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Background It was difficult to compare the outcome of partial nephrectomy among different studies due to the absence of standardized description of different renal masses. This problem led to the development of nephrometry scoring systems. R.E.N.A.L. is among the commonest nephrometry scoring systems; however, some studies failed to find any relation between R.E.N.A.L. with perioperative outcome. We evaluated our designed newly modified nephrometry score in prediction of outcome following partial nephrectomy and compared its predictability versus original R.E.N.A.L. Methods Fifty-one patients with cT1-2N0M0 renal masses amenable for partial nephrectomy were included prospectively. Different perioperative outcome variables were compared according to complexity level in R.E.N.A.L. and the newly modified nephrometry score. Results Clinical staging was T1a (21.6%), T1b (49%), T2a (25.5%), T2b (3.9%). Median R.E.N.A.L. was 9 (4–12). Hilar position and intrarenal pelvis were detected in 19.6% and 68.6%. Low, moderate and high complexity masses were found in 21.6%, 39.2% and 39.2%. Complications and rate of conversion to radical nephrectomy were 17 (33.3%) and 4 (7.8%). The only significantly affected variable (p = 0.039) by R.E.N.A.L. was rate of secondary intervention, but it was higher in low than in high complexity level. In the newly modified nephrometry score, complications (p = 0.037) and rate of positive surgical margin (p = 0.049) were significantly higher with increased complexity level. Although other variables (pelvi-calyceal system entry, operative time, blood loss, hemoglobin loss, blood transfusion and conversion to radical nephrectomy) did not show statistically significant difference according to both scores, they were better associated with the complexity level in the newly modified nephrometry score with their remarkable increase in the high when compared to the low complexity level. Conclusions The newly modified nephrometry score was associated with better prediction of outcome of partial nephrectomy when compared to R.E.N.A.L.

The aim of this study was to find the correlation between severity of dry eye and rheumatoid arthritis (RA) disease activity. Forty- two RA patients with dry eye were recruited from Rheumatology Outpatient Clinic in Minia University Hospital. Assessment of RA disease activity was performed using disease activity score (DAS-28). Ocular tests include Schirmer test I, tear film break up time (TBUT) and ocular staining score (OSS) was performed by ophthalmologist to find evidence of ocular dryness. Erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti SSA/Ro and anti SSB/La was also tested. Patients with severe dry (OSS ≥ 3) underwent minor salivary gland biopsy (MSGB) as suspected to have secondary Sjögren's syndrome (SS). Of 42 RA patients, 30 had definite dry eye. DAS-28 did not show significant correlation with any of ocular tests for dryness while the duration of RA was significantly positively correlated with Schirmer test and OSS. The biopsy results of RA patients with severe dry eye show no evidence of SS. The severity of dry eye is not correlated with activity of RA but with its duration.

Premature rupture of membranes is an obstetric problem with an obscure etiology, difficult to diagnose and is associated with significant maternal and neonatal morbidity and mortality. Its management strategies are diverse and controversial. The aim of this study: was to identify the relationship between premature rupture of membranes and maternal and neonatal outcomes. Subjects and method: The study was conducted at obstetric departments' labor units of two settings; Tanta University hospital and El-Menshawy hospital. A convenient sample of 120 parturient women who fulfilled the inclusive criteria were included in the study. Three tools were used for data collection; Tool (I): A structured interview schedule that included (a). Socio demographic characteristics, (b), Reproductive history, and (c). History of present pregnancy. Tool (II): Maternal outcome assessment observational checklist that included two parts. Part I: assessment of general condition of the women, and Part II: obstetrical and local abdominal examination. Tool (III): Neonatal outcome assessment observational checklist. Results: The results of the present study revealed that there was a significant relation between premature rupture of membranes and the occurrence of maternal and neonatal outcomes. Socio-demographic factors include residence, income; age, educational level, and occupation were risk factors predictors of premature rupture of membranes. History of abortion, and exposure to infection, anemia, strenuous effort/activity, and number of follow up visits were also significant risk factors predictors of premature rupture of membranes. Conclusion: The gestational age in weeks and latent period of premature rupture of membranes were the main determinants of maternal and neonatal outcomes. Prematurity is the principal risk to the fetus with its associated morbidity. On the other hand, infectious morbidity is the primary maternal risk among women. Recommendations: Premature rupture of membranes is one of the most importance obstetric complications that should be focused in the curriculum of basic nursing education as well as continuing education. Additionally, antenatal classes should be planned and developed in order to increase pregnant women's awareness to seek obstetrical care regarding premature rupture of membranes at proper time.

Many patients offered endourological procedures are concerned about potential sexual dysfunction following endoscopy, and there are scarce published data to support an evidence-based response. We aim to assess possible effects of endourological procedures on sexual activity and erectile function.Sexually active men undergoing cystoscopy and/or upper tract endourological procedures were enrolled and evaluated using the IIEF-5 score and the IPSS, filled the day before and 10 days and 45-60 days after the procedure. Patients' characteristics (age, chronic medical condition, smoking, and medications) were recorded. The primary outcome was the change in the IIEF-5 score.One hundred patients aged 24-60 years (mean 37.4) underwent endourological procedures (42 PCNLs, 30 ureteroscopies, 22 retrograde ureteropyelographies ± stenting, and 6 cystolitholapaxies) between January and August 2014. Preoperative IPSS ranged from 0 to 32 (mean [SD] 11.93 [8.64]), while IIEF-5 ranged from 14 to 25 (mean [SD] 21.63 [2.96]), with eight patients in the mild to moderate (12-16) ED range, 31 mild ED (17-21), and 59 no ED (22-25). Following the procedure, the IPSS improved (mean IPSS down from 11.9 to 6.1 at 10 days and 6.2 at 45 days, P 0.001), while the IIEF remained unchanged [21.6 preoperative to 21.0 at 10 days (P = 0.43) and 21.7 at 45 days (P = 0.81)]. Patients with indwelling ureteric stents (28 patients) had significant LUTS postoperatively with a mean [SD] IPSS of 9.8 [7.2] at 10 days and 11.6 [7.8] at 45 days. The IIEF-5 score was not affected with a mean [SD] of 21.5 [3.3] at 10 days and 21.8 [3.1] at 45 days, compared to 22.0 [3.0] preoperatively (P = 0.44).Endoscopic procedures did not negatively impact erectile function and sexual activity.

METHODS: We retrospectively reviewed patients’ records with renal trauma that were treated at adult level 1 trauma centers in Utah from January 2005 to January 2011. Data on patient demographics, injury characteristics, management, and outcomes was collected. All available radiological imaging was independently reviewed and renal injury was graded with the AAST organ injury scale. RESULTS: 138 patients were identified as having an AAST III-V renal injury. 30% (42 of 138) of renal injuries were sustained during sporting activities. The most common sports-related injuries were skiing and snowboarding in 26 (62%), being struck by another person or collision with stationary object in 10 (24%), and biking in 3 (7%). Mean AAST renal grade was 3.5 (SD 0.55) for sports and 3.7 (SD 0.78) for non-sports (p1⁄40.08). Male gender was over-represented amongst all renal injuries, but more so in sports related injuries (90.5% vs 61%, p