ABSTRACT
Abstract Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media. Objective The aim of the present study was to compare clinical outcomes in terms of healing and audiological outcomes of two groups. The authors used single layer graft (perichondrium with cartilage island) graft in one group and double layer grafts (perichondrium cartilage island composite plus temporalis fascia) were used in the second group. Methods Forty patients complained of chronic suppurative otitis media safe type with subtotal perforation subdivided into two groups. The first group author used single-layer perichondrium with cartilage island graft (composite graft) while in the second group authors used double graft in the form of perichondrium/cartilage island (composite graft) plus temporalis fascia. Results There was no significant difference in the mean Air bone gap (ABG) between pre- and post-operative audiometry in subjects who had single layer tympanoplasty. There was a significant difference in the mean ABG between pre- and postoperative audiometry in subjects who had double layer tympanoplasty. There was a significant difference in in the mean ABG differences between subjects who had single layer tympanoplasty and double layer tympanoplasty. Also, there was a significant difference in the healing of the tympanic membrane between subjects who had single layer tympanoplasty and double layer tympanoplasty. Conclusion Tympanoplasty by double graft (temporalis fascia and tragal cartilage/perichondrium) achieved a considerable improvement in healing of the tympanic membrane ™ with lower risk for residual perforation or graft rejection.
ABSTRACT
OBJECTIVES: This study was to evaluate the antibacterial effect of different instrumentation and irrigation techniques using confocal laser scanning microscopy (CLSM) after root canal inoculation with Enterococcus faecalis (E. faecalis). MATERIALS AND METHODS: Mesiobuccal and mesiolingual canals of extracted mandibular molars were apically enlarged up to a size 25 hand K-file, then autoclaved and inoculated with E. faecalis. The samples were randomly divided into 4 main groups according to the system of instrumentation and irrigation: an XP-endo Shaper (XPS) combined with conventional irrigation (XPS/C) or an XP-endo Finisher (XPF) (XPS/XPF), and iRaCe combined with conventional irrigation (iRaCe/C) or combined with an XPF (iRaCe/XPF). A middle-third sample was taken from each group, and then the bacterial reduction was evaluated using CLSM at a depth of 50 µm inside the dentinal tubules. The ratio of red fluorescence (dead cells) to green-and-red fluorescence (live and dead cells) represented the percentage of bacterial reduction. The data were then statistically analyzed using the Kruskal-Wallis test for comparisons across the groups and the Dunn test was used for pairwise comparisons. RESULTS: The instrumentation and irrigation techniques had a significant effect on bacterial reduction (p < 0.05). The iRaCe/XPF group showed the strongest effect, followed by the XPS/XPF and XPS/C group, while the iRaCe/C group had the weakest effect. CONCLUSIONS: Combining iRaCe with XPF improved its bacterial reduction effect, while combining XPS with XPF did not yield a significant improvement in its ability to reduce bacteria at a depth of 50 µm in the dentinal tubules.
Subject(s)
Bacteria , Dental Pulp Cavity , Dentin , Disinfection , Enterococcus faecalis , Fluorescence , Hand , Microscopy, Confocal , MolarABSTRACT
Background: Autoimmune thyroid diseases are multifactorial conditions that result from genetic predisposition in combination with environmental risk factors. Some bacteria and viruses are suspected of being able to mimic the antigenic profile on the thyroid membrane and play an important role in the onset of auto immune diseases
Object: The aim of this study was directed to investigate the association between helicobacter pylori infection and Hashimoto's thyroiditis
Methodology: The present study included 100 subjects divided into two groups: Patient group: this group included 70 patients, chosen from attending outpatient medical clinic patients and were newly diagnosed as having Hashimoto's thyroiditis guided by clinical diagnosis and detection of TSH, free T3, free T4, thyroperoxidase antibodies [TPOAbs] and Thyroglobulin antibodies [TgAbs] in serum samples. Control group: This group included 30 age- and sex-matched apparently healthy individuals with normal thyroid profile [TSH, freeT3 and freeT4]
Results: In the present work, there was abnormal elevation of TSH in 60 patients [85.7%], compared to just one subject [3.3%] of control group with statistically significant difference between groups. In the present work, there was significant and proportional [positive] correlation between HPIgG and each of TPO and ATG values
Conclusions:Our results showed significant association between Hashimoto's thyroiditis and HP infection. This association might be related to the disease severity, and might reflect the need of adding anti-HP medications as additional choice in management of Hashimoto's thyroiditis
ABSTRACT
Background: since cancer-associated pain is a common occurrence in malignancies involving the chest. In these cases, pain is complex and may have visceral, somatic or neuropathic components. It has been noticed that the number of cancer patients with refractory chest pain is increasing with more cancer prevalence, also with the advances in therapy and prolonged life expectancy. The demand for interventional procedures to control pain for these patients also increases. Interventional pain procedures are indicated for refractory pain when analgesic drugs are ineffective or associated with intolerable side effects. In controlling cancer pain it is commonly inadequately managed for these patients leading to suffer form of physical disabilities, psychological disturbance and avoiding treatment
Aim of the work: this study was designed to test both the efficacy and safety of thermo-coagulative ablation of the thoracic dorsal root ganglia for pain control in cancer patients that have refractory chest pain
Methodology: this prospective randomized study was conducted in the National Cancer Institute, Cairo University and Aswan University after board approval from October 2016 to March 2018. Sixty-five patients with Refractory Chronic Chest Cancer Pain were selected randomly and prospectively from the pain clinic of both the National Cancer Institute of Cairo University and Aswan University, after taken an informed written consent from the patient. The complete duration of the follow up lasted 3 months post-interventional with assessments after 1 week, 1 month and 3 months. At each follow up each patient was re-assessed with the following assessments; VAS, ECOG Performance Status
Results: we found that with effective pain relief there was a significant reduction in the mean VAS values; which means that there was functional improvement, in all the post-interventional follow ups. Also, there was an improvement in the functional state of the patients throughout the follow-up post-intervention with regards to the ECOG performance status from the results
Conclusion: we concluded that thermal radiofrequency ablation is considered an alternative for treating refractory chronic chest cancer pain of several types and causes. This is because of its efficacy, safety and ease of use. It also requires a minimal hospital stay or can even be performed on an outpatient basis
ABSTRACT
Background: Endotracheal intubation is the prominent cause of airway mucosal injury which results in postoperative sore throat [POST], with an incidence of 21%65%. Although this complication is minor, if left unresolved, it produces significant agony and annoyance to the patient
Aim of the Work: to compare efficacy of magnesium/ nebulizer versus ketamine nebulizer in decreasing postoperative sore throat incidence, severity and duration with fixed endotracheal tube intra cuff pressure at or below 20 cm H2O using handheld tracheal cuff pressure monitor in adults ASA [American Society of Anesthesiologists] I-II in 20-60 years age group of either sex in operations less than 2 hours
Methodology: our study included 90 adult patients, status I-II [ASA I-II] in the age group 20-60 years, of either sex undergoing operation under general anesthesia [GA] scheduled for a day case surgery and operation time less than 2 hours with fixation of endotracheal tube cuff at 20 cm H2O using hand held tracheal cuff pressure monitor [Pressure Gauge] and checked every half hour till end of surgery and maintained at or below 20 cm H2O
Results: Our study showed reduction in POST incidence and severity after preoperative magnesium sulfate nebulization in all time points 0, 2, 4, 8, 12 and 24 hours postoperative, so it was proved that magnesium nebulizer has great role in reduction of incidence, severity and duration of POST
Conclusion: we concluded that preoperative magnesium sulfate nebulization reduce incidence and severity of POST and it is more effective than preoperative ketamine nebulization
ABSTRACT
Background: in controlling cancer pain it is commonly inadequately managed for these patients leading to suffer in the form of physical disabilities, psychological disturbance, avoiding treatment. Therefore pain that is caused by cancer may directly affect the patient's quality of life; by having an effect on his/her daily activity, physical state and also psychological and emotional status. Thus, making pain relief and control the patient's right; right for a new life "pain free" or at least tolerable non-disabling pain
Aim of the work: this study aimed to test both the efficacy and safety of thermo-coagulative ablation of the thoracic dorsal root ganglia for pain control in cancer patients that have refractory chest pain And the impact on quality of life for patients
Patients and Methods: our prospective study was done on sixty-five patients selected from pain clinics of both the National Institute of Cancer, Cairo University and Aswan University with refractory chronic chest cancer pain according to the inclusion and exclusion criteria. The complete duration of the follow up lasted 3 months postinterventional; with assessments after 1 week, 1 month and 3 months. At each follow up each patient was reassessed with the following assessments; VAS, ECOG performance status, QOLS, drug consumption, side-effects [complications] and patient satisfaction
Results: we found that with effective pain relief there was a significant reduction in the mean VAS values which means that there was functional improvement, in all the postinterventional follow ups. Also, there was an improvement in the functional state of the patients throughout the follow-up post-intervention with regardsto the ECOG performance statusfrom the results. In addition to the ECOG improvement there was also a significant improvement in the QOL [Quality of Life] results, which was due to the pain relief. Regarding drug consumption, it was recorded that all three drugs; pregabalin, oxycodone and amitryptline, should maximum reduction after 1 month following the intervention, with a slight increase 3 months post-interventional, which matched the degree of pain reduction based on the pain scaling scores. Only 11% of our patients were found with numbness and neuritis, which were the only two complications reported. With regards to our patients, 30.6% certainly would repeat the procedure, 54.8% probably would, and 12.9 % probably would not while, only 1.6% certainly would not repeat it. With25.8% certainly would recommend the same procedure, 56.5% probably would, 14.5% probably would not and only 3.2% certainly would not recommend it
Conclusion: we concluded that thermal radiofrequency ablation is considered an alternative for treating refractory chronic chest cancer pain of several types and causes. This is because of its efficacy, safety and ease of use, patient's quality of life of was largely affected
ABSTRACT
Background: vitamin D is a fat-soluble vitamin; it has skeletal and non-skeletal functions. The effect of Vitamin D on CV disease had several mechanisms including elevated PTH and Calcium-phosphate metabolism. It decreases the pro- remodeling of Angiotensin II on the cardiomyocytes
The Objectives: To study relation between serum levels of vitamin D and echocardiographic determinants of systolic and diastolic functions in patients with and without cardio-renal syndrome
Patients and Methods: Prospective study was conducted on 90 patients of all age groups and both sexes, admitted to Ain-Shams University hospital. The study included 3 groups of patients: Group 1: systolic dysfunction and renal insufficiency [30 patients], Group 2: systolic dysfunction only [30 patients]. Group 3: renal insufficiency only [30 patients], in addition 10 healthy controls were taken as controls. Patients were subjected to full comprehensive echocardiography and KFT with estimation of creatinine clearance, and Vitamin D level that was statistically studied against echocardiographic parameters of cardiac systolic and diastolic function
Results: Our study found that, compared to patients with normal vitamin D level, patients with vitamin D deficiency [defined as having vitamin D level <20 ng/ml] had significantly higher ventricular thickness [IVS, PW and mean wall thickness] [P value < 0.001], and higher LV mass which seems to be linked eventually to worse outcomes with no significant impact on worsening Diastolic dysfunction. A ROC curve was done revealing a sensitivity of 80% for the mean wall thickness [>/= 10 mm] to identify patients with vitamin D deficiency
Conclusion: Vitamin D deficiency was associated with ventricular hypertrophy with worsening outcomes with no impact on diastolic function
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Vitamin D/blood , Echocardiography , Blood Pressure , Cardio-Renal Syndrome , Prospective Studies , Heart Failure, SystolicABSTRACT
Echocardiographic assessment of left atrial pressure [LAP] in mitral stenosis [MS] is controversial. We sought to examine the role of the radius of the proximal isovelocity surface area [PISA-r] in the assessment of the hemodynamic status of MS after fixing the aliasing velocity [Val]. We studied 42 candidates of balloon mitral valvuloplasty [BMV], for whom pre-BMV echocardiography was done and LAP invasively measured before dilatation. PISA-r was calculated after fixing aliasing velocity to 33 cm/s. In addition, the ratio IVRT/Te'-E was also measured, where IVRT was isovolumic relaxation time, and Te'-E was the time difference between the onset of mitral flow E-wave and mitral annular early diastolic velocity. IVRT/Te'-E and PISA-r showed a strong correlation with LAP [r= -0.715 and -0.637, all p < 0.001] and with right-sided pressures. In addition, PISA-r correlated with mitral valve area by planimetry method [MVA] and with left ventricular outflow tract stroke volume [r = 0.66 and 0.71, all p < 0.001]. Receiver operator characteristic curve [ROC-curve] showed that PISA-r was not inferior to IVRT/Te'-E in differentiating LAP >/=25 from <25 mmHg. Provided that Val is set to a constant of 33 cm/s, PISA-r can assess the hemodynamic status of MS, and seems a simple alternative to the tedious IVRT/Te'-E for estimation of LAP
ABSTRACT
Problem: With studies rarity which take the satric programme as a new programme in Egypt and exposure the politic issue, we can determined the Study problem in this main statment [the satric programme in Arabic satellite channel and the adolescents attitude towards it
Importance: The study related with an important strip in the society isadolescents strip, and rarity of satirical programs and the newly appearance in EgyptAnd addressed political issues
Aims: This study aims to Know what's adolescents attitude towards the satric programme in Arabic satellite channel and the
Study Kind: This study is adscription study
Methods: Survey Method
Tools: Content Analysis Form, Questionnaire Form, and Attitude Scale
Results: The program used vernacular language, The template used in program is direct talk, Presidential elections were at the forefront of the issues by 16%, The sample watched the program for Entertainment by 64.2% and Corruption revealed by 49.7. The programe present Political information by 42.5% and About Army Men by 13%, The study demonstrated verify partially the first hypothesis, which states on the presence of a statistically significant correlation between the exposure of adolescents study sample programs sarcastic and attitudes towards it, The study showed that there were no statistically significant differences in the attitude of adolescent males and females towards satirical programs through exposure to them in favor of male teenagers and from here we can say that the hypothesis has not been achieved, and The study demonstrated a statistically significant differences between age and the trend toward programs Sarcastic in favor of older teenagers, so we can say that the hypothesis has been achieved parthly
ABSTRACT
We aimed to test the ability of a simple equation using proximal isovelocity surface area method [PISA], created by fixing the angle to 100° and the aliasing velocity to 33 cm/s, to calculate mitral valve area [MVA] and assess severity in patients with rheumatic mitral stenosis [MS]. In a series of 51 consecutive patients with rheumatic MS, MVA was assessed by four methods, conventional PISA equation PISA[conventional], simple PISA equation PISA[simple], pressure half time [PHT], and planimetry [PLN] which was taken as the reference method. All methods correlated significantly with PLN with the highest correlation found in case of PISA[conventional] and PISA[simple] [r = 0.97, 0.96, p < 0.001], while the correlation in case PHT was relatively weaker [r = 0.69, p < 0.001]. Bland-Altman analysis revealed that the level of agreement with PLN was better in case of both PISA methods than PHT and, moreover, were close to each other. The number of cases that showed agreement of severity grade with planinetry was better in case of PISA[conventional] [42 cases] and PISA simple [44 cases] than that in case of PHT [34 cases, p = 0.037]. Finally, the measure of agreement with Cohen's Kappa test was better in case of PISA[conventional] and PISA[simple] than that in case of PHT. Provided that aliasing velocity is fixed at 33 cm/s, PISA can effectively predict mitral valve area and severity of MS by a simple equation, with the advantage of easy and accurate calculation over other methods
Subject(s)
Humans , Female , Male , Rheumatic Heart Disease/physiopathology , Blood Flow Velocity , Mitral Valve Stenosis/diagnosisABSTRACT
This study was carried out on 1250 randomly selected first year secondary school students in Alexandria to assess the prevalence and severity of malocclusion and some other oral health conditions, namely, plaque accumulation, gingivitis and gingival recession and the possible association of these conditions with malocclusion. The Prevalence of malocclusion was determined using the dental aesthetic index [DAI] that links clinical and aesthetic component mathematically to produce a single score; also DAI have been developed to allow categorization of malocclusion according to levels of treatment need. Plaque accumulation, gingivitis and gingival recession were assessed using plaque index of Silness and Loe [1964], gingival index of Loe and Silness [1963]and gingival recession index of Stahl and Morris [1955], respectively. The study showed that the mean DAI for total students was 23.05 +/- 5.1. The students who had a normal occlusion accounted for 76.2%, while individuals who had severe malocclusion where treatment was highly desirable accounted for 5% and individuals who had very severe malocclusion [handicapping] and needed a- mandatory orthodontic treatment accounted for 2.3%. The DAI showed no significant difference between males and females. However, the students in urban areas showed a higher score of DAI than those in rural areas, this difference was statistically significant. The mean plaque index [P1I] for total students was 1 .2 +/- 0.5.While the mean gingival index was 0.83 +/- 0.6. About 238 [19%] of individuals exhibited gingival recession. Male groups showed significantly more plaque accumulation, worse gingival condition and greater recession than female groups. Crowding as well as irregularity of the teeth in the anterior segment were found to be significantly correlated with plaque accumulation, gingivitis and gingival recession. It is concluded that the handicapping malocclusion is not prevalent among the studied students and consequently mandatory orthodontic treatment is not highly needed and that crowding and irregularities are predisposing to poor oral hygiene, gingival inflammation and gingival recession. Thus, it is strongly recommended that students suffering from malocclusion problems should receive a regular prophylactic therapy and proper dental health education to be aware of their oral hygiene status
ABSTRACT
Studies shows that ST depression in leads V1-V3 is generally believed to be associated with larger acute myocardial infarction and worser left ventricular function. Several studies have suggested that ST depression in V4-V6 confers a higher incidence of concomitant left anterior descending artery or multivessel disease. This study was performed to study the correlation between angiographic findings in form of affection of left anterior descending artery or number of vessels affected and Rt [V1]-V3] versus left [V4-V6] precordial ST segment depression in patients with acute inferior wall myocardial infarction. The study included 60 patients with 1[st] time acute inferior myocardial infarction. All of them received strep-tokinase [IV]. Resting EGG, serum cardiac enzymes and coronary angiography was done to all patients. We compared the data between patients with no ST depression in precordial leads and patients with ST depression in RT [V1-V3] precordial leads and patients with ST depression in left [V4-V6] precordial leads .The LVEF was significantly lower in patients with ST depression in left leads [p < 0.05] Significant LAD lesion was more in the same group [P < 0.01]. This group also showed higher incidence of three vessel disease [P < 0.01]. The mean peak CK level was higher in patients with ST depression in Right leads [P < 0.01]. So we concluded that patients with inferior wall myocardial infarction with no ST depression in precordial leads runs a benign course with low enzymatic release, normal ejection fraction, single vessel disease. Patients with Right precordial leads ST depression is characterized by high enzymatic release in comparison with patients with left precordial leads ST depression who show an aggressive course with low ejection fraction, multivessel disease, and more LAD artery affection. Thus we recommend that more attention should be paid to EGG analysis since this may affect the treatment strategy
Subject(s)
Humans , Male , Female , Coronary Angiography , Electrocardiography , Creatine Kinase , Cardiac CatheterizationABSTRACT
Occlusion of the vascular inflow to the liver is a useful technique in liver surgery; unfortunately, it may influence postoperative liver regeneration. The purpose of this study is to evaluate the effect of hepatic blood inflow occlusion on liver regeneration following partial hepatectomy in normal and thioacetamide induced cirrhosis in a rat model, and to investigate the protective effect of trimetazidine. a known anti-ischemic drug on liver regeneration after hepatectomy with blood inflow occlusion. Sixty male Wistar rats were divided into two groups [30 rats in each, group I and II]. Rats in group [I] represented normal liver; those in group [II] represented a model of induced liver cirrhosis by intraperitoneal injection of thioacetamide, three times per week for 8 consecutive weeks. Animals of each group were subdivided into 2 subgroups [15 rats in each, subgroup Ia, Ib and Ia, IIb]. Animals of subgroups Ib and IIb were pretreated for 7 days before surgery with trimetazidine by intraperitoneal route. All animals were subjected to laparotomy with 30 minutes hepatic blood inflow occlusion, followed by approximately 65% hepatectorny. The rats were allocated to killing on days 1, 2, 7 posthepatectomy. Liver function tests [albumin, alanine amino-transferase [ALT] and bilirubini, percentage of liver weight and proliferating cell nuclear antigen [PCNA] labeling indices were assessed. The postoperative mortality rates were higher among rats with cirrhotic liver subjected to hepatectomy compared to control rats. There was no significant change in serum albumin and ALT between subgroup Ia. Ib with normal liver, however there was significant difference as regard serum albumin and ALT between cirrhotic subgroup IIa, IIb with improved results for subgroup IIb pretreated with trimetazidine. There was no significant difference in serum bilirubin between subgroup Ia and Ib and subgroup IIa and IIb. On comparing normal and cirrhutic rats, subgroup Ia and IIa and hb and IIb there was highly significant decrease of albumin level and highly significant increase in ALT and bilirubin levels in cirrhotic animals compared to control rats. There was significant improvement in hepatic regeneration measured by the percentage of liver weight at the time of killing and PCNA labeling indices between control rats, subgroup Ia and Ib and cirrhotic rats, subgroup IIa and IIb on days 1 and 2 with non-significant difference on day 7. Comparing the regenerative capacities of normal and cirrhotic liver, there was highly significant increase of proliferating cells in control rats and the regeneration of cirrhotic Iiver was delayed than normal liver. Hepatic blood inflow occlusion for thirty minutes before hepatectomy caused an injury in the remnant liver with significantly depressed regenerative capacity and consequent delayed recovery of liver function particularly in cirrhotic rats compared with normal controls. However, pretreatment with [rimetazidine alleviated ischemia-reperfusion injury during liver surgery resulting in improved liver regeneration, function and survival rate
Subject(s)
Male , Animals, Laboratory , Liver Regeneration , Liver Cirrhosis , Rats , Trimetazidine , Liver Function Tests , Treatment OutcomeABSTRACT
Changes in angiogenesis and expression of extracellular matrix-degrading enzymes have been substantiated during tumor changeover and progression. This study was carried out on 60 retrospective endometrial endometrioid carcinoma [EEC] cases in addition to 15 normal endometrial biopsies as controls. EEC cases were grouped according to both histological grade [G], from G1 to G3, and the depth of myometrial [M] invasion, from M1 to M3. The study investigated all cases immunohistochemically to determine their microvessel number and the expression of matrix metalloproteinase-9 [MMP-9] and showed significantly high counts in EEC as a whole over the control endometria [P < 0.001]. Moreover counts of the G1 group overlapped those of the control endometra, increased significantly [P < 0.01] in the G2 and even more in the G3 group. G3 cases, in particular, displayed most microvessels widely scattered in the tumor tissue, in close association with tumor cells and as winding and arborized tubes, often dilated in microaneurysmatic segments. The counts also increased in M2 and M3 [P < 0.001] while those of the M1 group overlapped the counts of control endometria. Expression of MMP-9, evaluated as percentages of positive cases, revealed that the overall EEC cases gave a significant increase [P < 0.01] over the normal control endometria. Also, the frequencies of expression were significantly increased with the histologic grade [P = 0.01] and with the depth of myometrial invasion [P = 0.08]. The increases for MMP-9 were more evident on transition from G2 to G3 than from G1 to G2. The relationship to the depth of invasion revealed that the increases for MMP-9 were found at each depth, mostly on transition from M2 to M3. By contrast, only two of the control biopsies [13.5%] expressed few MMP-9. In EEC, MMP-9, as well, was, expressed by the host stromal cells. These data suggest that angiogenesis and degradation of extracellular matrix occur simultaneously with EEC upgrading and advancing depth of invasion. Also, they suggest that EEC cells and some host stromal cell populations cooperate in the tumor progression
ABSTRACT
Forty patients with a single septal accessory pathway were included in this study and divided into two equal groups. Ablation for group I patients was done in the power controlled mode using the RF generator [3-D, Radioncics] that allows continuous measurements of current, voltage, power, time and impedance. Ablation for group II was done in the temperature controlled mode using the RF generator [3-E, Radioncics], where the power supply automatically modulates the amount of power delivered to that the tip temperature approaches, but does not exceed that selected temperature >5C. The initial target temperature was set at 70C. After ablation, patients of both groups were followed for three months. It was concluded that temperature monitoring incorporating closed loop feedback control is a valuable tool during RF ablation of septal accessory pathways as it provides important information regarding the adequacy of tissue heating, reduces the RF pulses application and prevents coagulum formation with a temperature of 70C, thus reducing the time of harmful radiation exposure as well as the procedure time