Endoscopic assisted transoral approach with palatal splitting for a giant retropharyngeal schwannoma: a challenging case

Retropharyngeal schwannoma is rare. To the best of our knowledge, only 18 cases have been published in the English literature. Complete surgical excision is the treatment of choice for schwannomas. Transoral approaches have been applied for smaller lesions, and external cervical approaches are preferred for larger and more complex lesions. In this report, we present a case of large retropharyngeal schwannoma that was excised using an endoscopic-assisted transoral approach with palatal splitting. Postoperative functional and oncologic outcomes were satisfactory with no reported intraoperative/postoperative complications.

Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device

Objectives@#To assess the predictive value of the initial uterine artery Doppler indices, the pulsatility index (PI), and resistance index (RI) in the prediction of heavy menstrual bleeding before and after copper intrauterine contraceptive device (IUCD) insertion. @*Methods@#The current prospective clinical study included 100 women who intended to use a copper IUCD (Cu T-380A) and met the inclusion criteria. Uterine artery Doppler PI and RI indices were calculated before IUCD insertion and at three and six months after insertion. Based on the presence or absence of menorrhagia, all women were classified into two groups: non-bleeding (n=52) and extreme menstrual bleeding (n=48). Receiver operating curve analysis was used to determine the predictive value of uterine artery PI and RI in patients with menorrhagia relevant to IUCD. @*Results@#The PI and RI indices displayed a highly significant difference between the IUCD groups at three and six months after insertion (P<0.001). Uterine artery PI ≤2.02 (sensitivity of 95.8%, specificity of 100%, and area below the curve [AUC] of 0.97 at P-value<0.001) and RI ≤0.83 (sensitivity of 93.8%, specificity of 100%, and AUC of 0.949 at P-value<0.001) were correlated with significant menstrual bleeding following insertion of IUCD. @*Conclusion@#The presented results confirmed our assumption that the initial studies of uterine artery Doppler can predict heavy-menstrual bleeding associated with IUCD and therefore, should be conducted in women pursuing reversible longacting contraception.

Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device

Objectives@#To assess the predictive value of the initial uterine artery Doppler indices, the pulsatility index (PI), and resistance index (RI) in the prediction of heavy menstrual bleeding before and after copper intrauterine contraceptive device (IUCD) insertion. @*Methods@#The current prospective clinical study included 100 women who intended to use a copper IUCD (Cu T-380A) and met the inclusion criteria. Uterine artery Doppler PI and RI indices were calculated before IUCD insertion and at three and six months after insertion. Based on the presence or absence of menorrhagia, all women were classified into two groups: non-bleeding (n=52) and extreme menstrual bleeding (n=48). Receiver operating curve analysis was used to determine the predictive value of uterine artery PI and RI in patients with menorrhagia relevant to IUCD. @*Results@#The PI and RI indices displayed a highly significant difference between the IUCD groups at three and six months after insertion (P<0.001). Uterine artery PI ≤2.02 (sensitivity of 95.8%, specificity of 100%, and area below the curve [AUC] of 0.97 at P-value<0.001) and RI ≤0.83 (sensitivity of 93.8%, specificity of 100%, and AUC of 0.949 at P-value<0.001) were correlated with significant menstrual bleeding following insertion of IUCD. @*Conclusion@#The presented results confirmed our assumption that the initial studies of uterine artery Doppler can predict heavy-menstrual bleeding associated with IUCD and therefore, should be conducted in women pursuing reversible longacting contraception.

Are Peripheral Natural Killer Cells and Interleukin-21 Interrelated in Psoriasis Pathogenesis?

No abstract available.

Are Peripheral Natural Killer Cells and Interleukin-21 Interrelated in Psoriasis Pathogenesis?

No abstract available.

level of brain natriuretic peptide in patients with mitral stenosis before and after percutaneous balloon mitral valvuloplasty

The aim is to assess the plasma level of brain natriuretic peptide before and after percutaneous balloon mitral valvuloplasty in patients with mitral stenosis. The brain natriuretic peptide level was measured in 20 patients with rheumatic mitral stenosis and in another 20 age- and gender- matched healthy subjects as a control group. Patients with mitral stenosis underwent percutaneous balloon mitral valvuloplasty. Plasma brain natriuretic peptide level was measured before and after the procedure. The level of brain natriuretic peptide was found to be higher in patients with mitral stenosis [239.5 pg/ml] compared to the control group [15 pg/ml]. The level of brain natriuretic peptide was found to be reduced from 239.5 pg/ml to 162.75 pg/ml after percutaneous balloon mitral valvuloplasty. The level of brain natriuretic peptide was found to be reduced in patients with mitral stenosis after percutaneous balloon mitral valvuloplasty. This reduction was found to be correlated with the reduction in pulmonary artery systolic pressure [r=0.7] and the increase in the mitral valve area [r=0.55]

Prevention of postspinal shivering by using nefopam in comparison with clonidine

Postspinal shivering is a frequent complication following spinal anaesthesia. The aim of this study was to compare the effectiveness of nefopam with clonidine and placebo in the prevention of postspinal shivering. We studied 60 patients undergoing orthopedic surgery. Patients were located to one of three groups. Group A [n = 20] received 0.2mg.kg[-1] nefopam. Group B [n = 20] 1.5 ug.kg[-1] clonidine and group C [n = 20] saline 0.9% as placebo. We found a significant reduction in the incidence of shivering in group A compared to other groups. Both groups A and B showed reduction in the incidence and the seventy of shivering compared to placebo. At 5 minutes postoperatively clonidine treated patients showed a significant decrease in MAP. No haemodynamic or sedative adverse events were observed in the nefopam treated patients. The results of our study showed that nefopam [0.2 mg. kg[-1]] is superior to clonidine [1.5 ug.kg[-1]] in the prophylaxis of postanaesthetic shivering and not accompanied by sedative or haemodynamic side effects

Study of cytokines and postoperative outcome after laparoscopic and open cholecystectomy

To investigate stress response and postoperative outcome in laparoscopic and open cholecystectomy. In addition, to compare between two anesthetic techniques for laparoscopic cholecystectomy as regards serum cytokines changes and postoperative outcome. Thirty patients scheduled for elective cholecystectomy for gall stone disease were classified into 3 equal groups. Group I: underwent open cholecystectomy under halothane anesthesia; Group II : underwent laparoscopic cholecystectomy under halothane anesthesia; Group III : underwent laparoscopic cholecystectomy under isoflurane anesthesia. All patients were subjected to the following : [1] Measurements of IL-6, IL-1 before anesthesia, I hour and 24 hours postoperatively; [2] Recordings the time to eye opening and orientation to persons and place; [3] Evaluation of postoperative pain at 1, 6, 12, 24 h and 48 h postoperatively; [4] Frequency of nausea and vomiting; [5] Length of the hospital stay, IL-6 and IL-I increased significantly in the-three groups at 1 hour postoperatively, then decreased significantly at 24 hours postoperatively. The differences between group I and group II or III was significant, but there was no significant difference between group II and group III. Laparoscopic groups [II and III] were associated with less postoperative pain and narcotic requirements compared with open group [I] while no significant difference between laparoscopic group [II and III]. Nausea and vomiting were encountered more frequent in laparoscopic groups than in open group, but the difference was not significant. Hospital stay was significantly short in laparoscopic group than in open group. Time to eye opening and time to orientation to place and person were significantly short in isoflurane laparoscopic cholecystectomy group than halothane laparoscopic cholecystectomy group. [1] Laparoscopic cholecystectomy is associated with less tissue injury and less stress response as indicated by lower serum levels of IL-6 and IL-1 compared to open cholecystectomy; [2] Laparoscopic cholecystectomy is associated with better postoperative outcome as indicated by less postoperative narcotic requirements and short hospital stay; [3] Apart from early eye opening and early orientation associated with isoflurane anesthesia, it exerts minor influence on postoperative outcome compared to fluthane anesthesia for laparoscopic cholecystectomy

Videoscopic study of adenoids and adenoidectomy

Videoscopic study was applied in this work for 2 main purposes. Firstly, to diagnose the size of adenoids depending on fixed landmark, that is the posterior lip of the torus tubarius. This was done on 230 patients above 3 years old and resulted in classification of adenoids size into 3 degrees. First degree "normal" has its anterior limit behind the posterior lip of the torus. Second degree has its anterior limit in line with the posterior lip of the torus. Third degree has its anterior limit in front of the posterior lip of the torus [high indication of adenoidectomy]. Secondly, to perform adenoidectomy under magnified vision on monitor and this was applied on 86 patients. By this maneuver, trauma to Eustachian tube orifice and posterior nasopharyngeal wall was avoided, any remnants and control bleeding points could be removed. During the period of follow up of 1-3 years, no case developed complications of recurrence, postoperative bleeding and middle ear troubles

Evaluation of laparoscopic trans-abdominal preperitoneal repair of recurrent inguinal hernia

Fifteen adult male patients with recurrent inguinal hernia were treated with laparoscopic transabdominal preperitorteal repair [TAPP]. Controllable intraoperative complications were recorded in 3 patients [20%] with no conversion to open. No major postoperative complications were encountered. The mean operative time was 77.3 minutes. The mean time of ambulation out of the bed was 10.3 hours and the mean hospital stay was 19.8 hours. The mean time to return to usual social activity was 8.5 days. During the short period of follow up [6-24 months] no recurrence was reported. Long term follow up is needed for proper evaluation of this new procedure

Parasitic infestations during pregnancy in Zagazig

In a study of parasitic infestations in [1041] pregnant women in Zagazig, more than half of the cases [553:53.3%] were infested while 182 women [17.48%] were infested with more than one parasite. The detected helminthes were Schistosoma mansoni [129:12.39%]. Schistosoma haematobium [38:3.56%], enterobius vermicularis [167:16.04%] Ascaris lumbricoides [108:10.37%], H. heterophyes [40:3.84%], Hymenolepis nana [14:1.34%], Strongyloides stercora lis [5:0.48%] and Trichuris trichura [1:0.096%]. Protozoa were entamaeba histolytica [103:9.89%]. Giardia lamblia [54:5.19%] while Toxoplasmosis was detected in 17 cases from 45 cascs of abortion. More incidence of bacteriuria [15.37% vs 6.96%], albuminuria [11.21% vs 3.48%] and anaemia [63.47% vs 15.37%] was found in the infested than in the non-infested cases. Also obstetric complications such as abortion [8.5% vs 3.69%], premature labour [3.8% vs 1.43], puerperal sepsis [3.26% vs 0.41] and postpartum haemorrhage [1.08% vs 0.41] were of more incidences in the infested than in the non-infested cases

Retinal vasculitis

This work envolves the study of 34 cases of different fundus conditions associated with angiographically proved vaculitis. An extensive medical evaluation was done for all cases. In 8 cases a definite aetiological diagnosis has been reached e.g., toxoplasmosis. Twenty two cases could be categorized into known clinical enteties although their exact aetiology is still unkown e.g. Behcet's disease. In the remining 4 cases no aetilogical or clinical diagnosis could be reached

Posterior IOL implantation under air

In this work we tried to evaluate the results of posterior IOL implantation using air as cushioning material. The air was used in anterior capsulotomy and lens implantation. To maintain air during capsulotomy, we used an air filled silastic squeeze bulb connected to the cystitome by a plastic tube. To maintain the air during implantation we used a simple anterior chamber maintainer and the air filled silastic bulb. The work involved thirty nine posterior lens implantations. The results has been discussed

Angioid streaks

In this study we have been concerned with illustrating and correlating the different ophthalmoscopic and angiographic presentations of the angioid streaks and the associated fundus lesions, demonstrating the value of fundus fluorescein angiography in detecting the ophthalmoscopically unrecognized cases. In four cases a diagnosis of associated systemic diseases have been established. The successful role of prophylactic photocoagulation treatment in cases of angioid streaks with neovascularization has been confirmed

Idiopathic multifocal retinal arteriolar occlusion

This paper presents a clinical study of four cases showing multiple nasal retinal arterial branch occlusions of unknown cause in healty middle aged patients. All of them were subjected to extensive medical evaluation with negative results. Fundoscopic and fluorographic findings suggested focal arterities rather than embolism or thrombus. These cases may represent a clinical syndrome whose couse is benign from the systemic as well as the ocular point of view All patients retained good visual acuity

Trichostrongylus infection among humans and animals in an agricultural area [El-Sharkia Province]

One thousand individuals and 1100 animals were chosen from the attendants of rural health units and veterinary clinics of Faquos, El-Didamon, El-Beirum, El-Zawya El-Hamra and Mit El-Izz. Stool samples were collected, examined macroscopically, microscopically and stool culture for some positive cases. Percentage of infection among examined patients was 14.8 [males 11.2 -females 20.7]. Percentage of infection was highest with age group 50-60 years [20.0%] and lowest with age group 30-40 years [12.5%]. Percentage of infection among animals was 24.6% [sheep 46.8 - Goats 47.7 - Rabbits 46.0 - Camels 25.8 - cows 12.4 - and Buffaloes 6.8]. Percentage of infection was highest in El-Didamon [20.4 human 31.5 animals] and lowest in El-Zawya El-Hamra [7.2 human - 17.7 animals]. These results indicate that Trichostrongylus infection is an important public health problem and needs more attention