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Objective Arteriovenous grafts (AVGs) are frequently needed in hemodialysis (HD) patients with unsuitable superficial veins. First cannulation of standard arteriovenous grafts (sAVGs) still require about 2 weeks after implantation. Early cannulation arteriovenous grafts (eAVGs) were suggested to overcome this shortcoming. The present randomized study proposed to compare the clinical outcomes of sAVGs and eAVGs in HD patients. Methods The present single-center randomized clinical study recruited 477 HD patients indicated for AVG creation. They included 236 in the sAVG group and 241 in the eAVG group. Eligible patients were simply randomized and allocated to the studied groups using 1:1 allocation ratio. Blinding was secured using the sealed envelope technique. Enrolled patients were followed up for 12 months. The primary outcome in the present study was primary, primary assisted, and secondary patency rates at 12 months. Other outcome parameters included time to first cannulation, graft complications, and mortality. Results Comparison between the studied groups regarding the primary outcomes revealed no statistically significant differences. Primary patency rate was 65.7% and 68.0% (P = .58) at 6 months and 53.8% and 56.4% (P = .57) at 12 months in the sAVG and eAVG groups, respectively. Primary assisted patency rate was 70.8% and 69.7% (P = .8) in patients with sAVG and eAVG, whereas the reported rates at 12 months were 59.3% and 61.0% (P = .71), respectively. Secondary patency rate was 78.4% and 73.9% (P = .25) at 6 months and 67.8% and 69.7% (P = .65) at 12 months in the sAVG and eAVG groups, respectively. As expected, patients in the eAVG group experienced significantly earlier cannulation when compared with patients in the sAVG group (median, 3.0 days; range, 1.0-9.0 days vs 19.0 days; range, 15.0-22.0 days; P Conclusions Patients in the eAVG group have comparable outcomes to those in the sAVG group at 12 months with the added advantage of earlier time to first cannulation.

Objectives: The aim of this study is to compare between the platelet rich plasma and balanced moist dressing as regards the healing rate in chronic non ischemic diabetic foot ulcers. Patients and Method: From Feb. 2014 till May 2015, 73 patients from the attendees to Zagazig university hospitals were selected to our study. 2 groups were created, one for PRP (platelet rich plasma) and the other for balanced moist dressing. Frequent registration for the number of healed ulcers was done every week. Results: By the end of the 3rd week almost all the ulcers in the PRP group were healed. But the other group needed about 8th weeks for the same results. Conclusion: PRP seems to be an attractive choice in management of chronic diabetic ulcers provided that there is good blood supply and proper offloading was done.

Background Ischemic stroke represents a major health problem and it is an important cause of long-term disability. The aim of this study was to compare short-term results of carotid endarterectomy and stenting without the use of cerebral protection device. Patients and methods During a 2-year period, we enrolled 40 patients with carotid artery stenosis and performed 18 carotid endarterectomy operations and 22 carotid artery stenting procedures without distal protection devices. Results Mortality was zero. The main postoperative results after endarterectomy were as follows: one patient developed hemorrhagic stroke and another one developed myocardial infarction. With carotid artery stenting, one patient developed minor stroke and two patients developed restenosis. Conclusion No superiority of certain procedure over the other was found. Proper patient selection is the key to successful outcomes when deciding the optimal treatment for carotid artery stenosis. Carotid stent placement without the use of distal protection devices was found to be a safe and effective procedure with a relatively low incidence of periprocedural complications.