ABSTRACT
Background: hepatic encephalopathy [HE] is a common complication in patient with liver cirrhosis. It comprises of a broad spectrum of neuropsychiatric abnormalities of varying severity, and affected patients usually suffer from psychomotor, cognitive, emotional, behavioural, and motor coordination dysfunctions. Patients with minimal HE [MHE], a subclinical form of HE, usually have a normal mental and neurological status upon routine clinical examination. The subtle deficits in patients with MHE can only be elicited by specialized neuropsychological tests
Aim of the Work: the aim of this study was to evaluate the role of 3-Nitro-Tyrosine as a biomarker of Minimal Hepatic Encephalopathy in patients with liver cirrhosis
Patients and Methods: our conducted study was a prospective case control study carried on 60 adult patients and 30 age matched controls. All were recruited from Internal Medicine and Hepatology and Gastroenterology Department at Ain Shams University Hospitals in the period between September 2016 and June 2018. All patients enrolled in the study were subjected to detailed history taking, full physical examination, laboratory investigations, psychometric tests for detection of MHE using specially digit symbol test [DST], Trail making test A [TMT A], Trail making test B [TMT B], serial dotting test [SDT] and 3-Nitro-Tyrosine level [3NT]
Results: our study found that the serum levels of 3-nitro-tyrosine are a good predictor of the presence of MHE in patients with liver cirrhosis, with good sensitivity [90%] and specificity [93.33%] and positive and negative predictive values were 93.1% and 90.3% respectively at a cutoff of 14.8 ng
Conclusion: determination of 3-nitro-tyrosine in serum is easy and is not time consuming. It only requires taking a serum sample from the patient and determining 3-nitro-tyrosine concentration. This procedure can be therefore easily added to the routine clinical determinations in patients with liver cirrhosis. This would also allow extending the diagnosis of MHE to most clinical settings, helping to identify patients with MHE
ABSTRACT
To evaluate the feasibility, safety and efficacy of laparoscopic repair of inguinal hernia in pediatric age group. A total of 401 laparoscopic inguinal herniorrhaphies were performed in 362 children [340 boys and 22 girls]. The age ranged from 2 months and 12 years. A total of 397 indirect hernias sacs were closed [238 right, 81 left and 78 bilaterally], 2 direct hernia [boys] and 2 femoral hernias [one male and one female] were repaired. The median operating time was 25min [range for unilateral 16 to 45min; bilateral 20 to 54 min]. There were no intra-operative complications. Recurrence occurred in 10 [2.5%] patients during a follow up time of 6 months to 4 years. Laparoscopic inguinal hernia repair in children is feasible, safe and effective procedure; especially in case of recurrence and bilateral hernias
Subject(s)
Humans , Male , Female , Laparoscopy , Ligation , Child , Retrospective Studies , Hernia, Inguinal/embryologyABSTRACT
It is well documented that the anterior repositioning of the mandible achieved by mandibular advancement prosthesis has a potent effect on relieving the signs and symptoms of obstructive sleep apnea [OSA]. However, little is known about the degree of vertical opening that has to be made by those appliances to achieve the best possible results. The objective of the present article is to assess the validity of increasing the vertical dimension induced by the mandibular advancement prosthesis in treatment of OSA. Six patients with diagnosed OSA were chosen to carry out this study. Each patient received two forms of the same adjustable mandibular advancement prosthesis. The two forms were designed with the same amount of mandibular protrusion but with different vertical dimensions. A wash out period was allowed between using the two forms to avoid carryover effects. The effect of changing the vertical opening was assessed through both Polysomnographic and cephalometric evaluations. Results obtained seemed to favour the fabrication of mandibular advancement prosthesis at the minimal possible vertical dimension necessary to accommodate this appliance
ABSTRACT
Recent reports have demonstrated that immediate loading of dental implants is a clinically feasible concept with results similar to those for two-stage procedures, at least in good bone qualities. However, documentation of the outcome of immediate loading in the totally edentulous maxilla especially when opposed with natural dentition is scarce. This prospective study presents results from immediate loading of 24 newly designed one stage flapless dental implants [Mini Osteocare] for overdenture restorations in 6 patients with single edentulous maxillary arches. Implants were all placed at the anterior maxillary region, a region of questionable prognosis. Clinical and radiographic records of participated patients were reviewed during a follow up of one year. As compared to those reported from immediate loading of standard-sized implants in edentulous maxilla, the results achieved by the use of Mini implants in this challenging situation could be encouraging. Total implant survival rate was 75%. Six implants were lost at the subsequent observation stages. The results suggest that immediate loading of Mini implants should be revised with further long term studies before attempting to generalize this treatment alternative to solve both functional and esthetic problems in single maxillary edentulism
ABSTRACT
The objective of this prospective study was to compare the efficacy of mandibular advancement porstheses to mandibular distraction osteogenesis in retrognathic patients with obstructive sleep apnea [OSA]. Twelve patients with mandibular retrognathia and confirmed OSA were studied. The participated patients were equally divided into two groups, those who were scheduled for surgical correction of the retrognathia through distraction osteogenesis [group I] and those who were treated with custom made mandibular advancement prostheses [group II]. Lateral cephalometric tracings and polysomnographic data were utilized to compare the efficacy between the two different modalities of treatment. Based on the limited number of patients, the results of this study suggest that both mandibular advancement prostheses and distraction osteogenesis are useful alternatives when indicated in treatment of OSA
ABSTRACT
The aim of this study was to evaluate the acupuncture therapy as well as the transcutaneous electrical nerve stimulation [TENS] versus the occlusal splint therapy in the management of temporomandibular disorders [TMDs]. According to the treatment regimen, the selected patients were divided into four groups, each comprising eight patients. Group I and IV received acupuncture and occlusal splint therapies respectively as sole mode of treatment, while group II and III received combination therapy of acupuncture of TENS with splint therapy alternatively. Both subjective and objective evaluations were carried out for each patient at the pre-treatment stage and on regular recall visits up to nine months from the end of treatment. The results of this study showed a varying degree of success of the selected treatment approaches between the four groups being in favor to the combination therapy
ABSTRACT
Forty eight temporomandibular joints [TMJs] of thirty patients with anterior disc displacement [ADD] with reduction were evaluated in this study before and after occlusal appliance therapy. The patients were randomly divided into two equal groups. Patients in group I received muscle relaxation appliances and patients in group II received anterior repositioning appliances. Clinical assessments, magnetic resonance imaging [MRI] and interference pattern analysis of electromyography [EMG] were used as evaluation tools in this study. Although clinical signs and symptoms were alleviated by occlusal appliance therapy in both groups, these clinical results were not associated with favorable outcomes on using MRI or EMG. The results of this study suggest that the use of occlusal appliance therapy in patients with reducible derangement of TMJ should be revised as the clinical improvements associated with the use of these appliances did not necessarily mean that the disorder has been cured
ABSTRACT
The purpose of this study was to evaluate the clinical results of maxillary obturators retained by both natural teeth and standard endosseous implants placed in the zygomatic bone following the surgical ablation of maxillary tumors. Six patients with maxillary tumors were studied. All patients underwent hemi or partial maxillary resection. Two standard endosseous implants were placed at the ipsilateral zygoma simultaneously at time of surgical resection. Definitive maxillary obturator was fabricated after a healing period of six months and retained in the defect side by ball attachments to the standard endosseous implants. Masticatory efficiency, biting force, speech function with the definitive obturators as well as the survival rate of the standard endosseous implants were evaluated. The results of this study suggest that maxillary obturators retained with a combination of natural teeth at the non-defect side and endosseous implants placed within the defect can be used to reliably reconstruct patients after ablative resection of the maxilla