (A) showed no abnormalities in ciliated epithelial cells. only 12% of cases showed abnormalities in the form of damage in the ciliated cells with an architectural rearrangement. In group (B) 78% of patients showed abnormalities in cilia and epithelial cell damage and only 22% of them showed no abnormalities. Conclusion: Radiofrequency thermal ablation (RFTA) seems to be a good modality dealing with the problem of inferior turbinate hypertrophy. It showed minimal injury to turbinate mucosal tissues with good ciliary structure, along with an intact and functioning epithelium

Enlargement of inferior nasal turbinates is a common cause of nasal obstruction. Surgical methods used to treat hypertrophied inferior turbinates such as electrocautery, cryosurgery, partial turbinectomy, laser turbinoplasty, microdebrider reduction and radiofrequency thermal ablation (RFTA).The mucosal condition after surgery is an important factor that should be considered in evaluation of different techniques. This study aimed to examine the microstructural appearance of the ciliated epithelial tissues by light microscope.It was done by cytological examination of inferior turbinate mucosain patients treated by radiofrequency thermal ablation (RFTA) and bipolar electrocautery (BEC) of hypertrophied inferior turbinates. A prospective study included thirty six patients with hypertrophied inferior turbinates causing nasal obstruction not responding to medical treatment. Patients were divided into two groups: group(A) were managed with radiofrequency thermal ablation (RFTA)and group (B)were managed with bipolar electrocautery (BEC).Routine nasal examination was done with the aids of anterior rhinoscopy and nasal endoscopy. The postoperative follow up period wasthree months. cytological examination of nasal mucosa was done postoperatively. Results: there was no abnormalities in ciliated epithelial cells and only 12% of cases showed abnormalities in the form of damage in the ciliated cellswith anarchitectural rearrangement.While, the majority of sample showed abnormalities in cilia and epithelial cell damage. 78% of patients had abnormal ciliated epithelial cells im group B. Radiofrequency thermal ablation seems to be a good modality dealing with the problem of inferior turbinate hypertrophy. It showed minimal injury to turbinatemucosal tissues with good ciliary structure, along with an intact and functioning epithelium.‏

Background

Spinal anesthesia (SA) remains the most popular anesthetic technique for caesarean sections (CS), as it abolishes the possible risks of pregnant airway management. The ability to anticipate the episodes of hypotension following spinal anesthesia will enable anesthesiologists to interfere early and provide better patient management.

Objective

The aim of the current study was toevaluate the perfusion index and the blood pressure positional changes in the prediction of hypotension after SA in CSs.

Patients and methods

A prospective cohort study was conducted at the Obstetrics and Gynecology Department of Zagazig University Hospitals. A total of 80 pregnant women who were prepared for elective CS delivery, aged from 18 to 40 years with ASA-II (American Society of Anesthesiologists Status), were recruited in the current study.

Results

The mean perfusion index (PI) pre-spinal was 5.81 and immediately after spinal was 4.65 with a statistically significant decrease (P<0.001). There was also a statistical difference between the mean of mean arterial pressure (MAP) of the studied cases pre-spinal at the lateral position (91.76 mmHg) and mean MAP in the supine position (83.29 mmHg) with P-value <0.001, with a mean difference of 8.48 mmHg. PI cut-off >4 had a sensitivity of 85.9%, specificity of 75%, and accuracy of 83.8% in the prediction of hypotension. The positional change in blood pressure at cut-/off >5 mmHg had a sensitivity of 82.8%, specificity of 75%, and accuracy of 81.3% in the prediction of hypotension among cases.

Conclusion

The preoperative PI and positional blood pressure change can predict spinal anesthesia 

Abstract

Anaesthesia team should guarantee the patient safety first. To achieve this, it is necessary to be aware of both the anesthetic methods and all potential perioperative physiological changes). Spinal anaesthesia (SA) is the most preferred anesthetic method in caesarean deliveries because it eliminates the potential risks associated with airway management in pregnant women However, SA leads to hypotension in approximately 70% of patients Aortocaval compression caused by the uterus and a decrease in systemic vascular resistance due to sympathetic block induced by SA are important factors in the precipitation of hypotension. Hypotension following SA may cause dizziness, nausea, and vomiting in the mother, as well as fetal acidosis. Pregnant women are more sensitive to local anesthetics, less responsive to vasopressors and have lower mean arterial pressure (MAP) at term.

Abstract Introduction: Abdominal wall defects (AWD) are a common problem that can become difficult to manage, especially when the defect is large and resources are limited (silo and TPN). Methods: Retrospectively, 85 medical records of patients who have been admitted to TMC over a decade (2005 - 2015) were studied. The defects have been categorized into three groups: omphalocele minor, omphalocele major and gastroschisis. The aim is compare the outcomes within these three groups between developed and developing nations. Results: Out of 85 neonates with abdominal wall defects, 50 are males and 35 are females. 58 patients had omphalocele minor, 16 omphalocele major and 11 with gastroschisis. Associated congenital anomalies are reported in 45% of omphalocele groups (1 and 2) and in 27% of gastroschisis group. Post-operative morbidity rate among the omphalocele groups (1 and 2) is 27.37%, and 54.54% among gastroschisis group. Mortality rate among the group one is 3.45%, group two 12.5%, and group three 27.27%. The mortality rate among the two patients who received devices was 50%. Conclusion: Omphalocele can be treated effectively in the developing world; however, gastroschisis cases need more sophisticated supportive measures to reach the reported rates.