Transcrestal sinus lift with simultaneous implant placement using osseodensification in posterior maxilla with residual bone height of 4-6 mm / Elevação de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador em região posterior de maxila com altura do remanescente ósseo de 4 a 6 mm

Objective: The aim of this study was to evaluate the transcrestal sinus lift using Osseodensification technique with simultaneous implant placement. Material and Methods: In this case series 7 patients who needed implant placement in the atrophic posterior maxilla were enrolled. In all the cases the residual bone height between the sinus floor and the alveolar crest was 4-6 mm. Transcrestal sinus lift was performed using Osseodensification with simultaneous implant placement. Cone-beam computed tomography (CBCT) were obtained immediately postoperative and 6 months after operation. Implant stability using Osstell® were assessed at the time of implant placement and implant exposure (6 months). Results: The results showed that the mean bone height gain was 5.33±0.83mm at 6 months postoperatively. Mean bone density value was 818.43±109.63 HU. Mean ISQ value was 80.00±3.11 at 6 months postoperatively. The duration of surgical procedure (minutes) ranged between 25-38 minutes with an average of 30.86±4.10 minutes. Conclusion: The crestal maxillary sinus floor elevation using Osseodensification technique with simultaneous implant placement provide superior results regarding bone density and implant stability and less duration of surgical procedure. (AU)

Objetivo: O objetivo deste estudo foi avaliar a elevação de seio maxilar via crista do rebordo com a técnica de Osseodensificação com instalação simultânea de implante. Material e Métodos: Nesta série de casos, participaram 7 pacientes que necessitavam de implantes em região posterior de maxila atrófica. Em todos os casos a altura de remanescente ósseo entre o soalho do seio e a crista alveolar estava entre 4 a 6 mm. A elevação de seio maxilar via crista do rebordo foi realizada com osseodensificação com instalação simultânea de implante. As Tomografias Computadorizadas Cone Beam (TCCB) foram obtidas imediatamente após a cirurgia e 6 meses depois. A estabilidade dos implantes utilizando Osstell® foi avaliada no momento da instalação do implante e no momento da reabertura (6 meses). Resultados: Os resultados mostraram que a média de ganho de altura óssea foi de 5.33±0.83mm após 6 meses da cirurgia. A média da densidade óssea foi de 818.43±109.63 HU. A média de ISQ foi de 80.00±3.11 após 6 meses da cirurgia. A duração do procedimento cirúrgico (minutos) foi entre 25 a 38 minutos com uma média de 30.86±4.10 minutos. Conclusão: A elevação do soalho de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador promove resultados superiores em relação à densidade óssea, estabilidade do implante e menor duração do tempo cirúrgico (AU)

Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

A simple noninvasive test that accurately distinguishes NASH from NAFL as well as determines the disease severity is urgently needed. Recently, it was found that determination of Cytokeratin-18 [CK-18] fragments in the blood, predicts and correlates with histological NASH in which there is development of lobular inflammation, cell ballooning and fibrosis, supporting its usefulness in clinical practice To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients. 90 subjects were divided into 3 groups: group I: including 30 patients with NASH, group II: including 30 patients with NAFL, and group III: including 30 healthy subjects as control. Diagnosis of NASH and its discrimination from NAFL was done by liver biopsy. CK-18 level in plasma was measured for all subjects using ELISA. CK-18 was significantly elevated in patients of group I in comparison to group II and III patients, with mean +/- SD: 460 +/- 279, 167 +/- 56 and 149 +/- 57, respectively, and/3 value: 0.001. The [ROC] curve diagnostic performance of CK18 in diagnosis of NASH shows: cutoff value of >240U/L, with sensitivity 76.7%, specificity 95.0%. Ck-18 was found to correlate with disease severity assessed by NAS scoring system with P value: 0.001. Measurement of CK18 in NASH is a useful screening, diagnostic and staging bio-marker

Frequency and risk factors of post renal transplant anaemia among Egyptian patients

Background: There is a relative lack of recent information about post kidney transplantation anemia [PTA], especially in the developing countries. In Egypt data are scarce about the frequency and risk factors of PTA, although the first kidney transplantation was done in 1976

Objective: is to identify the frequency and risk factors of post renal transplant anemia

Patients and methods: This is across sectional hospital analytic study enrolling all kidney transplant recipients following in Assiut nephrology outpatient clinic, Kasr EL-Amy transplant outpatient clinic, and Sohag insurance hospital outpatient clinic, within the period from July 2014 to October 2015. Clinical and laboratory data were obtained from 86 patients; anemia was defined as Hb levels of < 13 g/dl for male patients and < 12 g/dl for female patients. Exclusion criteria were pregnancy, patients below 13 years old, multiple organ transplantation, and patients with less than six months from the transplantation

Results: The study showed that 53.5% of the patients were anemic. Multiple logistic regression analysis showed that GFR [p-value =0. 026] is a strong predictor for the development of post-transplant renal anemia. It also showed that high serum phosphorus level [p-value =0. 049] is significantly associated with post- transplant renal anemia. The use of Angiotensin converting enzyme inhibitors [ACEI], immunosuppressive treatments, presence or absence of co-morbidities, and donor type are not significantly associated with Post transplant renal anemia

Conclusion: Our study concluded that post-transplant renal anemia is common and under recognized. Risk factors include renal dysfunction and high serum phosphorus level

Chromatographic methods for simultaneous determination of diiodohydroxyquinoline and Metronidazole in their binary mixture

Two chromatographic methods were developed for analysis ofdiiodohydroxyquinoline [DIHQ] and metronidazole [MTN]. In the first method, diiodohydroxyquinoline and metronidazole were separated on TLC silica gel 60F254 plate using chloroform: acetone: glacial acetic acid [7.5: 2.5: 0.1, by volume] as mobile phase. The obtained bands were then scanned at 254 nm. The second method is a RP-HPLC method in which diiodohydroxyquinoline and metronidazole were separated on a reversed-phase C18 column using water: methanol [60 :40, V/V, PH=3.6] as mobile phase at a flow rate of 0.7 mL.min[-1] and UV detection at 220 nm. The mentioned methods were successfully used for determination of diiodohydroxyquinoline and metronidazole in pure form and in their pharmaceutical formulation

Spectrophotometric and spectrofluorimetric methods for determination of racecadotril

Two accurate and sensitive spectrophotometric and spectrofluorimetric methods were developed for determination of Racecadotril. In the first method reduction of Fe3+ into Fe2+ in presence of o-phenanthroline by Racecadotril to form a stable orange-red ferroin chelate [Fe- [Phen][3][2+] was the basis for its determination. The absorbance at 510 nm was measured and linear correlation was obtained in the concentration range of 2.5 - 25 microg mL[-1]. In the second method the native fluorescence of Racecadotril in acetonitril solvent at lambda, = 319 nm when excitation was at 252 nm is used for its determination. Linear correlation was obtained in the concentration range of 50 to 500 ng mL[-1]. The proposed methods were applied for determination of Racecadotril in bulk powder with mean accuracy of 100.39 +/- 1.239 for the spectrophotometric method and 100.09 +/- 1.042 for the spectrofluorimetric method. The proposed methods were successfully applied for determination of Racecadotril in its pharmaceutical dosage form

Prognostic values of intracranial pressure monitoring in severe closed head injury

The increased intra cranial pressure is the most significant factor determining morbidity and mortality in patients with severe closed head injury. The continuous monitoring of the ICP is very useful in assessing the ICP dynamics. The purpose of this study was to assess the effect of continuous ICP monitoring in determining the outcome of severe head injury. And how far ICP monitoring can limit the indiscriminate use of therapies to control ICP which themselves can he potentially harmful. Forty patients with severe head injury, with Glasgow Coma Scale [GCS] 8 or less, were involved in this study. On arrival to casualty unit, resuscitation started, general examination was done to assess cardiopulmonary system, and to detect any other associated injuries. All patients were intuhated, sedated, and ventelated. Intubation was facilitated with succinyl choline. Intracranial pressure [ICP] monitoring is done via ventricular catheter using hemodynamic monitor. Monitoring was continued for 48 hrs in controlled cases, and it was contintied when ICP was not controlled. Control of intracranial pressure was done by: I] -Brain dehydrating measures. II]-Dexamethason. III]-Cerebrospinal fluid drainage, and If ICP was still persistently elevated, trials were made to elevate mean arterial pressure [MAP] by using volume expansion and inotropics. These measures used to maintain cerebral perfusion pressure [CPP]. CT scan was done for all patients. Mean arterial pressure [MAP] and cerebral perfusion pressure [CPP] were measured and the injury admission time was recorded for all patients. The outcome was assessed according to Glasgow Outcome Scale. The outcome was divided into two groups: favorable outcome group and unfavorable outcome group. As regard to ICP, it's found that: 35% of cases had ICP<20 mm Hg. 64% of this group had favorable outcome while 36% had unfavorable outcome, Glasgow Coma Scale was >5 in 71% of cases and CT scan finding was normal and defuse lesion [N and D] in 64%. The intracranial pressure was >/= 20 mmHg in 65% of cases. 23% of this group had favorable outcome while 77% had unfavorable outcome GCS was > 5 in 38% of cases and CT scan findings were normal and defuse brain lesions [N and D] in 35% of cases. ICP was significantly higher in the unfavorable group [P<0.01] and injury admission time was significantly longer in the unfavorable group [<0.05], while the mean arterial pressure and cerebral perfusion pressure were significantly lower in the unfavorable group [P<0.05 and P<0.07 respectively]. Osmotherapy reduced the intracranial pressure 22.3 +/- 27%and the duration of reduction was 4.79 +/- 2.1 hours while the CSF drainage reduced the ICP 50.2 +/- 9.6% and the duration of reduction was 5.3 +/- 6.3 hours .The incidence of complication was slipped catheter in two cases. No cases of infection from the catheter were recorded. Mean duration of monitoring was 5 days [maximum 14 days]. The mortality rate was 35%[15 patients]. Intracranial pressure monitoring:[l] helps in early detection of intracranial pressure changes, [2] It can limit the indiscriminate use of therapies to control ICP which themselves can be potentially harmful[3] It can reduce ICP by CSF drainage directly and thus improve cerebral perfusion, [4] It helps in determining prognosis, and [5] It helps to improve the outcome. In prolonged monitoring [>4 days], daily bacteriological examination of CSF for early detection of contamination is recommended