Radiographic and computed tomographic anatomy of the fetlock, pastern and coffin joints of the manus of the donkey [Equus asinus]

The digit of the donkey as a draught animal is commonly susceptible to much affection. The purpose of the present study was to provide a detailed anatomic reference of radiographic and computed tomographic images in conjunction with cross and sagittal sections of the normal fetlock, pastern and coffin joints of the donkey for anatomists, surgeons and veterinary students. Eight adult donkeys of both sexes free from any joints affection were used in our study. The digit of two donkeys had undergone radiographic and computed tomographic scanning; the other donkey's specimens were used to anatomical dissection and sectional anatomy. In the computed tomography [CT] of the fetlock joint all bone structures of the joint appeared also the soft tissue structures that could be identified and evaluated on the different soft tissue window planes included the common digital extensor tendon, lateral digital extensor tendon, superficial digital flexor tendon [SDFT], deep digital flexor tendon [DDFT], straight, oblique, and cruciate distal sesamoidean and intersesamoidean ligaments. For the pastern joint the structures that can be identified including the proximal phalanx, DDFT and digital cushion. In the coffin joint the collateral sesamoidean ligament [CSL] is difficult to identify on CT images

In vitro evaluation of the effect of different times of sandblasting on the bond strength of feldspathic porcelain to composite resin

Intraoral repair of fractured porcelain is an acceptable method to avoid replacement and therefore saving time and cost. The purpose of this study was to determine the in-vitro shear bond strengths of composite resin to feldspathic porcelain after different durations of sandblasting and to compare the effect of sandblasting with that of hydrofluoric acid [HF]. In this in-vitro study, 40 porcelain disks were fabricated and randomly divided into 4 groups [n=10]. Porcelain surface in group 1 was etched with 9.5% HF for 2 minutes. Groups 2, 3 and 4 were sandblasted with 50am alumina particles for 5, 10 and 15 seconds, respectively. All specimens received the same silane agent, bonding agent and composite resin. The samples were subjected to 5000 thermal cycles and then underwent shear bond strength testing. The mean bond strength was analyzed with one-way ANOVA. The mode of failure was determined using stereomicroscope and scanning electron microscope. An additional porcelain sample was fabricated and prepared according to the aforementioned protocols in each group and its surface topography was observed by SEM. The mean bond strength was 15/28 [ +/- 3/64], 13/82[ +/- 4/03], 15/77[ +/- 3/94] and 16/54[ +/- 3/73] MPa in the 4 groups, respectively. There were no statistically significant differences among groups. The most common mode of failure was cohesive in porcelain. No statistically significant difference was found in SEM results of different durations of sandblasting. The shear bond strength was not significantly different after various durations of sandblasting treatment. The bond strength after sandblasting was similar to that of HF. SEM showed that HF acid etching and sandblasting patterns were different

Evaluation of some biochemical changes in diabetic patients

The present study consisted of 50 subjects were classified into three groups; Group [GI] Control group consisted of 10 clinically healthy adult subjects of both sexes free from any liver, kidney or cardiovascular diseases. Group [GII] diabetes mellitus type 1 consisted of 20 patients of both sexes. Group [GIII] diabetes mellitus type 1 with nephropathy consisted of 20 patients of both sexes. All subjects were undergo to the following investigated parameters; Ascorbic acid [vitamin C], Catalase, Total antioxidant capacity, Aldolase and Pyruvate kinase enzyme. vitamins C, catalase, total antioxidant capacity enzymes were highly significant decreased [P < 0. 01] in diabetes mellitus type 1 [GII] and diabetes mellitus type 1 with nephropathy [GIII] when compared to the control group. Adolase activity was highly significant increased [P < 0. 01] in diabetes mellitus type 1 with nephropathy [GIII] when compared to the control group. Pyruvate Kinase activity was highly significant increased [P < 0. 01] in diabetes mellitus type 1 [GII] when compared to the control group. The antioxidant and enzymes can be used for follow up in patients suffering from diabetes mellitus type 1 and predict other complications

[Restless legs syndrome and the quality of sleep in type II diabetes]

Restless legs syndrome is one of the most common sleep disorders that decreases the quality of life. Diabetic patients suffer from restless legs syndrome more than the others. The purpose of this study was to determine the relationship between restless legs syndrome and the quality of sleep in type II diabetes. In this cross-sectional study, type II diabetic patients [n=108] referred to the Saqqez diabetes unit were selected through purposive sampling. Data were collected using screening questionnaires for restless legs syndrome including Pittsburgh sleep quality index [PSQI] and Epworth sleepiness scale [ESS] and were analyzed using descriptive statistics, correlation coefficient and independent T tests. The mean sleep quality scores in the presence and absence of restless legs syndrome were 8.1 +/- 0.6 and 5.5 +/- 4.4, respectively and there was a significant difference in the quality of sleep between the two groups [P=0.001]. Forty-two percent of samples suffered from restless legs syndrome and other sleep disorders. Considering the high incidence of sleep disorders in diabetic patients and also the lack of proper diagnosis of restless legs syndrome, using various screening methods for the diagnosis of restless legs syndrome is necessary for diabetic patients

Is the airtraq laryngoscope superior to macintosh laryngoscope using armord endotracheal tube in head and neck surgery?

The control of the airway is a fundamental aim for the anaesthiologast during routine anaesthesia. The incidence of difficult tracheal intubation has been estimated at 3-18%. This incidence may be more in head and neck Surgery. Our study conducted on 30 patients divided randomly in two groups each of 15 patients. Fifteen patients intubated by Macintosh laryngoscope and 15 by Airtraq laryngoscope. We found that success rate in Airtraq laryngoscope was 100% in comparisons to Macintosh laryngoscope which was 81.8%. We found also the intubation time was reduced significantly with use the Airtraq laryngoscope. The intubation was done in the first attempts in all patients in Airtaq group without need to optimizing maneuvers in comparison to Macintosh laryngoscope which need optimizing maneuvers and also use intubating aids like Bougie. Nearly no complication in Airtraq group like oral mucosal laceration, oxygen alteration and heamodynamic changes. We found that the Airtraq laryngoscope provides superior intubating condition without need intubating aids and less or no complications

Orthodontic pull out of an ectopic canine through a novel [HUJ] loop- a case report

This case report describes the effective management of a palatally impacted canine in a girl, having Class I malocclusion whose problem has been exclusively addressed through a newly designed loop named [HUJ] loop, after the name of the inventor, Hameed Ullah Jan

Class III malocclusion! Does it really pose a challenge? - a case report

A case report of a young girl having mild skeletal class III malocclusion with negative overjet and overbite is exclusively managed on orthodontic grounds. Patient's mandibular first premolars were already extracted by some local dentist. Her major esthetic concern was pivoting around her obtuse nasolabial angle. All pertinent treatment options were presented so as to address and serve her primary purpose. She opted for dentoalveolar compensation and defying all other treatment options, although all pros and cons were thoroughly explained in the best interest of the patient, including the surgical orthodontic treatment. Treatment goal was attained by restoring normal overjet, overbite thus improving not only the function but also enhancing and augmenting her nasolabial profile which was the major concern at the outset of treatment

Portal-image IMRT verification

The aim of the present work was to develop and utilizing the use of an amorphous silicon electronic portal imaging device [EPID] in IMRT dosimetric verification. Neither pre-irradiation nor extra build-up materials was needed for EPID dosimetry applications. Accurate absolute dosimetry [output] obtained using the EPID up to 250 cGy with mean deviation of 0.39% and 0.62% while the maximum observed deviation was 0.7% and 1.9% at 250 MUs for 6 and IS MV photon energy respectively. Beam-by-beam fluence profiles obtained from portal images were used in air [i.e. without phantom presence] The EPID estimated the relative dose up to 1.5% accuracy. The in-air absolute dose [i.e. number of MUs] of an arbitrary clinical breast [aperture-based] IMRT test fields were extracted, the difference rose to 1.7% in the most severe tested field. One disadvantage of beam-by-beam verification is that the cumulative effect of dose errors from all beams is not quantified, however, it allows the potential origin of dose errors to be isolated more easily. The EPID could estimate the dose at each segment with average accuracy of around 1% for central axis positions and up to 1.7% for off-axis positions in the tested fields. The absolute dose verification plus the fluence map verification of IMRT fields may represent a sufficient procedure to examine the step-and shoot-IMRT treatment. Multi-leaf-collimator [MLC] related QA also tested using EPED. The mean difference between EPID effective penumbra results and both ion chamber and film measurements was 0.06 and 0.01 cm respectively. These results could justify the use of EPID in dosimetric applications including aperture-based IMRT verification, and quality control programs

MLC leaf position and dynalog file accuracy QA procedure using the EPID

A main concern about the IMRT dose validation tool using Monte Carlo [MC] simulation and R and V-system/Dynalog file is the potential inconsistency between the actual leaf-end positions and those recorded by the Dynalog file. The present study investigates a method to validate the accuracy of the Dynalog tiles using amorphous silicon electronic portal imaging device [aSi-EPID] images. A computer program was developed to detect the MLC segmented field edges in EPID images [l024x768 pixels, pixel size: 0.392 mm], Standard reference MLC segmented fields were designed and leaf-end positions were measured accurately. EPID images for these reference MLC fields were recorded and the leaf-end positions were calculated as the locations where the image intensity is 50% of the maximum. Small corrections were made to minimize the effect of scattered photons [background]. Daily EPII] images of the same MLC segmented fields were compared to the original images and to check the accuracy of the Dynalog files. A daily QA tool was developed to check the accuracy of the Dynalog file and MLC leaf end positions as part of the comprehensive IMRT-QA procedure. This ensures the accuracy of the MC based patient-specific IMRT dose verification using the information recorded in the Reeord and Verify system/Dynalog files

[Effect of three post types on fracture resistance of maxillary central incisors]

Endodontically treated teeth, because of extensive structural defect, have the increased risk of fracture. For desirable reconstruction of coronal tooth structure, the post provide retention, nowadays non - metal post systems were introduced to dentistry. This study compared the fracture strength of maxillary central incisors restored with metallic, fiber composite and ceramic posts. Thirty human maxillary incisors were used in this invitro experimental study. The crown of each incisor was cut off 1 mm coronal to CEJ and perpendicular to the long axis of the tooth by metal disk. The root canals of the teeth were prepared for post after root canal therapy, then three groups of 10 specimen were formed. Teeth restored with Glass fiber, ceramic and prefabricated metallic posts and numbered as group 1, 2 and 3 respectively. Then, all teeth restored with composite core [Z100, 3M] and metal crowns were fabricated and cemented with glass ionomer vitremer luting cement. Specimens were embedded in autopolimerize acrylic resin 4 mm below CEJ, and then secured in a universal testing machine. A compressive load was applied at 135 degrees angle to long axis with crosshead speed of 0.5 mm/min, till fracture occurred and fracture pattern was recorded. The data were collected and analyzed using ANOVA and LSD tests. Fracture resistance by Newton was respectively: 765 +/- 113.26, 790 +/- 95.34, and 614 +/- 105.32 for glass fiber posts, ceramic and metallic groups. Resistance to fracture for glass fiber and ceramic posts was significantly more than Titanium post [P<0.05], but there was no significant difference between glass fiber and ceramic posts. Considering the results, usage of prefabricated glass fiber and ceramic posts are more preferable than prefabricated titanium posts. Because of more undesirable fracture in ceramic posts group than glass fiber, glass fiber posts are recommended

Placenta previa accreta: risk factors, morbidity and new strategy in the management

The aims of this study were to identify the risk factors, morbidity and mortality associated with placenta previa accreta, and effectiveness of using new strategy in the management of the placenta previa accreta, particularly those covering the cervix [major placenta previa] with a history of previous Cs. A total number of 280 pregnant patients, with placenta previa as diagnosed by ultrasound after 20 weeks of pregnancy were followed till the time of delivery during the period of4 years. After delivery, patients were divided into two main groups, those with placenta accreta [cases; n = 42], and those with 110 accreta [control; n = 238], and compared. Out of 280 patients with placenta previa, 42 [15%] had placenta aecreta, previous CS, advanced maternal age, grandmultiparity, previous dilatation and curettage were found to be a risky factors associated with a higher incidence of placenta accreta. Previous history of CS showed a significant increase In the incidence of placenta previa accreta [p < 0.0001], and the percentage f placenta accreta, increased linearly with the number of the CS from 0.99% in patients with no history of previous CS to 86.6% in patients with a previous history of 6 CS. However, post partum hemorrhage, and hospital stay were significantly higher in patients with placenta accreta than control [p < 0.0001], both groups had a similar delivery gestational age and neonatal outcome. Bimanual compression for at least 10 minutes, rectal insertion of 4 tablets [800 micro g] of misoprostol with bilateral internal iliac artery ligation were significantly associated with the stop of severe bleeding in cases of placenta previa accreta with. or without previous CS up to 90.5%. Emergency cesareanhystel-ectomy, needed only in 4 patients [9.5%], in addition to the above line of treatments. Previous repeated CS, hyypertensive disorders, previous dilation and curettage, grandmultiparity, advanced maternal age, are risky factors associated with higher incidence of placenta accreta. Placenta accreta is associated with higher maternal morbidity, but with similar neonatal outcomes compared with control. Combination of rectal insertion of 800 micro g misoprostol, bimanual compression for at least 10 minutes and bilateral internal iliac artery ligation were found to be promising treatment for the difficult cases of placenta previa accreta with or without previous CS, which might lead to lowering the maternal morbidity and mortality, saving the uterus and raises the psychological support which may have a direct effect on the women's health and fertility particularly those nulliparous or low parity

comparative study on therapeutic effect of sodium chloride and alcohol in infants with umbilical granulomas

Umbilical granuloma is a common inflammatory reaction which occurs during falling of umbilicus. Some treatments include use of daily alcohol, burning with silver nitrate and granuloma ligator. To compare the therapeutic effect of common salt and alcohol in infants with umbilical granuloma. This was a clinical trial carried out on 105 infants with umbilical granuloma. The cases were randomly divided into three groups. The first group received common salt for three days [once every 12 hours] and the second group treated with 70% alcohol twice a day [0.5 ml each time]. In the third group [control] the umbilicus was washed with pure water twice a day [0.5 ml each time]. The data was analyzed using Chi-square test and the One-way analysis of variance. The recovery rates among infants were 100% [common salt], 34.3% [alcohol] and 14.3% [pure water] following 3 days, This difference was statistically significant [p=0.0000].However, in 25.7% of infants treated with alcohol and 60% of control group, who were cured before 3 days, the umbilical granuloma recurred after an average of 8.3 days and 4 days, respectively. There was no recurrence among infants treated with common salt. All infants in control group and those who were treated with alcohol for 3 days, either with no cure or with recurrence, went under treatment with common salt. Follow up for two months in infants treated with common salt was indicative of no recurrence among them. Our data showed that the use of common salt in treating umbilical granuloma was more effective than 70% alcohol. So,it is suggested that the technique using common salt to be substituted for other procedures due to low price and lack of any complications

Evaluation of cryptosporidiosis in diarrheic children referred to Amir al Moemenin hospital, Semnan

Cryptosporidium parvum, a coccidian parasite, has been shown to cause diarrhea in animals and human especially children and immunocompromised patients. This parasite has gained increasing attention since infection in human was first identified in 1976. However there are a few published evidences about Cryptosporidium infection in human and domestic animals in Iran, but there is no data in many parts of the country, because in routinely ova and parasite testing this parasite don't consider. To address the existence or lack of human cryptosporidiosis and probable prevalence of that in diarrheic children was evaluated. The stool samples from 153 diarrheic children under 12 years were formalin-ether concentrated and tested by both modified Ziehl- Neelson [acid-fast] and rodamine staining. Cryptosporidum parvum was detected in 5 [3.26%] cases [Confidence Interval 0.005-6.1%, P=0.05]. four boys [1, 3, 5 and 6 years old] and one girl [12 years old] were positive when tested with both staining methods. The only significant associated factor with cryptosporidiosis was contact with domestic animals [P=0.0026] and the infection was not associated with age, sex and breast-feeding in babies. This study show Cryptosporidium infection in 3.26% of diarrheic children referred to hospital in Semnan. There was no statistically significant difference between this study and most reports from other parts of the country. Hence, it seems necessary to detect other microbial agents such as Cryptosporidium in routine examination of diarrheic patient's stool at least in children's hospital or reference labs

Essential fatty acid status in infants and children with chronic liver disease

The relationship between essential fatty acid [EFA] status and degree of hyperbilirubinaemia and oxidant stress in infants and children with chronic liver diseases was evaluated. Thirty patients with chronic cholestasis and 30 with liver cirrhosis were examined; 30 healthy subjects served as controls. Patient groups had significant decreases in EFAs and significant elevation of total bilirubin. Levels of thiobarbituric acid reactive substances were significantly raised and were significantly inversely correlated to decreased EFA levels. There were also significant decreases in retinol, alpha-tocopherol and alpha-tocopherol/total lipids ratio, which had significant positive correlations with decreased EFA levels. Infants and children with chronic liver diseases have a high risk of EFA deficiency correlated with progressive elevation of serum bilirubin and progressive deterioration of oxidant status

Urinary pyrilinks-D / creatinine ratio and serum estradiol levels in long-term deport medroxy progesterone acetate users

This study was done on 36 women who had been using depot medroxy progesterone acetate [DMPA] for more than three years [as cases] by injection of 150 mg/3 months and on 12 women who had never used it before [as control]. Urinary pyrilinks-D/creatinine ratios [nM/mM] and serum estradiol level [pg/ml] were assessed. Women who had been using DMPA showed significantly higher urinary pyrilinks-D/creatinine ratios and lower serum estradiol levels indicating tendency for higher bone resorption regardless age, parity, weight and height

Nephrotoxic effects of silica dust

The hypothesis of chronic nephropathy in association with silica exposure is supported by several epidemiologic studies. Our study investigates the adverse effects of silica exposure on the kidneys, in both silicotic and non-silicotic workers. The studied population included an exposed group [n=112], working as millers in the manufacture of bricks, and in underground mining, and a referent group [n=51] matched for age, sex and socioeconomic status. Our results revealed renal affection caused by silica exposure which was proved to occur earlier than chest manifestations of silicosis and that laminin levels serve as an early indicator of renal dysfunction. Also laminin levels show positive correlation with the duration of exposure

Progesterone receptors content of the endometrium in patients with luteal phase defect and its relationship to endometrium maturation and serum progesterone level

Luteal phase defect [LPD], a disorder characterized by delayed secretory endometrial maturation is associated with infertility and/or recurrent abortion. This endometrial retardation may not be a result of deficient progesterone secretion, but rather a consequence of endometrial failure to respond adequately to progesterone stimulation. This study included 20 patients with LPD suffering of infertility or habitual abortion and 20 control cases. All cases were subjected to endometrial biopsy on the 26th day of the cycle to assess maturation, immunostaining of the endometrial tissue for progesterone receptor content and serum progesterone level on the 25th and 26th days of the same cycle. The endometrial maturation had a lag of 4.46 days in infertile cases and 4.86 days in habitual aborters. The difference was insignificant. The serum progesterone levels showed no significant difference between study and control cases. The glandular progesterone receptors were higher in LPD cases, while stromal receptors were more in the control cases. These results suggested that serum progesterone determination is not ideal for LPD prediction. Estimation of progesterone receptors in the endometrium is valuable as failure of down regulation of glandular progesterone receptors in late luteal phase may be an etiologic factor in LPD

Radiotherapeutic implications of genetic instability of tumor cells

A mathematical model was used to explore the radiotherapeutic implications of genetic instability. The model included two populations whose different radiosensitivity was represented by different values of alpha parameter of linear quadratic model. It was shown that the presence of a small fraction of mutants may profoundly affect an optimal treatment schedule structure, especially for radiosensitive tumors currently deemed suitable for treatment by hyperfractionation. In some cases, the analysis favors hypofractionation or hybrid schedules composed of hyperfractionated and hypofractionated phases

Application and limitations of the linear-quadratic survival curve alpha/Beta ratio in selection of radiotherapeutic treatment schedules

This paper dealt with special situations in which limited information may suffice to select between alternative treatment schedules. It was shown that selection between any two schedules might be made on the basis of no more than knowledge of the linear-quadratic model alpha/beta ratio for tumors cells and critical normal tissue in the following circumstances. 1] When the schedules, being compared, are given in the same overall time. 2] When the schedules, being compared, are given in the same overall time, but the schedule of shorter duration has a smaller fraction size. These are shown to be the only circumstances in which knowledge of the alpha/beta ratio alone is sufficient to allow schedule selection. In all other circumstances, some knowledge will be required of the absolute values of alpha and beta as well as kinetic parameters relating to tumor repopulation