ABSTRACT
SUMMARY: This study evaluated the effects of ethnicity, sex, and age on the linear dimensions of the sella turcica (ST) and the pneumatization patterns of the sphenoid sinus (SS). In this cross-sectional retrospective study, we examined digitally standardized computed tomography scans of 100 Jordanians. These study participants comprised 50 men and 50 women, and their age ranged from 23 years to 77 years. We assessed linear ST dimensions and SS pneumatization patterns and correlated this data to age and sex. Furthermore, we compared the data with different ethnic groups from previous studies. The mean (standard deviation [SD]) length, diameter, width, and depth of the ST were 9.98 (1.89) mm, 12.45 (2) mm, 11.96 (1.76) mm, and 8.38 (1.63) mm, respectively. The mean (SD) interclinoid diameter was 8.84 (2.03) mm. These measurements were not significantly correlated with sex or age. With regards to pneumatization patterns of the sphenoid sinus, the conchal type was observed in 2 % of the study participants. Presellar involvement was observed in 30 % of the patients. The sellar and postsellar type was observed in 66 % and 2 % of patients, respectively. In our study, ST measurements did not differ significantly between the sexes. Pneumatization patterns of the SS differed from the patterns reported for other races. The findings of this study could assist neurosurgeons, orthodontists, and forensic medical investigators in diagnosing and planning treatment for pituitary gland pathologies.
Este estudio evaluó los efectos de la etnia, el sexo y la edad sobre las dimensiones lineales de la silla turca y los patrones de neumatización del seno esfenoidal (SE). En este estudio retrospectivo transversal, examinamos tomografías computarizadas estandarizadas digitalmente de 100 jordanos. Los participantes del estudio comprendían 50 hombres y 50 mujeres entre los 23 y los 77 años de edad. Evaluamos las dimensiones lineales del SE y los patrones de neumatización del SE y correlacionamos estos datos con la edad y el sexo. Además, comparamos los datos con diferentes grupos étnicos de estudios previos. La media (desviación estándar) de la longitud, el diámetro, el ancho y la profundidad del SE fueron 9,98 (1,89) mm, 12,45 (2) mm, 11,96 (1,76) mm y 8,38 (1,63) mm, respectivamente. El diámetro interclinoideo medio era de 8,84 (2,03) mm. Estas medidas no se correlacionaron significativamente con el sexo o la edad. Con respecto a los patrones de neumatización del seno esfenoidal, el tipo conchal se observó en el 2 % de los participantes del estudio. Se observó afectación preselar en el 30 % de los pacientes. El tipo selar y postsillar se observó en el 66 % y el 2 % de los pacientes, respectivamente. En nuestro estudio, las medidas del SE no difirieron significativamente entre los sexos. Los patrones de neumatización de la silla turca diferían de los patrones informados para otras razas. Los hallazgos de este estudio podrían ayudar a los neurocirujanos, ortodoncistas e investigadores médicos forenses en el diagnóstico y el tratamiento de las patologías de la hipófisis.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Sella Turcica/anatomy & histology , Sphenoid Sinus/anatomy & histology , Sella Turcica/diagnostic imaging , Sphenoid Sinus/diagnostic imaging , Tomography, X-Ray Computed , Cross-Sectional Studies , Retrospective StudiesABSTRACT
Background: ultrasound-guided quadratus Lumborumblock is performed as one of the perioperative pain management procedures for patients undergoing abdominal surgeries
Objective: the aim of this study was to compare the analgesic efficacy of ultrasound-guided trans-muscular quadratus lumborum block with transversus abdominis plane [TAP] block and intravenous opioid drugs during laparoscopic bariatric surgery and in the early postoperative period regarding pain relief, provision of comfort, early mobilization and improved respiratory functions
Patients and Methods: Setting and design: pilot exploratory study was conducted on 60 patients scheduled for elective laparoscopic bariatric surgeries. All patients received general anesthesia using IV fentanyl [1-2 micro g/kg LBW]. Group QLB [20 patients]: received bilateral ultrasound-guided quadratus lumborum block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%. Group TAP [20 patients]: received bilateral ultrasound-guided TAP block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%. Group GA [20 patients]: received general anesthesia and then IV Morphine [0.1 mg/Kg LBW]
Results: there was statistically significant difference between the three groups as regardsthe first call for rescue analgesia [morphine], total morphine consumption and pain scores; indicating that tansversus abdominis plane block was more effective than intravenous opioid drug analgesia, while quadratus lumborum block was more effective than tansversus abdominis plane block
Conclusion: this study concluded that quadratus lumborum block was the most effective technique in providing analgesia after laparoscopic bariatric surgery without associated hemodynamic instability in comparison to transversus abdominis plane block and intravenous opioid drugs
ABSTRACT
Background: The first Millennium Development Goal to "eradicate extreme poverty and hunger" implied reducing by 50% the prevalence of underweight status among children younger than five years between 1990 and 2015. Aim of Work: This study investigates the prevalence and determining factors of anemia and malnutrition among children of Albasra village, one of the Egyptian villages, to produce directives for a management program. Materials and Methods: All inhabitants aged between six months and15 years (397 children) were subjected to a structured interview, clinical assessment, anthropometric assessment, and laboratory examination. A complete blood picture analysis and a hemoglobin percentage assessment were done. Results: The main prevailing symptom in the two weeks preceding the survey was diarrhea (55%). Complete weaning before the age of 18 months occurred in 20.5% of the below-six children. The children more likely to be anemic were those under the age of two years, children having the first or more than the fourth order among their siblings, and those who suffered a diarrheal attack, vomiting, grunting, or chest indrawing within two weeks preceding the survey, among children completely weaned after the age of 24 months and those from a low socioeconomic level. Stunting was highest among younger children from extended families. Children who suffered a chronic disease were more likely to be wasted (13.2%). Conclusion: An understanding of the risk factors for anemia and malnutrition among a population is fundamental to provide efficient preventive and control measures.
ABSTRACT
@#BACKGROUND: This study was undertaken to identify the prevalence of pulmonary embolism (PE) in the emergency department (ED) of an urban teaching hospital and also to test a Bayesian model in estimating the number of CT pulmonary angiography (CTA) expected to be performed in an emergency department. METHODS: The data for this study was obtained through a retrospective review of electronic medical records for all ED patients suspected of PE who underwent chest CTA or ventilation perfusion scanning (V/Q) between 2009 and 2010. The data is presented as means and standard deviation for continuous variables and percentages with 95％ confidence intervals (95％CI) for proportions. The prevalence of PE was used as pre-test probability in the Bayesian model. Post-test probability was obtained using a Fagan nomogram and likelihood ratios for CTA. RESULTS: A total of 778 patients (560 females) with mean age of 50 years (range 18–98 years) were enrolled (98.3％ underwent chest CTA and 1.7％ underwent V/Q scan). A total of 69 patients had PE, rendering an overall prevalence of 8.9％ (95％CI, 7.1％ to 11.1％) for PE. We calculated that 132 CTA's per year could be avoided in our institution, without compromising safe exclusions of PE (keeping post-test probability of PE below 2％). CONCLUSIONS: Despite differences in our patient populations and /or study designs, the prevalence of PE in our institution is about average compared to other institutions. Our proposed model for calculating redundant chest CTA is simple and can be used by institutions to identify overuse of CTA.
ABSTRACT
Urethrocutaneous fistula [UCF] after hypospadias repair remains a frustrating problem for pediatric urulogist, furthermore, with the improvement of suture materials and surgical techniques, such complications are increasingly unacceptable. During the last decade many principles of an ideal repairing technique have been clarified. To evaluate the outcome of urethrocutaneous fistula repair after hypospadias and determine the role of the fistula characteristics on the outcome of repair. Sixty patients with a mean age of 7.6 years, range [2.5 to 20 years], underwent repair of urethrocutaneous fistula after hypospadias surgery at Al-Sahel teaching hospital, Cairo, Egypt from May 2007 till May 2010. The fistulae were small [less than 2mm] in 27 cases and large [more than 2mm] in 33 cases. Fistulas were coronal in 10, distal penile in 20, mid penile in 15 and proximal penile in 15 cases. The interval between primary hypospadias repair and first attempt of fistula repair was 6 to 9 months. Small fistula repair by multiple layer simple closure, large coronal fistula changed into complete hypospadias and re do TIP with or without incised plate and covered by Dartos flap. Small coronal fistula repaired by trapped door flap and large fistula repaired by using rotational skin flap, Dartos fascia flap or tunica vaginalis flap used for recurrent cases. The overall success rate of repair was 75% [45 of 60 cases]. The relationship between the success of repair and the site, size and number of fistulas I. No statistically significant relation was fond between the success rate of the operation and these parameters [p>0.05]. The recurrent fistula occur in 25% [15 from 60 cases], The success rate [100%] was 6 from 6 with the use of tunica vaginalis flap and 5 from 9 [55.5%] with the use of the Dartos fascia flap, which is statistically significant [p<0.05]. The recurrent cases after Dartos fascia flap treated by tunica vaginalis flap with success rate of 100%
Subject(s)
Humans , Male , Fistula , Treatment OutcomeABSTRACT
Vascular endothelial growth factor [VEGF] is the most potent angiogenic factor known so far and it plays an important role in tumor biology. Elevated level of VEGF has been associated with poor prognosis in many cancers; however significance in hepatocellular carcinoma is still controversial. Was to evaluate serum VEGF level in hepatocellular carcinoma patients with or without portal vein thrombosis [PVT] compared to liver cirrhosis patients and healthy subjects and to study possible relation of other clinical and laboratory findings to VEGF level. Serum VEGF level was measured in 20 cirrhotic patients complicated with HCC and PVT, 20 cirrhotic patients complicated with HCC with no portal vein thrombosis, another 20 cirrhotic patients matched for Child-Pugh score 20 he1thy subjects matched for age and sex. VEGF level was compared across different groups, its level was evaluated hug to tumour size, Okuda stage, Child-Pugh class and etiology of liver disease. Serum VEGF was not significantly different between HCC patients with or without PVT, neither a significant as found between HCC patients and liver cirrhosis patients. Yet VEGF level was significantly higher in all cases of liver cirrhosis compared to control subjects. No significant relation was found between serum VEGF level and any of: tumour size, Okuda stage. Alpha fetoprotein, Child-Pugh class or etiology of liver disease. VEGF level is elevated in patients with liver cirrhosis even prior to the emergence HCC
Subject(s)
Humans , Male , Female , Vascular Endothelial Growth Factors/blood , Portal Vein/pathology , Thrombosis , Liver Cirrhosis , Liver Function TestsABSTRACT
Haemorrhoids are common health problems afflicted man since the dawn of history. As a benign condition its management should be as minimally aggressive as possible. This study aimed to evaluate the DGHAL as a new minimally invasive approach in managing cases of symptomatic grade III and IV piles. A total of 24 patients of grade III and IV piles were studied using Doppler guided hemorrhoidal artery ligation "DGHAL". DGHAL is considered to be successful in 91.6%and poor in 8.2%. Follow-up of 6 months, provided that 18 patients were free of symptoms, 4 patients had significant symptom relief but the procedure failed in 2 patients. DGHAL is a simple, safe and well-tolerated technique treating grade III piles
Subject(s)
Humans , Male , Female , Ligation/methods , Ultrasonography, Doppler/methodsABSTRACT
Omental torsion [O.T] is a rare cause of acute abdomen, not usually diagnosed pre-operatively as it mimics acute appendicitis. In this study six cases of O.T have been studied retrospectively to describe O.T as a definite clinical entity. The clinical picture, investigations, operative findings, results and complications were discussed
Subject(s)
Humans , Male , Female , Torsion Abnormality/surgery , OmentumABSTRACT
In this study, 148 admissions of 113 patients were retrospectively studied over a period of eight years to evaluate conservative approach in managing adhesion ileus. It was found that non-operative therapy of up to five days duration can be used safely for the majority of patients presented with postoperative intestinal obstruction including those with complete obstruction. In patients who responded to conservative treatment, obstruction resolved within a mean of 22 hours and a maximum of five days. A trial of more than five days duration proved to be ineffective. The conservative approach resulted in 73% resolution of obstruction with no significant increase in mortality or in rate of strangulated bowel