PURPOSE: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. METHODS: A retrospective analysis was conducted of 42 patients (31 males; mean age, 14.2±6.2 years) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median 12.0±1.5 years of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. RESULTS: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. CONCLUSIONS: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.
Adult ; Child ; Compliance ; Follow-Up Studies* ; Humans ; Ileum ; Lost to Follow-Up ; Male ; Retrospective Studies ; Urinary Bladder Calculi ; Urinary Bladder* ; Weight Gain

Aims: The coronavirus disease 2019 (COVID-19) is a contagious respiratory disease. The massive use of antibiotics during COVID-19 treatment induced the problem of antibiotic resistance among different strains of microbiome. The current study was conducted to evaluate the level of antibiotic resistance among pathogenic and microbiome bacteria isolated from the blood and upper respiratory tract of COVID-19 patients and its correlation with the case fatality rate in each patient. Methodology and results: COVID-19 patients were diagnosed using real-time reverse transcription-polymerase chain reaction (RT-PCR) technique. Swabs and blood samples were collected from each patient to isolate bacteria and every isolate identification was performed using the bioMérieux VITEK® 2 system. The case fatality rate among the study group was 50% for patients whose isolates were highly antibiotic-resistant. Blood culture was positive in 2.5% compared to nasal swab culture in 65%. Results of nasal swab culture revealed growth of Gram-positive bacteria isolated from 17.1% of patients, Gram-negative isolates were found in 9.75% and fungal isolates formed 9.75%. Most of the isolates were reflective of normal microbiomes; unfortunately, isolates were 100% resistant to penicillins, cephalosporins, azithromycin and amoxicillin-clavulanate. On the other hand, isolates were 100% sensitive to daptomycin. Conclusion, significance and impact of study Results were alarming and there is a need to take measures to prevent the increase in bacterial resistance to antibiotics and limit the excessive use of it. It is crucial to monitor the rise in fungal infections among patients and consider it a risk factor for increasing the case fatality rate.

Objective To summarize the precise association between pulmonary tuberculosis (PTB) and P2x7 A1513C gene polymorphism. Methods PubMed and Google Scholar web-databases were searched for the studies reporting the association of P2x7 A1513C polymorphism and PTB risk. A meta-analysis was performed for the selected case–control studies and pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for all the genetic models. Results Eleven studies comprising 2 678 controls and 2 113 PTB cases were included in this meta-analysis. We observed overall no significant risk in all the five genetic models. When stratified population by the ethnicity, Caucasian population failed to show any risk of PTB in all the genetics models. In Asian ethnicity, variant allele (C vs. A: P = 0.001; OR = 1.375, 95% CI = 1.159–1.632) and heterozygous genotype (AC vs. AA: P = 0.001; OR = 1.570, 95% CI = 1.269–1.944) demonstrated significant increased risk of PTB. Likewise, recessive genetic model (CC + AC vs. AA: P = 0.001; OR = 1.540, 95% CI = 1.255–1.890) also demonstrated increased risk of PTB in Asians. Conclusions Our meta-analysis did not suggest the association of P2x7 A1513C polymorphism with PTB risk in overall or separately in Caucasian population. However, it plays a significant risk factor for predisposing PTB in Asians. Future larger sample and expression studies are needed to validate this association.