Use of patient-specific drain-phase parameters has previously been suggested to improve peritoneal dialysis (PD) adequacy. Improving management of the drain period may also help to minimize intraperitoneal volume (IPV). A typical gravity-based drain profile consists of a relatively constant initial fast-flow period, followed by a transition period and a decaying slow-flow period. That profile w...

Submit Manuscript | http://medcraveonline.com position of the drain across the heart (Figure 1). Bed side echocardiogram showed the drain traversing the left ventricle (Figure 2). Bubble study through the chest drain showed contrast bubbles inside the left ventricle confirming position of the drain and perforation of the left ventricle (Figure 3). The drain was kept in situ. She was taken to th...

Subconjunctival emphysema is a condition that must theoretically exist in severe subcutaneous emphysema due to the laxity of the conjunctival tissues. However, this is generally obscured by associated periorbital emphysema and is hidden from view. We present documented evidence of subconjunctival emphysema in the absence of periorbital emphysema. A 53 year old man was admitted with a large righ...

The practice of Egyptian psychiatrists emigrating to high-income countries is not a recent phenomenon. Egyptian doctors have long travelled in search of training and education and to better their standards of living. The debate continues. What effective measures can be taken to reduce the brain drain, or at least its effect on Egyptian mental health services?

Laparoscopic cholecystectomy (LC) was introduced to the arsenal of surgical techniques in 1987 and has become the gold standard in treating cholecystolithiasis. In spite of undoubted benefi ts for patients, it is not a complication-free procedure. The type of complications after a classical , i.e. " open " surgery and LC do not differ in a significant way. The difference lies in their prevalenc...

A 64-year-old man with multiple comorbidities (obesity and metabolic syndrome, dilated cardiomyopathy, type 2 diabetes mellitus, chronic renal insufficiency, obstructive sleep apnea syndrome, and colonic diverticula) underwent anterior resection for distal rectal cancer with protective ileostomy. A few days later, enteral juice was flowing from surgical drains; an urgent endoscopy with fluorosc...