ABSTRACT
Energy drinks are available worldwide and frequently consumed to increase energy level and compensate lack of sleep. Energy drinks consumers aim to improve their cognitive functions. Red Bull is the most popular energy drink consumed in Egypt. However, the link between the impact of energy drinks on the structure of hippocampal cornu ammonis 1 (CA1) and dentate gyrus (DG), a highly vulnerable brain regions to various insults, has not yet documented. To study the effect of energy drinks on structure of hippocampal CA1 and DG of adult male albino rats. Twenty one adult male albino rats were divided into three groups; group I control group, groups II and III received Red Bull, with a dose of 3.75 ml/kg/day orally using gastric tube for four and eight consecutive weeks respectively. At the end of the experiment, brains were dissected and hippocampal specimens were processed for histopathological and immunohistochemical studies. Histopathological examination of hippocampal sections in group II revealed vacuoles, decrease thickness of pyramidal cell layer with irregular dark or ghost nuclei. However, changes were more severe in group III with cracks in pyramidal cell layer, massive vacuolation and signet ring cells. Moreover, star shaped astrocytes and glial fibrillary acidic protein immuno-reactivity were more abundant in group III than in group II. Caffeinated energy drinks produced neurodegenerative changes and reactive astrocytosis in hippocampal CA1 and DG of adult male albino rats. These changes were duration-dependent being more severe in longer duration of intake.
ABSTRACT
Energy drinks are available worldwide and frequently consumed to increase energy level and compensate lack of sleep. Energy drinks consumers aim to improve their cognitive functions. Red Bull is the most popular energy drink consumed in Egypt. However, the link between the impact of energy drinks on the structure of hippocampal cornu ammonis 1 (CA1) and dentate gyrus (DG), a highly vulnerable brain regions to various insults, has not yet documented. To study the effect of energy drinks on structure of hippocampal CA1 and DG of adult male albino rats. Twenty one adult male albino rats were divided into three groups; group I control group, groups II and III received Red Bull, with a dose of 3.75 ml/kg/day orally using gastric tube for four and eight consecutive weeks respectively. At the end of the experiment, brains were dissected and hippocampal specimens were processed for histopathological and immunohistochemical studies. Histopathological examination of hippocampal sections in group II revealed vacuoles, decrease thickness of pyramidal cell layer with irregular dark or ghost nuclei. However, changes were more severe in group III with cracks in pyramidal cell layer, massive vacuolation and signet ring cells. Moreover, star shaped astrocytes and glial fibrillary acidic protein immuno-reactivity were more abundant in group III than in group II. Caffeinated energy drinks produced neurodegenerative changes and reactive astrocytosis in hippocampal CA1 and DG of adult male albino rats. These changes were duration-dependent being more severe in longer duration of intake.
ABSTRACT
Introduction: transpedicular spinal fixation has recently been the focus of increased attention in several institutions throughout the world, but its safety and efficacy requires a precise knowledge of the lumbar pedicles and their relations with neural structures
Objective: in this study, it was aimed at studying the morphometry of the lumbar pedicle in Egyptian population for more safety and better efficacy during pedicle screw fixation
Patients and methods: Study of the lumbar pedicles was conducted using CT scanning for lumbar blocks of 5 cadavers together with 75 cases of lumbar disc patients to clarify the lumbar pedicle morphology in Egyptian population. Measurements of the axial length, the axial angle, the pedicle breadth, and endosteal thickness were performed on CT images obtained at the middle of the cranio-caudal axis of the pedicle of patients and cadavers. Moreover, these measurements were reviewed by direct caliper measurements in these cadavers
Results: this study illustrated that the axial length of pedicles is around 5 cm at all lumbar levels with negligible shortening at L 4 and L 5. The angels of inclination of the lumbar pedicle axis on the midline are more obtuse than the known Western measurements and becoming more obtuse from L1 to L 5. The study clarified that the pedicle breadth becomes progressively thicker from L 1 [6.6 cm] to L 5 [18.5 cm] and the endosteal thickness follows the pedicle breadth becoming thicker as we descend from L1 [3.8 cm] to L 5 [8.3 cm]. We could not detect any statistically significant difference between all the above mentioned measurements when we compared the direct caliper measurements of the cadavers with its CT measurements and with patients CT measurements. Wide range of measurements of the lumbar pedicle for each particular level was noticed
Conclusion: CT pedicle measurements are accurate indicators for the actual pedicle morphometry. The Egyptian lumbar pedicles differ in some aspects from the pedicles of other populations. The pedicle screw diameter, the screw length, and the angle of its insertion are better to be tailored according to the CT pedicle measurements of each patient
ABSTRACT
Background: carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. It is more common in females and in certain occupations. Nowadays various surgical methods are available to obtain carpal tunnel release. Surgical treatment of CTS is both safe and effective. Total relief of pain is obtained in over 90% of patients soon after the operation
Objectives: to evaluate the cases of operated carpal tunnel syndrome in regard to the way of wound closure in a trial to find the effect of this factor on the postoperative outcome of these cases
Material and methods: this series consists of 180 patients who underwent surgical release of the transverse carpal ligament for carpal tunnel syndrome [CTS]. Patients were classified into two groups, each group included 90 patients. Group A, in whom the wound was closed in one layer of silk sutures, and group B, in whom the wound was closed in two layers, subcutaneous layer of 2/0 vicryl and a second layer of silk sutures. Patients were followed-up and were asked about their hand pains and hand tenderness. The two groups were compared regarding the duration of post-operative tenderness, in other words, the duration required to use the hand comfortably, and post-operative relief of symptoms [patient satisfaction]
Results: in-group A there were 6 patients who showed post-operative tenderness of more than three weeks compared to 18 patients in-group B and the difference was statistically significant. Post-operative tenderness was significantly prolonged in-group B [5 +/- 1.8 weeks] than in-group A [3 +/- 1.5 weeks]. Post- operative residual pain was more common in-group B [I8 patients] than in group A [8 patients] and the difference was statistically significant. Three cases [3.3%] required re-operation in-group A within two years of fist surgery. On the other hand, seven patients [7.8%] required re-operation in group B
Conclusion : when the wound is closed in a single layer of silk sutures in CTS, the incidence and duration of post-operative tenderness is de- creased. Moreover, the incidence of post-operative residual pain and surgical recurrence will also be less frequent
ABSTRACT
Background: shunt failure is by far the most frequent problem in children with shunts, and most of them will experience this condition at some point in their lives
Objectives: we did the study in order to identify patient-related causes that could be responsible for early shunt failure in children and its significance to help reduce the risk of this failure
Methods: we reviewed and analyzed retrospectively the records of 200 hydrocephalic children operated with V-P shunts in the period between March, 2002, to April, 2004. These patients were regularly followed up according to standard follow-up protocol. The preoperative radiological evaluation included computerized tomography scanning, and/or magnetic resonance imaging. Preoperatively, as well as 1, 3, and 6 months postoperatively, patients were interviewed and examined using the standard protocol in which common symptoms and signs were described. Patients were grouped according to the expected factors that could be responsible for shunt failure
Results: there were a total of 76 patients [38%] with new shunt failures in the first 6 months post-insertion. The significance of each particular factor that could be responsible for shunt failure was tested and illustrated
Conclusion: the incidence of early shunt failure is unexpectedly higher in certain groups of shunted children. There are many patient factors that could be relevant to this problem increasing the possibility of shunt failure. This study inters that better outcome in shunted children could be achieved by correcting avoidable factors and taking the utmost care when these factors are unavoidable
ABSTRACT
Using pedicle-screw fixation for the management of spinal fractures in the dorsolumbar junction is widely used. Despite the proper insertion of the pedicle screws, progressive kyphotic deformity may develop post-operatively. Study of different factors related to pedicle-screw fixation in cases with dorsolumbar spinal fractures trying to find out the underlying causes of progressive kyphotic deformity after fixation. This retrospective study includes 52 patients with traumatic fractures of the dorsolumbar junction. All cases were managed by pedicle screw fixation and decompressive laminectomy. Two-level fixation [one above and one below the fractured vertebra] was done in 41 patients, 3 level-fixation in 8 patients, and 4-level fixation in 3 patients. Mean follow up period was 28 months [range from 12-39 months]. Fifteen cases developed post-operative progressive kyphotic deformity. Four of these 15 patients had malposition of pedicle screws and were excluded from the study. The other 11 patients [group A] had two-level fixation and had proper position of the screws as documented by CT scan. Patients in group A were compared to the group of patients who were also operated by two-level fixation but they did not develop postoperative progressive kyphosis [group B, n = 26]. Comparison included number of spinal columns fractured, disruption of facet joints, percentage reduction in the height of the anterior border of vertebral body by the fracture, presence of vertebral body fracture in the coronal plan dividing the body into anterior and posterior segments, presence of anterior dislocation or translation, degree of canal compromise, and presence of associated fracture in the vertebral body adjacent to the injured vertebra. The remaining 11 patients [group C] had 3 or 4 level fixation and did not develop this progressive post-operative kyphosis. Our results showed that the incidence of the following findings were significantly higher in group A than in group B: reduction in the height of the anterior border of vertebral body of 50% or more [82% and -15% respectively], body fracture in the coronal plan [73% and 19% respectively], associated adjacent vertebral body fractures [73% and 27%]. No significant difference was observed between the two groups in the other aspects of comparison. The results of this study indicate that the presence of: more than 50% reduction in the anterior body height, body fracture in the coronal plan, and/or associated adjacent body fracture would indicate a higher degree of spinal instability in patients with fractures of the dorsolumbar junction. It also infers that 2-level fixation is not enough to avoid post-operative progressive kyphosis in such patients
Subject(s)
Humans , Male , Female , Bone Screws , Thoracic Vertebrae , Lumbar Vertebrae , Postoperative Complications , Kyphosis , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Fracture FixationABSTRACT
The aim of this study was to present our experience in using a modified double-puncture technique for percutaneous nephrostomy [PCN] of nondilated renal collecting systems under ultrasound [US] guidance without using fluoroscopy. Over a 6-years period, 35 patients [42 kidneys] without calyceal dilatation at US who required nephrostomy drainage were studied. Twenty-five patients [30 kidneys] had ureteral leaks or fistulas, six patients [7 kidneys] had ureteral injuries after gynaecologic surgery, two patients [3 kidneys] had acute nondilated renal failure and two cases had PCN for extraction of ureteral stents [2 kidneys]. Mean age was 47.5 years [range, 18-68 years]; 26 patients were men and nine were women. A modified double apuncture technique was used under ultrasound guidance. After intravenous administration of frusemide to allow visualization and distention of the nondependent calyces for definitive renal access, a 22-gauge needle was inserted into the renal pelvis, and an 18-gauge 5-F sheath-needle set was used to puncture the desired calyx and a hydrophilic wire was introduced. After serial dilation, a nephrostomy catheter was inserted. Success and major complication rates were studied. Catheter placement was successful in 40 [95.2%] of 42 kidneys. Five patients [14.3%] developed urinary tract infection after PCN. One patient [2.8%] developed septicaemia. Drainage catheter dislodgement occurred in six cases [17.2%]. Tube blockage occurred in two cases [5.7%]. Two patients [5.7%] developed peri-renal urinomas .One patient developed severe hematuria that required blood transfusion but no further intervention was performed. The modified double-puncture technique is a simple and relatively safe procedure to fix a nephrostomy tube in the nondilated renal collecting systems with few complications
ABSTRACT
To present our experience in the treatment of distal urethral diverticula using a novel surgical transurethral approach. Sixteen women with distal urethral diverticula were studied. Their ages ranged from 26 to 52 years [mean 36 years]. Clinical presentation included chronic intermittent pelvic pain, dysuria, dyspareunia, urgency and post void dribbling of urine. Clinical examination revealed tender anterior vaginal mass or fullness in all cases. Diagnosis of urethral diverticula was based on voiding cystourethrogram [VCUG] and Cystourethrocopy. Patients with proximal, multiple diverticula and those having stress urinary incontinence were excluded from the study. Transurethral diverticulectomy was performed successfully in all cases. The urethral defect was closed transversely with vicryl 3/0 and a Foley's catheter was fixed for two weeks. Follow up VCUG was performed two weeks after surgery to exclude extravasation. The diverticula were posterior in 14 cases and posterolateral in two cases. The average operating time was about 30 minutes. All patients reported subjective relief of pain after surgery. Complications included a urinary tract infection in four patients. One patient had persistent signs of a small, residual diverticulum on VCUG on the 15th day. There were no recurrences or urethrovaginal fistulae. Transurethral diverticulectomy is a simple, safe and effective procedure for treatment of distal urethral diverticula
Subject(s)
Humans , Female , Diverticulum , Plastic Surgery Procedures , Female , Postoperative ComplicationsABSTRACT
This is a retrospective analysis of 14 patients with foramen magnum meningiomas over 12 years. Two types were encountered: craniospinal type [64.3%] and spinocranial type [35.7%]. The mean age was 51.8 years with 9 women. The clinical features were vague and bizard. Misdiagnosis and incorrect surgical intervention were common. Hemiparesis or quadriparesis were found in all patients, dysesthesias in 50%, C2 sensory hypoalgesia in 35.7% and cranial nerve dysfunction in 28.6%. MRl was the diagnostic procedure in all cases. Meningiomas were of large size in 81.4%. Partial transcondylar approach was used in 3 patients, retromastoid approach in 6 patients. Gross total tumor resection was possible in 43%, while operative complications occurred in 57%. On conclusion: the patients got benefit from surgery with good functional recovery in 50% without perioperative deaths [P < 0.005]