Rhinopathic migraine: evaluation and surgical treatment

The concept of rhinopathic migraine has evolved during the last few years, although its pathophysiology and treatment are still controversial. This prospective study was conducted to assess the efficacy of endoscopic sino-nasal surgery in its treatment. Fifty patients with diagnosed migraine who failed to improve after full neurological work up and treatment underwent complete sino-nasal evaluation. Thirty-five patients met the diagnostic criteria of rhinopathic migraine [chief complaint of migraine, positive response to nasal anesthetic and the absence of significant sino-nasal symptoms]. Endoscopy and sinus computed tomography revealed either anatomic variations [e.g. septal deviation, 71.4% and concha bullosa, 25.7%] and/or mucosal disease [e.g. thickening, 40% and retention cyst, 11.4%] in all 35 patients. Endoscopic surgery, tailored to the pathology of each patient, succeeded in eliminating or significantly reducing migraine attacks in 32 patients [91.5%], while 3 patients [8.5%] failed, to improve [mean follow-up period of 24 months]. We conclude that endoscopic sino-nasal surgery is highly effective in eliminating rhinopathic migraine in carefully selected cases

Adult onset diabetes mellitus in hepatitis C virus infection

There is growing evidence to suggest an association between hepatitis C virus [HCV] infection and diabetes, two common disorders that cause devastating long-term complications in a signficant number of patients. Several reports have found a high prevelance of HCV infection among diabetic patients. Additionally, a high prevelance of diabetes has also been reported in HCV- infected patients in comparison with other liver diseases. On the other hand some authors have not observed an association between HCV infection and diabetes, while others found that diabetes mellitus type 2 occurred with increasing frequency among patients with hepatitis C and this was associated with family history of diabetes mellitus. HCV seropositivity among patients with type 2 diabetes mellitus is higher than in the general population. Aim of work: Is to study the association between HCV infection and diabetes mellitus. This study included 410 consecutive patients with chronic liver diseases. They were attending the outpatient clinic of the National Hepatol-ogy and Tropical Medicine Research Institute and Aswan Teaching Hospital in the period from May 2004 to July 2005. Their ages ranged from 20-60 years. They were 304 males and 106 females. Patients were classified into 3 groups. Group A consisted of 220 non cirrhotic patients with HCV +ve. Group B consisted of 110 cirrhotic patients with HCV +ve. Group C consisted of 80 patients all are -ve for HCV Ab. Type2 diabetes was diagnosed as a fasting plasma glucose level [7.0mmol/L [126 mg/L] or on treatment with oral hypoglycaemic agents. It was found that distribution of diabetes mellitus between group A and B [HCV +ve] and group C [HCV Ab -ve] were 21.21%, 27.27%, 12.5% in respect order. There were no significant difference between AST levels, ALT level, BMI and diabetes mellitus. we have found an association between diabetes mellitus and HCV infection. It remains to be determined whether an HCV infection leads to diabetes mellitus or vice versa

Radiofrequency palatal reduction versus LAUP as a treatment of snoring and mild obstructive sleep apnea

In this study, 30 patients complaining of snoring and mild obstructive sleep apnea were randomly distributed into two groups, 15 patients each. One group was subjected to laser assisted uvulopalatoplasty [LAUP] while the other to RF. The follow up of these patients revealed that LAUP is more effective than RF, whereas RF is more tolerable than LAUP. LAUP was proved to be an effective method in the treatment of snoring and mild obstructive sleep apnea, while RF proved to be very safe and well-tolerated but needs further study to exactly evaluate its efficacy

Re-evaluation of management policy of children with high Anti-streptolysin O titre

ASO [Anti-sireptolysin O] antibody is formed in response to infection with streptococcal pyogenes. Measurement of ASO antibody titre is an important investigation of post streptococcal diseases, particularly rheumatic fever. Management of children with elevated levels of ASOT is still controversial some prefer medical therapy while other prefer surgical tonsillectomy. Is to define the best method of management of high ASOT through trial of three different therapeutic therapies which are the classic long acting BPG or recent macrolide oral azithromycin or tonsillectomy. The study enrolled 109 patients with a mean age 5.3 years. Group I [50 patients] were treated, with long acting BPG, Group II [40 patients] treated by oral azithromycin and Group III [19 patients] with tonsillectomy. Patients with failed medical treatment had undergone surgical tonsillectomy with follow up of their ASOT for 3 months. Surgical tonsillectomy revealed the highest curative rate 86.3% followed by long acting BPG 66% then oral azithromycin 62.5%. Conservative medical therapies should be the first line of management of high ASOT. Its failure urges the attempt for surgical tonsillectomy with a follow up period of 3 months at least for their ASOT

Immunoaffinity isolation of Schistosoma mansoni species specific molecules using monoclonal antibodies

Traditional diagnosis of schistosomiasis by stool and urine examination techniques is both insensitive and labor intensive; many efforts are directed towards the development of alternate sensitive and specific assays for diagnosis of schistosomiasis. With the development of hybridoma technology, monoclonal antibodies [MoAb] with high specificity to diagnostic antigens could be produced. In the present study, a species-specific fraction namely, Gp30 prepared from S. mansoni microsomal antigen [MAMA] was purified by a simple, easy and cheap apparatus [491-prep cell] [Bio-Rad]. Balb/c mice were immunized with the isolated glycoprotein [Gp] to produce a panel of MoAbs, which can be used to immunoaffinity purify target antigen. Among the produced panel, 6B3-1B432 MoAb of IgG2a isotope was able to detect 10-20 ng of Gp30 antigen in ELISA [O.D[650] = 1.985] and dot blot. In immunoblotting, 6B3-1B432 recognized only one band in the MAMA antigens, namely Gp30. This MoAb was purified with protein G Suprose using FPLC and PD-10 column and consequently used to immunoaffinity purify target antigen. The specificity and sensitivity of the immunoaffinity purified Gp30 [IP Gp30] was determined before using it in the dipstick assay. Our results indicated the absolute specificity of IP Gp30 and sensitivity results, 98%, was comparable to that obtained by the electroeluted GP30. The simplicity of the purification and the efficacy of the dipstick assay may render this diagnostic method for widespread use in the field of schistosomiasis

Evaluation of sense of nasal obstruction after nasal surgery

Sense of nasal air flow is very important as regard patient comfort. 25 patients operated upon for rhinoplasty, septoplasty and S.M.R. were asked about sense of nasal obstruction pre and post operatively and were compared with nasal flow meter measurements. 10 healthy persons without nasal complaint were taken as control group. There was mismatch between postoperative subjective sensation of obstruction and objective improvement in air flow study, especially in septoplasly and rhinoplasty operations. With follow up the subjective sensation of nasal obstruction has disappeared. This has been explained by cutting of nerve fibres in the region of vestibule which are thermo receptors and responsible for sensation of air flow