Efficiency of topical ozone gel as an adjunct to antibiotics and analgesics on sequelae after extraction of impacted mandibular third molar / Eficiencia del gel de ozono tópico como complemento de antibióticos y analgésicos en las secuelas tras la extracción del tercer molar mandibular impactado

Introduction: Extraction of the impacted mandibular third molar is a common procedure in dentistry. Many complications may arise after this operation, the most common being pain, trismus, and swelling. Systemic medications have been used in an attempt to manage these problems, but because of their side effects, the need for non-medication treatment arises to treat these complications without side effects, such as cryotherapy, ice packs, low-level laser therapy, and ozone. Ozone is one of the most effective antimicrobials used in the dentistry field, and it also has a positive effect on soft tissue healing, activates cellular metabolism, and can react with blood components; for these reasons ozone is used to manage trismus, swelling, and pain after removal of the mandibular third molar. Aim: The purpose of the study was to assess the effects of topical ozone gel on complications from the extraction of the impacted mandibular third molar. Materials and Methods: Thirty patients were enrolled in the current study and were randomly divided into two equal groups. Preoperatively clinical examination included measurement of facial swelling measurements and maximum mouth opening. The position and configuration of the impacted lower third molar, the surrounding bone, the mandibular canal, and the neighboring tooth were all assessed using a panoramic X-ray. On days 2 and 7, after surgery, the facial swelling dimensions and maximum mouth opening were again assessed. Statistics were used to analyze results. Results: Findings indicate statistical significance for pain, but not for swelling or mouth opening. Conclusions: After lower third molar surgery, topical ozone gel helps reduce postoperative pain.

Introducción: La extracción del tercer molar mandibular retenido es un procedimiento común en odontología. Pueden surgir muchas complicaciones después de esta operación, siendo las más comunes dolor, trismo y edema. Se han utilizado medicamentos sistémicos en un intento de controlar estos problemas, pero debido a sus efectos secundarios, surge la necesidad de tratamientos sin medicamentos para tratar estas complicaciones sin efectos secundarios, como crioterapia, bolsas de hielo, terapia con láser de baja intensidad y ozono. El ozono es uno de los antimicrobianos más eficaces utilizados en el campo de la odontología, además tiene un efecto positivo en la cicatrización de los tejidos blandos, activa el metabolismo celular y puede reaccionar con los componentes sanguíneos; Por estas razones, el ozono se utiliza para controlar el trismo, la hinchazón y el dolor después de la extracción del tercer molar mandibular. Objetivo: El propósito del estudio fue evaluar los efectos del gel de ozono tópico sobre las complicaciones de la extracción del tercer molar mandibular impactado. Materiales y Métodos: Se inscribieron treinta pacientes en el estudio actual y se dividieron aleatoriamente en dos grupos iguales. El examen clínico preoperatorio incluyó la medición de la hinchazón facial y la apertura máxima de la boca. La posición y configuración del tercer molar inferior impactado, el hueso circundante, el canal mandibular y el diente vecino se evaluaron mediante una radiografía panorámica. Los días 2 y 7, después de la cirugía, se evaluaron nuevamente las dimensiones de la hinchazón facial y la apertura máxima de la boca. Se utilizaron estadísticas para analizar los resultados. Resultados: Los hallazgos indican significación estadística para el dolor, pero no para la hinchazón o la apertura de la boca.Conclusión: Después de la cirugía del tercer molar inferior, el gel de ozono tópico ayuda a reducir el dolor postoperatorio.

Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients

Abstract Introduction Olfactory and gustative alterations are frequent in the initial stages of the COVID-19 infection. Vitamin B12 deficiency has been linked to olfactory dysfunction. Objective The present study aimed to assess the relationship between vitamin B12 levels and smell affection in COVID-19 patients. Methods The present study included 201 laboratory-confirmed COVID-19 patients. Smell affection was assessed using self-rated olfactory function. Serum vitamin B12 levels were assessed using commercial enzyme-linked immunosorbent assay (ELISA) kits. Results According to the smell function assessment, the patients were classified into three categories: normal osmesis (n = 77), hyposmia (n = 49), and anosmia (n = 75) (►Fig. 1). Four weeks later, 195 patients (97.0%) had their normal smell function restored. The remainder 6 patients included 4 anosmic and 2 hyposmic patients. Patients with hyposmia or anosmia had significantly lower vitamin B12 levels when compared with patients with normal osmesis (median [IQR]: 363.0 [198.0-539.0] versus 337.0 [175.0-467.0] and 491.0 [364.5-584.5] pg/ml, respectively, p < 0.001). Conclusion Vitamin B12 appears to have some contribution to smell affection in patients with COVID-19 infection.

Revising our concepts about stoma covering a low rectal anastomosis

Introduction: There has been conclusive evidence that defunctioning stoma with either transverse colostomy or ileostomy mitigates the serious consequences of anastomotic leakage. However,whether transverse colostomy or ileostomy is preferred for defunctioning a rectal anastomosis remains controversial. The present study was designed to identify the best defunctioning stoma for colorectal anastomosis. Objective: To improve the quality of life in patients with rectal resection and anastomosis and reduce the morbidity before and after closure of the stoma. Patients and Methods The present study included 48 patients with elective colorectal resection who were randomly arranged into 2 equal groups, with 24 patients each. Group I consisted of patients who underwent ileostomy, and group II consisted of patients who underwent colostomy as a defunctioning stoma for a low rectal anastomosis. All surviving patients were readmitted to have their stoma closed and were followed-up for 6 months after closure of their stomas. All data regarding local and general complications of construction and closure of the stoma of the two groups were recorded and blotted against each other to clarify the most safe and tolerable procedure. Results: We found that all nutritional deficiencies, dehydration, electrolytes imbalance, peristomal dermatitis, and frequent change of appliances are statistically more common in the ileostomy group, while stomal retraction and wound infection after closure of the stoma were statistically more common in the colostomy group. There were no statistically significant differences regarding the total hospital stay and mortality between the two groups. Conclusion and Recommendation: Ileostomy has much higher morbidities than colostomy and it also has a potential risk of mortality; therefore, we recommend colostomy as the ideal method for defunctioning a distal colorectal anastomosis. (AU)

Diagnostic Accuracy of Two Softwares for Detection of Intra-Bony Lesions in Multi-Detector Computed Tomography

Background: Bony jaw lesions have varied radiographic appearance and may pose difficulty in establishing radiographicdifferential diagnosis. Computed tomography is a useful tool to facilitate the correct diagnosis of these bony lesions.Objectives: To compare the volumetric measurement of bony lesions of the jaw using two commercially available softwaresfor the evaluation of CT imaging. Material and Methods: All patients were subjected for multi-slice CT scanning. Thevolumetric measurements were performed using two softwares; Myrian and Siemens. Results: This study was conducted on15 patients of both genders; males (66.7%) and females (33.3%), where 21 diagnosed lesions with an intra-bony spaceaffecting one or both of the jaws were included in the measurements. Myrian software showed statistically lower mean ofvolumetric measurement than Somatom (P-value <0.001). Conclusion: Although, Myrian software showed statisticallylower mean of volumetric measurement than Somatom. The clinicalrelevance of these finding still needs to be determined infuture studies. Thus, both softwares can still be useful diagnostic tool for volumetric measurements.

Bilateral simultaneous endoscopic dacryocystorhinostomy: outcome and impact on the quality of life of the patients

Introduction: Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective: To evaluate the feasibility and the outcome of simultaneous bilateral Endo- DCR and its impact on the quality of life of the patients. Methods: We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results: Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion: Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients (AU)

Arabic Coffee as a Potential Alternative to Black Coffee in the Post- Bleaching Period: An in-vitro Study

Objective: To investigate the effect of Arabic coffee on bleached teeth in comparison to black coffee. Material and Methods: Forty teeth (sound maxillary or mandibular premolars with no carious lesions) were randomly selected into 4 groups (A, B, C and D). One group (A) did not receive bleaching and was incubated in saline. The second group (B) was bleached and then incubated in saline. The last two groups were bleached and were immersed in either Arabic coffee (C) or black coffee (D). Color recording of the samples was always carried out as near to their mid-buccal surfaces as possible using VITA Easyshade Advance System. Color measurements were carried out using a digital spectrophotometer at baseline and after short-term and long-term immersion. Data were subjected to two way ANOVA and T-test. The level of significance was set at was set at 0.05. Results: Results show that immersion in Arabic coffee resulted only in significant reduction in the b* color value upon long-term immersion (i.e. a reduction in the yellow hue). Black coffee on the other hand resulted in significant: reduction in lightness, increased red tint and increased yellow hue altogether. Conclusion: The use of Arabic coffee did not deteriorate color, with the only significant change being the reduction of yellowish hue. Arabic coffee could be an alternative to black coffee after bleaching.

Antibiotic Self-Medication for Oral Conditions: Characteristics and Associated Factors

Objective: To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

Morphometric analysis of the foramen magnum / Análisis morfométrico del foramen magno

SUMMARY: The foramen magnum is morphometrically typified by two perpendicular diameters and a distinct margin. This important anatomical landmark is subject to high interindividual variation. The objective of this study was to evaluate the dimensions and morphology of the foramen magnum in a Jordanian population. In this retrospective study, 247 individuals were consecutively sampled using the institutional picture archiving and communication system. The anteroposterior and transverse diameters of the foramen magnum were measured; the foramen magnum index was calculated; and, the shape of the foramen magnum was visually assessed. The sex-pooled anteroposterior and transverse diameters were 35.1 ± 3.2 mm and 29.3 ± 2.5 mm, respectively. The sex-pooled foramen magnum index was 1.20 ± 0.10. The diameters were significantly different (P<0.001) and positively correlated (r=0.52, P<0.001). Participant age was negatively correlated with the anteroposterior (rs=-0.15, P=0.02) and transverse (rs=-0.14, P=0.03) diameters. After controlling for participant age, there was a statistically significant difference in the anteroposterior diameter (P<0.001), the transverse diameter (P<0.001), and the foramen magnum index (P=0.02) between sexes. The foramen magnum was most commonly irregular in shape (36 % of all cases). In contrast to previous studies, we report, for the first time, a negative correlation between age and the diameters of the foramen magnum. In addition, a predominance of irregularly shaped foramen magnum was found. The finding makes an already heterogenous group of published data even more variable, prompting reconsideration of the role of visual assessment in morphometric studies.

RESUMEN: El foramen magno está morfométricamente tipificado por dos diámetros perpendiculares y un margen. Este punto importante de referencia anatómica está sujeto a una alta variación interindividual. El objetivo del estudio fue evaluar las dimensiones y la morfología del foramen magno en una población jordana. En este estudio retrospectivo, 247 individuos fueron muestreados consecutivamente utilizando el sistema institucional y de comunicación de imágenes. Se midieron los diámetros anteroposterior y transversal del foramen magno; Se calculó el índice del foramen magno y se evaluó visualmente la forma dede éste. Los diámetros anteroposterior y transversal agrupados por sexo fueron 35,1±3,2 mm y 29,3±2,5 mm, respectivamente. El índice del foramen magno, agrupado por sexo, fue 1,20±0,10. Los diámetros fueron significativamente diferentes (P <0,001) y positivamente correlacionados (r = 0,52, P <0,001). La edad de los participantes se correlacionó negativamente con los diámetros anteroposterior (rs = -0,15, P = 0,02) y transversal (rs = -0,14, P = 0,03). Después de verificar la edad de los participantes, hubo una diferencia estadísticamente significativa entre el diámetro anteroposterior (P <0,001), el diámetro transversal (P <0,001) y el foramen magno (P = 0,02) entre ambos sexos. El foramen magno era más comúnmente de forma irregular (36 % de todos los casos). A diferencia de estudios anteriores, se informa por primera vez de una correlación negativa entre la edad y los diámetros del foramen magno. Además, se encontró un predominio de forámenes de forma irregular. El hallazgo indica que un grupo heterogéneo de datos ya publicados, sea aún más variable, lo que lleva a reconsiderar el papel de la evaluación visual en los estudios morfométricos.

Ultrastructural alterations in Schistosoma mansoni juvenile and adult male worms after in vitro incubation with primaquine

BACKGROUND Praziquantel has been cited as the only drug for treating schistosomiasis. However, concerns over drug resistance have encouraged the search for novel drug leads. The antimalarial drug primaquine possesses interesting anti-schistosmal properties. OBJECTIVES This study is the first to document the potential role of primaquine as a schistosomicide and the ultrastructural changes induced by primaquine on juvenile or adult male worms of Schistosoma mansoni. METHODS Ultrastructural alterations in the tegumental surface of 21-day-old juvenile and adult male worms of S. mansoni were demonstrated following primaquine treatment at different concentrations (2, 5, 10, 15, and 20 µg/mL) and incubation periods (1, 3, 6, 24, and 48 h) in vitro, using both scanning and transmission electron microscopy. FINDINGS At low concentrations (2, 5, and 10 µg/mL) both juvenile and adult male worms were alive after 24 h of incubation, whereas contraction, paralysis, and death of all worms were observed after 24 h of drug exposure at 20 µg/mL. The tegument of juvenile and adult male worms treated with primaquine exhibited erosion, peeling, and sloughing. Furthermore, extensive damage of both tegumental and subtegumental layers included embedded spines, and shrinkage of muscles with vacuoles. The in vitro results confirmed that primaquine has dose-dependent effects with 20 µg/mL as the most effective concentration in a short incubation period. MAIN CONCLUSIONS The schistosomicidal activity of primaquine indicates that this drug possesses moderate in vitro activity against juvenile and adult male worms, since it caused high mortality and tegumental alterations. This study confirmed that the antimalarial drug primaquine possesses anti-schistosomal activity. Further investigation is needed to elucidate its mechanism of action.

Tea Tree Oil (Melaleuca alternifolia) - An Efficient Treatment for Warts: Two Case Reports

Traditional herbal medicines are a valuable natural resource for preventing and treating diseases, including some infectious diseases. Tea tree oil (TTO) has been used over many years as a traditional treatment for a variety of skin disorders. The oil of the tea tree was used twice daily on two patients to treat their skin warts on different anatomical locations. The wart on the first patient needed 10 days to be totally removed, while it took 20 days in the second patient due to poor medication compliance. This paper sheds light on TTO as an efficient and safe treatment for common warts.

Epidemiological evaluation and outcome of pure abdominal trauma victims who underwent surgical exploratory laparotomy

Objective: The aim of this study was to evaluate the epidemiological profile, surgical treatment, andoutcome of patients suffering from pure abdominal injuries who underwent exploratory laparotomy in the emergency department of Aswan University Hospital, Egypt

Patients and methods: This was an evaluation and assessment of observational and descriptive study with prospective approach through interviews of 80 patients with pure abdominal trauma who were subjected to surgical treatment in the form of exploratory laparotomy and evaluation of their medical records

Results: The most affected individuals were male patients younger than 49 years, most of them withlow educational level and single. There was a predominance of trauma in the rural areasthat mostly occurred at night time and evening. Blunt trauma was the most common type of abdominal trauma, and road traffic accidents were the most frequent mechanism of trauma.The upper abdomen was the most affected region. Pain was the most common presenting symptom, and the spleen was the most affected organ. The hospital stay ranged from 1 to11 days. Most patients were discharged with permanent sequelae; there were six deaths

Conclusion: Blunt trauma was the most common type of abdominal injury. Road traffic accidents were themost common mechanism of blunt trauma, and stab wounds were the most common type of penetrating injuries. A number of risk factors were identified in this study, which include the type of abdominal trauma, presence of chronic diseases, delay in early transport from the siteof trauma to the emergency department, and age of patient. Despite the magnitude of traumas,the outcome was satisfactory

Tachycardia induced cardiomyopathy, case report

Tachyarrhythmia is a one of the well-known causes of dilated cardiomyopathy. The cardiomyopathy is reversible once arrhythmia is controlled. Cardiologists need to be aware of this reversible cause of left ventricular impairment. We report an eight year old girl who presented with severe left ventricular impairment secondary to paroxysmal junctional reciprocating tachycardia. She failed drug therapy, so radiofrequency ablation was successfully done afterwards. Her left ventricular function returned to near normal within the following six months

Synchronous haematogenous colonic metastasis from a primary renal cell carcinoma: an unusual cause of colonic haemorrhage: [case report]

Background: renal cell carcinoma [RCC] represent 2-3% of all malignant tumors in adults. Clear cell carcinoma is the most frequent histological type, and 25-30% of renal carcinoma have metastasis at the time of diagnosis. RCC very rarely metastasize to the colon. The objective of the present study is to report synchronous haematogenous solitary colonic metastasis that presented as severe recurrent lower gastrointestinal haemorrhage which required right hemicoloectomy and right nephrectomy plus chemotherapy

Clinical Case: we report the case of a 46-year old male patient who presented with multiple episodes of severe haemotochezia and anemia. He had a right flank mass. CT scan of the abdomen showed a large right kidney mass together with a lesion in the ascending colon, not connected to the renal mass. It also showed hepatic metastasis, lung metastasis and ascites. Colonoscopy revealed an ascending colonic mass. The patient was managed by right nephrectomy and right hemicolectomy. The pathology report of the colonic mass showed clear cell carcinoma with involvement of the colon from serosa to mucosa. It indicated the presence of haematogenous spread of the RCC as the mechanism of metastasis. The colonic haemorrhage did not recur. the patient survived close to a year after surgery

Conclusion: RCC metastasis to the colon is very rare and can be synchronous with the primary renal tumor and can be metachronous after nephrectomy. Also, it can be the result of direct invasion, haematogenous spread or after local recurrence following nephrectomy. Metastatic RCC requires surgery, immunotherapy, tyrosine kinase inhibitors, and mammalian target rapamycin inhibitors. Surgery is the first step for disease control and control bleeding from colonic metastasis. Metastectomy is indicated in localized disease and when surgically accessible

Copper induction and differential expression of laccase in Aspergillus flavus

Aspergillus flavus was isolated from soil and exhibited laccase activity under both constitutive and copper induced conditions. Spiking the medium with 1 mM copper sulfate resulted in an increase in the activity which reached 51.84 U/mL, a distinctive protein band was detected at 60 kDa. The extracellular enzyme was purified 81 fold using gel filtration chromatography and resulted in two different laccase fractions L1 and L2, the latter had a higher enzymatic activity which reached 79.57 U/mL and specific activity of 64.17 U/μg protein. The analysis of the spectrum of the L2 fraction showed a shoulder at 330 nm which is characteristic for T2/T3 copper centers; both copper and zinc were detected suggesting that this is an unconventional white laccase. Primers of laccase gene were designed and synthesized to recover specific gene from A. flavus. Sequence analysis indicated putative laccase (Genbank ID: JF683612) at the amino acid level suggesting a close identity to laccases from other genera containing the copper binding site. Decolorization of textile waste water under different conditions showed possible application in bioremediation within a short period of time. The effect of copper on A. flavus was concentration dependent.

Saudi orthopedic residency program: a comparison of the Riyadh training center with other Saudi training centers

To evaluate the training quality of the Saudi Orthopedic Residency Program in general, and to compare the Riyadh training center with other training centers in Saudi Arabia. A group of 38 residents from Riyadh and 32 residents from other centers in Saudi Arabia were surveyed in a cross-sectional manner. The participants completed carefully designed questionnaires pertaining to the most critical issues of their training. Reading peer-reviewed, scholarly articles was more popular with trainees in Riyadh compared with trainees working outside Riyadh, for whom textbooks were the dominant educational resource [P = 0.028]. The data revealed insufficiencies in surgical training in the trauma discipline in Riyadh and relative deficiencies of surgical experience in subspecialties outside of Riyadh. In contrast to residents trained outside of Riyadh, Riyadh trainees denied having a weak level of training [P = 0.021]. Examination scores did not reflect the actual level of resident competency according to the residents' responses. The program's capacity could not accommodate the growing number of trainees. Both groups reported similar levels of expertise with regard to the basic orthopedic operative skills. Educational resources should be within the reach of all residents. Senior supervisors should not compromise resident training. The number of trainees should be proportional to program capacity. Resident feedback should not be neglected, and the program committee must recognize delinquent trainers and protect the trainees from them. Deficient areas of training should be identified and rectified. A case logbook may be used as an indicator of surgical exposure. Frequent changes to examination formats, dates and locations should be avoided

Desmoid tumor [fibromatosis] of the head and neck

Desmoid tumors [fibromatosis] are rare benign tumors, they arise from musculoaponeurotic structures throughout the body. They are locally infiltrative, resulting in a high rate of local recurrence following surgical resection. Due to the rarity of these tumors in the head and neck region, we report a case of a patient with a desmoid tumor in the upper neck that was diagnosed and treated in our institution, to increase the awareness of the Otolaryngology-Head and Neck surgeons, and report available treatment options of this condition

role of magnetic resonance enterography [MRE] in detecting features of inflammatory bowel disease [IBD]

Magnetic resonance enterography MRE is a clinically useful technique for the evaluation of intraluminal and extraluminal small bowel disease, particularly in younger patients with Crohn disease [CD]. MRE offers the advantages of multiplanar capability and lack of ionizing radiation. It allows evaluation of bowel wall contrast enhancement, wall thickening, and edema, findings useful for the assessment of CD activity. MRE can also depict other pathologic findings such as lymphadenopathy, fistula and sinus formation, abscesses, and abnormal fold patterns

Objective: to enhance the use of MRE in the diagnosis of IBD in the Middle East area especially in Jordan

Role of allopurinol in the treatment of hyperuricemic patients with non alcoholic fatty liver disease

Non Alcoholic Fatty Liver Disease [NAFLD] is the most common cause of chronic liver injury, recently elevated uric acid [UA] level was found to be an important factor in the development of NAFLD so lowering the level of UA by allopurinol might play an important role in the improvement of NAFLD. The objective of the study is to evaluate the effect of treating hyperuricemia by allopurinol on NAFLD patients assessed by ultrasonography [U/S] and liver enzymes. 3l hyperuricemic patients suffering from NAFLD were enrolled in the study. These patients were randomly assigned into two groups; Group A [14 patients]: Placebo group who received starch based placebo for 2-3 months and Group B [17 patients]: Treatment group who received allopurinol for 2-3 months. Fatty liver [FL] grade and size were assessed by U/S before and after treatment; also liver enzymes [GPT , GOT] and UA were measured before and after treatment. The present study showed significant difference between GPT and GOT before and after lowering UA level [P<0.001 and P=0.013, respectively] in the treatment group while U/S parameters showed no significant difference in the FL size and grade before and after treatment [P:0.208 and 0.325 respectively]. We concluded that Allopurinol can be used to improve patients with NAFLD associated with hyperuricemia as assessed by improved liver enzymes

Factors affecting albuminuria in diabetic patients at King Fahad Hospital in Almadinah Almunawwarah

To identify factors associated with development of albuminuria in diabetic patients. A hospital based case control study. Fifty diabetic nephropathy patients were compared with 100 diabetic patients without nephropathy. Data were collected using an interview questionnaire. Frequencies, percentages and mean were calculated. Chi-square test, T-test and Univariate logistic regression analysis were used. P < 0.05 was considered significant. An Univariate logistic regression analysis has shown significant associated factors including old age [OR = 8.1] [95%CI = 2.2-30.1], sex [male] [OR = 2.4] [95%CI = 1.18-4.99], the duration of diabetes mellitus above 10 years OR were 4.23 [95%C = 1.6-15.4], associated mild, moderate, and severe hypertension ORs were 5.2 [95%CI = 2.3-11.7], 5.1 [95%CI = 1.5-16.93] and 15.2 [95%CI = 1.4-158.1], respectively, cardiac disease [OR = 3.77] [95%CI = 1.6-8.7], using Angiotensin-Converting Enzyme Inhibitors [ACEIs] and Angiotensin II Receptor Blockers [ARBs] [OR = 8.1] [95% CI = 3.61-18.2], low triglyceride level [OR = 0.38] [95%CI = 0.10-0.81]. Six factors showed a significant positive relationship to the progression of albuminuria in diabetic patients. Older age and males were found to be predictors of high albuminuria. Also, cardiac disease, poor hypertension control, the use of ACEIs or ARBs were found to be predictors of higher albuminuria. Low triglyceride levels were significantly associated with low albuminuria. Higher levels of HbA1c showed less albuminuria while body mass index, smoking and retinopathy showed no association to the albuminuria

OUTCOMES OF APLASTIC ANEMIA PATIENTS IN ASSUIT UNIVERSITY HOSPITAL, ONE YEAR STUDY

Aplastic anemia is a disorder in which the bone marrow fails to make enough blood cells. to identify the various aetiological factors that stands behind aplastic anemia as a common hematological problem and the various outcomes of those patients along one year. The study included 80 patients with aplastic anemia who were admitted to the Clinical Hematology Unit of Assuit University Hospital from November 2011 to October 2012. All patients were recruited for careful history and meticulous investigations to detect predisposing factors. Results: 42.5% of all studied aplastic anemia patients had any definite etological or predesposing factor, so considered as idiopathic group while, 57.5% were secondry to chmicels and/or insecticides [22.5%], hepatitis C[15%], systemic lupus erythematosis[SLE] [12.5%] and rheumatoid arthritis[7.5%]. The observed outcomes showed that complete recovery in 39%t of the secondry aplastic anemia patients [P<0.001], chronicity in 22% while 39% died. However, none of the idiopathic aplastic anemia' patients reached recovry, 59% become chronic [P<0.001] and 41% died [P<0.05]. Secondary aplastic anemia patients have a chance for recovery by correcting the primary etiology that is not an option in idiopathic patients. The hope for not recovered aplastic anemia patients is dependency on transfusional support and immunosupressive therapy waiting for a chance in allogeneic stem cell transplantation. The expected outcome of most of unrecovered patients is death unless find early chance for transplantation.So, there is a very potential need for stem cell transplantation center in Assuit University as an important referral center in Upper Egypt