AbstractBackground: Pelvic organ prolapse (POP) is a common condition that significantly impairs quality of life. Aim: This study aimed to evaluate the outcomes of laparoscopic management of POP at Minia University Hospital.Methods: This prospective interventional cohort study included 48 women with symptomatic POP-Q stage II or higher who underwent laparoscopic prolapse repair between June 2025 and June 2026. Results: The mean age was 53.0 ± 11.8 years and mean BMI was 34.7 ± 4.0 kg/m². Laparoscopic sacrocolpopexy was the most frequently performed procedure (31.2%). Mean operative time was 128.9 ± 26.5 minutes, and mean estimated blood loss was 92.6 ± 50.6 mL. All patients were discharged after a standardized 2-day hospital stay. No postoperative complications occurred in 52.1% of patients. The most common complications were port-site infection (14.6%), dyspareunia (10.4%), chronic pelvic pain (10.4%), and port-site abscess (8.3%). Major complications were rare, with one case each of mesh avulsion requiring laparotomy and port-site bowel herniation (2.1% each). Blood transfusion was required in only one patient (2.1%).Conclusion: Laparoscopic management of pelvic organ prolapse is a safe and effective minimally invasive approach with acceptable operative outcomes, low blood loss, short hospitalization, and infrequent major complications. These findings support its wider implementation for appropriately selected women with symptomatic POP.
Preoperative anxiety is a common problem in pediatric surgical patients and is a recognized predictor of emergence delirium (ED) and postoperative negative behavioral changes (PNBC). Intranasal premedication has emerged as a preferred route in children. Both dexmedetomidine and esketamine have demonstrated independent efficacy in this context. Their pharmacological complementarity has prompted growing interest in their combined use, yet no systematic review has comprehensively compared their efficacy and safety as monotherapies across pediatric procedural settings. This review aimed to evaluate and compare intranasal dexmedetomidine versus intranasal esketamine in pediatric patients. The study was conducted in accordance with the Cochrane Handbook and reported following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases were searched without date restriction. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for the cohort study. Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals were calculated using RevMan 5.4, with fixed- or random-effects models applied based on heterogeneity. The final analysis included five studies (four RCTs, one prospective cohort) with a combined sample of 481 pediatric participants. In elective surgical settings, dexmedetomidine at 2 µg/kg significantly reduced ED incidence compared to esketamine (RR 0.57 (0.38, 0.86); p=0.008) and was associated with significantly lower Pediatric Anesthesia Emergence Delirium (PAED) scale scores (MD -1.28 (-2.36, -0.20); p=0.02). Conversely, esketamine demonstrated significantly lower PAED scores in the bronchoscopy subgroup (MD 2.73 (1.84, 3.62); p<0.00001). Dexmedetomidine was also associated with significantly lower Face Legs Activity Cry Consolability (FLACC) pain scores in the emergency department subgroup (MD -3.25 (-5.64, -0.86); p=0.008). Regarding the primary endpoints, the overall pooled ED incidence did not differ significantly between agents (RR 0.77 (0.37, 1.62); p=0.49), nor did overall FLACC pain scores (MD -0.24 (-1.13, 0.65); p=0.60). Intranasal dexmedetomidine and esketamine demonstrate comparable overall efficacy and safety as pediatric premedication agents, with neither showing a significant pooled advantage over the other. However, their comparative performance is context- and dose-dependent, with dexmedetomidine at 2 µg/kg proving superior in elective surgical settings, and esketamine performing better in bronchoscopy procedures. These findings support individualized agent selection based on procedural context and dosing rather than a universal preference for either agent. Larger, standardized multicenter trials are needed to establish definitive evidence-based premedication recommendations across pediatric surgical settings.
Purpose: To evaluate the effect of reattachment of tibialis posterior tendon after excision of accessory navicular bone on flat foot patients clinically and radiologically. Methods: This prospective clinical trial included 10 patients with painful accessory navicular bone type II who were admitted and operated upon in minia university hospital from August 2024 to August 2025, accessory navicular bone excised and tibialis posterior tendon reattached to native bone with anchor mainly by double sutures , proximal which is very important for tensioning the tendon to improve the medial arch, distal for compression over the tendon ,then Demographic data, surgical complications, and follow-up period were documented. Functional outcome assessed clinically by AOFAS ,VAS scores and radiologically by meary ,pitch angles , navicular height. Results: Regarding clinical evaluation AOFAS and VAS scores show difference between pre and post operative scores which were highly significant (p value <0.05) ,also Regarding radiological evaluation the difference between Meary angle , Pitch angle and navicular height pre and postoperatively scores were highly significant (p value <0.05). Conclusion: Reattachment of the tibialis posterior tendon after excision of accessory navicular bone in patients with flatfoot achieved favorable outcomes as it provides significant pain relief, functional improvement, restoration of arch support and accelerated return to daily activities. Level of evidence IV
Introduction: Dry eye disease (DED) presents symptoms such as blurred or hazy vision, burning or stinging, a foreign body sensation, and photophobia, and is increasingly recognized as a significant public health issue. [1]. Assessment of dry eye disease includes both objective clinical tests and subjective symptom evaluation. Among symptom-based assessment tools, the Ocular Surface Disease Index (OSDI) questionnaire is one of the most widely validated and commonly used instruments.[2] Its simplicity and patient-reported nature make it especially suitable for young adult populations, where subjective symptoms may precede significant objective ocular surface changes.[3] Aim of the study: Quantitative assessment of the of DED using OSDI questioner Patients and methods: This is an observational cross-sectional, non-comparative study. which was conducted in Ophthalmology department, Minia University Hospital, Egypt. The study included 100 eyes. Results: OSDI showed over than 70% of eyes in this study had some degree of dry eye symptoms Conclusion: Severity of the dry eye disease
Clinical expression among children with transfusion-dependent β-thalassemia major varies substantially, and this heterogeneity is not fully explained by HBB mutations alone. We evaluated whether HLA-DQB1 alleles were associated with case status in a pediatric case-control cohort and whether selected alleles correlated with hematologic and hemoglobin fraction profiles among affected children. This single-center case-control study included 45 children with transfusion-dependent β-thalassemia major and 45 age- and sex-matched healthy controls. HLA-DQB1 genotyping was performed using a sequence-specific primer real-time PCR assay. Allele frequencies were compared between groups, and within-patient analyses examined associations with pre-transfusion hemoglobin, reticulocyte counts, and hemoglobin fractions. Multivariable and internal-validation analyses were treated as exploratory because of the modest sample size. DQB1 0601 was more frequent in cases than controls (9.7
