Transcrestal sinus lift with simultaneous implant placement using osseodensification in posterior maxilla with residual bone height of 4-6 mm / Elevação de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador em região posterior de maxila com altura do remanescente ósseo de 4 a 6 mm

Objective: The aim of this study was to evaluate the transcrestal sinus lift using Osseodensification technique with simultaneous implant placement. Material and Methods: In this case series 7 patients who needed implant placement in the atrophic posterior maxilla were enrolled. In all the cases the residual bone height between the sinus floor and the alveolar crest was 4-6 mm. Transcrestal sinus lift was performed using Osseodensification with simultaneous implant placement. Cone-beam computed tomography (CBCT) were obtained immediately postoperative and 6 months after operation. Implant stability using Osstell® were assessed at the time of implant placement and implant exposure (6 months). Results: The results showed that the mean bone height gain was 5.33±0.83mm at 6 months postoperatively. Mean bone density value was 818.43±109.63 HU. Mean ISQ value was 80.00±3.11 at 6 months postoperatively. The duration of surgical procedure (minutes) ranged between 25-38 minutes with an average of 30.86±4.10 minutes. Conclusion: The crestal maxillary sinus floor elevation using Osseodensification technique with simultaneous implant placement provide superior results regarding bone density and implant stability and less duration of surgical procedure. (AU)

Objetivo: O objetivo deste estudo foi avaliar a elevação de seio maxilar via crista do rebordo com a técnica de Osseodensificação com instalação simultânea de implante. Material e Métodos: Nesta série de casos, participaram 7 pacientes que necessitavam de implantes em região posterior de maxila atrófica. Em todos os casos a altura de remanescente ósseo entre o soalho do seio e a crista alveolar estava entre 4 a 6 mm. A elevação de seio maxilar via crista do rebordo foi realizada com osseodensificação com instalação simultânea de implante. As Tomografias Computadorizadas Cone Beam (TCCB) foram obtidas imediatamente após a cirurgia e 6 meses depois. A estabilidade dos implantes utilizando Osstell® foi avaliada no momento da instalação do implante e no momento da reabertura (6 meses). Resultados: Os resultados mostraram que a média de ganho de altura óssea foi de 5.33±0.83mm após 6 meses da cirurgia. A média da densidade óssea foi de 818.43±109.63 HU. A média de ISQ foi de 80.00±3.11 após 6 meses da cirurgia. A duração do procedimento cirúrgico (minutos) foi entre 25 a 38 minutos com uma média de 30.86±4.10 minutos. Conclusão: A elevação do soalho de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador promove resultados superiores em relação à densidade óssea, estabilidade do implante e menor duração do tempo cirúrgico (AU)

Management of postpartum iron deficiency anemia: review of literature

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis.

possible toxic effect of different doses of Nigella sativa oil on the histological structure of the liver and renal cortex of adult male albino rats

Nigella sativa seeds are commonly known as black seed or black cumin. It has been used for thousands of years as a spice and food preservative and also as a protective and curative remedy for numerous disorders. Our research aimed to study the possible toxic effect of different doses of N. sativa oil on the liver and kidney. Twenty-one adult male albino rats were used and divided equally into three groups. The first group was the control group. The second and third groups received the oil in two gradually increasing doses of 15 and 25 ml/kg, respectively, for 1 month. The animals were then sacrificed and samples of liver and kidney were taken and prepared for histological examination. In the kidney of group II there was epithelial shedding and necrosis of some cells of the proximal and distal convoluted tubules, but there was no effect on renal glomeruli. In contrast, in group III there was glomerular injury in the form of degeneration of the tuft of capillaries, ill-defined basement membrane, and destruction of endothelial cells, in addition to tubular necrosis. In group II there was minimal effect on the liver in the form of perivascular cellular infiltration; in group III was seen a markedly vacuolated foamy cytoplasm of hepatocytes, with dilated sinusoids and perivascular cellular infiltration. In conclusion, large doses of N. sativa oil have toxic effects on the histological structure of the kidney and to a lesser degree on the liver. Therefore, Nigella oil should be used in proper doses, and further studies on the effect of large doses of oil are recommended

effects of different nutritional supplements on experimentally induced osteoporosis in male albino rats: a scanning electron microscopic study

Osteoporosis is one of the major health problems afflicting our modern world, especially disuse osteoporosis. Reduction of mechanical stresses on bone could lead to osteoporosis. To study the role of Ca and vitamins D and K on the prevention of immobilization osteoporosis. The study included 30 adult male albino rats, They were divided into three groups. Group I [the control group] and group II were immobilized by casting their right lower limb for 4 weeks. Group III [the immobilization group that concomitantly received a dietary supplement] was further subdivided into four subgroups; subgroup IIIa was given Ca citrate, subgroup IIIb was given vitamin D [alfacalcidol], subgroup IIIc was given Ca and vitamin D, and subgroup IIId was given vitamin K during the same period of immobilization. The distal ends of the femur of the immobilized limb were taken, processed, and examined using scanning electron microscopy. Morphometric studies were carried out. The results showed significant thinning of both compact and cancellous bone on immobilization. Multiple cavities and cracks and widening of the Haversian canal were detected in the compact bone. Thin irregular spike-like bone traveculae and fracture were also seen in the cancellous bone trabeculae. Administration of either Ca [subgroup IIIa] or vitamin D [subgroup IIIb] with immobilization did not improve most of the previous results. Combined administration of both Ca and vitamin D [subgroup IIIc] improved cortical bone thickness but not the thickness of cancellous bone. Administration of vitamin K [subgroup IIId] with immobilization resulted in extensive branching and anastomosing bone trabeculae in the metaphysic. For the period of this experiment, vitamin K proved to be more effective as a protective agent compared with combined Ca and vitamin D administration in cases of immobilization osteoporosis

Comparative study on the effect of vitamin K versus combined Ca and vitamin D administration on the prevention of experimentally-induced osteoporosis in adult male albino rats

Immobilization is one of the important causes of osteoporosis especially after cast application and in the elderly people who might be bedridden or suffering from joint diseases. To compare between the effects of vitamin K and the combined use of Ca and vitamin D on the prevention of experimentally-induced osteoporosis of the femur. This study included 24 adult male albino rats. They were divided into four groups: group 1 [control group], group 2 [immobilization group that were immobilized by casting of their right lower limb for 4 weeks], group 3 [immobilization group that concomitantly received 0.0009 mg/g body weight of vitamin K daily during the casting period], and group 4 [that was given Ca [0.09 mg/g body weight daily] and vitamin D [0.5 micro g/kg alfacalcidol daily] during the casting period]. At the end of the experiment, the distal end of the femur of the immobilized limb was taken, processed, and examined by different histological techniques. A morphometric study was conducted to measure cancellous bone thickness, osteoid thickness, osteoid surface percentage, and the eroded surface percentage. The data were statistically analyzed. It was observed that immobilization caused marked thinning of the cancellous bone trabeculae. Erosion cavities were frequently seen in both compact and cancellous bones. Increased mean eroded surface percentage and decreased mean osteoid thickness and mean osteoid surface percentage were also noticed with immobilization when compared with the control group. Concomitant administration of vitamin K with casting resulted in significant improvement of most of the above-mentioned bone parameters. With combined administration of Ca and vitamin D with immobilization, erosion cavities were still seen in a few areas. Decreased mean cancellous bone thickness was also noticed when compared with groups 1 and 3. According to the results of this experiment, vitamin K proved to be more effective, as a protective agent, than combined Ca and vitamin D administration in cases of immobilization osteoporosis. Level of evidence Level three in vitro [prospective case-control study in vitro]

Isolated torsion of the penis: technique and review of the literature

Torsion of the penis is a rather rare condition in which the penis is rotated to one side with different degrees. It is a common condition when associated with other congenital defects of the penis such as hypospadias and epispadias and their variants. The association of chordee and bending of the penis is a common happening. This study in meant to demonstrate a new technique in the treatment of Torsion of the penis. Among the cases admitted to the Paediatric Surgical Unit of the Medical Research Institute and of the Faculty of Medicine-University of Alexandria, 18 cases of isolated torsion were included in this study. These were gathered based on consecutive admission in the period between March 2001 and February 2003. A total of 11 cases were admitted in the Faculty of Medicine Unit, while 7 cases were managed in the Medical Research Institute. The age ranged between 1 and 10 years with a mean of 4.4 years. The cases associated with hypospadias and epispadias were not included in this study. However, some deviation of the isolated cases of torsion included 1 case with chordee, 1 case of lateral bent penis and 2 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases in 2002 and 3 cases in 2003, Fifteen out of the 18 cases were showing an anti-clokwise torsion. Simple detorsion under general anaesthesia was the rule using a modification to adjust the shape of the penis after circumcision. This depends on protection of the glans and determination of the ratio between the post-coronal collar and the skin in anticipation. Adequate apposition of the median raphe to the new de-roted shaft is put in consideration. No complications were encountered except in one case, where residual torsion was reported after healing. Another go was necessary to ensure satisfactory detorston

Role of laser [KTP] in airway disorders in pediatric surgery

The aim of this work was to assess the role of laser in airway disorders in pediatric surgery. A prospective study in 10 patients with airway disorders, consecutively admitted to the Pediatric Surgery Center, University of Alexandria between September 1996 and September 1997. We have a laser apparatus [Laserscope] of 2 different wavelengths, the first is 532 of KTP and the second is 1064 of Nd:YAG. The KTP laser irradiation was induced through the bare fiber of different sizes [200 micro m, 400 micro m, 600 micro m]. We define the technique used: either contact or non contact and we define laser parameters as regards, technique [continuous, non contact], pulse interval, pulse duration and power according to the required tissue effect. Laser was used through rigid bronchoscopic video-camera system. General anesthesia was used as a rule either through endotracheal intubation or ventilation through the same stoma of tracheostomized patients. Through the pediatric bronchoscopic procedures done, laser was used in 10 patients of different age varied from 1 day-15 years old age. Twenty laser sessions were applied for 10 patients. The subglottic tracheal stenosis represented the highest incidence. Prolonged intubation was the most common respiratory indication of laser bronchoscopic procedures. Laser may be used alone or in association with other procedures. The most common laser procedure was excision. The complications were reported. The use of laser [KTP] has no substitution in the treatment of some cases of respiratory obstruction