A rare complication of hemolacria after Le fort I osteotomy: a case presentation / 대한악안면성형재건외과학회지

Background@#Nasolacrimal duct obstruction (NDO) is a common pathology preventing the proper drainage of the tears, and its main symptom is epiphora. Secondary acquired nasolacrimal duct obstruction (SANDO) can be due to a variety of causes including infection, trauma, or neoplasms. It has been reported to occur with different forms of maxillofacial trauma, especially Le Fort II, Le Fort III, naso-orbital-ethmoidal, and orbital floor fractures.Case presentationA 20-year-old Egyptian female presented to correct a facial disharmony due to a cleft lip and palate defect. The patient reported a history of congenital NDO and had deficient lateral nasal walls. Bimaxillary surgery was planned, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split osteotomy for the mandible. The surgery was uneventful, but the patient complained from bloody tears or hemolacria few days postoperatively. This complication began to cease spontaneously after 2 days and completely recovered after 4 days. @*Conclusion@#Hemolacria is an infrequent finding after maxillofacial surgeries and may be associated with CLP surgeries more than other surgeries. In this case, it was easily managed, and surgeons should be more aware of it to try to prevent its occurrence.

Thyroglossal duct cyst imaging: thyroid scintigraphy versus ultrasound

The two imaging modalities most frequently used in thyroglossal duct cyst [TDC] are thyroid scintigraphy and ultrasound. The imaging is mainly used to exclude the cyst from being the only functioning ectopic thyroid tissue. The main objective of this study is to compare the results of scintigraphy and ultrasound. A total of 56 patients referred to the National Cancer Institute [NCI], University of Gezira in the period from Jan 2007 to Dec 2009 were included in this study, 30 females and 26 males patients; with median of 12.5 years. Data were analyzed by SPSS software. Both thyroid scintigraphy and ultrasound reached the same imaging findings i.e. 53 patients with TDC and 3 patients with ectopic thyroid tissues. The Fisher exact test revealed no significant difference between the two modalities final results [P- value = 1]. In addition, Pearson correlation showed complete correlation between the final ultrasound and scintigraphy results [R2 = 1, P-value < 0.0001]. Furthermore, ultrasound has provided detailed cyst characterization. Both modalities revealed almost identical results. Ultrasound has the additional advantages of being non-ionizing radiation and accurately localizes and characterizes the TDC

Hair mercury measurement in Egyptian autistic children

A review of medical literature has shown that exposure to mercury, whether organic or inorganic, can give rise to the symptoms and traits defining or commonly found in autism spectrum disorders [ASD]. Mercury can cause impairments in social interaction, communication difficulties, and repetitive and stereotyped patterns of behavior, which comprise the three DSM-IV diagnostic criteria of autism. The aim of this work was to measure the concentration of total mercury trace elements in the hair of some Egyptian autistic children and to correlate these levels with severity of the disease. Thirty- two patients diagnosed by DSM-IV-TR criteria [diagnostic and statistical manual of mental disorders, 4th edition criteria, text revised] were subjected to hair mercury measurement using Atomic Absorption Spectrometry [AAS] and were compared to hair mercury measurement of fifteen, age and sex matched healthy children. Results revealed a highly significant increase in the mean hair mercury level in autistic patients than the control group [0.79 +/- 0.51 vs 0.12 +/- 0.086 ppm] respectively, [P < 0.001]. There was a significant increase of mercury level in autistic children who received routine and additional vaccines, and there was mild yet not significant increase in mercury level in patients with maternal history of dental amalgam and high fish consumption during pregnancy and also in autistic children whose mother received anti-D. There was a higher concentration of mercury levels in the hair of children with autism as compared to the age and sex matched healthy controls. Hair analysis is of potential usefulness for determination of mercury level and offering a chance for intervention to treat by chelation therapy

Agave angustifolia: a potential source of control agents against Schistosomiasis mansoni

A gave angustifolia [Agavaceae] has been studied for its potential effectiveness against Schistosoma mansoni and its intermediate snail host in Egypt Biomphalaria alexandrina. Thus, the methanolic extract of its leaves and the isolated saponins containing fraction were tested in vitro against the adult worms and the free living larval stages of the parasite. Both solutions were examined also on the survivorship of mature snails, egg production and hatchability. The results showed that the methanol extract of the leaves of Agave angustifolia had moderate molluscicidal effectiveness on B. alexandrina snails with LC50 =26.4 ppm after 24 hours at 25 +/- 1[0]C. While, the saponins containing fraction separated from the above extract showed much higher molluscicidal activity at the same conditions [LC50=5.9ppm]. Continuous exposure for 5 weeks to half the molluscicidal concentration [3ppm], showed a considerable effect on the survivorship of snails, and a decrease of egg production rate, being 16.9 eggs/snail vs 29 eggs/snail in control group. The egg masses of treated snails contain 20% less number of eggs/ egg mass than those of the control group and the total number of produced eggs is 52% less as a result of this exposure. Three different concentrations of the saponins fraction [the molluscicidal 0.1 LC50, 0.5 LLC50 and LC50] were tested on hatchability of B. alexandrina eggs and showed a sound reduction in hatchability being 56%, 77% and 82% respectively, compared to the control one [92%]. Saponins fraction of A. angustifolia leaves gave also marked miracidicidal and cercaricidal activities especially at the molluscicidal LC50 [5.9ppm] causing total death of these organisms after seven minutes and one minute, respectively. From this study, both methanol extract and saponins fraction of A. angustifolia leaves have in vitro marked schistosomicidal activity against S. mansoni adult worms with LC50 30 micro g/ml and 11.4 micro g/ ml respectively. Therefore, A. angustifolia may provide a potential source of effective compounds for the control of Schistosomiasis mansoni

Nitric oxide synthasis implication in indomethacin induced gastric mucosal lesion in albino rats: Immunohistochemical study

Eighty adult male albino rats weighing from 150-250 gm. were used in this study. They were divided into four groups: Group I [control group]: eight rats given distilled water 35 mg/kg subcutaneously. Group II [Indomethacin treated group]: twenty-four rats received indomethacin subcutaneously as a single dose of 35-mg/kg body. Group III [Indomethacin and L-NAME treated rats]: twenty-four rats received L-NAME [NG -nitro-L-arginine methyl ester] intraperitoneally at a dose of 50 mg/kg half an hour before giving the indomethacin intake. Group IV [Indomethacin and L-N treated rats]: twenty-four rats were given L-NIL [N6-[iminoethyl]-L-lysin] intraperitoneally at a dose of 3 mg/k half an hour before giving the indomethacin injection. At the assigned time [after 6, 24 48 and 72 hours], the animals were sacrificed. The stomach was removed. The specimens were processed for paraffin sections at 4 microns and stained by immunohistochemical staining for eNOS and iNOS. Immunohistochemically stained sections were submitted for the image analysis to detect the optical densities of immunoreactivity of eNOS and iNOS in the specimens of studied groups. Immunohistochemically-stained sections with eNOS of the control group revealed the presence of immunoreactivity in the form of brown deposits of variable intensities in blood vessels of the lamina propria and in the deep half of the gastric glands. Immunohistochemically-stained sections with iNOS of the control group revealed immunoreactivity mainly in the cells of the lamina propria and in cells of gastric glands especially at the bases of the glands. Expression of iNOS was less prominent than with eNOS in normal gastric mucosa. In indomethacin-administration rats immunohistochemically-stained sections with eNOS revealed that the level of expression of eNOS was significantly increased after ulcer induction reaching its maximum level at 24 hours then, declined then, started to increase again on the 72 hours group. Immunohistochemically-stained sections with iNOS revealed that there was increase in the level of expression of iNOS reaching its maximum on the 72 hours group. Expression of both iNOS and eNOS was significantly high on the third day Statistical results revealed that expression of iNOS was more than eNOS. In indomethacin and LNAME treated rats, immunohistochemically-stained sections with eNOS revealed decrease in eNOS immunoreactivity from 6 hours until 72 hours reaching its minimum level on the third day. It was also observed that expression of eNOS was less than that in indomethacin only administration group on the 24 and 72 hours but higher than the control. Immunohistochemically-stained sections with iNOS revealed increase in iNOS immunoreactivity from 6 hours until 72 hours reaching its maximum level on the third day. Expression of iNOS was more than that in indomethacin given group or control group. It was observed that iNOS immunoreactivity was higher than eNOS immunoreactivity in this group. In indomethacin and L NIL treated rats, immunohistochemically-stained sections with eNOS revealed increase in eNOS immunoreactivity reaching its maximum level on 48 hours and 72 hours as compared with animals received indomethacin only or received indomethacin and L-NAME Immunohistochemically-stained sections with iNOS revealed decrease in iNOS immunoreactivity reaching its minimum level on the third day as compared with indomethacin and L-NAME given group but higher than the control group, also expression of iNOS was more in 6, 24, 48 hours groups but less in 72 hours group as compared with indomethacin only given group. The eNOS immunoreactivity was higher than iNOS immunoreactivity in this group. The present data suggested that eNOS-derived NO is the most important in terms of affects on the healing process, most likely through its effects on angiogenesis. It could be concluded that inhibition of NOS could have either beneficial or deleterious effects on gastric injury, depending on which isoforrn is being inhibited

role of Nitric Oxide synthases inhibitors in indomethacin induced gastric mucosal lesion in albino rat

The present work was undertaken to explore the role of nitric oxide synthases [NOSs] inhibitors L-NAME [non-selective constitutive NOS and inducible NOS inhibitor] and L-NIL [selective inducible NOS inhibitor] in the pathogenesis of indomethacin induced gastric mucosal lesions in the early stage of ulcer development and healing [0-3 days]. Eighty adult male albino rats weighing from 150-250 gm. were used in this study. They were divided into four groups: Group I [control group]: eight rats given distilled water 35 mg/kg subcutaneously. Group II [Indomethacin treated group]: twenty-four rats received indomethacin subcutaneously as a single dose of 35-mg/kg body. Group III [Indomethacin and L-NAME treated rats]: twenty-four rats received L-Name [NG initro-L-arginine methyl ester] intraperitoneally at a dose of 50 mg/kg half an hour before giving the indomethacin Group IV [Indomethacin and L-NIL treated rats]: twenty-four rats were given L-NIL [N6- [iminoethyl]-L-lysine] intraperitoneally at a dose of 3 mg/kg half an hour before giving the indomethacin. At the assigned time [after 6 hours, 24 hours, 48 hours and 72 hours] the animals were sacrificed. The stomach was removed and dissected along the greater curvature. The macroscopic lesions in obtained specimens were assessed by magnifying lens and dissecting microscope The numerical data obtained from macroscopic studies of stomach sections were statistically analyzed to obtain the mean ulcer index. The specimens were processed for paraffin sections at 6 microns and stained by haematoxylin and eosin stain; and examined histologically. In the control group, macroscopic and histological examination revealed normal appearance of the gastric mucosa. In indomethacin-administrated group, macroscopic and histological examination revealed time-dependent occurrence of damage in the stomach from 6 hours up to 72 hours reaching maximum damage at 72 hours. After 72 hours, there was evidence of healing process. In indomethacin and L-NAME administrated group, it was observed that pre-treatment with L-NAME significantly enhanced gastric mucosal lesions induced by indomethacin. Macroscopic and histologieal examination revealed significant increase in the mean ulcer index in the mucosa of the stomach as compared with indomethacin only given rats reaching its maximum effect on the third day. No or little evidence of regenerating epithelium on the third day was observed. In indomethacin and L-NIL administrated group, it was observed that pre-treatment with L-NIL significantly reduced but not prevented gastric mucosal lesions induced by indomethacin. Macroscopic and histological examination revealed time-dependent occurrence of damage in the stomach from 6 hours up to 48 hours reaching maximum damage at 48 hours then ulcer index began to decrease on 72 hours. There was decrease in the mean ulcer index as compared with rats given either indomethacin and L-NAME or indomethacin only. Evidence of healing was observed in 48 hours and 72 hours groups. The results of the present study confirmed the importance of NOS inhibitors in the modulation of gastric ulcer healing in early stage of ulcer development [0-3] days. The present data suggested that eNOS-derived NO is the most important in terms of effects on the healing process, most likely through its effects on angiogenesis

Characterization of hepatitis b among incidentally detected asymptomatic hepatitis b surface antigen [HBSAG] positive subjects in Egypt

Background: Although chronic hepatitis B virus infections are common in Egypt, the incidentally discovered asymptomatic forms are very frequent. Their serological profile and clinical significance have not been determined

Aim: to characterize the clinical, serological and histological liver damage among incidentally detected asymptomatic hepatitis B surface antigen [HBsAg]-positive subjects [IDAHS] in Egypt

Methods: we prospectively studied 70 consecutive IDAHS patients who were long term HBsAg carriers. Tests for liver function, serological markers for HBV, HCV, HDV and schistosomiasis were done for all patients. HBV DNA was determined by the branched DNA technique and PCR at the core promotor/precore region and the S region. Liver biopsy specimens from 44 patients were studied and scored for activity and fibrosis stage by modified Knodell score and the METAVIR score. HBsAg and HBcAg were immunohistochemically evaluated in the liver tissue

Results: of the studied 70 patients, 57 [81.6%] were HBeAg negative and 13 [18.4%] were HBeAg positive. There was statistically significantly elevated hepatic transaminases in HBeAg-positive patients when compared to HBeAg-negative patients. HBV DNA was detected in only 3% of patients by the b-DNA technique and in 97% by the PCR techniques. Coinfection with HDV was found in 4.2% of patients. Pathological examination of liver tissue revealed mild activity in 21 [47.7%] of patients. Also, 21 patients [47.7%] revealed mild to moderate expansion of portal areas while 7 patients [15.9%] showed bridging fibrosis and no patient was cirrhotic

Conclusion: among 1DAHS sub jects, the majority are HBeAg negative without elevation of hepatic transaminases. They should be considered patients since viremia is detected in almost all cases using PCR technique, and histopathological evidence of chronic hepatitis B virus infection and liver damage is noted in varying degrees

effects of lobarotory Hepatozoon gracilis infection on the fecundity, mortality and longevity of Culex [Culex] pipiens hinneans [Diptera: Culicidae] in Egypt

Laboratory observations on the effect of Hepatozoon gracilis on the egg production of the mosquito Cx. [Cx.] pipiens Linnaeus under laboratory conditions revealed that H. Gracilis infected mosquitos produced significantly fewer eggs than the uninfected ones. The egg production decreased as the parasite burdens increased. The reduction in blood meal size in infected females did not reduce fecundity. No size difference was detected between oocyst-infected and uninfected females, although sporozoite positive females were significantly large. The preoviposition period was significantly affected, while the incubation period and percentage of egg hatching showed no significant changes. The longevity of female infected mosquitos decreased insignificantly than in the uninfected ones

Complexing behaviour of naphthylidene sulfamethazine schiff base ligand towards some metal ions

Mn [II], Co [II], Ni [II] and Cu [II] complexes of the Schiff base derived from 2-hydroxy-1-naphthaldehyde and sulfamethazine were prepared by both chemical and electrochemical methods. The structure of the complexes was investigated by chemical microanalysis, conductance and magnetic moment measurements as well as spectral methods. The results indicated that the Schiff base ligand behaved as tetradentate dibasic for 1:2 [L:M] complexes and bidentate monobasic for 1:1 and 2:1 [L:M] complexes. The thermal behavior of the complexes was studied using TGA and DTA. The energy of activation [Ea] for the decomposition process was calculated. The values of Ea of binuclear complexes were higher than those of the mononuclear complexes. For the 1:1 complexes, Ea increased as the ionic radii of metal ion increased

Physiological responses in nutrient solution treated phaseolus vulgaris plants grown on calcareous soil

The results of this work showed that the observed responses of plant growth and some related physiological aspects were dependent on [1] the concentration of CaCO 3 in soil, [2] the organ of the plant. Thus, the results of this work could be summarized as follows: - 1. The growth criteria of shoot [length, dry weight, area of fully expanded leaf and the total leaf area] were highly significantly decreased in response to the high levels of CaCO 3 treatments [40, 60 and 80 percent] during the plant growth. 2. Soil application of different levels of CaCO 3 induced appreciable decrease in total auxins, gibberellins and cytokinins and caused accumulation of abscisic acid. 3. The different levels of CaCO 3 induced different decreases in chlorophyll a, chlorophyll b, and total pigments with respect to the recorded values for control. Also, the results showed that the high concentration of CaCO 3 [60, 80 percent] highly significantly increased the carotenoids content while the lower levels of CaCO 3 [10, 20 and 40 percent] non-significantly affected such photosynthetic pigment. The results also showed a reduction in 14CO2-photo-assimilation in response to the different levels of CaCO3, the magnitude of reduction in the soluble, insoluble, total photosynthates and soluble/insoluble ratio photosynthates was more pronounced with the increase in the concentration of CaCO3 4. It has found that uptake and transport of Ca [++], Na [+] and K [+] ions under soil application of CaCO 3 are closely related to the individual parts of Phaseolus vulgaris plants

Plant growth, metabolism and adaptation of glycine max and phaseolus vulgaris subjected to anaerobic conditions and drought

The present study was to investigate further the effects of water stress whether induced by water regime or excessive water supply on growth, yield and metabolism of three, leguminous plants [Phaseolus vulgaris cv. Giza 3, Phaseolus vulgaris cv. Contender and Glycine max cv. Crowford] to observe differences, in growth and metabolism, if any among these three plants of commercial interest in Egypt. The induction of water stress was applied in the form of four different water treatments; two of them were drought treatments [water withholding] where the two other treatments were anaerobic water stress [excessive water supply]. Except for the stimulation effect which was elected in growth criteria of soybean plants [shoot length, number of leaves, fresh and dry weights and mean leaf area of the fully expanded leaves] at the flowering stage in response to the excessive water supply, water withholding [at two levels] and excessive water supply [at the higher level] treatments reduced these growth criteria of the three tested plants during the experimental stage. On the other hand, the low level of excessive water supply [wet treatment] stimulates the growth criteria of the tested plants. Treatment of the three bean plants with various water levels led to marked changes in the total amounts and in the relative composition of carbohydrate and nitrogen contents in shoots and in the yielded seeds. Furthermore, a highly significant decrease in oil content of soybean seeds under the dry treatment was obtained whereas a reversible situation was apparent in seeds of wet treated plants. In seeds of both P. vulgaris plants, a significant decrease in oil content was induced under wet treatment in relation to control values; both plants did not survive to the yield stage under dry treatment Marked changes were also obtained for the constituent saturated and unsaturated fatty acids in the yield of seeds. In soybean seeds, the dry treatment increased the saturated fatty acids and decreased the unsaturated fatty acids, whereas an opposite results were observed in seeds of wet-treated plants. Also in seeds of both cultivars of P. vulgaris, the increase in saturated fatty acids was accompanied by a decrease in unsaturated ones under wet treatment. In relation to control levels, water stress appeared to induce marked qualitative and quantitative changes in the types of protein produced by the legume plants. These changes appeared to substantiate the conclusion arrived at from the other results that soybean plants can be considered as being more tolerant to water stress than both cultivars of P. vulgaris used

Electrochemical behaviour of some arylidene derivatives of carbohydrazide at mercury electrode in aqueous ethanolic buffer solutions

The electrochemical behavior of some arylidene derivatives of carbohydrazides was investigated by dc-polarography, de-polarography, cyclic voltammetry, and controlled potential coulometry techniques, at a mercury electrode in 50% ethanolic Britton-Robinson buffer solutions of pH 2-10. In acidic media [pH <4], the reduction occurs along a single irreversible 8-electron wave corresponding to the cleavage of the 2 N-N bonds and saturation of the 2 C=N centers, while at 6 /7] the total limiting current decreases on increasing the pH, this decrease is accompanied with the formation of a polarographic minimum till the wave disappears completely at pH's >10. The kinetic parameters, nature of the waves, the effect of pH on the limiting current and half-wave potentials as well as the reduction mechanism are discussed

characterization of chemical and electrochemical synthesis of some metal chelates derived from ethyl benzoylacetate hydrazide

Coordination compounds of some transition metal ions with the hydrazide derivative of ethyl benzoyl acetate were synthesized by both chemical and electrochemical techniques. Their structures were elucidated by elemental analysis, molar conductance, magnetic susceptibility [at 25 degree] and spectral [IR, UV-vis, esr] studies. The IR spectra showed that the ligand reacted mostly in the enol form except for the complex derived from hydrated Cu [II] sulfate. The thermal stability of the complexes was investigated by differential thermal analysis [DTA]

Role of Helicobacter pylori in the genesis of gastric ulcerations among smokers and nonsmokers

Helicobacter pylori infection was investigated by three different methods [serologically, microbiologically and biochemically] in 210 male patients aged 20-40 years. Gastric ulcers were diagnosed in 126 patients in which H. pylori infection showed a significant association X[2] = 162.8]. Smokers had a higher rate of infection than nonsmokers, both among patients with gastric ulcers [99% compared to 79%] and without. The risk of H. pylori infection was computed for different categories of smoker. Heavy cigarette smokers were found to have the highest risk, followed by moderate to mild cigarette smokers and communal shisha smokers; neither private shisha nor cigar/pipe smokers showed any significant risk

electrochemical formation of nitrosonaphthol complexes I. Spectral, magnetic and thermal studies of Fe [II], Co [II], Ni [II], Cu [II] and Cd [II] complexes

Electrochemical and chemical reaction of alpha-nitroso-beta-naphthol [HL] with some transition metals gave complexes of the type ML2nH2O and MLCl[H2O]nH2O. The mixed ligand adduct [CuL2L]2H2O was also prepared, where L=1,10-phenanthroline. The complexes have been characterized by elemental analyses and differential thermal analysis [DTA]. The thermal stability of the investigated complexes is discussed in terms of the type of metal ions and structure of the complexes. The energy of activation of the thermal decomposition is determined. The bonding of the complexes is confirmed IR spectra while, the electronic and ESR-spectra as well as magnetic measurements indicated the arrangement of the ligand groups around the central metal ions

Sacrococcygeal tumours: an unsolved problem

Sacrococcygeal tumors are rare and remain a difficult management problem. The present study was conducted to assess the results of treatment of five consecutive cases, one with schwannoma, one with malignant mesenchymoma and three with chordoma. Four patients were males [80%] and one female [20%]. The mean age was 48.2 years. Two patients had local tumor resection and two others had radical excision with sacrococcygectomy at S2 level. Three of these four patients received adjuvant radiotherapy. The fifth patient received palliative radiotherapy only. No operative deaths were encountered. Limited postoperative morbidity and excellent preservation of neurological function, including sphincter control, was achieved in three of the five patients. Local recurrence occurred in only one patient [schwannoma] and was cured with re-excision. Distant metastases were encountered in two patients [40%] and the 2-year disease-free survival rate was 60%. Based on these data, it may be concluded that radical surgical excision with adjuvant radiotherapy may achieve cure of patients with sacrococcygeal tumors

Synthesis and characterization of Pd [II] and Ru [III] complexes with arylidene derivatives of picolinic, nicotinic and isonicotinic acids hydrazides

The complexes of Pd [II] and Ru [III] with arylidene derivatives of picolinic, nicotinic and isonicotinic hydrazides were prepared and characterized by elemental analysis, TGA, DTA, IR, electronic, ESR spectra as well as magnetic measurements. In the light of the results it was concluded that the palladium complexes are of square planar configuration, while the ruthenium complexes exhibit low spin octahedral geometry

Evaluation of suspected clinical cases of acute appendicitis: a prospective study of 72 patients

The accurate clinical diagnosis of acute appendicitis is difficult, and many techniques have been suggested to improve diagnostic accuracy. In this study serial total leucocyte counts, C-reactive protein [CRP] concentrations, st and ard ultrasound [US] machine and plain abdominal X-ray were performed. The sensitivity and specificity of serial leucocyte counts in acute appendicitis were 92 and 100%, and for CRP concentrations 69 and 75%, respectively. US was superior to plain X-ray with a sensitivity and specificity of 89 and 96%, respectively, as compared with plain X-ray with 48 and 93%, respectively. The negative appendicectomy rate was 8%. It is suggested that in patient with equivocal clinical findings, clinical observation, combined with serial leucocyte counts may improve decision making. In the alternative diagnosis, plain X-ray was superior to US due to the prevalence of intestinal diseases, ureteric calculi and basal pneumonia which were best shown in plain X-ray. US was, however, most useful in detecting female pelvic pathology. It is prudent to perform both ultrasound and plain abdominal X-ray, while the patient is in the Radiodiagnostic Department