[ relationship between shape of the nose and the underlying hard tissue structures in adults in Syrian society [cephalometric study]]

The nose plays an important role in diagnosis and in orthodontic and surgical treatment plan. The aim of this study is to evaluate the relationship between the nose shape and the underlying hard structures. This study has been done in orthodontic department / Damascus University. The sample included 60 patients [48 men and 12 women] divided into 3 groups according to ANB [20 class1,20 class2, 20class3].Seven skeletal parameters and 13 nasal parameters were measured on lateral cephalometry by digital tracing [ORTHO-DAMASCUS 2003]. Pearson correlation r was used for statistical analysis. Aim of the study: The Relationship Between Shape of The Nose and The Underlying Hard Tissue Structures in syrian Adults. There was a correlation between skeletal and nasal parameters. The facial high, anteroposterior and vertical position of the maxilla and mandible, was correlate with the nose shape and the length. In skeletal class 1 The NMA,NLA negatively correlated with the SNA,SNB [r = - 0.60, P<0.05] ?[r = - 0.52, P<0. 01] and a positive correlate was found between B and NMA, NboneL [r= 0.55,P<0.05] and [r= 0.52,P<0.05] negatively correlated with Cconv. [r= - 0.47,P<0.05], and positive correlated between SNGoMe and NMA, NboneL[r = 0.54, P<0.05,] [r = 0.54 ,P<0.05]. In skeletal class 2 a negative correlated between SPP and NMA [r= -0.53, P<0.05] and positive correlated with SFC [r=0.650,P<0.01] and negative correlated between S.Go/ N.Me and DConv. [r=- 0.47 ,P<0.05]. In skeletal class 3 a positive correlated between ANB and NLA [r=0.61 ,P<0.05] and positive correlated NS- SPP and NL [r=0.57, P<0.05] and negative correlated between NS- SPP and NBA[r= -0.46, <0.05]. In long face the nose appears convex and increase in length and the nose tip inclines downward while in short or normal face the nose appears convex or straight and shorter nasal bone and nasal tip incline upward.The nasal tip moves with the anterior part of the maxilla

Prevalence of hepatitis C virus infection and human immunodeficiency virus in a cohort of Egyptian hemophiliac children

The risk of blood-borne infections, especially hepatitis C virus [HCV] and human immunodeficiency virus [HIV] infection still remains in developing countries among children receiving blood products as hemophiliacs, but the risk is not known in Egypt. The objective of this study was to detect the prevalence of HCV and HIV infection among hemophiliac children to know the magnitude of the problem and determine potential risk factors. This was a cross-sectional study conducted on 100 hemophiliac children that assessed the liver clinically and by laboratory tests. All children were screened for HCV and HIV antibodies by enzyme-linked immunosorbent assay. Those with positive HCV antibody titre were tested by polymerase chain reaction [HCV-PCR]. Forty were positive for HCV antibodies with 19 children [47.5%] HCV-PCR positive as well. The mean age, average frequency of bleeds/year, dose of replacement therapy/year and alanine aminotransferase [ALT] levels were significantly high in HCV-antibody and PCR positive patients as compared to HCV antibody and PCR negative ones. None of our patients had clinical evidence of hepatic involvement or was co-infected with HIV HIV infection does not appear to be a current health problem in Egyptian hemophiliac children though the prevalence of HCV infection is still high

Antibody response to hepatitis B immunization in Egyptian children with sickle cell disease

Despite improvement in the safety of blood products, sickle cell disease [SCD] and thalassemic patients are at greater risk than the general population for hepatitis B infection and chronic liver disease, making hepatitis B immunization especially important for this population. This study was conducted to evaluate and follow up the antibody response to hepatitis B vaccination, in patients with SCD, after 1-15 years of vaccination. participants were 30 SCD and 30 thalassemic patients attending the Hematology Department, Children's Hospital, Cairo University as well as 30 ages and sex matched normal controls. They were subjected to clinical evaluation, complete blood count, and measurement of liver transaminases, serum bilirubin, and serum ferritin levels as well as estimation of anti-HBs titer by enzymatic immunoassay. Anti-HBs titers in SCD patients ranged between 5.6 and 381 IU/L [54.83 +/- 15.30], while the levels of thalassemic patients ranged between 16 and 343 IU/L [93.4 +/- 30] and those of the control group ranged from 10 to 523 IU/L [83.4 +/- 28.1] which revealed statistically significant decrease in SCD patients compared to thalassemic and healthy controls [p =0.0317]. Out of the 30 SCD patients, 40% showed anti-HBs titer below 10 IU/L [non-protective titer], while none of the thalassemic patients or the control group revealed the same. Achievement of a protective titer had no correlation with sex, consanguinity, or any of the clinical or laboratory data tested. Immune dysfunction in thalassemia is not playing a major role in response to hepatitis B vaccination. However, SCD children should have their anti- HBs titer measured after routine hepatitis B immunization to ensure that they achieved protective titer, then after 1 year of vaccination and repeated every 5 years and those who do not seroconvert should receive additional doses. Booster HBV vaccination of unprotected SCD patients seems mandatory

value of transesophageal echocardiography in the assessment of the degree of mitral regurgitation

Accurate evaluation of the severity of mitral regurgitation [MR] is of paramount importance for decision making for a patient who may undergo heart surgery. This study was aimed to evaluating the accuracy of transesophageal echocardiography [TEE] in the assessment of the severity of MR. Fifty patients with different grades and etiologies of MR underwent clinical examination, electrocardiography, plain X- ray, transthoracic echocardiography [TTE] and TEE. Left ventriculography was also performed as a gold standard to estimate the degree of MR. Sensitivity and specificity of TEE and TTE in the assessment of the different grades of MR were calculated using left ventriculography as a gold standard. The relationship between the maximum mosaic jet area of MR by TTE and TEE showed a significant difference with a good correlation. It was concluded that TEE is a highly sensitive and specific technique not only in detection of MR, but also in evaluating its severity

Effects of thrombolytic therapy on evolution of mitral regurgitation in patients with inferior wall myocardial infarction

Forty patients with first inferior wall MI were prospectively studied. Thrombolytic therapy [i.v. Streptokinase] was administered to 20 patients [SK group]. The other 20 patients [control group] received the conventional treatment for acute MI, but not streptokinase as they were not candidates for reperfusion therapy due to either late arrival or contraindications. Doppler echocardiography was performed one week after acute MI and repeated one month later aiming at studying MR and left ventricular function [LV]. Significant MR was defined as moderate or severe. Only p value < 0.05 was considered significant. It was concluded that thrombolytic therapy in inferior MI has beneficial effects, it reduces the incidence and severity of MR, preserves LV function and improves survival. In view of the present findings, the study supported the use of thrombolytic therapy in patients with inferior wall myocardial infarction

metabolic and hormonal profile of diabetic children on CSII

To assess the correction of the metabolic and hormonal profile in diabetic children as normoglycemia is reached, two groups [newly-diagnosed and chronically-treated] were treated with the insulin pump. Fasting and postprandial levels of metabolites and hormones were measured before and after 10 days of pump treatment. Normoglycemia resulted in correction of fasting plasma free insulin and growth hormone, a decrease of plasma glucagon with significant hypokalemia in newly-diagnosed diabetic children. A fall in [VLDL + LDL] cholesterol levels was accompanied by a substantial increase in HDL cholesterol concentration. The postprandial blood glucose and free insulin were similar to that of control subjects. These changes suggest that optimal glycemic control is achievable at the expense of increased insulin action despite absence of peripheral hyperinsulinemia, and that the normalisation of the metabolic and hormonal profile is not absolutely possible with this mode of therapy

Changes in soft tissue profile associated with mandibular lip bumper

This study was carried out to identify the possible changes in the soft tissue profile after six months of mandibular lip bumper wear. The sample consisted of twenty subjects with class 11 division 1 malocclusion. Their age ranged from 8-12 years. The samples were divided into two equal groups. The first group received mandibular lip bumper for six months, and second group was used as a control group. It was found that in the lip bumper group the soft tissue submentale and the labrale inferius, moved significantly forward. On the other hand the soft tissue subspinale and the labrale superius moved significantly backward with a highly significant improvement in the mutual relationship of soft tissue subspinale and submentale. The soft tissue profile tended to become more convex

treatment of ununited fractures of the carpal scaphoid by styloidectomy and bone grafting

Many procedures were described for treatment of non-union of the scaphoid. Radial styloid-ectomy and grafting of the pseudarthrosis were used to treat 27 cases of scaphoid non-unions. 25 cases were available for the final evaluation. The technique and results are here presented. The procedure has led to union in 21 cases. The function of the wrist and hand has definitely improved. There has been marked relief of pain in most of the cases. The improvement in the grip strength has been moderate. The range of movements of the wrist has mildly increased

Double patella: case of duplication in the horizontal plane

A case of duplication of the patella in the horizontal plane is reported. Previously reported cases of double patella have shown frontal, horizontal or coronal duplication, and some have been associated with multiple epiphyseal dysplasia. In our case, the patient has suffered form patellofemoral joint pain for five years. Excision of smaller inferior patella has relieved the complaint

Unstable-colles fractures: a comparative study of four closed methods of immobilization

Eighty patients suffering from unstable Colles' fractures were treated by closed reduction and external immobilization with 4 different methods; either the traditional below elbow plaster of Paris, a ready made functional cast brace, a bipolar fixation using 2 Kirschner wines incorporated in a below elbow plaster of Paris cast or small Hoffman external fixator applying the principle of ligamentotaxis across the wrist. The functional results with bipolar fixation were the same as after using a functional cast brace, however both of them were superior than after using the external fixator and the ordinary below elbow plaster of Paris

Treatment of ununited femoral neck fractures by internal fixation and muscle-pedicle and free cancellous bone grafts

Fifty-eight patients under the age of 50 years suffering from nonunion of intracapsular fractures of the femoral neck with or without previous surgical intervention were treated by internal fixation combined with quadratus femoris muscle-pedicle and free cancellous bone grafts. Forty-four cases presented with varying degrees of femoral neck absorption and five with avascular necrosis of the femoral head. Satisfactory bony union occurred in 49 patients [84.5%] and failures in 9 [15.5%]. Failure were noticed mostly after gross absorption of femoral neck and avascular necrosis and cavitation of femoral head due to previous internal fixation. It was seen also after inadequate internal and external immobilization and premature weight bearing against advice. This method of treatment is suitable for patients under age of 50 years suffering from ununited fractures of the femoral neck with or without previous operative fixation provided that there is no gross absorption of femoral neck and no cavitation of femoral head

Operative treatment of intercondylar Y and T shaped fractures of the lower end of the humerus

Intercondylar Y and T shaped fractures of the lower end of the humerus are uncommon and difficult to treat. Surgical management is recommended to achieve a successful outcome. It is important to reconstruct accurately the capitellum and trochlea and to obtain rigid secure internal fixation so as to permit early controlled postoperative active range of motion. In this series, 23 patients with these fractures were treated by open reduction and internal fixation through a trans-olecranon approach. Approximately 70% good to excellent results were obtained

safer, new surgical approach for tibial plating

To avoid wound complications of incisions for tibial plating, a long incision curved lateraly overlying the lateral muscle compartment of the leg, has been used prospectively, in plating of sixty fractures of the tibial shaft. This is a report of the technique and definitely better results of such an approach which can be used in dealing with fresh as well as ununited fractures of the tibial shaft. The excellent results we obtained have permitted us to recommend this type of exposure to avoid the well-known, but not as well documented, complications of more classic ones

Synthesis of some indole derivatives of expected biological activity

Many of indole derivatives were known to have marked biological activity Indole acetic acid, e.g. and many of its derivatives [auxins] are plant-growth hormones. In the present study we investigated the synthesis of some indole acetic acid derivatives and their reaction with hydrazine hydrate to give 4,5-dihydropyridazin-3[2H]-ones