Surgeon oriented preoperative radiologic evaluation in cochlear implantation - our experience with a proposed checklist

Introduction: Preoperative temporal bone imaging studies have been routinely performed prior to cochlear implantation. Radiologists need to report these examinations with special focus on the surgeon's expectations. Objectives: To provide a basic structured format, in the form of a checklist, for reporting preoperative computed tomography (CT) and to its clinical impact on operative findings. Methods: The preoperative temporal bone CT scans of 47 patients were analyzed and reported according to the proposed checklist. Intraoperative assessment of mastoidectomy, posterior tympanotomy and round window access was done by the surgeon in a blinded fashion and were correlated with the radiological findings to assess its significance. Results: The proposed radiological checklist was reliable in assessing operative difficulty during cochlear implantation. Contracted mastoid and lower tegmen position were associated with a greater difficulty of the cortical mastoidectomy. Presence of an air cell around the facial nerve (FN) was predictive of easier facial recess access exposure. Facial nerve location and posterior external auditory canal (EAC) wall inclination were predictive of difficult round window (RW) accessibility. Conclusion: Certain parameters on the preoperative temporal bone CT scan may be useful in predicting potential difficulties encountered during the key steps involved in cochlear implant surgery (AU)

Evaluation of serum level of 25-hydroxy vitamin d in vitiligo patients

Introduction: Vitiligo is an acquired skin disease characterized by loss of functional melanocytes from the epidermis. Despitethe several factors studied, the pathogenesis of vitiligo remains unclear. Vitiligo could be associated with low vitamin D levels. The aim of this study was to evaluate serum 25(OH) D levels in vitiligo patients in comparison of normal controls. Methods: After meeting inclusion and exclusion criteria, serum 25 hydroxy vitamin D levels were assayed, in all subjects included in this case control study (21 patients and 21 age and sex matched healthy individuals). Vitiligo disease activity index (VIDA), affected body surface area (BSA),site of lesion, age of patients and duration of vitiligo were evaluated in relation to vitamin D level. Results: A total of 42 participants were enrolled in our study, 21 patients with vitiligo and 21 who served as controls. The mean serum level of vitamin D were significantly decreased in the patients group as compared with the control group ( 17.3ng ̸ml ± 5.3 vs 25.8 ng/ml ±7.9, P = 0.006). There was non-significant correlation between vitamin D level with age, duration of vitiligo, and affected body surface area (P>0.05), but there was significant difference in 25(OH)D levels between different grades of VIDA. Conclusion: In this study, we found a significant 25(OH) D deficiency in patients with vitiligo, suggesting that vitamin D deficiency may plays a role in the pathogenesis of vitiligo

Study of the relationship between severity of liver cirrhosis and Pulmonary function tests

Background: Cirrhosis is a condition in which the liver does not function properly due to long-term damage. This damage is characterized by the replacement of normal liver tissue by scar tissue. Objective: The aim of this work is to study the relationship between severity of liver cirrhosis according to the Child-Pugh score and pulmonary function tests (namely spirometry and arterial blood gas). Patients and Methods: The study is a cross sectional one, which was carried out on 50 patients admitted in the inpatient wards, or in regular follow-up in the out-patient's clinics of the Gastroenterology Departments, in Al-Azhar University Hospitals between November 2018 and May 2019.They were divided into 3 groups according to Child Pugh Classification (A, B and C). Result: The prevalence of hypoxia was (30%) in all studied groups (50 patients), the hypoxia was present in patients with Child C and Child B (62%) and (29.4%) respectively but none of Child A had hypoxia. It was noted that all pulmonary functions were worst in patients Child class C when compared to other groups. However, patients Child B had also significantly worse pulmonary functions when compared to patients class A. We also showed that pulmonary functions are significantly correlated with synthetic liver function, Child and MELD score. The deterioration of liver functions and rise of patients score is accompanied by worsening of all pulmonary functions. Conclusion: Patients suffering from severe liver cirrhosis and ascites, have significant reduction in (PaO2) and (SaO2) in association with restrictive pulmonary function pattern (up to 100% of patients with massive ascites)