The dramatic increase in newly diagnosed cases of type 2 diabetes is a major public health concern within Egyptians in recent years and it is estimated that by the year 2030, Egypt will have at least 8.6 million adults with diabetes. Several studies worldwide were done and concluded that type 2 DM is preventable by specific interventions. Rural Egyptians are thought to be less risky for developing type 2 diabetes because of the less sedentary lifestyle and less obesity compared to urban population, but the problem is that in rural areas the diagnosis of the disease is underestimated because of the less available medical care and primary screening programs. This work applies certain interventions among risky individuals in rural Egypt to determine the rate of type 2 diabetes progression in Asyut university hospital to prove whether they are effective in preventing it among them or not. Randomized 80 subjects with IGT were classified into two groups, group A was given Metformin 500 mg twice daily plus given instructions regarding lifestyle modifications, and group B which was the control group and it was given nothing. Follow up was done for one year and incidence of new cases of diabetes in both groups plus comparable effects on body weight and BMI were recorded. Four cases were newly diagnosed as diabetic patients among group (A) while 12 patients were diagnosed among group (B) by the end of the year and this signifies that new case diabetes was significantly reduced among group (A) than group (B) in favor of group (A). In conclusion, the study ascertained that lifestyle interventions and Metformin 1000 mg daily significantly reduce incidence of type two diabetes mellitus among Egyptians with impaired glucose tolerance (IGT).

The dramatic increase in newly diagnosed cases of type 2 diabetes is a major public health concern within Egyptians in recent years and it is estimated that by the year 2030, Egypt will have at least 8.6 million adults with diabetes. Several studies worldwide were done and concluded that type 2 DM is preventable by specific interventions. Rural Egyptians are thought to be less risky for developing type 2 diabetes because of the less sedentary lifestyle and less obesity compared to urban population, but the problem is that in rural areas the diagnosis of the disease is underestimated because of the less available medical care and primary screening programs. This work applies certain interventions among risky individuals in rural Egypt to determine the rate of type 2 diabetes progression in Asyut university hospital to prove whether they are effective in preventing it among them or not. Randomized 80 subjects with IGT were classified into two groups, group A was given Metformin 500 mg twice daily plus given instructions regarding lifestyle modifications, and group B which was the control group and it was given nothing. Follow up was done for one year and incidence of new cases of diabetes in both groups plus comparable effects on body weight and BMI were recorded. Four cases were newly diagnosed as diabetic patients among group (A) while 12 patients were diagnosed among group (B) by the end of the year and this signifies that new case diabetes was significantly reduced among group (A) than group (B) in favor of group (A). In conclusion, the study ascertained that lifestyle interventions and Metformin 1000 mg daily significantly reduce incidence of type two diabetes mellitus among Egyptians with impaired glucose tolerance (IGT).

The dramatic increase in newly diagnosed cases of type 2 diabetes is a major public health concern within Egyptians in recent years and it is estimated that by the year 2030, Egypt will have at least 8.6 million adults with diabetes. Several studies worldwide were done and concluded that type 2 DM is preventable by specific interventions. Rural Egyptians are thought to be less risky for developing type 2 diabetes because of the less sedentary lifestyle and less obesity compared to urban population, but the problem is that in rural areas the diagnosis of the disease is underestimated because of the less available medical care and primary screening programs. This work applies certain interventions among risky individuals in rural Egypt to determine the rate of type 2 diabetes progression in Asyut university hospital to prove whether they are effective in preventing it among them or not. Randomized 80 subjects with IGT were classified into two groups, group A was given Metformin 500 mg twice daily plus given instructions regarding lifestyle modifications, and group B which was the control group and it was given nothing. Follow up was done for one year and incidence of new cases of diabetes in both groups plus comparable effects on body weight and BMI were recorded. Four cases were newly diagnosed as diabetic patients among group (A) while 12 patients were diagnosed among group (B) by the end of the year and this signifies that new case diabetes was significantly reduced among group (A) than group (B) in favor of group (A). In conclusion, the study ascertained that lifestyle interventions and Metformin 1000 mg daily significantly reduce incidence of type two diabetes mellitus among Egyptians with impaired glucose tolerance (IGT).

The dramatic increase in newly diagnosed cases of type 2 diabetes is a major public health concern within Egyptians in recent years and it is estimated that by the year 2030, Egypt will have at least 8.6 million adults with diabetes. Several studies worldwide were done and concluded that type 2 DM is preventable by specific interventions. Rural Egyptians are thought to be less risky for developing type 2 diabetes because of the less sedentary lifestyle and less obesity compared to urban population, but the problem is that in rural areas the diagnosis of the disease is underestimated because of the less available medical care and primary screening programs. This work applies certain interventions among risky individuals in rural Egypt to determine the rate of type 2 diabetes progression in Asyut university hospital to prove whether they are effective in preventing it among them or not. Randomized 80 subjects with IGT were classified into two groups, group A was given Metformin 500 mg twice daily plus given instructions regarding lifestyle modifications, and group B which was the control group and it was given nothing. Follow up was done for one year and incidence of new cases of diabetes in both groups plus comparable effects on body weight and BMI were recorded. Four cases were newly diagnosed as diabetic patients among group (A) while 12 patients were diagnosed among group (B) by the end of the year and this signifies that new case diabetes was significantly reduced among group (A) than group (B) in favor of group (A). In conclusion, the study ascertained that lifestyle interventions and Metformin 1000 mg daily significantly reduce incidence of type two diabetes mellitus among Egyptians with impaired glucose tolerance (IGT).

Purpose. To evaluate a new technique for treating complete rectal prolapse in adults that combines injection sclerotherapy with anal encirclement. Methods. From 2008 to 2012, 20 patients were treated using combined perirectal injection sclerotherapy with anal encirclement. The primary outcome was recurrent full-thickness/mucosal rectal prolapse. Results. The mean age of the patients was 39 years. The mean operating time was 17 minutes. Patients had short hospital stays (range = 2-4 days) and rapid recovery with no serious postoperative complications. After a mean follow-up of 22 months, recurrence occurred in 9 patients, and was complete in 6 cases and mucosal in 3 patients. Recurrent mucosal prolapse was treated with a mucosectomy, while recurrent complete rectal prolapse was treated with an open rectopexy with mesh. Conclusion. The combination of perirectal sclerotherapy and anal encirclement for treating complete rectal prolapse in adults is a simple and safe procedure with reasonable outcome. These findings call for confirmatory trials in larger series.

Purpose. To evaluate a new technique for treating complete rectal prolapse in adults that combines injection sclerotherapy with anal encirclement. Methods. From 2008 to 2012, 20 patients were treated using combined perirectal injection sclerotherapy with anal encirclement. The primary outcome was recurrent full-thickness/mucosal rectal prolapse. Results. The mean age of the patients was 39 years. The mean operating time was 17 minutes. Patients had short hospital stays (range = 2-4 days) and rapid recovery with no serious postoperative complications. After a mean follow-up of 22 months, recurrence occurred in 9 patients, and was complete in 6 cases and mucosal in 3 patients. Recurrent mucosal prolapse was treated with a mucosectomy, while recurrent complete rectal prolapse was treated with an open rectopexy with mesh. Conclusion. The combination of perirectal sclerotherapy and anal encirclement for treating complete rectal prolapse in adults is a simple and safe procedure with reasonable outcome. These findings call for confirmatory trials in larger series.

BACKGROUND: Melasma is a common disorder of facial hyperpigmentation that is often resistant to treatment. OBJECTIVE: To evaluate the efficacy of trichloroacetic acid (TCA) peeling in comparison with double frequency Q-switched neodymium-doped:yttrium aluminum garnet (QS-Nd:YAG) laser in the treatment of melasma. PATIENTS AND METHODS: Sixty-five adult Egyptian female patients with melasma were enrolled in this study. Wood light was used for determination of the histological type of melasma. The patients were divided into 4 groups according to treatment modalities: peeling with different concentrations of TCA and double frequency QS-Nd:YAG laser. Trichloroacetic acid peeling was performed every 2 weeks up to 8 sessions, whereas laser treatment was performed every month up to 6 sessions. Melasma area and severity index (MASI) score was used before and after treatment for evaluation. RESULTS: Improvement percentage of MASI score was significantly higher among patients treated with TCA 25% (p .001). Epidermal type of melasma was significantly improved compared with the dermal type (p = .0029). Q-switched neodymium-doped:yttrium aluminum garnet laser showed the highest incidence of postinflammatory hyperpigmentation (53.3%). CONCLUSION: Trichloroacetic acid peeling is effective in the treatment of melasma, TCA 25% was the most effective concentration. Q-switched neodymium-doped:yttrium aluminum garnet laser is not recommended in the treatment of melasma because it was associated with the highest incidence of complications.

BACKGROUND: Melasma is a common disorder of facial hyperpigmentation that is often resistant to treatment. OBJECTIVE: To evaluate the efficacy of trichloroacetic acid (TCA) peeling in comparison with double frequency Q-switched neodymium-doped:yttrium aluminum garnet (QS-Nd:YAG) laser in the treatment of melasma. PATIENTS AND METHODS: Sixty-five adult Egyptian female patients with melasma were enrolled in this study. Wood light was used for determination of the histological type of melasma. The patients were divided into 4 groups according to treatment modalities: peeling with different concentrations of TCA and double frequency QS-Nd:YAG laser. Trichloroacetic acid peeling was performed every 2 weeks up to 8 sessions, whereas laser treatment was performed every month up to 6 sessions. Melasma area and severity index (MASI) score was used before and after treatment for evaluation. RESULTS: Improvement percentage of MASI score was significantly higher among patients treated with TCA 25% (p .001). Epidermal type of melasma was significantly improved compared with the dermal type (p = .0029). Q-switched neodymium-doped:yttrium aluminum garnet laser showed the highest incidence of postinflammatory hyperpigmentation (53.3%). CONCLUSION: Trichloroacetic acid peeling is effective in the treatment of melasma, TCA 25% was the most effective concentration. Q-switched neodymium-doped:yttrium aluminum garnet laser is not recommended in the treatment of melasma because it was associated with the highest incidence of complications.