Balloon catheter sinuplasty for chronic rhinosinusitis: feasibility and impact on quality of life

To evaluate the outcome of balloon sinuplasty for patients with chronic rhinosinusitis [CRS] and its impact on patients' symptom and quality of life scoring The study included 35 patients with mean age of 34.1 +/- 4.4 years. All patients underwent complete otorhinolaryngological examination and endoscopic staging according to Lund and Kennedy endoscopic score. CT scans of paranasal sinuses were assessed according to Lund-Mackay scale. All patients underwent symptoms and quality of life assessment using Sino Nasal Outcome Test-20 [SNOT-20]. All patients underwent balloon catheter sinuplasty under guide of fiberoptic nasal endoscope. Patients were assessed at three and six months after dilatation for SNOT-20 score. Intraoperative catheter insertion and advancement was accomplished successfully in 26 patients with a procedural success rate of 92.9% and the other two patients were shifted to FESS and were excluded of follow-up. No intraoperative or postoperative complications were encountered. Intraoperative bleeding was minimal and controllable without the need for nasal packing and all patients were discharged once they were ready for. All patients showed progressive improvement of SNOT-20 scoring that showed significant improvement at 3-months and 6-months follow-up evaluation compared to baseline score with significantly lower scores determined at 6-months compared versus 3-months. Balloon catheter sinuplasty is a feasible, safe and effective therapeutic modality for CRS associated with significant improvement of patients' quality of life and could be managed as one-day surgical procedure

Osteoporosis knowledge, beliefs, and behaviors among Egyption female students

The purpose of this study was to investigate the knowledge, believes and behaviors regarding osteoporosis risk factors and preventive health habits such as adequate calcium intake and physical activity. A sample of 494 girls aged between 16-24 years from Faculty of Education for Specific Studies was recruited in the study. Information was gathered through across-sectional survey. A self administered questionnaire was distributed among the students to collect data about osteoporosis knowledge physical activity and calcium intake. Four hundred and thirty five girls [88.1%] had heard of and [48%] had the correct definition of osteoporosis. The main source of information about osteoporosis was television [34%] followed by mothers and relatives [27.1%]. Overall,[22.5%] of girls perceived that they were likely to develop osteoporosis for different reasons. Respondents believed that osteoporosis is more serious [59.6%] than other common causes of morbidity and mortality such as heart disease and breast cancer. More than half of girls were aware of the benefits of exercise in preventing osteoporosis [59.1%], only [42.9%] participate in some sort of sports not on regular basis. Knowledge related to calcium rich food and requirements were poor. In summary, results obtained from this study were used to build on for health education intervention program targeted to this group of girls

Concurrent chemoradiotherapy with low dose weekly gemcitabine in stage III non-small cell lung cancer [NSCLC]

Background: combined chemoradiotherapy [CRT] is the treatment of choice for unresectable stage III NSCLC. Gemcitabine [G] is a novel deoxycitidine analogue that has been proven to be a potent radiosensitizer

Purpose: to demonstrate the efficacy, toxicity and tolerability of low dose Gemcitabine given weekly as radiosensitizer in stage III NSCLC

Patients and Methods: twenty-five patients with unresectable NSCLC were evaluable with a median age of 54 years [range 44-69]. Ten patients [40%] had stage IIIa and 15 patients [60%] had stage IIIb. Treatment consisted of gemcitabine 75 mg/m[2] day 1 of every week of irradiation [6 courses]. Thoracic irradiation was delivered in daily doses of 2Gy to a total dose of 60Gy over 6 weeks

Results: the overall response rate was 56% with complete response [CR] in 5 patients [20%], partial response [PR] in 9 patients [36%], stable disease [SD] in 5 patients [20%] and 6 patients showed progressive disease [PD] [24%]. The median overall survival was 15 months [95% CI: 11.2-20.6] and 1 year and 2 year survival rates were 58% and 37% respectively. The most frequent hematologic toxicity was neutropenia [40%] while radiation pneumonitis [32%] was the most frequently observed non-hematologic toxicity followed by esophagitis [24%], nausea and vomiting [20%]. One and two year progression-free survival rates were 55% and 28% respectively with median progression free survival 9 months [95% CI: 2.5-17.3]

Conclusion: gemcitabine might be used as rediosensitizer for patients with unresectable stage III NSCLC with feasible, tolerable side effects and considerable response rate. However, further randomized studies are needed to identify the optimal chemoradiotherapy regimens and schedules for treatment of unresectable NSCLC stage III

Paclitaxel as induction chemotherapy plus radiation for locally advanced sequamous cell carcinoma of the head and neck

The primary objective of this study was to asses the complete response [CR] rate to a new innovative induction regimen plus combined chemoradiation in patients with locally advanced head and neck cancer [LA-HNC]. From April 2003 to March 2005, 66 eligible patients with LA-HNC referred mainly from Oncosurgery Department to Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospital were treated by three cycles of induction chemotherapy [IC] with paclitaxel 175mg/m[2] in 3-h infusion on d1, leucovorin [LV] 200mg/m[2] over 20min immediately followed by fluorouracil [FU] 400mg/m[2] bolus and then 600mg/m[2] as 24h continuous infusion on d1 and 2, cisplatin 75mg/m[2] over 1-h infusion on d2 every 3 weeks. This was followed by radiation [70Gy] am weekly cisplatin 20mg/m[2]. After the completion of IC, 12/66 [18.2%] patient had CR. The CR rate was increased to [53.03%] post concomitant chemoradiotherapy [CCRT]. Hematologic toxicity, alopecia and mucositis were the most common complications of treatment. Median time to progression was 10 months and median survival was 18 months. This novel induction regimen is active, well tolerated and can be successfully followed by CCRT with weekly cisplatin. CCRT should remain standard treatment for patients with LA-HNC

comparative study on the effect of emdogain and calcium hydroxide on apical closure of young permanent teeth of dogs

The aim of this study was to compare the influence of Emdogain versus Calcium hydroxide on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals. twenty premolar of two 6 month old dogs were included. After access to the root ca nals and complete removal of the pulp, the canal system remained exposed to the oral environment for 2 weeks, then all infected canals were cleaned chemically and mechanically and shaped. The.treated teeth were divided into two experimental groups of 20 canals each. In group I, canals were filled with Emdogain. In group II, canals were filled with calcium hydroxide. The animals were sacrificed 3 months post operatively. The blocks of teeth and surrounding tissues were studied to evaluate five parameters: formation of an apical calcified tissue barrier, inflammatory reaction, extrusion of root canal filling, root and bone resorption. The total amount of reparative dentin formed in both groups was calculated using histometric analysis. significant differences [P < 0.05] were found in relation to formation of apical calcified tissue barrier, thickness of calcified tissue barrier, inflammatory reaction and material extrusion. The barrier was formed in 100% of canals from Emdogain group and 75% of canals from calcium hydroxide group. Mild inflammatory reaction and extrusion occurred mainly in roots from group 2. The total amount of reparative dentine formed in Emdogain treated teeth was significantly higher [P < 0.05] than Calcium hydroxide treated specimens. Emdogain showed promising results as a valuable material for apexification, primarily for treating immature teeth with necrotic pulps. It favored the formation of an apical calcified tissue barrier and periapical healing

Management of iatrogenic iliac artery injury complicating angiographic procedures

Twenty one patients with iatrogenic iliac artery injury complicating diagnostic [4] and interventional [17] angiographic procedures were managed from February 1994 to April 1999. Clinically they presented with acute lower limb ischemia [16], progressive retroperitoneal bleeding [4] and progressively growing false aneurysm [1]. Patients were managed by one or more of the following: 8 femorofemoral bypass, 8 iliac stent [with one failure], 3 balloon catheter thrombectomy [all failed], and 6 iliac exploration and proceed [with one mortality]. We conclude that for iliac occlusion, femorofemoral bypass is a safe and reliable option. With endovascular and imaging facilities, iliac stenting should be the first choice if possible. Blind thrombectomy is dangerous and should not be attempted. Temporary balloon tamponade is useful to stop bleeding in iliac artery rupture which should be managed without delay

Genetic and dental study in patients with ectodermal dysplasia

Thirteen patients suffering from ectodermal dysplasia presented to the Pediatric Dentistry Department for dental rehabilitation. They were subjected to clinical genetic examination, pedigree construction, dental clinical and radiographic evaluation and dermatoglyphic study. Different modes of inheritance were evident in this study including autosomal dominant, autosomal recessive and X-linked inheritance. Rapp Hodgkin and ectrodactyly clefting syndrome [both associated with ED] were found among the group. Dental clinical examination and panoramic X-ray films revealed a mean of 12.8 missing teeth in the ED group. Upper central incisors, canines and first molars were the most stable tooth types. Asymmetry in absent teeth was present in all tooth types. Dermatoglyphic study in ED patients showed a wide variation when compared with a normal group of individuals. Almost all the parameters studied recorded a significant difference

Conscious sedation by oral administration of midazolam versus midazolam plus ketamine for treatment of uncooperative pediatric dental patients

The purpose of this study was to assess the effectiveness of oral midazolam versus oral midazolam and ketamine in sedating uncooperative and young children for dental treatment. Fifteeen children who needed two comparable restorative interventions that could be done on separate visits, participated in this study. The patients were assigned double blindly to receive 0.35 mg/kg midazolam or 0.35 mg/kg midazolam + 3 mg/kg ketamine with the alternate regimen administered at the second visit. Degree of alertness, crying and movement were assessed at the beginning of the session and at 5 minutes interval throughout the procedure. Overall patient behavior and operator's level of satisfaction were assessed on a special rating scale. Heart rate, respiratory rate, arterial oxygen saturation and blood pressure were recorded as a baseline and then every 5 minutes,; thereafter, during the operative session. Statistical analysis showed no difference in mean scores of crying and movement between both groups, although the midazolam and ketamine always scored higher means. Sedation was deeper during the first 10 minutes in the midazolam + ketamine group [P <0.05] as evidenced by higher mean scores for alertness. Overall mean patient's behavior and operator's satisfaction were higher in the midazolam + ketamine group with no statistical difference. No adverse effects were observed. Blood pressure, heart rate, respiratory rate and arterial saturation were all maintained at normal level

Effect of some factors on the activity of milk clotting enzymes

The clotting activity of calf rennet, lamb rennet and sheep extract was less influenced by the changing in the pH value than that of porcine pepsin while, the clotting time with all milk coagulants was directly proportional to the substrate concentration. Porcine pepsin was more sensitive to change in substrate concentration than other milk coagulants. Addition of calcium and sodium chloride to milk decrease in clotting time with all enzymes. This effect was more pronounced in porcine pepsin than other milk coagulants

effect of different etching times on subsequent depths of ground primary enamel A scanning electron microscopic study

Labial surfaces of 30 caries free recently exfoliated primary teeth were used in this study. Outer, middle and inner enamel layers were ground on the same labial surface of each tooth. All teeth were etched 37% phosphoric acid gel for 20, 30, 60, 90 and 120 seconds. The results are given in details

Fracture of the penis and its surgical management

Rupture of the corpora cavernosa is an uncommon injury resulting from a direct blow to the fully erected penis. Only 200 cases have been reported in the world literature and this condition constitutes only one in every 175000 hospital admissions in the U.S.A. Although this condition is easily recognized, there is a great deal of controversy about its management. Conservative treatment is not satisfactory and is accompanied by a high incidence of late complications. In this study the work on 12 patients with this condition as regards predisposing and causative factors is reported. The way of management in the form of immediate surgical exploration, sharp trimming and primary repair of the tunica albuginea is also advocated with the use of a tunica vaginalis graft to patch defects in the tunica albuginea in the severe cases. The results are encouraging and the patients regained full erection after one month. The early surgical repair of the ruptured corpora cavernosa is recommended as the method of choice