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Background Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Prevalence of H.pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim is to investigate H.pylori resistant patients toward Levofloxacin and detect the most effective antibiotic in eradication of H.pylori. Objective To investigate H.pylori resistant patients toward Levofloxacin including regimens and to detect the most effective antibiotic in H.pylori eradication. Patients and Methods The present study aimed to investigate the Susceptibility of Levofloxacin Resistant H.pylori in patients who had been diagnosed and received any regimen including Levofloxacin and still signs and symptoms of H.pylori infection not releaved and after proper time of stoppage of PPI and antibiotics H.pylori Ag in stool still positive at the period from January 2019 to February 2020. Results In the present study we found a wide spectrum of resistance to rates of H. pylori, from nearly negligible rates of Rifampicin (0%), Imipenem (0%), Cefotaxime (2%), Tetracycline (6%), Doxycycline(10%), and Amoxicillin(38%). To high rates resistance to Metronidazole (100%), Erythromycin (72%), Clarithromycin (68%), Azithromycin (60%), Ciprofloxacin (52%), and Levofloxacin (48%). Conclusion Helicobacter pylori is the most common chronic bacterial infection in humans. Antibiotic resistance is a major issue nowadays. Prior use of macrolide antibiotics or metronidazole appears to increase the risk of H. pylori resistance. Clarithromycin resistance appears to be an "absolute" condition that can not be overcome by increasing the macrolide dose. Levofloxacin resistance seems to be increasing. Culture and susceptibility should be done before starting second line treatment.

Fluorinated ethylene propylene (Teflon FEP) was used as external layer thermal insulator for Hubble Space Telescope (HST) and on the outside surfaces of space crafts in the low earth orbit (LEO). Teflon FEP was eroding as a result of exposure to atomic oxygen (AO) and different electromagnetic waves such as ultraviolet radiation and X-ray. Model molecules were used to simulate Teflon FEP and its interaction with other nanoparticles such as ZnO and SiO2. Density functional theory (DFT) was used to calculate model structures using B3LYP/LAN2DZ model. Molecular electrostatic potential as contour, band gap energy, and total dipole moment were computed for all models. Thermal stability properties were also studied for Teflon FEP both individually and interacted with ZnO and SiO2. Results showed that a layer of OZn and SiO2 on Teflon FEP, especially Teflon FEP + OZn + OSiO structure, improves the physical, chemical, thermal, and electrical stability of Teflon FEP, potentially acting as a corrosion-inhibiting layer.

Background Infants and young children explore objects by putting them in the mouth. Although most swallowed foreign bodies pass spontaneously through the gastrointestinal tract without causing harm, some of them are potentially dangerous and may be lethal. Patients and methods Five children (3boys and 2girls) have swallowed multiple high strength and powerful rare earth element Neodymium magnets. Their ages ranged between (nine months to six-year-old). Three cases were subjected to open and two for laparoscopic exploration (one of them converted to open). Results multiple complicated enteroenteric fistulae in three cases and multiple perforation of small intestine in two cases. Resection anastomosis was done for one case and simple closure of small bowel perforations for other four cases. Post operative course was uneventful for all patients and discharged in a good general condition. Conclusion General practitioners should be aware of the danger and complications of Neodymium magnetic beads ingestion by children. Early endoscopic removal is recommended if the patient presents immediately after ingestion. Parents awareness through media is required to abandon magnet balls in houses and where children can ingest those dangerous balls.

Fusion of the undescended testes with splenic, renal and adrenal tissue have been described in several cases but hepato-testicular fusion is a very rare entity of undescended testes. Herein, we report a case of hepato-testicular fusion. To the best of our knowledge, this is the 2nd such case in the English literature.

Introduction: Rectal prolapse is a relatively common, usually self-limiting illness in children. Peak incidence is between 1 and 3 years. The intervention is required for the persistent rectal prolapse (PRP). Only scanty experience is available with laparoscopic rectopexy in children. There is no available work using both mesh and suture laparoscopic rectopexy in literature. This work is unique that it presents our clinical experience with both mesh and suture laparoscopic rectopexy in children. This is a prospective clinical study for the outcome of laparoscopic rectopexy (LRP) by both mesh and suture technique in children with persistent rectal prolapse (PRP). Materials and Methods: Fourteen cases of PRP were managed with LRP from February 2008 to August 2012. Results: Of the 14 children, 10 (71.42%) were males and 4 (28.57%) were females. Male to female ratio was 2:1. The mean age of presentation was 5 years (range 3 - 8 years). The presenting complaints were mass descending per rectum along with bleeding per rectum lasting from 1 to 3 years. All had rectal prolapse of 5 - 7 cm in length. 12 out of 14 children had recurrence even after sclerotherapy before referral to laparoscopic rectpexy. The mean duration of surgery was 30 minutes (range 20 - 60 minutes). No intraoperative complications were reported; only one case got constipation and was managed conservatively and no recurrence. Conclusion: LRP is safe, feasible in children and gives satisfactory results after failure of all conservative even sclerotherapy injection.

Purpose: Morgagni hernia (MH) is a rare entity that accounts for less than 6% of all surgically treated diaphragmatic hernias in pediatric age group. They are mostly asymptomatic and discovered incidentally. Open surgical repair has been the gold standard in all cases. However, since the introduction of minimal access surgery, different laparoscopic techniques of MH repair have been reported. Most of them are reporting on few cases and the immediate outcomes. I report one of the largest experiences to date assessing the safety and efficacy two trocars laparoscopic repair of MH in children with more emphasis on the short-term outcomes, such as the recurrence, conversion rate, operative, postoperative complications and the fate of the hernia sac. Patients and methods: Fifteen children with MHs underwent primary laparoscopic repair by placement of U-shaped, nonabsorbable sutures through the full thickness of the anterior abdominal wall incorporating, the posterior rim of the defect, and returning back out through the anterior abdominal wall with the sutures tied in the subcutaneous tissue using the Storz port closure needle and without hernia sac excision, no insertion of chest tube or drain. Results: A total of 15 patients with MH were operated upon. There were 10 males and 5 females. Left-sided MH was present in five cases (33%), right-sided MH was present in seven cases (47%) and three bilateral MH (20%). Male-female ratio was 2:1. Intraoperative and postoperative analgesia requirement was minimal. All operations were completed laparoscopically. None of the patients developed intraoperative or postoperative complications. The maximum follow-up was 48 months (mean, 20 months). All patients are in good health without recurrence or significant sac residual. Conclusion: This easy save technique of MH repair is reducing the operative time and postoperative hospital stay. Also it is minims the need of postoperative analgesia. The hernia sac excision or not is not affecting the outcome.

Splenogonadal fusion is a rare congenital anomaly in whichthere is fusion of the spleen and the gonad or mesonephricderivatives. Approximately, 150 cases have been reported sincethe condition was first described by Bostroem in 1883.The diagnosis of this uncommon anomaly is rare even to besuspected preoperatively; I describe a case in whichlaparoscopic diagnosis and management has been done andreview of the literature.

Hemangiopericytoma is a rare vascular tumour of infants. Although generally considered to be benign, local recurrence and metastases can occur. Herein, we report on two full term girls, delivered with lumbosacral swelling and left thigh swelling respectively. Complete surgical excision with safety margins was performed for each lesion. Histologic examination of both lesions showed picture of infantile hemangiopericytoma. There is no evidence of local recurrence or distant metastasis during last 20 and 17 months for 1st case and 2nd case respectively. In conclusion; most infantile hemangiopericytoma follow a benign course. Rarely these tumours behave aggressively with local infiltration, recurrences and even distant metastases. Careful follow up is therefore essential.

Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac.Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7%) cases were suffering unilateral hernia and 20 (22.2%) patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%). The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus.Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.