Identification of right ventricular infarction in acute inferior wall myocardial infarction by tissue doppler imaging

It's important to identify patient with dominant right ventricular infarction with inferior wall MI in which right ventricular dysfunction is primarily responsible for development of hypotension and cardiogenic shock Jacob, et al., 2000.Aim to assess tissue Doppler imaging is a useful method for the detection of the right ventricular myocardial infarction in patients with acute inferior wall myocardial infarction. Thirty patients, nine females and twenty-one males, admitted to [CCU] at Al-Hussein University Hospital between December 2009 and July 2010, classified into 2 groups, group A 15 without RVI and group B 15 with RVI plus Control group C Ten healthy individuals ;following scheme. History, risk factors, Clinical examination, 12 leads ECG ,Cardiac enzyme and Echocardiography was performed within 48 hours after the MI. As the following. Left ventricular ,Right ventricular study,Pulsed Tissue Doppler parameters show statistically significant difference between groups in JVP, Blood pressure ,cardiac enzymes, Right ventricular ejection fraction ,tricuspid annular motion ,Tricuspid regurgitation, Myocardial systolic velocity, Myocardial early diastolic velocity, Myocardial late diastolic velocity ,Isometric contraction time Jsometric relaxation time, Ejection time, myocardial performance index. The right ventricular MPI increases in patients with RVMI when accompanied by acute inferior wall MI .So RVMI could be diagnosed and predicted correctlyby the use of these Tissue Doppler imaging which are easily obtained

Diagnostic significance of trans-vaginal ultrasonography for pre-operative evaluation of stress urinary incontinence in females

The Aim of this work is to demonstrate the dynamic relationships, of the urinary bladder, urethra, urethrovesical junction, and symphysis pubis during stress and to assess the reproducibility of trans-vaginal ultrasonography [TVUS] for preoperative evaluation of stress urinary incontinence in females, together with evaluation of its diagnostic value compared to urodynamic findings. This study was conducted on 97 female patients including 71 patients with clinically diagnosed stress urinary incontinence [SUI] as group [A] for comparison with 26 patients with no urological complaints as control group [B]. All patients underwent complete history and physical examination, laboratory investigations, urodynamic evaluation especially valsalva leak point pressure [VLPP], and trans-vaginal ultrasonography [TVUS]. Patients of group [A] were further subdivided into two sub groups [GI and GII] according to the results of VLPP. GI and GII included 47 and 24 patients with VLPP above and below 60 cm H[2O] respectively. Statistical analysis of seven transvaginal ultrasonic anatomical parameters that include measurement of bladder symphysis distance [BS], rotational angle [RA], bladder neck mobility [BNM], bladder neck vertical descend [BNVD], BN funneling [BNF], BN position [BNP], and posterior urethrovesical angle [PUVA], was done in both study groups at rest and during strain together with correlation of these 7 parameters and urodynamic VLPP findings. A highly statistically significant difference was found in all the seven parameters measured by TVUS in group [A] when compared to control group B and in each patient of the two groups during both phases at rest and during strain [p <0.001]. There is a significant high positive correlation between TVUS parameters and VLPP findings. The sensitivity and specificity of TVUS in detecting SUI were 92.9% and 92.31% respectively when compared to 83.09% and 84.61% of urodynamics. Positive and negative predictive values of TVUS are 97.1%, and 82.7%, respectively. The over all accuracy of TVUS was 92.8% compared to 83.50% of urodynamics. TVUS is a simple minimally invasive endosonographic technique that provides opportunity to combine anatomic and functional views of the urinal bladder and urethra compared to other radiological method. The patients avoiding catheterization hazards, exposures to radiation, and the sophistication of multi-channel urodynamic evaluation, readily accept it. TVUS not only can be considered as a significant reliable tool for diagnosing and classifying [SUI] but also of prognostic value in predicting better successful surgical outcomes with proper choice of the surgery type according to each type of SUI. We strongly believe that TVUS is a technique that deserves to be supported for further applications

Troponin T as a useful marker for myocardial damage in neonates with perinatal asphyxia

This study was designed to delineate the role of cardiac troponin T in neonates with perinatal asphyxia as a marker for myocardial damage. It included 25 neonates suffering from per/natal asphyxia. They were 15 males and 10 females and their gestational age ranged from 37 to 41 weeks [group I]. Also 15 apparently healthy neonates of age and sex matched to group/were taken as control group [group II]. All neonates in the study were subjected to laboratory investigations as CBC, C-reactive protein; arterial blood gases [ABGS], blood glucose level and serum level of cardiac troponin T [TNT]. The mean serum level of [TNT] among asphyxiated neonates was 0.027 +/- 0.01 7ng/ml and was 0.011 +/- 0. 002ng/m/in control and there was statistical significant difference between both groups. There were 7 cases [28%] with tachycardia, 3 cases of them [%12] had irregular rhythm and heart failure. The mean level of [TNT] in patients with HF was 0.062 +/- 0. 048ng/ml and the mean level in the rest of asphyxiated newborns was 0.020 +/- 0.0033ng/ml. In this study there was high statistical significant negative correlation between TNT level and arterial PH, Po[2], HCO[3] and base excess [BE]. There was also high significant positive correlation between the mean TNT level and PCo2. This means that TNT mean level correlate with severity of perinatal asphyxia. In It would be useful to measure cardiac troponin T in all asphyxiated neonates. Then these patients with high level of TNT can then submitted to electrocardiographic and echocardiographic examination for detection of cardiac affection and to offer apportune treatment when required

Local facial flaps for reconstruction of post-resectional facial defects in basal cell carcinoma

This study includes 60 cases with Basal Cell Carcinoma [BCC] of the face. They are 37 males and 23 females, with average age 58 years. There are 26 cases with BCC of the cheek, 26 cases with BCC of the nose, 5 cases with BCC of the lip and 3 cases with BCC of the forehead. The repair of the defect after surgical excision of the lesion with adequate safety margin was done as follow: nasolabial flap in 20 cases. local cheek flap in 16 cases, glabellar and forehead flap in 10 cases, advancement in 4 cases, Kite flap in 6 cases and double flaps in 4 cases. There are minimal complications such as haemorrhage in 2 cases, infection in 2 cases, partial dehiscence in 3 cases, partial necrosis in 4 cases, deformity in 2 cases and tumor recurrence in 2 cases. The aesthetic results were excellent in 20 cases, good in 32 cases, moderate in 6 cases and poor in 2 cases