Surgical management of lobar intracerebral hemorrhage

Aim of work: We conducted a case study to evaluate the surgical management of lobar intracerebral hemorrhage

Patients and Methods: This study included 20 patients who were diagnosed with Lobar ICH between January 2017 and December 2017, All cases were managed surgically. ICH is a neurological emergency and medical care should starts rapidly with stabilization of airway, breathing functions, circulation and other associated pathologies as fits and elevated blood pressure. CT scan was the standard diagnostic tool in the 1ry management of the cases. A routine preoperative investigation as CBC, PT was done. Cases admitted to a postoperative ICU for at least 48 hours and a follow up CT scan was done. Results: We observed all survivors for at least 2 months and asses our outcome using Glasgow Outcome Scale

Conclusion: Care of such cases and rehabilitation plays an important role to have a good prognosis

Role of surgery in management of discitis

Background: discitis is an inflammation of the vertebral disc space which may spontaneous or post spinal surgery; that is often diagnosed late. With good response to conservative treatment and in some condition the plan of management is surgical

Aim of the Work: to assess the role of surgery in management of discitis and which approach is appropriate, with comparison between conservative and surgical management and the relationship between risk factors and outcome

Patients and Methods: this prospective and retrospective study was conducted on 25 patients of specific criteria confirmed to have discitis by clinical presentation, radiological findings and laboratory investigations

Results: discitis is more common in old age that occurred in lumbar more that dorsal or cervical disc space with risk factors such as failed spinal surgery [40%], DM [36%], HCV +ve [8%], TB [8%], Brucella [4%] and addiction [4%] of past history with affect the outcome. There was a statistically significant relation between location of discitis and pre modified ranking scale, while modified ranking scale pre and post management were statistically highly significant in each cervical, dorsal and lumbar

Conclusion: both conservative and surgical management have good outcome. But we observed that the risk factors like DM and addiction worsened the prognosis. We also observed that the shorter surgical maneuver the better is the outcome

Efficacy of recombinant human erythropoietin in critically ill anaemic septic patients

To investigate the erythropoietic response to high dose of a weekly dosing schedule of recombinant human erythropoietin [rHuEPO] in critically ill anaemic septic patients, and to determine whether the administration of rHuEPO would reduce the number of red blood cell [RBC] transfusions required and whether would affect clinical course and final outcome or not. A prospective, randomized, controlled single center study. Critical Care Department [medical/surgical ICU], Cairo University Hospital. A total of 60 patients who were admitted to the intensive care unit [ICU] and met the eligibility criteria were enrolled into the study [30 into the rHuEPO group, 30 into the control group]. Patients were randomized to receive either rHuEPO or not. The study drug [40.000 units of rHuEPO] was administrated by subcutaneous injection beginning on ICU day 2 and continued once weekly for a minimum of 2 doses or until ICU discharge [for patients with ICU length of stay >2 weeks] up to a total of 4 doses. CBC, reticulocytic count, iron variables, APACHE II, SOFA scores were measured at baseline and subsequently thereafter every 3rd day until ICU discharge or death or up to a total of 28 days. The EPO treated group showed significant increases in reticulocytic count compared with baseline [P<0.001] as well as with the control group [P<0.006]. The EPO-treated group exhibited also significant increases in Hb concentration compared with baseline [P<0.001] as well as with the control group [P<0.03]. All patients in the control group received RBC transfusion [100%] while only [83.33%] of the patients who received rHuEPO were transfused. Concerning the in hospital clinical course, the EPO treated group showed significant decreases in their APACHE II score during the study period compared with baseline [P<0.001] as well as with the control group [P<0.05], the EPO treated group showed also no significant difference in their SOFA score during the study period compared with baseline [P=0.923], however, the control group exhibited continous and significant increase in their SOFA score throughout the study period compared with baseline [P<0.003]. There was no significant difference in the final outcome [i.e. recovery, mortality or morbidity] [P:0.337, P: 0.286 respectively]. The administration of rHuEPO to critically ill anaemic septic patients is effective in raising their reticulocytic counts, Hb concentrations and in reducing the total number of units of RBCs they require. In addition there was a trend toward better inhospital clinical course, increased recovery and decreased mortality in rHuEPO group

Von wilebrand factor in acute myocardial infarction

To determine the sensitivity of von Willebrand factor [vWF] and fibrinogen as diagnostic predictors of vascular injury in acute myocardial infarction [MI], the changes in plasma level of vWF and fibrinogen were assessed in 15 patients with acute MI, 15 patients with unstable angina and 10 control subjects with no subjective or objective evidence of ischemia. The samples were obtained immediately on admission from all groups. In patients with acute MI, the samples were drawn at 24 hours and 5 days later. The samples were analyzed for serum cardiac enzymes, vWF and fibrinogen. Plasma concentrations of vWF antigen were measured by enzyme linked immunosorbent assay [ELISA] method and by coagulation method for fibrinogen level. Compared with the control subjects, patients with acute MI and unstable angina had significantly higher levels of plasma vWF on admission. Twenty four hours and 5 days later, the plasma levels of vWF increased significantly from 203.6 +/- 17.7 and 252.6 +/- 2.6, respectively, compared with that on admission [104.1 +/- 23.8]. On the other hand, fibrinogen levels were significantly higher in patients with unstable angina compared with the control subjects, but insignificantly higher than that in patients with acute MI

Sports Dentistry in Egypt

Sports dentistry is needed in Egypt to provide on-going comprehensive standardized national data on the incidence and prevalence of sports related traumatic injuries and improve the means of protection and treatment to increase the safety range of the athletes