The Effect of Using Bone Marrow Mesenchymal Stem Cells Versus Platelet Rich Plasma on the Healing of Induced Oral Ulcer in Albino Rats

BACKGROUND AND OBJECTIVES: Oral ulceration is one of the most common debilitating condition that affects the oral cavity. In this study, the effect of locally injected platelet rich plasma (PRP) and bone marrow-derived mesenchymal stem cells (BMSCs) on the healing of oral ulcer was investigated. METHODS AND RESULTS: An ulcer was induced in buccal mucosa of rats by using 5mm biopsy punch followed by application of cotton swab soaked with formocresol for 60sec. The ulcer was left untreated in the control group, treated with intralesional injection of PRP, or isolated cultured BMSCs. Data were analyzed clinically, histologically and immunohistologically on day 3, 5, 7 and 10. BMSCs group showed smaller ulcer area throughout the whole experimental period than the other groups with complete resolution of the ulcer on day 10, unlike the control group. However, there was no significant difference with PRP, on day 5, 7 and 10, regarding clinical ulcer size. BMSCs group showed better histological results regarding the rate of epithelial cell migration, the number of inflammatory cells, thickness and organization of collagen fibres and the number of blood vessels, with complete re-epithelization on day 10. BMSCs group showed a greater number of anti-PCNA positive nuclei throughout the whole experimental period than the other groups except on day 5, PRP had higher mean numbers of anti-PCNA positive nuclei in both tissues. CONCLUSIONS: Both PRP and BMSCs accelerate wound healing and enhance the quality of the healing tissue with the latter being slightly more effective and faster.

[Exertional heat stroke: about 4 cases]

Exertional heat stroke is defined as hyperthermia associated with neurological signs related to intense physical activity performed in a hot environment. This is a medical emergency and life-threatening. In this study, we investigated four cases of exertional heat stroke hospitalized at the military hospital in Tunis [Tunisia] to describe the clinical, therapeutic and preventive characteristics and factors favoring this disease. Four young soldiers, 23 to 44 years older, have developed Exertional heat stroke after Intense and prolonged exercise. Exercises were performed in May and June, in high ambient temperature, high humidity and lack of wind. Three soldiers were in battle dress, a backpack and their weapon. Our four subjects had overweight, were not sufficiently trained and were highly motivated. Insufficient hydration and a diet rich in carbohydrates were noted. Upon hospitalization, patients were febrile and had neurological disorders, neuromuscular disorders, rhabdomyolysis and hemoconcentration. The medical care consisted of a rehydration and oxygen

Environmental assessment of surface water quality of the River Nile surrounding the project of the new Assuit barrage and ITS hydropower plant, Egypt

Owing to the great pressure experienced on the developing countries due to increasing of population and widens industrialization; developing countries have to diverse sources of energy to produce electricity, control irrigation systems and transportation means. At the beginning of 2012, the new Assiut barrage and its hydropower plant was initiated in the River Nile at Assiut city in Egypt. The chemistry of physico-chemical parameters and biological characteristics play a discriminative role for assessment of water quality in the vicinity of the hydropower plant area. About 190 water samples were collected around the project in the period of 2012- 2014, for the analysis of physicochemical properties such as pH, TDS, DO, COD, BOD, NO3 in mg/I and temperature in OC and Turbidity [NTU]. Their mean values are 8.09, 206.25, 7.15, 9.80, 5.11, 0.55 mg/l and 23.20 OC and 5.95 NTU respectively. The obtained values were compared with allowable levels stated by WHO and Egyptian laws 48/1982 for the River Nile protection from pollution. The overall water quality index is 75.50 falls in the second class [70- 90] of water quality categorization of good water quality. Biological species of water environment such as zooplankton, benthos and concentration of the heavy metals in fish were assessed in water samples and sediment around the imdustrial area. The study showed that surface water quality is suitable for industrial projects, but meeds some purification for drinking water. Recommendation to protect surface water quality from environmental pollution was suggested

Arthrogryposis, renal tubular dysfunction and cholestasis [ARC] syndrome: a case report

Arthrogryposis, renal tubular dysfunctions and chloestasis [ARC] syndrome is a rare multisystem, usually fatal, autosomal recessive disorder. Awareness of this syndrome is growing with more reported cases over the last three decades. Many previously reported cases with similar association are now labeled as ARC syndrome. Although the genetic mutation is recently recognized, the diagnosis still depends on the clinical findings. Our patient is the first case of ARC syndrome to be reported from Kuwait. To the best of our knowledge this is also the first report of an Egyptian family with two siblings of ARC syndrome

Arthroscopic capsular release in frozen shoulder

In frozen shoulder, the aetiology, pathogenesis, course duration, various treatment measures and the response to these treatment measures are still debatable. In this study arthroscopic capsular release to treat frozen shoulders that were resistant to conservative measures. Fourteen cases of frozen shoulders were included [10 females and 4 males] that underwent arthroscopic capsular release. Their average age was 57 years with an average follow-up of 3.3 years [2 to 5 years]. All patients underwent arthroscopic capsular release with the same postoperative rehabilitation program. Twelve of the 14 cases showed marked improvement of all parameters. The average forward elevation improved from 87° to 150°, external rotation improved from 13° to 47° and internal rotation improved from the buttock to Tb. The average UCLA scoring improved from 17.7 [poor] preoperatively to 32.6 [good] postoperatively. If proper conservative management does not improve cases of frozen shoulder then arthroscopic capsular release is a good option with favorable results in most cases

Fulminating shigella encephalopathy [Ekiri syndrome]: a case report

Neurological manifestation, particularly seizures and encephalopathy, are common in childhood shigellosis. Fulminating shigella encephalopathy [Ekiri syndrome] is a rare form of shigella associated encephalopathy characterized by a rapid, severe and fatal course with few dysenteric symptoms. Brain edema is a common finding in patients presenting with severe shigella encephalopathy. Shiga toxin production is not essential for development of shigella-associated neurological symptoms. Early recognition and proper management of cases of severe shigella encephalopathy may help to improve the outcome. We are reporting the case of a six and half year old male child with severe fulminating shigella-encephalopathy [Ekiri syndrome] who made a partial recovery. Brain magnetic resonance image [MRI] findings of this patient are reported. To the best of our knowledge, brain MRI studies were not reported before in the pediatric population with Ekiri syndrome; moreover, this is probably the first case of Ekiri syndrome to be reported in the Arab population

Post-hysterectomy vesico-vaginal fistula: outcomes of vaginal cuff excision in transabdominal repair

To evaluate the outcome and effectiveness of vaginal cuff excision in transabdominal repair of vesico-vaginal fistulas [VVFs]. Uncontrolled prospective study. Al-Salam Hospital, Sadaah, Republic of Yemen [A tertiary Hospital funded by KSA]. Eleven women suffering from post-hysterectomy VVFs were operated upon during the period from April 2000 to April 2005, at Al-Salam Hospital in Sadaah, Republic of Yemen, using vaginal cuff excision in primary trans-abdominal vesicovaginal fistula repair. During this period, eleven women suffering from posthystrectomy VVFs [non-complex fistulas] for benign conditions [5 after hysterectomy, 3 after supravaginal hysterectomy for ruptured uterus and 3 after vaginal hysterectomy]. Preoperative demographic data and fistula characteristics [size, number and location of the fistula] were gathered. Postoperative review included successful repair and postoperative urinary and sexual dysfunction. The subjects were evaluated at 3 weeks and at 3 months. The outcome was assessed using subjective estimation, gynecologic examination and objectively by instillation of diluted methylene blue dye into the bladder. Five patients [45.5%] suffered VVFs after abdominal hysterectomy for benign conditions, three patients [27.3%] were after supravaginal hysterectomy [for ruptured uterus] and three patients [27.3%] were after vaginal hysterectomy. Seven fistulas [63.6%] measured 1 cm or more but less than 3cm in diameter and were located supra-trigonal, and the remaining four fistulas [36.4%] measured 5 mm or less and were located in the trigonal area without bladder neck involvement. Multiple fistulas were found in two cases [18.1%]. The fistula tract was excised totally and closure of the bladder and vaginal cuff scar excision were achieved in all patients. All patients were cured of their fistulas at their last follow-up. There were no major postoperative complications and no significant or symptomatic vaginal shortening. Mild self-limited gross hematuria occurred in 8 cases [72.7%], superficial wound infection in 1 case [9.1%] and paralytic ileus in 1 case [9.1%]. At 3 months postoperatively, one patient [9.1%] reported urinary urgency and increased frequency, the remaining denied any urinary dysfunction and one out of eleven sexually active patient [9.1%] reported mild deep dyspareunia. vaginal cuff excision in primary transabdominal repair of post-hysterectomy vesicovaginal fistulas is a safe and feasible procedure with excellent outcome and does not appear to cause postoperative irritative voiding symptoms or dyspareunia. Excision of the fistulus tract and vaginal cuff scar enable the surgeon to suture viable tissues in every layer, thereby providing conditions optimal for wound healing

Effects of prolonged use of injectable depot medroxyprogeterone acetate on serum lipid profile

To study the effects of prolonged use of injectable depot medroxyprogesterone acetate on lipid profile Cross sectional study. Four hundred young, healthy, non-smoking and normotensive women of childbearing age [age range 20-35years] were selected for the study. Out of them, 300 [three hundred] women were the study group who were taking injectable hormonal contraceptive, DMPA [depot medroxyprogesterone acetate] 150mg as a twelve-weekly intramuscular injection for 3-5 years uninterruptedly, and 100 [one hundred]women without hormonal contraceptive were the control group. Fasting serum levels of total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C] and high-density lipoprotein cholesterol [HDL-C] were measured for the subjects of the study and control groups. The mean serum total cholesterol, mean serum triglycerides and mean serum LDL-C levels of the DMPA users were significantly elevated [P < 0.05] in comparison to that of the non-users. Whereas the mean serum HDL-C level was significantly decreased [P < 0.05] in DMPA users as compared to that of the non-users. Prolonged use of DMPA adversely affects serum lipid profile. Since low HDL-C level and high LDL-C level are independent risk factors for the development of atherosclerosis and cardiovascular disease, one might hesitate advocating long term use of the injectable DMPA

Anterior cruciate ligament reconstruction using quadiple hamstring graft

This study evaluated the graft as regards its stability and donor site morbidity as compared with the results mentioned in literature of bone patellar tendon bone [BPTB] graft. Twenty-seven patients had quadruple hamstring anterior cruciate ligament [ACL] reconstructions following the study protocol were included in the study. Twenty-four patients were available for the final follow up [minimum of 27 months]. They were evaluated using Lysholm score, international Knee Documentation Committee [IKDC], Lachman test, anterior drawer test, pivot-shift test and KT-1000. The average Lysholm score improved from 66-89.2 points and the final average IKDC was severely abnormal in two cases, abnormal in two cases, nearly normal in eleven cases and normal in nine cases. Anterior drawer test and KT-1000 were improved. Of the 24 ACL reconstructions, 4 failed. One of these reconstructions failed from new later injury, one from technical error and two from patient non-adherence to rehabilitation protocol. An anterior knee pain was present in seven patients [comparable with the opposite side] and four experienced some numbness over the hamstring graft site that did not interfere with athletic activity

Subchondral drilling for stages [I] and [I I] of osteochondritis dessicans of the dome of the talus under arthroscopic guidance

Purpose: Reviewing the clinical and radiological results of subchondral drilling aiming at revisualization and new bone formation in the early stages of osteochondritis dissicans of the dome of the talus. Consecutive sample. Over a 2.2- year period, subchondral drilling under arthroscopic guidance in stages I and II of osteochondral lesions of the dome of the talus was performed for 9 cases with at least 26 months of follow-up. They were 5 males and 4 females. Their average age at the time of surgery was 32 years [19 to 43]. The average follow-up was 2.6 years. Six had the lesion at the lateral aspect of the talus, while 3 were at the medial aspect. In 5 cases the pain and limping disappeared with regaining of the full range of motion together with no feeling of insecurity [instability] in the ankle. Recurrent effusion, though much less, persisted over another 6 months after disappearance of pain. In 3 cases pain was reduced and limping improved with little improvement in the range of motion, but with persistence of the sense of insecurity in the ankle and with recurrent effusion. The pain-free walking distance was more than doubled in the 3 cases. One patient complained of persistence of pain, limping and recurrent effusion together with additional occasional catching feeling in the ankle. On MRI examination she had loosening of the fragment. This case was treated by arthroscopic removal of the loose fragment with mild improvement in symptoms. Improvement can be expected through drilling of the subchondral bone in symptomatic stage I and II osteochondral lesions of the dome of the talus under arthroscopic guidance, but long-term success of this line of treatment has yet to be determined

Arthroscopic meniscal repair using vertical sutures: a simple, safe and efficient procedure

Reviewing the clinical results of meniscal repair using modified outside-in meniscal suturing technique and reporting on the safety and efficacy of this technique. Retrospective, consecutive sample. Over a 2.5-year period, medial meniscal repairs were performed using No 1 PDS II sutures. All patients underwent meniscal repair with at least 37 months of follow-up. Thirty four patients had a meniscal repair performed and 29 were available for final follow-up. The average age at surgery was 27 years. There were 22 male and 7 female patients. Sixteen patients had an anterior cruciate ligament [ACL] reconstruction with the meniscal repair and 13 repairs were performed in ACL stable knees. The average follow-up was 42 months. The average Lysholm knee scores for ACL-intact and ACL-deficient knees that underwent ACL reconstruction, improved from 47and 35, respectively, to 91 and 96 postoperatively. Tegner activity scores improved from 2.7and 0 respectively, to 7.4 and 4.5 after surgery. There were no surgical complications, no infections, and no neurovascular injuries. One patient had mild subcutaneous irritation caused by the No 1 PDS II knot, which was managed by removing the subcutaneous knot 6 months postoperatively. There were 2 failures [7%] that required later arthroscopy and partial meniscectomy. One failure was in an ACL-deficient knee, and the other was in an ACL-reconstructed knee. Although the data presented in this report are based on mid-term clinical follow-up, the results of the modified outside in meniscal suturing repair technique are extremely good and comparable with the results present in literature. It is also a cheap, efficient and a relatively safe method

Abrasion and intrameniscal needling for meniscal partial tears during arthroscopicaly assisted ACL reconstruction

This study included a retrospective review of 26 patients with stable longitudinal partial medial meniscal tears who were treated with parameniscal synovial abrasion and intrameniscal needling using 18 gage spinal needle at the time of anterior cruciate ligament reconstruction. The morphology of the meniscal tears was 24 single longitudinal tears and 2 double longitudinal tears. Twenty-one tears were located in the posterior third of the meniscus, while five were present in the middle third. The distance between the tear and the meniscocapsular junction [rim width] was 3 mm in 22 tears and >3 mm in 4. In this study, failure was defined as symptomatic medial meniscal tear requiring subsequent arthroscopic management. The overall failure rate at an average follow up of 2.45 years was 11.54%. The median time to failure was 8.85 months, with one of the failures occurring secondary to a significant re-injury

Adequacy of ventilation during anesthesia using a cuffed oropharyngeal air way or laryngeal mask air way

A study conducted on 50 patients scheduled for elective minor operations under general anaesthesia. The 50 patients were classified into two groups COPA and LMA groups. For induction, propofol 3mg/kg was given IV preceded by 3-5 minute, of preoxygenation by 100% oxygen then LMA or COPA was inserted and anaesthesia was maintained with nitrous oxide in oxygen 60%-40% and isolfurane 2-3%. The study showed that the insertion success rate was higher in LMA than COPA. In COPA group the incidence of airway obstruction was higher than the LMA group. In both groups, there was no significant change in HR and there was significant decreases in MAP on comparing the preinduction mean value, with the mean value after induction, during placement and during surgical incision. Patients in LMA group showed better arterial oxygen saturation, lower values of carbon dioxide tension and end-tidal carbon dioxide tension compared with patients in COPA group. Although values in both groups were within normal range. There was higher incidence of blood on the cuff of LMA after removal of the device and more frequent post-operative sore throat than in COPA group. We concluded that both devices can be used to establish a safe and effective airway for spontaneously breathing anaesthetized adults

Correlative study of fungal infections in peptic ulcer disease before and after treatment

25 patients were involved in this study, which showed the presence of fungal growth in 6 patients with duodenal ulcer before treatment. This number was reduced to 3 patients after treatment with H2-receptor blockers. Only one patient was negative before to turn positive after treatment. All positive cases with fungal growth proved to be yeast and among this Candida albicans was the most frequent. It was concluded from this study that the presence of fungal growth in patients with peptic ulcer disease was not related to the use of H2-Receptor blockers and that the healing rate and healing time were not affected by the presence of such growth