Using a practical scoring system for diagnosing acute appendicitis can help reduce the rate of unnecessary surgery. This prospective study was carried out to evaluate Alvarado scoring system for diagnosing of acute appendicitis in our set up. Out of total 100 patients, appendicitis was confirmed 80 patients, thus giving negative appendectomy rate of 20% (male 6%, female 16%). Perforation rate was 4%. Positive predictive value was 89%. The sensitivity was 54% and specificity 75%. Alvarado score is not sensitive tool for aiding diagnosis of acute appendicitis.

Trocar site hernia (TSH) is an incisional hernia occurring at the trocar insertion sites after different types of laparoscopic surgeries. The aim of this study is to present characteristics of patient and surgery series with trocar site hernia after laparoscopic cholecystectomy. A 2930 consecutive patients underwent laparoscopic cholecystectomy in two major university- affiliated hospitals from April 2014 to March 2018 and the patient followed up for variable periods of time. Retrospective medical chart review to study trocar site hernia including patient, operation, instruments, and pathologic characteristics described. Six patients had trocar site hernia (incidence 0.20%), the hernias occurred mostly at the umbilical port site after using 10 mm trocar. Risk factors included mainly obesity, female gender and use of 10 mm trocars at midline sites. TSH is more described. It occurs mostly at the umbilical port site. Major risk factors include obesity, diabetes mellitus, lengthy procedure, extension of entry site, and wound infection. Closure of fascial defect is supposed to reduce the incidence despite weak evidence.

Dumping syndrome (DS) is a collection of gastrointestinal (GI) and vasomotor symptoms arising postprandially because of prompt gastric emptying. This can develop due to any changes in gastric anatomy or innervation during esophageal, gastric, or bariatric surgery. Due to the increase in the number of bariatric operations and innovative surgeries performed internationally, bariatric surgery has emerged as the most common cause of this disease entity. 25–50% of all gastric surgery patients experience dumping symptoms after their procedures. Patients who have had Roux-en-Y gastric bypass (RYGB) are at an extremely high risk (up to 40%) of developing dumping syndrome postoperatively. The goal of this review is to provide an insightful evaluation of the most recent literature on the overlooked scientific and clinical elements of dumping syndrome, such as diagnostic aspects, pathogenesis, terminology, and management. More research is needed to establish guidelines and terms used to properly document and manage dumping syndrome.

BACKGROUND:Cancer of the male breast is a rare malignancy comprising less than 1% of all male cancers. The traditional surgical management for male breast cancer is modified radical mastectomy. Other surgical methods such as breast conserving surgery...

Urethrocutaneous fistula may complicate hypospadias repair. We noticed that double-layered preputial dartos flaps added to tubularized incised plate urethroplasty can reduce the risk of urethrocutaneous fistula. The aim of this study was to compare the outcomes of tubularized incised plate urethroplasty with double-layered preputial dartos flaps to with single-layered local fascial flaps in preventing urethrocutaneous fistula. A retrospective cohort study was conducted between January 2017 and December 2020 at Jordan University Hospital (Amman, Jordan). Boys who were aged between 6 months and 5 years, diagnosed with distal hypospadias, and not circumcised were included. The primary outcome was the occurrence of urethrocutaneous fistula in patients who underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The results showed a total of 163 boys with distal hypospadias; among them, 116 patients underwent tubularized incised plate urethroplasty with a single-layered fascial flap, and 47 underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The development of urethrocutaneous fistula was higher in the group receiving tubularized incised plate urethroplasty with a single-layered fascial flap than in the group receiving tubularized incised plate urethroplasty with a double-layered fascial flap after 1 month, 6 months, and 12 months (6.9% vs 0, 10.3% vs 0, and 5.2% vs 0, respectively), and the difference after 6 months was statistically significant (P = 0.02).