Psychological and audiological profile of tinnitus patients

The interplay of personality traits, depressed mood and tinnitus severity is highly relevant to diagnosis and prognosis in tinnitus related handicap. The aim of this work was to assess a sample of patients with annoying tinnitus audiologically and psychologically to determine whether personality factors differ with different experiences of tinnitus. This study was conducted on forty patients of both sexes complaining of tinnitus. They were assessed audiologically using; Pure tone audiometry [PTA], Transient evoked otoacoustic emission [TEOAE], distortion product otoacoustic emission [DPOAE] and were administered the Tinnitus Handicap Inventory [THI]. Psychological assessment included two self assessment questionnaires: SCID IT Personality test and Middle sex psychological test. TEOAE were abnormal in 9.8% of control group [CG], 29.34% of study group [SG-l] and 58.34% SG-2. DPOAE results were abnormal in 50% CG, 67.6% of SG-l, 89.9% of SG-2 and 92.4% of SG-3. THI scores were not correlated with age, gender, duration or level of hearing loss. Obsession and antisocial personality were significantly related to THI. There was a weak significant negative statistical relationship between Depression and THI. A negative statistical correlation between DPOAE, TEOAE and THI was found. On the SCID-Il Personality test, 30% of the sample [12 persons] completed the criteria for the Narcissistic Personality disorder and also 30% [12 persons] completed the criteria for Borderline Personality Disorder. On the Middle Sex test the most frequent significant symptoms were Depression and obsession, 17.5% of the sample. Given that this is a preliminary study of the psychological profile of Egyptian patients with tinnitus, multicenter research is needed for better understanding of the psychology of those patients

Effect of Artemesia plant on parasite load and morbidity in murine Schistosomiasis mansoni

The efficacy of Artemesia inculta and A. absinthium, on oogram changes, tissue egg load and hepatic granuloma was evaluated in experimental schistosomiasis mansoni. The ethanol extract of each plant was given in a dose of 800mg/kg b.w. to all treated groups at different time intervals 7 week's, post infection [P.I.] and 24 hrs, 7 and 15 days post infection. Their effect was more obvious when the plant extract was given 24 hrs, 7 and 15 days post infection; where the number of dead ova was 15.95 +/- 0.49 [A. inculta] and 15.80 +/- 0.45 [A. absinthium] compared to 12.03 +/- 0.0 and 14.00 +/- 0.42 when both extracts where given respectively 7 week P.I. Concerning the number of ova/gm liver, the percentage reduction was 38.14% and 43.46% when [A. inculta and A. absinthium] extracts were given 24 hrs, 7 and 15 days post infection compared to 5.25% and 12.78% where both extracts were given respectively 7 weeks P.I. Histopathological effect of A. inculta and A. absinthium, on liver 7 weeks P.I. revealed that granulomas were lobular, cellular with mild fibrous tissue and large in size, while when treatment was 24hrs, 7 and 15 days post infection., smaller granulomas, with more fibrous and normal dilated portal veins, liver architecture was noticed. In conclusion the use of repeated doses of Artemesia plants in the early stages of schistosomiasis infection may be of value in overcoming the recent problem of reinfection, they are less castly and more safe than other antibilharzial drugs, with minimal side effects as revealed by the histopathological studies

Susceptibility of giardia lambia to newly introduced synthetic compounds in experimentally infected animals

Therapeutic strategy has included diverse pharmaceutical agents of traditional use such as metronidazole, quinacrine, furazolidone and paramomycin, other drugs of more recent introduction, such as albendazole and nitazoxanide, have also been applied as clinical practice. Of these e.g. metronidazole may be considered the most representative anti-giardial agents of traditional and recent use. However, evidence points to an increasing frequency of cases refractory to treatment with these drugs, the causes of which include non-compliance to treatment and emergence of drug resistant Giardia. The aim of this study is to evaluate the therapeutic effect of four new compounds, 3- / [[2E]-3-[dimethylamino] Prop-2-enoyl/ ] -5, 6-diphenyl- 1, 2, 4-triazin-3 [2H]-one [T1] 3-/ [[2E]-3-[dimethylamino] prop2-enoyl]-2H-chromen-2-one [C1] and 3-[Hexa-2, 4 dienoyl]- 4 hydroxy-1-methyl quinolin-2 [1H]-one [Q1] and N, N-Bis / [2,4-dioxo-1-methyl-1, 2, 3, 4-tetrhydroquinol-3y1] methy1/ ] benzidine [Q2] on the infection with Giardia lamblia. Treatment of Giardiasis 2 weeks post-infection with compound T1, C1, orally administered gave a very highly significant reduction in the number of cysts/gm stool were the percentage reduction rate reported for compound T1 given in a dose of [100 and 60 mg/kg] was 94.3% and 83.8%] respectively. However groups treated with compound C1 given in a dose of [100mg/kg and 60mg/kg] resulted 96.2% and 89.1%. When Q1 and Q2, were administered orally a significant reduction in the number of cysts/gm stool was noticed. Percent reduction reported for compound Q1 given in a dose [80 and 60mg/kg] was 89.6% and 72.6% respectively. Representing a highly significant reduction in number of cysts/ gm stool. Where in the compound Q2 percent reduction of cysts/ gm stool was 80.35%, 68.9% stool. The effect of compounds T1, C1, Q1, Q2 on the vegetative [Trophozoite] forms in the small intestine of sacrificed hamsters was studied. Compound T1 orally administered in a dose [100 mg/kg and 60 mg/kg] gave a highly significant reduction in the number of trophozoites [96.7% and 91.7%]. However compound C1 resulted to a significant reduction in the number of trophozoites [75.2% and 60.2%]. It was found that in treatment with compound Q1 and Q2 [80mg/kg and 60mg/ kg] the former was much more efficient than the later i.e there is a highly significant difference [94.5%, 96.7%] in case of Q1, Q2 at a dose of 80mg/kg, where as groups treated with 60mg/ kg of Q1 and Q2 showed much less reduction in the number of trophozoites. The curative effect of these compounds almost ranks with metronidazole. Histopathological examination, revealed a profound effect on the structure and function of the intestinal mucosa, villous shortening and a trophy, hypercellularity of the lamina propria due to increase in the number of mononuclear, polymorphonuclear and eosinophilic cells with diffuse loss of brush border microvillus surface area

Mini-open blind carpal tunnel release via 1- centimeter transverse incision above the wrist crease versus open release

Carpal tunnel release has become one of the most popular forms of hand surgery with high success rates. However, scar and post-operative morbidity accounts for most of the reported complications due to the presence of rich cutaneous nerves across the palm liable for iatrogenic injury and releasing of the superficial structures to the transverse carpal ligament as the subcutaneous fat palmar fascia, and palmaris brevis muscle. Minimally invasive surgical techniques employing endoscopic instruments or special mini-open techniques aimed at avoiding or minimising surgical scars in the palm, reducing scar morbidity, and post-operative pain, whilst enabling earlier and better functions. Between September 2006 and September 2007, a prospective comparative study evaluating the safety and effectiveness of a mini-open technique for blind [not under direct vision] carpal tunnel release using a 1 centimeter transverse incision proximal to the wrist crease, assisted with a 6 mm kuntscher nail and arthroscopic scissors for releasing the transverse carpal ligament, compared with limited open release. Twelve female patients and three male patients [30 wrists], with bilateral carpal tunnel syndrome aged [32-55 years], clinically and electro-physiologically diagnosed, with failed conservative management, were enrolled in this study. All cases were done under local anesthesia. Right hands underwent mini-open procedure, while the left hands underwent limited open release procedure. Details of the technique, patient satisfaction and outcomes are presented. This study revealed that the patients' right hands [mini-open CTR], have an easier postoperative course in comparison with their left hands [limited OCTR], reporting excellent improvement in symptoms severity, functional and cosmetic status post-operatively with high satisfaction, plus no encountered neurovascular or major complications. This technique is effective, simple and safe and cost effective. It can be used where endo-scopic release is expensive and not widely available

Evaluation of molluscicidal and schistosomicidal activity of two species of Egyptiana Plant in schistosomiasis inansoni

The present study showed that the two plants Artemisia absinthium and Artemisia inculta as cold or boiled water suspensions of their dry powder were nontoxic against Biomphalaria Alexandrina snails. On the other hand, the ethanol extracts of A. absinthium and A. inculta were effective as molluscicides against B. Alexandrina, and the LC9O being 250 ppm and 400 ppm respectively, after 24 hours of exposure. It was observed that these LC9O values killed Schistosoma mansoni ova after 15 minutes of exposure. The free living larval stages of S. mansoni [miracidia and cercariae]. were killed after 30 and 45 minutes of exposure to LC90 of A. obsinthium and A. inculta respectively. The use of A. absimthium and A. inculta ethanol extracts for treatment of murine schistosomiasis mansoni was studied using different doses of 500 mg I kg, 700 mg /kg and 800 mg I kg to investigate the effect of either extract against immature stages, each dose was given as single oral dose 24 hours post infection, then 7 days post infection and lastly 15 days post infection. To study the effect of A. absinthium and A. inculta against adult Schistosorna worms, each dose of the ethanol extracts was given 7 weeks post infection as single oral dose. The percentages of reduction in mean worm burden 9 weeks post infection in animals treated with either A. absinthium or A. inculta, 7 weeks post infection with a single oral dose of 800 mg/kg, were 39.5% and 38.7% respectively. Moreover, the percentage of reduction in mean number of worms 9 weeks post infection reached 77.32% and 74.9%, respectively by using the same dose [800 mg/kg] for three successive treatment schedule, 24 hours, 7 days and 15 days post infection. Also, the mean number of eggs excreted in stool was significantly decreased with the use of both plants for the all designated time intervals. It is concluded that treatment with the ethanol extracts of Artemisia plants showed high efficacy when given early and in repeated doses in murine schistosomiasis mansoni

Single-portal endoscopic versus open carpal tunnel release

Open release of the transverse carpal ligament [TCL] has been the gold standard surgical treatment for patients with carpal tunnel syndrome for the past several decades. However, significant concerns are the transient post-operative [pillar pain] scar tenderness and the length of recovery time. There has been widespread misunderstanding and confusion regarding endoscopic carpal tunnel release [ECTR] owing to different techniques with different complications and efficacy being viewed as one technique. This prospective randomized study was carried out to compare the single-portal ECTR and open carpal tunnel release [OCTR]. Between May 2006 to May 2007 Thirty-one patients with 60 wrists clinically diagnosed and electrophysiologically confirmed idiopathic CTS, and nonresponded to non-operative treatment were assigned to this study. Singleportal ECTR was performed in 16 patients with 30 wrist [14 bilateral CTS patients and 2 cases with right side CTS] and OCTR was performed in 30 wrists [15 bilateral CTS patients]. All cases were available for follow-up at 3 weeks, 3 and 6 months post-operatively. Outcome measures were evaluated such as CTS symptoms improvement, time needed to resume activities of daily living [ADL] and return to work and complications. Early onset of CTS symptoms relief was prevalent in single-portal ECTR group [66.5% within 3 days]. During the first three months post-operatively, patients sustained to the single-portal ECTR procedure were better symptomatically and functionally. Local wound problems in terms of painful scar or palm was reported by 10 wrists [33%] in the OCTR group, whereas non in the single-portal ECTR group, occasional pain with ADL reported in 3 wrists [10%] of the OCTR group. The average time to return to work was appreciably less in the single-portal ECTR [12 days] compared to 25 days in the OCTR group. No significant difference was observed between the two groups as regard to symptoms improvement, electrophysiological studies and complications at the end of six months. In conclusion, Singleportal ECTR is a safe and effective treatment of CTS, was associated with less post-operative pain, more quickly good clinical outcomes and patient satisfaction than OCTR. Hence the small size of the benefit and similarity in other outcomes make its cost effectiveness uncertain

Interposition arthroplasty and reconstruction of the extensor apparatus in severe boutonniere deformity

Injuries of the hand finger joints can often lead to severe functional disability and rapid development of stiff joints. Although; Splinting and arthrodesis have been recommended because of the random results achieved by other reconstructive procedures, atrhrodesis for the young active patients should be reserved for limited causes and other arthroplasty techniques restoring joint mobility should be considered. A technique for interposition arthroplasty of the proximal inter-plalangeal [PIP] joint in sever type boutonniere deformity is described in this current study. It involves minimal resection of intra-articular adhesions and the use of autogenous fascia lata, and reconstruction of the extensor apparatus. Between May 2006 and May 2007 at the Orthopaedic Surgery Department of Mansoura University Hospital, 6 autogenous fascia lata interposition arthroplasties conducted on PIP joints of six patients of chronic post-traumatic sever type [stage III] boutonniere deformity according to Nalebuff and Millender classification [Terrono et al., 1990]. The resulted total active range of motion of the operated PIP joints ranged from 45 to 75 degrees. The restored range of motion constitutes from 42.9% to 71.4% of the normal range of motion of the PIP joint [Hume et al., 1990]. The operated PIP joints were stable and the restored motion was pain-free. All our patients were satisfied with both the functional and cosmetic outcomes. The method is simple, safe, and easily reproducible. In selected cases itcan offer restoration of pain-free active motion

Percutaneous interlocking nailing of tibial shaft fractures: Technique and outcomes

Closed interlocking tibial nailing is a well accepted method of treating tibial fractures. There are advantages to perfoming surgery via smaller incisions. This study provides a method for percutaneous interlocking nailing of tibial shaft fractures intended to improve the technique, functional results and also reduces the problem of anterior knee pain, by avoiding injury to the infrapatellar nerve and/or iatrogenic trauma to, or dissection around, the patellar tendon. The main difference in the technique is the use of a 6 cm-long k-wire fixed temporarily in the anterior cortex of the tibial tuberosity to indicate the midline for medullary canal opening, a small stab incision of an average length of 2.5 cm reaching the tibial cortex midway between the lower pole patella and tibial tuberosity, an invented bone awl for opening the medultary canal at the entry point [sweet spot], inserting an invented graded guide pin into the medullary channel and Slide an invented sleeve over the guide pin till it hits the entry point to check the actual needed nail length through the graded guide pin [depth gauge]. Between March 2004 and March 2007 a prospective trial on 40 patients with unilateral closed tibial diaphyseal fractures was done at the Orthopaedic Surgery Department of Mansoura University Hospital. All were followed up for one year. There were twenty-five men and fifteen women with a mean age of 40 +/- 9 years, two female patients were excluded from the results because of lost follow up with them shortly postoperative. Early perioperative complications, including compartment syndrome, and pulmonary embolism, were checked, but no patients had such complications. Patients began full weight bearing at an average of 14 +/- 4 weeks postoperatively; the median time for fracture healing was 17 +/- 4 weeks, 34% out of our patients experienced different degrees of anterior knee pain, 2.5% grade zero, 7.9% grade 1, 7.9% grade 2 and 15.8% grade 3 according to the Functional Assessment Score [FAS]. At the time of final follow-up, there were 20 excellent, 16 good results, one fair and one poor result according to Johner and Wruh's Criteria [Johner et al., 1983]. This modified technique and devices for percutaneous interlocking tibial nailing provide significant advantages when compared with the standard technique so that the time to union, the functional outcome and incidence of anterior knee pain,are significantly improved

Parasitological, hematological and ultrastructural study of the effect of Cox-2 inhibitor, pyocyanin pigment and praziquantel, on S. mansoni infected mice

The effect of cyclooxygenase-2 [COX-2] inhibitor, such [as meloxicam, and pyocyanin pigment of Pseudomonas aeruginosa] with and without praziquantel [PZQ] on worms, ova count, bone marrow and blood cells in 7 groups of Schistosoma mansoni infected mice was studied. The results revealed significant decrease of worm burden and ova count in all treated groups as compared to the infected untreated group, while those with combined treatment of PZQ and meloxicam or pyocyanin showed complete eradication of the worm with the highest reduction in the tissue egg load. EM showed extensive swelling and vesiculation of the tegument, completely implanted spines that overlie degenerated muscle layer were obvious in groups treated with either meloxicam or pyocyanin. Hematological study revealed significant increase [P < 0.05] of total leucocytic count of PZQ treated group while that treated with either meloxicam or pyocyanin showed significant decrease [P < 0.05], but in combination of PZQ with meloxicam or pyocyanin no significant difference as compared to the infected untreated group. The neutrophil was the main cell affected in groups treated with neither meloxicam nor pyocyanin alone with significant decrease [P < 0.05], but with significant increase [P < 0.05] in combination with PZQ as compared to the infected untreated group. Those treated with PZQ plus meloxicam showed significant increase as compared to that plus pyocyanin. Eosinophil count showed significant decrease [P < 0.05] in all treated groups as compared to the infected untreated group. Inverse correlation between serum level of sFas and peripheral neutrophil count was detected. Ultrastructural study of the bone marrow explained the results as groups treated with meloxicam revealed dissociation between nuclear and cytoplasmic development in the neutophils with cytoplasm maintaining primitive appearance despite maturation of the nucleus that is manifested by the persistent production of immature granules and the still orientation of Golgi cternae and the centriole around the nucleus. Groups treated with pyocyanin pigment revealed many abnormalities in neutophils as hypogranularity or early apoptotic morphology changes as intense pen- nuclear chromatin aggregation or nucleus fragmentation.In peripheral blood apoptotic morphology changes was detected in both groups treated with meloxicam or pyocyanin while most of cells of mice treated with PZQ were in an active state. Consequently, it is preferable to give meloxicam with PZQ for a short period of time [less side-effect] to eradicate S. mansoni worm completely but with continuous observation of the peripheral neutrophil count and function

Post-mortem diagnosis of renal failure

The present study was carried out on 100 Egyptian subjects, aged 17-75 years. They were classified into 4 groups: Group I [n=20] included healthy subjectswith negative history of renal troubles, group II [n=20] included patientswith previous known history of uremia, and the last group included 60 cadaverswhich again divided into group III [n=18] included cadavers without provedrenal pathology, and group IV [n=24] included cadavers with proved renalpathological changes. Randomly collected blood samples from the wholesubjects as well as vitreous samples from both eyes of cadavers were used forthe estimation of urea, creatinine, uric acid, and G- glutamyl transpeptidaseactivities. In addition, wedge-shaped renal slices from both kidneys weretaken from cadavers to assure the diagnosis, and to make if possible acorrelation between the histopathologic findings and the biochemical results

Use of biomembrane in the treatment of class 3 Furcation defect

Eight patients included in this study where two surgical procedures were done for each one who has furcation grade III in both sites. One surgical site is treated by Gore-tex biomembrane that cover the furncated area, and the other site just mucoperiostial flap. Clinical parameters were recorded for evey patient after follow-up time [3and 6 months].The clinical and radiographic satisfactory results of this study clearly show that a good method of treatment aimed at restitution of the attachment apparatus lost in periodontal disease, can be based on the biological principle of guided tissue regeneration. From that we can conclude the followings: The Gore-tex treatment resulted in more tissue growth outside as well as within furcation defects, which cause shallow probing depths in the partially healed furcation defects.-The size and the height of the furcation defect may be determining factors for success or failure following Gore-tex therapy at furcation defects. It seems that the larger and/or higher the detect, the smaller is the change for complete regeneration. Shallow and wide furcation defect has a greater chance for regeneration.-The important factor for the success of Gore-tex therapy at furcation may be the amount of periodontium that remains apical and/or lateral to the defect. That is, the smaller the amount of remaining periodontium, the smaller the amount of new attachement that may form.-from the present study, it could be recommended to use Gore-tex biomembrane in the treatment of shallow wide furcation class III defects

Morphological changes of the irradiated larynx

Twenty patients receiving radical dose of radiotherapy were divided into two groups [A + B]. Fourteen patients receiving radiotherapy for laryngeal cancer of an early stage [group A], and six patients receiving more extensive course in the form of hyperfraction for more advanced cancer larynx [group B]. The changes occurring in the tumor, the non diseased mucosa edema, mucositis, the mucus and clinical symptoms [dysphagia, change of voice] are recorded during and after the course of radiotherapy and compared in the two groups. The comparison has "clearly shown that the incidence of subjective and objective morbidity was much lower in group A than that of group B

Oral manifestations in Arab Down's syndrome children: a collaborative study

Sixty children over 8 years of age verified chromosmally as Down's syndrome constituted group A in this study. There were also sixty normal children of the same age and socioeconomic status who made up group B. Both groups were divided into two subgroups according to nationally: Kuwaiti or non-Kuwaiti. In group A,90% were affected by periodontal diseases, compared to 43.3% in group B; very poor oral hygiene and severe alveolar bone loss were also found in group A

Electron microscopy versus light microscopy as a diagnostic and prognostic tool in sclerema

Rhinoscleroma is a chronic progressive disease that can be accomplished by both light microscope and electron microscope. 30 cases clinically diagnosed as scleroma and had not received medical treatment before, were diagnosed after biopsy by both light and electron microscopy. The results of electron microscopy were more accurate than that of light microscopy, especially in the atrophic cases. After receiving medication, rebiopsy was done to ensure pathological cure. Some cases which were considered cured by light microscopy proved to have active disease by electron microscopy and continued on medical treatment for longer periods

Failure of intramedullary nails

The incidence of broken I.M.N. is increasing, so that a detailed study of this problem must be made, to discus the responsible factors leading to it. Forty patients with broken I.M.N. were reviewed and evaluated to discover the contributing factors. It was proved that there are many factors responsible: As with bad technique, improper nail and the state of healing at the fracture site. All these factors and others were discussed in this study

Free patellar graft reconstruction of femoral or tibial condyle after tumour resection

Free autogenous patellar graft was used to replace femoral or tibial condyle in twelve cases. We followed the sample technique described by Campanacci et al., [1985]. In 8 cases [out of 12], the result was satisfactory. Two cases showed non-union and instability of the knee [unsatisfactory] and two cases ended by amputation due to focal recurrence of osteosarcoma

Treatment of valgus foot by Batchelor-Grice subtalar arthrodesis

Several techniques were used to overcome the problems of the Grice technique in treating valgus foot. We used a combined Batchelor-Grice pocedures to arthrodese 36 valgus foot after poliomyelitis in children. The results were satisfactory in 31 of the 36 feets. The satisfactory results necessitate: good fibular graft, with preservation of the periosteal tube and prolonged immobilization in above knee plaster for 12 weeks