An Experimental Study of Oral Mucosal Wound Healing following Scalpel and Diode Laser Incisions in Guinea Pigs: Clinical and Histological Observations

Introduction: The available data regarding scalpel and diode laser incisions wound healing is variable, scarce and needs more clarification especially in normal healthy tissues. Hence, this study was aimed to evaluate clinical and histologic parameters of wound healing with scalpel and diode laser on oral mucosa of Guinea pigs. Materials and Methods: This is an experimental study conducted on four male Guinea pigs. Laser and scalpel incisions were made on the right buccal mucosa of each guinea pig approximately 5mm deep and 10 mm in length and both the incisions were placed 10 mm apart using No#11Bard Parker blades and diode laser (640 wavelength) under general anesthesia. Punch biopsies of both the incisions were obtained and compared for clinical changes such as ease of working, intra-operative bleeding, color and approximation of wound edges and histological changes such as epithelial proliferation, inflammation, angiogenesis, and fibrosis on day 1, 3 and 7. Results: Clinically, scalpel wounds showed better healing than laser wounds although laser incisions provided bloodless surgical field. There was no significant difference in inflammation, angiogenesis and fibrosis between scalpel and diode laser incisions on both day 3 and 7 except for the epithelization which was comparatively early and better in scalpel wounds than the diode laser wounds. Conclusion: Diode lasers provide bloodless surgical field with better visibility than scalpel without any difference in oral mucosal wound healing. Considering the clinical benefits, the diode lasers could be a superior alternative to conventional scalpel technique.

Health-related quality of life of chronic hepatitis c patients attending the outpatient clinics of Assiut University Hospital

Kgypl has possibly the highest chronic hepatitis C [CMC] prevalence in the world, which has been associated with decreased health-related quality of life [HRQoL]. Aim: The aim of the present study was to identify the most important predictors of HRQoL of CMC patients attending the outpatient clinics in Assiut city. HRQoL of 200 CMC patients and 200 age-and sex-matched normal subjects, was assessed by the validated Arabic version of the Medical Outcome Study Short Form Health Survey 36 [SF-36]. All patients were interviewed using a semi-structured questionnaire to assess the factors that could affect their HRQoL. Validated reliable instruments were used lo assess depression, illness-related stigma and disease related worries. HKQoL scores of CMC patients [age 40.43 +/- 12.11, 82.5% males] were significantly lower than age and sex matched controls. The most important predictors of the physical summary score of SF-36 were; depression [beta = 0.611, P = 0.000] and the presence of co-morbidities [beta =- 0.218, P - 0.000].while for the menial summary score, the most important predictors were; depression [beta =- 0,651. P=0.000] and illness-related stigma [beta= 0.222, P = 0.000]. Other factors such as age. Sexual dysfunction, interferon therapy and work affection by CMC illness showed a weaker, but nevertheless statistically significant relationship with HRQoL of CHC patients. The study found that patients with chronic hepatitis C had lower HRQoL than the healthy controls, and, depression, co-morbiditics, illness-related stigma were the most important predictors of their iower HRQoL. The results its of this study would assist healthcare personnel to introduce modifications in patient care protocols with relevance to patient needs

Ventilator associated pneumonia: incidence and risk factors in a university hospital

Ventilator associated pneumonia [VAP] is a type of nosocomial pneumonia associated with increased morbidity and mortality. Awareness about the risk factors can be used to implement simple and effective preventive measures.To determine the factors associated with development of VAP and its mierobial profile among patients admitted to ICUs. A nested case-cohort study was conducted at Al-Hussein university hospital in Cairo city, Egypt for a period of 6 months from the 1[st] of March 2013 to the end of August 2013. Patients who were on mechanical ventilation [MV] for more than 48 hours were monitored at frequent intervals fordevelopment of VAP. Samples obtained by endotracheal aspiration were ccultured on Blood agar -Chocolate agar - MacConkey agar, plates of which were incubated at 37c for 24 hours. The isolated organism was identified by morphological and biochemical identification. Of the 73 samples which were taken from endotracheal tubes of the patients, 42 cases were diagnosed as VAP with an incidence rate of 57.5%. Early onset VAP occurred in 36 [85.7%], while late onset VAP was observed in the remaining 6 patients [14.3%]. Escherichia coli [40.5%] followedby Klebsiella pneumonia [23.8%] were the most commonly isolated pathogens. Univariate analysis showed that the duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H[2] blocker use were the risk factors associated with VAP [p < 0.05], Logistic regression revealed duration of MV as an independent risk factor for VAP. The incidence of ventilator pneumonia is high in our study. VAP was significantly related to duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H[2] blocker use

Knowledge, attitude and practice of Hadhramout university students about dengue fever, Al-Yemen

The study aimed to assess the knowledge, Attitude and practice of Hadhramout university students about Dengue fever [DF]. Descriptive research design was used. The study was carried out at Hadhramout University that is located in Al-Mukalla city, 4 collages were taken randomly to collect the necessary data. 679 students were chosed from the previous mentioned faculties by systematic random sample technique. Two tools were used for data collection, the first was a self administrated questionnaire sheet and the second tool was the Likert scale. The study revealed that [78.5%] of the students had a fair knowledge about the vector. The main sources of information as stated by the students were television and posters and brochures. The vast majority of students [96.3%] had adequate score of practice [>/= 60%], while [98.1%] of the students had positive attitude [>/= 60%] about DF. Low significant positive correlation between knowledge, attitude and practice of students about DF was noted. Recommendations: educational programs should be directed and organized to all students from different educational levels to increase the community participation in the combat of the disease

Epidiological study of depressive disorders among patient attending outpatient clinics of Assiut University Hospital

Depression is a common mental health problem, seen frequently in general medical settings. Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension. To estimate the percentage of depressive disorders among patients attending outpatient clinics of Assiut University Hospitals, and to study the possible risk factors underlying these depressive disorders. This cross-sectional study was conducted during one year period from June 1[st] 2006 to May 31[st] 2007. 2034 subjects aged 15 and above were screened for depression using Beck Depression Inventory [BDI] scale. Subjects who scored 4 or more were further evaluated through psychiatric sheet especially prepared for the present work. Psychiatric diagnosis was made on the basis of DSM-IV TR criteria. Patients were also subjected to Suicidality sheet of the MINI plus and Sheehan Disability Scale. Depression was found in 202 subjects representing 8.8% of the whole sample, with 167 patients [82.7%] were classified as having major depressive disorders, 28 patients [13.9%] were assessed to have depressive disorder NOS [26 patients [12.9%] with minor depression and only 2 patients [1%] with postpartum depression], 5 patients [2.5%] were diagnosed with dysthymic disorder and finally 2 patients [1%] with bipolar disorder, depressive episode. Depression was significantly higher among female subjects, highly educated and literate individuals, non-working males and among divorced/widowed/separated individuals. Depressive disorders were also significantly higher among patients with Dcertain medical conditions [e.g. malignancy, disfiguring conditions, autoimmune conditions, renal diseases and hepatic diseases] and among those who had more medical conditions. The degree of impairment is significantly higher among patients with moderate and severe depression and particularly in patients with severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression and particularly among patients with severe depression with psychotic features. Depression is a common mental health problem, seen frequently in general medical settings and necessitates close psychiatric attention and management

Comparative effects of the two angiotensin converting enzyme inhibitors perindopril and ramipril on brain dopamine content in rats

The existence of brain rennin-angiotensin system [RAS] is well established and it may affect cognitive function and movement disorders. It has been suggested that manipulation of brain angiotensin could be a new therapeutic tool to modulate brain dopamine level, abnormalities of which are implicated in a wide range of conditions including extrapyramidal movement disorders, depression, appetite control, schizophrenia and arousal. In this work, we studied the changes in behavior and brain dopamine content under the effect of two lipophilic ACEIs, perindopril and ramipril, used orally daily for one week in normal rats. Other rat groups were then given single subcutaneous reserpine injection [5 mg/kg] to study the effect of pre-treatment with the ACEIs on the reserpine-induced akinesia, neurobehavioral changes and depleted brain dopamine. In normal rats, although perindopril increased dopamine content in the three brain regions examined, ramipril had no effect on striarum but there were no significant differences between the two ACEIs in their effects on frontal cortex and midbrain. Neither perindopril nor ramipril caused neurobehavioral effects. Both drugs reduced the reserpine-induced akinesia and behavioral changes and antagonized the reserpine-induced brain dopamine depletion. We concluded that chronic ACEIs therapy can influence dopamine level and this is a class effect depending on tissue penetration and crossing BBB

Concomitant administration of the selective cox-2 inhibitor, nimesulide, and vitamin E, comared to indomethacin in experimental animals

This study was designed to assess the safety and efficacy of the selective COX-2 inhibitor, nimesulide, in comparison with the non-selective COX inhibitor, indomethacin. The potentiation of the anti-inflammatory activity of nimesulide by concomitant administration of the anti-oxidant. vitamin E, was also investi- gated. The anti-inflammatory effect was tested in 24 rats by the cot- ton pellet granulomatous test. Animals were arranged into four equal groups. The first group received no drugs and served as control. The other three groups were treated with indomethacin [2 nig/kg b.w.], nimesulide [4 nig/kg b.w.] and nimesulide in combination with vitamin E [each in a dose of 4 mg/kg b.w.], respectively. All drugs were given orally once daily for two weeks. The extent of inhibition of granulomatous formation by the test drugs was taken as a measure of antiinflamniatory activity. it was found that nimesulide alone possessed a significantly less anti-inflammatory activity compared to that of indometha cin. However, concomitant administration of vitamin E with nimesulide produced a significant increase in the anti-inflammatory activity of nimesulide so that it became more than that of indomethacin alone. The analgesic effect of the test drugs was evaluated in mice. Acetic acid was injected i.p. in a dose of 0.5 ml of 1% concentration to induce abdominal constrictions [Writhing test]. Forty mice were divided into four equal groups. The first [control] group was treated with 0.5 ml saline; the second with indomethacin [2 ing/kg b.w.]; the third with nimesulide [4 mg/ kg b.w.] and the fourth with nimesulide plus vitamin E [4 mg/ leg b.w. each]. Each drug was given as a single intramuscular injection half an hour before conducting the Writhing test The average number of abdominal constrictions per minute [Writhing Response: WR] was calculated between the 10th and 14th minutes after acetic acid injection. Reduction of this WR was taken as a measure of analgesic activity of the tested drugs. Indomethacin induced a significant analgesic effect while nimesulide induced a iess analgesic activity. Simultaneous vitamin E administration did not add to the analgesic activity of nimesulide. To study the potential gastric toxicity, tests were performed using ten times the therapeutic doses of indomethacin [20 mg/ kg b.w.] and nimesuiide [40 mg/kg b.w.] in normal fasting albino rats, each given as a single oral dose. Nimesulide administration was not associated wish gastric uiceration while indomethacin produced high incidence of gastric uiceration. In conclusion, from the present data, it couid be recommended that the selective COX-2 inhibitor, nimesulide, is a safer but less effective analgesic anti-inflammatory agent, compared with indomethacin. However, combined with vitamin E, the anti-inflammatory efficacy of nimesulide is increased. Thus, this combination could provide the double benefit of good anti-inflammatory activity beside inducing no appreciable gastric adverse effects, if any at all, when compared with the traditional NSAID, indomethacin

Effect of rofecoxib [a new selective cox-II inhibitor] on plasma insulin level and pancreatic free hydroxyl radicals in diabetic rats

This study is designed to demonstrate the effect of a newly introduced selective COX-2 inhibitor, Rofecoxib, on streptozoto-cin-induced diabetes and whether it possesses an anti-oxidant effect or not. The effects of this drug were compared to those of the relatively selective COX-I inhibitor, indomethacin. The animals were divided into four groups, twenty rats each. The first group served as normal control; the second group received streptozotocin alone [45 ing/kg, i.p.] while the remaining two groups were given the same dose of streptozotocin after being treated orally for ten days with either 2.5 nig/kg/day of "Rofecoxib" [in the third group] or 1 mg/kg/day of indomethacin [in the fourth group]. Statistical analysis of the results revealed that animals treated with streptozotocin [STZ] alone exhibited significant plasma insulin reduction [both basal and half an hour after glucose load] while those treated with Rofecoxib showed insignificant reduction in plasma insulin level following STZ, in comparison to the control group. Histopathological changes revealed dial in the STZ group, there was depletion of insulin secretory granules while in the Rofecoxib group, they appear more or less normal. In the STZ group, there was a significant rise in the pancreatic malondialdehyde [MDA] level while in the Rofecoxib group there was insignificant elevation following streptozotocin, in comparison to control group. Treatment of animals with indomethacin [the 4 group] failed to protect them against the destructive effects of streptozotocin. It is concluded that, in contrast to indomethacin, Rofecoxib has beneficial effects in insulin dependent diabetes mellitus [IDDM] both by its modulatory effects on insulin secretion and its antioxidant properties

Ecto and endoparasites in primary school pupils in El-Ghanayem city, Assiut governorate, upper Egypt

Ecto and endoparasites are still of the public health problems in Egypt. This is particularly true among school pupils who are exposed to the parasitic infections or infestations by autoinfection or by contact. In this paper, 400 primary school pupils, in El-Ghanuyem City, Assiut Governorate, Upper Egypt, were examined [6-11 years old]. Their examination revealed pediculosis [30%], scabies [1.25%], Schistosomiasis haematobium [8.5%], entamoebiasis [8.75%], giardiasis [14%], taeniasis saginata [0.25%], ascariasis [1.75%], enterobiasis [31%], hymenolepiasis nana [9.75%] and Schistosomiasis mansoni [0.75%]. It was concluded that schoolchildren are at-risk group, as they spend long time outside their homes in a crowded area. Besides, they may transfer parasites to their families, particularly those transmitted by contact and autoinfection

Prevalence of glycosuria in rural areas in two upper egyptian governorates - a community - based study

The known caseload of diabetes worldwide is increasing at an alarming rate, its prevalence had tripled in six years. Early diagnosis is more important than tight control to contain fast rising worldwide costs of the disease in terms of life and wealth. A simple blood or urine test could detect early diabetes mellitus. This work aimed to measure the prevalence of diabetes mellitus in a wide geographic rural area in two Upper Egyptian Governorates in a community based study [cross-sectional]. A random sample of 3756 urine specimens was examined by means of dipsticks. The overall prevalence of glucosuria was 4.82%, the age of 35 years or more was the most vulnerable one for it. Multiple regression analysis of possible variables related to glucosuria beside age were leucocyturia and proteinuria

Threatened preterm labour: can biophysical profile predict its outcome?

Sixty pregnant women between 28-37 weeks with threatened preterm labor were evaluated by the ultrasound to determine the role of biophysical profile in the prediction of outcome of preterm labor. Out of the 60 women, 24 cases delivered prematurely. Out of these 24 women, 20 cases delivered within 48 hours of cessation of fetal breathing movements. For prediction of preterm labor, there was no correlation between the total score of biophysical profile and the rate of preterm labor; while there was a significant correlation between the absence of fetal breathing movements and the occurrence of preterm labor

Surgical treatment of Cranio-facial Neurofibromatosis

Craniofacial neurofibromatosis may cause severe soft tissue deformity together with pulsating exophthalmos. The orbital cavity is often enlarged, and the greater wing of the sphenoid bone is usually absent, the eye is proptotic and blind. In these situations, enucleation of the blind eye with soft tissue excision and orbital reconstruction, followed by replacement with a suitable prosthesis, are recommended. Eight patients with localized craniofacial neurofibromatosis were treated surgically, the results were satisfactory only in two patients, acceptable in four and unsatisfactory in two. This reflects the difficulty in treating the lesion and the need for multiple operative sessions

Nasal low dose ketamine combined with midazolam for paediatric premedication

Sixty Children aged from three to six years scheduled for tonsillectomy or bilateral insertion of tympanotomy tubes under general anaesthesia were studied. The patients were randomly allocated into two groups where group [A] received a combination of intranasal ketamine [2 mg/kg] and midazolam [0.1 mg/kg] and group [B] received placebo [normal saline]. Anaesthesia was induced with 5% halothane and 100% 02 via face mask, subjects given intranasal combination of ketamine-midazolam were more likely to separate willingly from their parents at or before 10 minutes compared to patients given placebo. 60% of patients given this combination separated at 4 minutes compared to 20% of patients given placebo. The quality of subsequent halothane induction was excellent in 70% of patients given this combination and adequate in the remaining 30%. In 70% of patients given placebo induction was unacceptable. There were no incidents of any behavioral changes or psychological disturbances in patients given this intranasal combination. No statistically significant difference as regards recovery time was recorded between both groups. It can he concluded that nasal low dose ketamine combined with midazolam provides an effective paediatric premedication with regard to sedation and mask acceptance. It has rapid action with no prolongation of recovery time and no instances of emergence phenomena. Nasal ketamine- midazolam combination offers an alternative to intramuscular or per rectum routes for preanaesthetic sedation in young children aged from three to six years