ABSTRACT
Objective@#Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases. @*Methods@#Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months. @*Results@#Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores. @*Conclusions@#Group I showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.
ABSTRACT
Background: Caesarean sections are increasing in number dramatically all over the world. So, it became very important to give more attention for their postoperative care. Objective: to evaluate the effect of immediate oral hydration initiated within 2 hours after uncomplicated Caesarean Section on the following post-operative outcomes: post-operative vomiting and abdominal distention, post-operative nausea and abdominal pain, the return of intestinal movements, duration of intravenous fluid administration, duration of hospital stay and participant satisfaction
Methods: this randomized controlled study was conducted at Ain Shams University Maternity Hospital. It was carried during the period from July 2016 to July 2017. 140 women, all of them underwent uncomplicated Cesarean Section under regional anesthesia were randomly assigned into two groups. In the immediate group: oral hydration was received in the first 2 hours postoperatively, and in the early group: oral hydration was received after 8 hours postoperatively
Results: all the results of the postoperative outcomes of both groups had non-significant differences except for the psychological satisfaction which was significantly higher in the immediate group with a [p<0.001]
Conclusion: immediate oral hydration group showed non-significant differences comparing with early oral hydration group regarding most of the postoperative outcomes, but the results were relatively better towards the immediate group. Also, immediate hydration is significantly better than early hydration regarding psychological satisfaction of women, allowing them to be more able to breastfeed their kids and to spend a less stressful time in the hospital
ABSTRACT
Background: caesarean sections performed every year are increasing in number dramatically all over the world. So, it became very important to give more attention for their postoperative care
Aim of the Work: to evaluate the effect of immediate oral hydration initiated within 2 hours after uncomplicated caesarean section on the following post-operative outcomes: post-operative vomiting and abdominal distention, post-operative nausea and abdominal pain, the return of intestinal movements, duration of intravenous fluid administration, duration of hospital stay and participant satisfaction
Patients and Methods: this randomized controlled study was conducted at Ain Shams University Maternity Hospital. It was carried during the period from July 2016 to July 2017. 140 women, all of them underwent uncomplicated cesarean section under regional anesthesia were randomly assigned into two groups. In the immediate group: oral hydration was received in the first 2 hours postoperatively, and in the early group: oral hydration was received after 8 hours postoperatively
Results: all the results of the postoperative outcomes of both groups had non-significant differences except for the psychological satisfaction which was significantly higher in the immediate group with a [p<0.001]
Conclusion: immediate oral hydration group showed non-significant differences comparing with early oral hydration group regarding most of the postoperative outcomes, but the results were relatively better towards the immediate group. Also, immediate hydration is significantly better than early hydration regarding psychological satisfaction of women, allowing them to be more able to breastfeed their kids and to spend a less stressful time in the hospital
ABSTRACT
Background: Undesirable fetal outcomes and reproductive failures mayfollowToxoplasma, Cytomegalovirus [CMV] and Rubella infections
Objective: Detection of Toxoplasma, Rubella and CMV infections among aborted women attending Sohag University Hospital and to determine factors related to these infections
Methodology: Blood samples were gathered from 121 aborted women attended the hospital, from June 2016 to February 2017. Samples were examined for specific IgM and IgG antibodies against Toxoplasma, Rubella, and CMV by ChemiluminescentMicroparticle Immunoassay [CMIA] technology
Results: About two thirds [64.5%] of participants were positive for at least one of the studied infections. The specific IgM antibodies were positive in 1 case for Toxoplasma,3 cases for Rubella, and 5 cases for CMV. Specific IgG antibodies were positive in 45 cases for Toxoplasma, 33 cases for Rubella, and48 cases for CMV. Multiple logistic regression analysis identified that rural residence was significantly linked to Toxoplasma [OR=8.35, p-value <0.001], CMV [OR=2.26, p-value = 0.042], Rubella [OR = 3.7, p-value=0.003] infections. Seropositivity for multiple infections was detected in 33.1% of participants. Rural residence and high parity were significantly connected with multiple infections [p-value <0.001 and 0.045 respectively]
Conclusion: Infection with the studied agents is highly prevalent [64.5%] among the studied women where antibodies againstToxoplasma, Rubella virus and CMV were found in different proportions [38 %, 29.8 %, and 43.8 % respectively]. Rural residence is a strong predictor of these infections. Hence the country's health authorities must be alerted, and preventive measures should be taken
ABSTRACT
Background: Anemia is a very common disease in critically ill patients. Approximately 29% of patients have lower than normal hemoglobin levels when admitted to an ICU, and about 95% develop anemia within 3 days of admission
Aim of the Work: The purpose of this study was to evaluate the effects of restrictive and liberal red blood cell transfusion strategies on mortality and morbidity in critically ill patients. And as a result, recommend the more beneficial and the less deleterious strategy for critically ill patients
Patients and Methods: This clinical interventional study was carried out at Intensive Care Unit, Benha Teaching Hospital, Egypt, during a period from July 2017 to November 2017. This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member
Results: Mortality rates in ICU were 16 % and 20% in group A and B respectively, 24% and 28% within 60 days respectively. There were lower mortality rates with group A but with no statistically significant difference between groups according to mortality during ICU Stay and mortality within 60 days
Conclusion: Comparison between the effect of restrictive and liberal strategies of blood transfusion on mortality and morbidity in critically ill patients showed no significant differences. Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Blood transfusion may be hazardous and cost-effective
Recommendations: Anemia is associated with adverse clinical outcomes. However, randomized clinical trials are required to establish if transfusion is beneficial or harmful in anemic patients. A restrictive transfusion strategy should be recommended within the well-studied patient populations and clinical conditions, and the clinicians must continue to use their experience and bedside clinical judgment to advocate the best management for their patients
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Anemia/blood , Anemia/prevention & control , Anemia/mortality , Intensive Care Units , Patient Outcome Assessment , Intensive Care Units , Critical IllnessABSTRACT
Background: Attention deficit hyperactivity disorder [ADHD] is a common neurodevelopmental disorder with associated mineral deficiency
Aim: To assess magnesium level in ADHD children and compare it to the normal levels in children. Then, to detect the effect of magnesium supplementation as an add on therapy, on magnesium deficient patients
Methods: The study was conducted on 25 patients with ADHD and 25 controls. All subjects had magnesium estimation in serum and hair. ADHD children were further assessed by Wechsler intelligence scale for children, Conners' parent rating scale, and Wisconsin card sorting test. Then magnesium deficient patients were assigned into 2 groups, those who received magnesium, and those who did not. The difference between the studied groups was assessed by Conners' parents rating scale and Wisconsin card sorting test
Results: Magnesium deficiency was found in 18 [72%] of ADHD children. The magnesium supplemented group improved as regards cognitive functions as measured by the Wisconsin card sorting test and Conners' rating scale. The patients reported minor side effects from magnesium supplementation
Conclusion: Magnesium supplementation in ADHD, proves its value and safety
Subject(s)
Humans , Male , Female , Child , Adolescent , Magnesium/therapeutic use , Child , Case-Control Studies , Prospective Studies , Magnesium/blood , Magnesium DeficiencyABSTRACT
Megakaryopoiesis requires a highly complex series of cellular events in which a hematopoietic stem cell generates a cascade of committed progenitors and culminates with the production of circulating blood platelets. Megakaryopoiesis is regulated by several factors and cytokines that affect the proliferation and differentiation of megakaryopoietic cells. The aim of this study was to evaluate the role of some cytokines namely Thrombopoietin [TPO], Transforming growth factor [TGF-beta1] and lnterleukin 6 [IL-6] in regulation of megakaryopoiesis in various platelet disorders. This study was conducted on 72 patients with various platelet disorders; they were either thrombocytopenic [ITP "group I" or liver cirrhosis [LC] "group II" patients] or they presented with reactive thrombocytosis "group III". [According to modified Child classification group II patients was divided into three subgroups; Child A, Child B and Child C]. Twelve apparently healthy volunteers were included in the study for comparison. Estimations of serum TPO level, TGF-beta1 level and IL-6 level by ELISA technique were done for all studied groups. A highly significant increase in TPO and significant increase in IL-6 levels was noted in ITP group compared with the control group while TGF-beta1 was non significantly increased. In LC group and subgroups [Child A] a significant increase in TPO was noted on comparing with the control group but non significant increase in Child B and C; with progressive decrease of TPO level from Child A to Child B and Child C respectively. In LC group and Child C and B the TGF-beta1 was highly significantly increased on comparing with control group. Also it was significant increased in Child A when compared with control group i.e. there was progressive increase in TGF-beta1 with the progression of liver damage. A significant reduction in IL-6 was noted in LC group on comparing with the control group. A non significant reduction in IL-6 was noted in Child A, B and C group on comparing to the control group. In thrombocytosis group a significant increase in TPO, TGF-beta1 and IL-6 levels were noted compared to the control group. Estimation of serum TPO in ITP, liver cirrhosis and reactive thrombocytosis seems to be of benefit in diagnosis and evaluation of megakaryopoiesis state in these platelet disorders. Also estimation of TGF- beta1 can be used as good indicator of liver disease progress. TGF-beta1 was increased in thrombocytosis and this makes highlight to its role in feed back inhibition of megakaryopoiesis. Serum IL-6 was significantly increased in reactive thrombocytosis and this may confirm its role in stimulation of megakaryopoiesis
Subject(s)
Humans , Male , Female , Thrombopoietin/blood , Transforming Growth Factor beta/blood , Interleukin-6/blood , Liver Cirrhosis , Thrombocytosis , Purpura, ThrombocytopenicABSTRACT
In dialysis patients, both atherosclerosis and arteriosclerosis are highly prominent. Fetuin A is a glycoprolein produced predominantly by the liver in adults. Fetuin A is known as the most powerful systemic inhibitor of vascular calcification. To study both carotid and valvular calcification in end-stage renal disease [ESRD] and some of biomarkers including fetuin-A, high sensitivity C-reactive protein [hs-CRP], and interleukin 6 [IL-6]. Subjects and Fifty three patients with [ESRD] aged [31.2 +/- 8.1 years]; 32 patients were men and 21 women, on regular haemodialysis [HD]. They were divided into two groups; 27 of them of less than five years duration on hemodialysis; and 26 of more than five years duration. Compared with seventeen; apparently healthy persons. All studied persons were assessed by: CBC; lipid profile, serum albumin; calcium; phosphate, calculated calcium phosphate product [ca x p], Fetuin-A, hs-CRP, and IL-6, performed by using ELISA kits. Doppler for carotid arteries, and echocardiography to the heart. There were sixteen [30.2%] patients with calcified valves; and 23 [43.4%] calcified carotid arteries. Fetuin-A was significantly reduced [p= 0.002], and no significant difference was detected in both hs-CRP [p=0.400], and IL-6 [p=0.464] between ESRJJ patients and controls. Patients with ESRD on chronic HD treatment are predisposed to morbidity from cardiovascular disease more than healthy persons. Controlling the process of vascular calcification [VC] can help patients with ESRD in limiting these cardiovascular problems. Low fetuin-A is independent risk factor for VC which acts as inhibitory factor for this process