Closed rhinoplasty, technique and results

Prior to 1990's, all rhinoplasty surgeries were performed via the intranasal approach which is often called closed rhinoplasty or basic technique. In the closed technique there is lacking of the external scaring, reduced post operative edema, shorter operative time, decreased morbidity, and gives rapid return to a normal appearance. In this study the closed technique was performed in forty cases with aesthetic, functional and traumatic nasal deformities. The patients were collected from the .ENT departments in Al Hussein university hospital in Cairo, Royal commission medical center in Yanbu, KSA, and Al Tamenal general hospital in Ryadh, KSA, during the period from June 2009 to June 2010. A simultaneous septoplasty was done in eleven patients partial turbinectomy in two patients were performed with the basic rhinoplasty procedure to improve nasal breathing. The incisions and other steps of the closed rhinoplasty technique used in this study, allowed exposure of all bony and cartilaginous compartments of the nose and offered the performance of all goals needed for nasal reconstruction. After analysis of the results of this study, the conclusion was that, the closed technique gives satisfactory results for all wanted purposes of rhinoplasty performed

Dental caries experience in patients attending Dr. Ishrat-ul-Ebad institute of oral health sciences, dubs, Karachi

The objective of the present study was to determine the caries experience in the patients attending a public sector hospital. A total 4000 patients were screened at Dr. Ishrat-ul-Ibad institute of Oral Health Sciences Karachi. Out of total 3620 patients were selected for the study. A prescribed perform of out door department was used to collect the information regarding the Biodata and DMFT [decayed, missing and filled teeth] score of an individual. From 3620 patients 1911 were males and 1709 were female. The DMFT index of total subjects examined was 3.92 SD+278. Whereas, female have OMET score 3.94 SD +/- 2.77 compared to male DMFT score 3.89 SD+2.78.Significantly higher [p-value <.05] DMFT score was recorded in older age groups compared to younger age groups. There was a considerable high level of caries rate found in patients attending the public sector dental hospital

Reversible cortical blindness following successful surgical repair of two stab wounds in the heart

This report describes a case of cortical blindness that followed successful surgical repair of two stab wounds in the heart in a 29-year old Libyan man. The patient presented in a state of pre cardiac arrest [shock and low cardiac output status], following multiple chest stab wounds. Chest tube was immediately inserted. Surgery was urgently performed suturing the two wounds; in the root of the aorta and in the left ventricle, and haemostasis was secured. Cardiac arrest was successfully prevented. The patient recovered smoothly, but 24 hours later he declared total blindness. Ophtalmic and neurological examinations and investigations that included fundoscopy, Electroencephalograms [EEGs] and Computed Tomography Scans revealed no abnormalities, apart from absence of alpha waves in the EEGs. We diagnosed the case as cortical blindness and continued caring for the patient conservatively. Three days later, the patient regained his vision gradually and was discharged on the 7[th] postoperative day without any remarks

effect of valproate monotherapy on hepatic and hemostatic functions in epileptic children: value of L-carnitine supplementation

The study included 15 epileptic children without previous hepatic or hemostatic defects [10 males and 5 females] aging 2 to 14 years selected from the outpatients attending the Pediatric Neurology Clinic of the Pediatric Department of Tanta University Hospital. We excluded patients receiving other medications which affect hepatic or platelet function, fifteen healthy children of matched age and sex served as controls. History, clinical examination and the following investigations were done for all of the cases: EEG, complete blood count, total serum proteins, albumin, bilirubin, ammonia, and alanine aminotransferase [ALT]. Hemostatic studies included bleeding time [BT], clotting time [CT], prothrombin time [PT], activated partial thromhopiastin time [PTT], serum fibrinogen, protein C, von Willebrand factor antigen, platelet count and platelet aggregation. All of the hepatic and hemostatic parameters were done before, and 9 weeks after commencement of antiepileptic therapy with valproate [VPA]. Serum valproate level was measured after establishment of therapy and showed a good complience to treatment. L-carnitine was measured before and after valproate therapy then oral L-carnitine was supplemented in a dose of 100 mg/kg/day for two weeks in all of the studied cases. The studied hepatic and hemostatic function parameters mentioned above were repeated again after L-carnitine supplementation. Valproate therapy was associated with a significant decrease in serum L-carnitine with impairment of hepatic functions [manifested by a significant increase in serum bilirubin, ammonia and ALT]. Following oral administration of L-carnitine there was a significant decrease in serum bilirubin and ALT, Hemostatic disturbances were also observed after valproate therapy in the studied cases [manifested by a significant increase in BT, CT, PT and PTT, with a significant decrease in serum fibrinogen, serum protein C, platelet count and platelet aggregation], VPA therapy or L-carnitine administration did not significantly affect Von Willebrand factor. Most of the studied hemostatic parameters improved significantly in response to oral L-carnitine. None of our studied cases showed life threatening or Reye-like hepatotoxicity. We conclude that within the usual therapeutic serum levels of VPA, it could be associated with L-carnitine deficiency and hepatic synthetic dysfunction as well as decreased number and function of platelets. Most of these abnormalities could be reversed by co-administration of L-carnitine. The latter might be recommended in epileptic children on VPA therapy particularly those with abnormal liver or platelet functions and those at risk for hepatotoxicity

Laparoscopic fundoplication in the treatment of gastro-oesophageal reflux disease. an initial experience in Zagazig and Minia University Hospitals

To study the role of laparoscopic surgery in the treatment of chronic gastro-oesophageal reflux disease [GORD], fourteen cases were admitted to the department of surgery of Zagazig and Minia University Hospitals. All patients were selected after failure of medical treatment, full investigations especially motility studies were done. All cases were examined endoscopicaly and for 24 hours pH-monitoring. All cases were operated by the same team of authors. Nissen fundoplication was done. The mean operative time was 120 +/- 12 minutes. There was no mortality recorded in our study. There was marked reduction in the postoperative complications in comparison to the open surgery, and there was significant improvement in the reflux problem. In conclusion laparoscopic fundoplication is a well promising technique that can effectively relieve symptoms of GORD with minimal morbidity and mortality as well as the mild postoperative pain. Short hospital stay and other benefits of laparoscopic surgery. However long term follow up is needed for proper evaluation

Salmonellosis in newborn calves in a closed dairy farm

An acute outbreak of calf salmonellosis occurred in a cow dairy farm during June 1991, where 7 calves died in acute course. Dead calves showed symptoms of diarrhea and enteritis and PM lesions of distended gallbladder, necrotic focci in the liver and swollen lymph nodes. Salmonella organisms were isolated from five cases. Fecal sample from 194 calves less than 3 months of ages were collected and examined. In calves with age ranged 9-27 days salmonella was recovered from 14 cases with an incidence of 7.2%. Serologically, all isolated strains proved to be Salmonella carrau

Incidence of clinical mastitis associated with mycoplasma infection

Incidence of clinical mastitis was calculated in three farms [I, II and III]. It was higher in winter 7.5%, 6%, and 8.5%, respectively, while in the summer season it was 2.7%, 4.1%, and 6.9% in the three farms, respectively. From the clinically mastitic milk samples collected from the three farms 160 [18%] were not respond to bacteriological examination and treatment. These samples were tested for the isolation of mycoplasma species. M. bovis [14.37%] and M. bovigenitalium [13.12%] were isolated from the clinically mastitic milk samples