Journal of Clinical Trials and Experimental Investigations

Priapism as an initial clinical manifestation in hematological disease: A case report and literature review

2025-03-12T16:50:14+03:00

Priapism is defined as an erection lasting more than 4 hours and is considered a urological emergency in pediatrics. The goal of treatment is to prevent both short and long-term erectile dysfunction. The incidence in boys has not yet been estimated because priapism is considered a rare clinical manifestation. A 15-year-old male was transferred to our clinic with priapism of 48 hours' duration, following two unsuccessful attempts to drain the corpora cavernosa at another facility. Preoperative evaluation revealed hyperleukocytosis with leukemic blasts in peripheral blood, prompting a hematology consultation for a multidisciplinary approach. In the operating room, aspiration and lavage of the corpora cavernosa were performed. Due to unsatisfactory results, a percutaneous shunt procedure was attempted, followed by a corpora cavernosa–spongiosum shunt. Postoperatively, hematology continued to monitor the patient, eventually diagnosing him with type B lymphoblastic leukemia as the underlying cause of the priapism episode. Priapism is an uncommon clinical manifestation in the onset of systemic diseases, with hematological causes being the primary etiology. The diagnosis is clinical, based on a comprehensive medical history, physical examination, and complementary studies, including blood gas analysis of the corpora cavernosa and penile color Doppler ultrasound. Treatment is staged, beginning with patient stabilization and pain control, followed by more invasive surgical interventions if necessary. The understanding and management of priapism in children remain challenging for healthcare providers, and further studies are needed to ensure timely and effective management.

The pathophysiology of abdominal surgical diseases and the therapeutic potential of mesenchymal stem cells

2025-06-30T18:48:30+03:00

Mesenchymal stem cells (MSCs) represent a promising therapeutic option for abdominal surgical diseases that are refractory to conventional treatments. Their unique immunomodulatory, antifibrotic, and pro-regenerative properties offer a novel biological platform for tissue repair and inflammatory regulation. In this letter, we summarize current evidence regarding MSC applications in key gastrointestinal and hepatopancreatobiliary conditions, including refractory peptic ulcer, inflammatory bowel disease, acute pancreatitis, and decompensated cirrhosis. Specific emphasis is placed on the relevance of administration routes—such as local, intravenous, or portal applications—tailored to each pathology. Notably, MSCs have demonstrated clinical efficacy in promoting mucosal healing, fistula closure, cytokine suppression, and hepatic function improvement. These findings highlight the translational potential of MSC-based interventions in surgical gastroenterology. Further research should aim to standardize delivery protocols and identify optimal patient populations. We believe this concise synthesis may guide future clinical strategies and regenerative innovations in the field.

Egyptian perspective of research in sickle cell disease

2025-03-10T21:34:30+03:00

Objective: Hemoglobinopathies including sickle cell disease (SCD) are prevalent inherited disorders in most Arab countries including Egypt. The heterogeneous distribution with variable prevalence in Egypt may be due to the historical trade exchange, high prevalence of consanguineous marriage, and internal migration.

Materials and methods: The literature search was conducted in the PubMed MEDLINE database including articles indexed as of 15^th Apr 2024, if they involved patients with SCD in Egypt.

Results: In this work, we presented the research originated from Egypt addressing the SCD which includes case reports, original articles, and randomized clinical trials, and highlighted how this research efforts open the doors for understanding the prevalence and pathophysiology, improvement of the diagnostic methods, and the breakthrough treatment.

Conclusions: Although scanty research was carried out in the nineteenth century and the first decade of the twentieth century, SCD became an area of focus for research in 2010. The standard of care and the infrastructure improved with the involvement of several centres in multicenter international clinical trials.

Use of Histidine-Tryptophan Ketoglutarate and St. Thomas Cardioplegia solutions in cardiac surgery: A narrative review

2025-06-23T10:36:13+03:00

Cardioplegia is the mainstay of myocardial protection in cardiac surgery with cardiopulmonary bypass. Historically, cardioplegia emerged in the late 19th century when scientists discovered that high concentrations of potassium could stop the heart in diastole and that this could be used as an approach in open heart surgery. The most important finding in cardioplegia is that the heart restores its function after cardiac arrest without myocardial damage. In this article, the myocardial protective effects of St Thomas cardioplegia and histidine-tryptophan-ketoglutarate cardioplegia solutions were evaluated in adult cardiac surgery. Both cardioplegia solutions continue to be useful and important in cardiac surgery, but their superiority over each other remains controversial. We also believe that cardiovascular surgeons and perfusionists should focus mainly on the myocardial protective effect in the selection of different cardioplegia solutions. In conclusion, whatever the preferred cardioplegia solution, it should provide basic cardioplegia properties such as preservation of energy stores, rapid diastolic cardiac arrest, reversibility and minimal toxicity.

Epidemiological and clinical characteristics of head trauma patients admitted to the emergency department: A prospective study

2025-01-16T18:50:04+03:00

Objective: Head trauma is a significant reason for emergency department admissions. In this study, we prospectively examined head trauma cases admitted between October and December 2011, aiming to identify risk factors and contribute to the epidemiological database in our country.

Materials and methods: Head trauma cases admitted to the emergency department between 08:00 and 17:00 during October-December 2011 were evaluated. Data collected included admission time, gender, vital signs, Glasgow Coma Scale (GCS) score, mechanism of injury, associated organ injuries, comorbidities, substance or alcohol use, neuroradiological findings, interventions performed in the emergency department, neurosurgical consultations, and surgical requirements. Statistical analysis was performed to determine the patients' epidemiological characteristics, discharge rates, hospitalizations, and mortality rates, providing results specific to our institution.

Results: A total of 206 patients were included. Among the patients, 59.22% were admitted due to domestic accidents, while 21.84% were brought in after traffic accidents. Of the 206 patients evaluated, 149 had normal findings on computed tomography (CT), while pathological findings were detected in 10 patients. Twelve patients were hospitalized, 3 underwent emergency surgery, and 191 were discharged from the emergency department.

Conclusion: In our study, domestic falls were more common than traffic accidents as a cause of head trauma; however, traffic accidents were associated with a higher risk level based on GCS scores. Patients aged 60 years and older demonstrated a higher prevalence of pathological findings on CT, identifying advanced age as a significant risk factor. The most frequently observed pathology was traumatic subarachnoid hemorrhage (SAH).