Surgical correction of alar collapse with alar batten graft: technique and results

Background: nasal valve collapse has great perception of nasal obstruction. The alar batten graft technique has proven to be a valid method for treatment of external and internal valve collapse. Aim: the aim of the present study was to evaluate a two year experience and follow up for external nasal valve collapse treatment using alar batten graft technique regarding results and complications

Patients and Methods: this prospective study was carried out on 18 patients attended the ENT and Plastic Surgery outpatient clinics of Al-Azhar University hospitals from January, 2014 to January 2016. Written consent was taken from every patient. All patients were complaining of nasal obstruction of gradual onset and progressive course with 7 years average. All patients were subjected to detailed history taking and questionnaire including the NOSE scale. Surgical correction was performed to all patients using the alar batten graft harvested from the septa cartilage or conchal cartilage. Postoperative results recorded in relation to subjective sensation of nasal obstruction and aesthetic appearance of the nose

Results: eleven patients [61.1%] were males and seven [38.9%] were females. Their age ranged from 18 to 45 years with a mean of 32+/-2. Bilateral obstruction was found in 33.3% of cases and unilateral obstruction in 66.7% of cases. There were 22.2%, 27.8%, and 50.0% of the cases had moderate, fair, and severe obstruction, respectively. Postoperatively, these figures were changed to no obstruction77.8% [P=0.0], mild 0.0%, moderate 11.1%, fair 11.1%, and sever 0.0%[P=0.0005]. The technique significantly abolishes the severe nasal obstruction. Postoperative complications include 1 case with graft resorption [4.2%] and 1 case of graft displacement [4.2%]. Both were improved on subsequent surgery. Regarding postoperative findings there was tenderness and hypertrophic postauricular scar in 5.5% of patient and nasal tip edema in 22.2%, all resolved. In the early postoperative period, 33.3% of patients complained of fullness in the supraalar region

Conclusion: Successful surgical correction of nasal obstruction requires the precise diagnosis of the anatomic point of collapse. Alar batten graft improves the rigidity of lower lateral cartilage preventing collapse of the lateral nasal wall preventing collapse during moderate and deep inspiration. The graft varies according to the severity of the obstruction and size of the collapsible area of the lateral nasal wall. The septal cartilage is usually sufficient. The technique significantly improves nasal breathing

Predicative factors for pegylated interferon-alpha plus ribavirin combination therapy in Egyptian patients with chronic hepatitis cinfected with genotype 4

Hepatitis C virus genotype 4 is a common infection in Egypt and is the leading cause of liver disease. Most reports suggest that predicative factors for the efficacy of interferon alpha and ribavirin combination therapy for chronic hepatitis patients could be due to the mutations in the interferon sensitivity determining region. The present study aimed to investigate the predictive factors for combined pegylated interferon-alpha and ribavirin therapy for chronic hepatitis patients with HCV genotype 4. The study was carried out on forty patients with genotype 4 chronic hepatitis C receiving a weekly dose of 180 microg of PEG -IFN-alpha in combination with RBV for 48 weeks. HCV RNA serumviremia levels were determined by a real-time polymerase chain reaction. The RNA samples were genotyped using specific primers for HCV genotype 4, and the interferon sensitivity determining region was amplified using polymerase chain reaction and sequenced. The amino acid sequence of the ISDR was compared with the published sequence for HCV 4 [GenBank: ABD75831.1]. Our data revealed that twenty one patients were responders [R; 52.2%], whereas 19 patients showed no-response [NR; 47.5%] to the combined pegylated interferon-alpha plus ribavirin therapy. The values of RNA titer in both responder and non-responder groups were statistically significant and could be used a predictive factor for combined pegylated interferon -alpha plus ribavirin efficacy. Other factors, such as gender, age, and interferon sensitivity determining region subtype were not related to its efficacy. These data collectively suggest that HCV RNA titer is an important factor for predicting the efficacy of pegylated interferon alpha plus ribavirin combination therapy in Egyptian patients with chronic HCV genotype 4

Retained soft contact lens masquerading as a chalazion: A case report.

A misplaced contact lens is a common ocular emergency presenting to the eye casualty. We report a case of lost soft contact lens which migrated in the lid and presented 13 years later with symptomatic eye lid swelling. Authors in the past have reported migration and subsequent retention of lost hard lenses in locations such as the superior fornix and eyelid. To the best of our knowledge, misplaced soft contact lens masquerading as a chalazion has not been reported in the literature. Consideration should be given to the possibility of a retained contact lens in a patient with a history of a lost or misplaced lens, and examination of the ocular surface with double eversion of the upper lid should be performed.

A study of in vitro antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand

<p><b>OBJECTIVE</b>To establish the antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand L.</p><p><b>METHODS</b>(N, N'-bis (1-naphthaldimine)-o-phenylenediamine) was prepared from the condensation of 2-hydroxy-1-naphthaldehyde with o-phenylenediamine in a molar ratio of 2:1. The antimicrobial activity of the resultant Ln (III) complexes was investigated using agar well diffusion and micro-broth dilution techniques; the latter was used to establish the minimum inhibitory concentrations for each compound investigated.</p><p><b>RESULTS</b>Most of Ln (III) complexes were found to exhibit antibacterial activities against a number of pathogenic bacteria with MICs ranging between 1.95-250.00 µg/mL. Staphylococcus aureus was the most susceptible bacterial species to [LaL(NO3)2(H2O)](NO3) complex while Shigella dysenteriae and Escherichia coli required a relatively higher MIC (250 µg/mL). The complexes La (III) and Pr (III) were effective inhibitors against Staphylococcus aureus, whereas Sm (III) complex was effective against Serratia marcescens. On the other hand, Gd (III), La (III) and Nd (III) were found to be more potent inhibitors against Pseudomonas aeruginosa than two of commonly used antibiotics. The remaining Ln (III) complexes showed no remarkable activity as compared to the two standard drugs used.</p><p><b>CONCLUSIONS</b>Tetradentate Schiff base ligand L and its complexes could be a potential antibacterial compounds after further investigation.</p>

Quality of life after breast carcinoma surgery in women with operable breast cancer a comparison of three surgical procedures

Because breast conservative surgery [BCS], mastectomy alone, mastectomy with reconstruction is equally effective for treatment of early stage of breast carcinoma. Now choice of women focus on quality of life, psychosocial results and individual response following breast carcinoma surgery. The involved women in this study aged between 30:85 years [median 57.5] with newly diagnosed breast carcinoma who underwent BCS [n=25]. Mastectomy alone [n=15], Mastectomy with reconstruction [n=10]. The quality of life was assessed after diagnosis [baseline] and at 1,3,6,12,18 and 24 months after baseline by using mischel uncertainly in illness scale [MUIS], profile for mood states [POTIS] and functional assessment of cancer therapy for breast cancer [FACT-B] Women who underwent mastectomy with reconstruction had greater mood disturbance and poorer well being than women who had mastectomy alone, women who underwent BCS had more mood disturbances than women who had mastectomy alone. As regarding well being BCS and mastectomy did not differ significantly. With regard quality of life is not better in women with BCS or mastectomy with reconstruction than in women with mastectomy alone. Mastectomy with reconstruction is associated with greater mood disturbance and poorer well being

Long-term results: tibial angioplasty in critical limb ischemia

Patients with CLI are typically elderly with multiple co-morbidity and limited life expectancy and therefore, a procedure, which is minimally invasive with reduced morbidity and mortality but lesser long-term patency, may be more appropriate than a more invasive procedure with better long-term patency. This study was conducted to assess the outcome of endovascular angioplasty in treating infragenicular arterial disease in Egyptian diabetic patients with critical limb ischemia. Forty nine patients with [51] limbs presented with critical limb ischemia were subjected to endovascular tibial angioplasty, of which 40 patients had gangrene, 6 patients had ischemic ulcers, 3 had rest pain and 2 with severe foot infections. Overall, 79 arteries of the infra-popliteal [7] and iliac [1] were associated. Technical success was evaluated on angiography at the end of the procedure revascularization of at least one of 3 leg vessels with re-establishment of arterial flow to the foot was regarding technical success. The technical success rate of angioplasty in the revascularization of infra-popliteal vessles was 92%. In the 4 [8%] patients with a technical failure, two patients were treated conservatively and two patients were lost to follow up during the study. The clinical success rate was [80%], healing of an ulcer or wound after minor amputation. The cumulative limb salvage rate quantified by Kaplan-Meier life table analysis was at 20 month 80%. The per-cutaneous tibial angioplasty of infra-popliteal artery stenoses and occlusions is considered as an effective and safe therapy modality to avoid below the-knee amputation in patients with limb threatening ischemia

Women's knowledge about emergency contraceptive methods

Emergency contraception [EC] refers to methods used by women to prevent pregnancy after unprotected intercourse. The aim of this study was to assess Women's Knowledge about Emergency. Contraceptives. The study was conducted at 10 family planning clinics affiliated to the different available health organizations in Alexandria Governorate. A total of 400 women, were randomly chosen from the study setting, 40 women from each clinic. An interview schedule was designed and utilized to collect data. It consisted of two parts: the first part included Socio-demographic characteristics and reproductive history. The second part entailed knowledge about emergency contraceptive. The main findings of the study revealed that 56.25% of the subjects were not aware about emergency contraceptives, and 62.5% of them did not knows the definition.35% did not know the effectiveness of their method. More than one quarter [28.75%] of those who had knowledge got it from family. In conclusion, Women's Knowledge about Emergency contraceptives was poor and there is urgent need for education and counseling about Emergency contraceptives

Water treatment plants assessment at Talkha power plant

Talkha power plant is the only power plant located in El-Mansoura. It generates electricity using two different methods by steam turbine and gas turbine. Both plants drew water from River Nile [208 m3/h]. The Nile raw water passes through different treatment processes to be suitable for drinking and operational uses. At Talkha power plant, there are two purification plants used for drinking water supply [100 m3/h] and for water demineralization supply [108 M3/h]. This study aimed at studying the efficiency of the water purification plants. For drinking water purification plant, the annual River Nile water characterized by slightly alkaline pH [7.4-8], high annual mean values of turbidity [10.06 NTU], standard plate count [SPC] [313.3 CFU/1 ml], total coliform [2717/100 ml], fecal coliform [0-2400/100 ml] and total algae [3 x 104 org/l]. The dominant group of algae all over the study period was green algae. The blue green algae was abundant in summer and autumn seasons. The pH range and the annual mean values of turbidity, TDS, total hardness, sulfates, chlorides, nitrates, nitrites, fluoride and residual chlorine for purified water were in compliance with Egyptian dinking water standards. All the SPC recorded values with an annual mean value of 10.13 CFU/1ml indicated that chlorine dose and contact time were not enough to kill the bacteria. However, they were in compliance with Egyptian degree [should not exceed 50 CFU/1ml]. Although the removal efficiency of the plant for total coliform and blue green algae was nigh [98.5% and 99.2, respectively], the limits of the obtained results with an annual mean values of 40/100ml and 15.6 org/l were not in compliance with the Egyptian degree [should be free from total coliform, fecal coliform and blue green algae]. For water demineralization treatment plant, the raw water was characterized by slightly alkaline pH. The annual mean values of conductivity, turbidity and TDS were 354.6 muS/cm, 10.84 NTU and 214.6 mg/l, respectively. There was an increase in the results of conductivity, turbidity, total hardness and TDS in carbon filter effluent which was attributed to the desorption of adsorbed ions on the carbon media. The removal efficiencies of turbidity, total hardness and TDS indicated the high efficiency of the cationic filter. The annual removal efficiencies of conductivity, turbidity, chloride and TDS proved the efficiency of the anionic filter for removing the dissolved and suspended ions. All of the recorded values of the pH, conductivity, turbidity, chlorides, hardness and TDS of the mixed bed effluent indicated that the water at this stage was of high quality for boiler feed. The study recommended adjustment of coagulant and residual chlorine doses as well as contact time and continuous monitoring and maintenance of the different units

Counting the days of positive end expiratory pressure therapy in acute lung injury a study guided by computerized tomography

This work was designed to evaluate the effects of titrating positive end expiratory pressure [PEEP] therapy in patients sustained acute long injury [ALI] by using CT scan lung regarding density distribution and the percentage of lung opacities. Twenty adult critical surgical patients fulfilling the criteria of ALI were exposed to different levels of PEEP therapy applied continuously for 30 minutes. Computerized tomography studies of lung zones were done following each PEEP to estimate the effects of PEEP therapy on lung opacities and density clearance

Auditory brain stem response in noise induced permanent hearing loss

The objectives of the study are: 1- To prove the existence of the cochlear affection in noise induced hearing loss by means of ABR. 2- To study the effect of noise exposure on speech discrimination ability. 3- To study the latency intensity function curve in the noise induced sensory-neural hearing loss as compared to a normal subject. 4- To study the effect of the period of noise exposure on the hearing threshold level. This study included twenty male individuals, chosen from textile factories, age ranged between 25 and 45 years, duration of exposure to noise is from 5 up to 30 years. In addition, 10 normal subjects were included as a control group. Both the study and control groups were submitted to full history, full ear, nose and throat examination and audiological examination [pure tone and speech audiometry-emittancemetry and evoked response audiometry]. The results were given in details

Smoking habits of King Saud University students in Riyadh

The smoking habits of 2264 male students at King Saud University were investigated. Thirty-seven percent of the students smoked, and over a half smoked more than 15 cigarettes per day. Cigarettes were the main form of smoking. Most of the smokers knew about the hazards of smoking through the media and wished to stop smoking. Nonsmokers cited religious consideration and nonsmoking parents as the most important reasons for not smoking. A public health campaign is strongly recommended to reduce the prevalence of smoking

Immunologic and cytologic studies in otitis media with effusion

In the present study, a trial was done to detect the presence of immune complexes [ICS] in serum of both control and patients group using the CIq ELISA technique. The sera of both control and patients showed no IC[s]. On the other hand, middle ear effusions were+ ve for IC[s] in 65.7% and -ve in 34.3% of cases. in the present work, it was found that the percentage of cytyological findings in patients with IC[s]+ ve MEE[s] were as follows: 34.7% neutrophils, 21.7% cellular remnants, 17.3% lymphocytes and monocytes, 13.04% few cells and 13.04% mixed neutrophils and lymphocytes. The mean serum complement level was found to be significantly lighter the normal control, indicating that some sort of inflammstory condition was present and the complement is acting as an acute phase reactant protein. From all the above, we can conclude that the study of the IC[s] MEE[s], combined with the cytological study, can provide useful information about the pathogenesis of otitis media with effusion