Vonoprazan has been more widely used for artificial ulcers after endoscopic submucosal dissection (ESD) for early gastric cancer; however, no reports have examined intragastric pH during ESD. The present study aimed to measure gastric pH at the time of ESD and the clinical course afterwards for patients treated with vonoprazan the night before undergoing ESD. We examined medication status regarding gastric acid secretion and antithrombotic drugs, post-ESD bleeding as a perioperative complication, and the timing of upper gastrointestinal endoscopy after ESD and ulcer healing in 156 patients who underwent gastric ESD at our hospital from January 2014 to December 2019. The gastric pH was measured at the time of ESD after administration of 20mg vonoprazan on the night before gastric ESD. There were 14 cases of post-ESD bleeding in patients treated with proton-pump inhibitors (PPIs), including oozing during second-look endoscopy compared to only 1 case of bleeding with vonoprazan administration (p<0.05). Vonoprazan was also associated with better post-ESD ulcer healing than PPIs. Gastric pH during ESD after vonoprazan administration on the night before gastric ESD was ≥6.96 in all 11 patients. Post-ESD bleeding was reduced, and ulcer healing was improved in patients treated with vonoprazan the night before their procedure. Our results suggest high gastric pH during ESD due to vonoprazan administration may be beneficial for hemostasis and ulcer healing following ESD.Post-ESD bleeding was reduced, and ulcer healing was improved in patients treated with vonoprazan the night before their procedure. Our results suggest high gastric pH during ESD due to vonoprazan administration may be beneficial for hemostasis and ulcer healing following ESD. Fibromyalgia (FM) is common with significant impact on patients quality of life. Limited reports on coexistence of FM with asthma. To assess the prevalence of FM in asthmatic patients and its impact on asthma severity and control. This case-control study included 103 patients with asthma and 102 apparently healthy controls matched in age and sex. Sociodemographic and clinical characteristics of FM and controls were recorded. FM was diagnosed according to the 2016 revision of American College of Rheumatology criteria. Asthma diagnosis and severity were performed by the pulmonologist according to Global Initiative for Asthma (GINA) guidelines and asthma control was assessed by Asthma Control Test (ACT) score. The mean age of asthmatic patients was 41.1 ± 12.7 years and for controls was 39.8 ± 12 years (p=0.453). Females were more prevalent in asthmatic patients and controls although statistically were not significant (p-value=0.532). Prevalence of FM was significantly more in asthmatic patients compared to controls [18 (17.6%) vs 7 (6.8%), p=0.018] and asthmatic patients had three folds risk of having FM (ranging from 1.2 to 7.4 times. FM increased the risk of severe asthma by 4.91 folds (P<0.005). Also, only FMS and glucocorticoids were significant independent predictor of having poor asthma control. FM was significantly and negatively correlated with low ACT score (β standardized regression coefficient=-0.291, p=0.005). fibromyalgia was common in asthmatic patients and was significantly associated with more severe and poorly controlled asthma.fibromyalgia was common in asthmatic patients and was significantly associated with more severe and poorly controlled asthma. Acute right iliac fossa (RIF) pain is amongst the most common presentation to the surgical team. LY333531 nmr Acute appendicitis is the most common cause of this pain and often warrants surgical intervention. In many cases intervention results in a negative appendicectomy with unnecessary complications as a result. The aim of this study was to compare the efficacy of pre-operative imaging in the diagnosis of acute appendicitis to reduce the rate of negative appendicectomy and unnecessary operative intervention. A retrospective single centre cohort study was undertaken in a district general hospital (DGH) of all laparoscopic appendicectomies over a six-year period. 1344 cases were included and were examined for the use of pre-operative imaging (and type) or none. The sensitivity, specificity, negative and positive predictive value for each type of imaging were analysed for their accuracy in diagnosis appendicitis based on the final histological analysis. The negative appendicectomy rate was found to be greatest in those undergoing ultrasonography (48.21%) as their method of pre-operative imaging whilst those who underwent computed tomography (CTAP 20.26%) had a lower rate equivalent to that of clinical diagnosis alone (20.73%). USS is less sensitive than CT in diagnosing acute appendicitis. There is no statistically significant difference in negative appendicectomy rate between clinical diagnosis and CT diagnosis. Pre-operative imaging has a role in the diagnosis of appendicitis but needs to be utilised appropriately to reduce the strain on the surgical department and prevent the potential of a negative appendicectomy.USS is less sensitive than CT in diagnosing acute appendicitis. There is no statistically significant difference in negative appendicectomy rate between clinical diagnosis and CT diagnosis. Pre-operative imaging has a role in the diagnosis of appendicitis but needs to be utilised appropriately to reduce the strain on the surgical department and prevent the potential of a negative appendicectomy. To study the clinical, pathological and surgical features of primary epithelial ovarian cancer treated at our institution. fifty-nine patients with primary epithelial ovarian cancer were included. Clinical data collected included patient's age, presenting symptoms, laboratory and tumor markers results as well as preoperative imaging reports. Pathological and surgical findings included were spread of the disease, histologic type, stage of the disease, type of surgical procedure and amount of residual disease. Mean age of the patients was 54.5 years. Lower abdominal pain was the most common presenting symptom, followed by abdominal distension. The commonest histopathological type was high grade serous carcinoma (72.9%). In our study, majority of patients were diagnosed with stage III disease, accounting for 69.5% of the total number of patients. Complete cytoreduction with no gross residual disease was achieved in 77.3% of patients with stage 3-4 disease. clinical and pathological features of primary epithelial ovarian carcinoma in our populations are similar to what is reported worldwide.