Volume analysis of second molar pulp chamber using cone beam computed tomography for age estimation in Egyptian adults.

AIM: The present work aimed to evaluate age-related variations in the dental pulp chamber volume of second molars using cone beam computed tomography (CBCT) imaging, in order to establish a specific mathematical model for second molars and measure its accuracy, especially in the case of Egyptian adults. SUBJECTS AND METHODS: From 187 subjects between 21-50 years of age, CBCT images of 257 maxillary and 248 mandibular second molars were included. A mathematical model for human age estimation was established. An independent additional set of CBCT images was obtained to test the model's accuracy. RESULTS: For maxillary and mandibular teeth, R2 for the pooled sexes were 0.51 and 0.52, and SEE were 5.92 and 5.71, respectively. A model for each sex was established, due to the significant difference between them, where R2 was equal to 0.668 and 0.650 in males and 0.46 and 0.48 in females, concerning maxillary and mandibular teeth, respectively. When testing the validation samples, the mean absolute error (MAE) between the actual and estimated ages from the pooled sex model were 4.89 and 4.61 for maxillary and mandibular teeth, respectively. CONCLUSION: The pulp chamber volume of second molars is a relatively accurate indicator for age estimation in Egyptian adults.

A comparative study between laparoscopic versus open appendicectomy in men.

One hundred men between the age of 15 and 65 admitted to Ain Shams Specialized Hospital and El Demerdash Hospital, Cairo, and to the Saudi German Hospital, Saudi Arabia between November 1998 and December 2000 were randomized to undergo either open or laparoscopic appendicectomy. Both groups were compared in terms of clinical parameters, duration of anaesthesia, operative time, duration of ileus and length of hospital stay. The histologic confirmation of appendicitis was present in 92% in both groups. Laparoscopic appendectomy required significantly longer anaesthetic time (78 minutes versus 51) and operating time (49 minutes versus 23) compared with open appendectomy. No significant difference was noticed between laparoscopic and open appendectomy groups in the recovery of bowel function (24 hours versus 21) and in the length of hospital stay (4.9 days versus 5.3). The result showed no significant advantages of laparoscopic appendectomy over open appendectomy for the treatment of male patients with suspected appendicitis.

Thoracoscopic sympathectomy for treatment of hyperhidrosis surgical experience and results of 30 cases.

The thoracoscopic sympathectomy in treatment of primary palmar and axillary hyperhidrosis was performed on 30 patients complaining of hyperhidrosis admitted to El Demerdash University Hospital and Ain Shams University Specialised Hospital and The Saudi German Hospital between March 1999 and March 2001. The indication of surgery was primary palmar hyperhidrosis in 24 cases and combined palmar and axillary hyperhidrosis in 6 cases. 25 cases were males and 5 cases were females. The mean age in our sample was 25.7 +/- 4.05 years. There were no major complications in our series and 4 cases were complicated by intercostal vessels bleeding which were successfully controlled by cauterization during surgery and no one of them necessitated neither thoracotomy nor application of intercostal tubes. The patients were followed up for one year after operation and only one case had recurrence of palmar hyperhidrosis.

Stapling procedure for hemorrhoids versus conventional haemorrhoidectomy.

Forty patients admitted at the Saudi German Hospital were randomly assigned to Milligan-Morgan haemorrhoidectomy (n = 20) or the circular stapled procedure. Under general anesthesia patients underwent standardized haemorrhoidectomy or had a circumferential doughnut of rectal mucosa and submucosa above the dentate line excised and closed with a standard circular end to end stapling device. All patients received the same preoperative and postoperative analgesic and laxative regimens. Patients completed linear analogue pain charts each day and were interviewed at 1, 3, and 12 weeks postoperatively. Summary measures of average pain experience were calculated from 10 cm linear analogue pain scores and were used as the primary outcome measure. The stapled group was found to have shorter anesthesia time (9-25 minutes, median 18) versus (15-35 minutes, median 22). Average pain in the stapled group was significantly lower than it was in the Milligan-Morgan group (0.2-7.6, median 2.1) versus (3.1-8.5, median 6.5). Hospital stay and time to first bowel motion were not significantly different between both groups. Return to normal activity was significantly shorter in the stapled group (3-60 days, median 17) versus (14-90 days, median 34). Early and late complications, patient assessed symptom control, and functional outcome appear to be similar after short term follow up.

Some genetic, clinical and immunologic interrelations in schistosomiasis mansoni.

The aim of the present work was to study the possible association of some class I, II MHC gene products with variations in the clinico-pathological outcome of human schistosomiasis mansoni as well as with the variability in immune responsiveness. The study was carried out on 47 patients with schistosomiasis mansoni and 20 healthy volunteers served as control group for the immunological parameters and 200 subjects for the genetic studies. The following were determined: class I, II HLA typing, serum IgG, IgM, C3c, immediate intradermal test and passive haemagglutination using S mansoni worm antigen, T lymphocyte subsets, delayed intradermal test and leukocyte migration inhibition using phytohaemagglutinin (PHA) and soluble egg antigen (SEA) of S mansoni. A statistically significant association was found between HLA-B5 and DR3 and with the occurrence of hepatosplenic disease; this phenotype also correlated with changes in T lymphocyte subsets and high immune reactivity, both humoral and cell mediated. HLA-DQI was also associated with failure to develop hepatosplenic disease. The present study consolidates also the view of the important role of host immune reactivity in the clinical outcome of schistosomiasis mansoni and demonstrates the contribution of the genetic impact on both clinical and immunological heterogeneity of the disease.

HLA-A, -B and -C specificities in insulin dependent diabetes mellitus in the Egyptian population.

The diversity of HLA antigens frequencies associated with Insulin Dependent Diabetes Mellitus (IDDM) reported in different populations raised the importance of determining HLA-A, -B and -C specificities in patients with IDDM in the Egyptian population. The study has been carried out on thirty patients with IDDM and thirty healthy control subjects matched for age and sex as patients included in the study. The results of the present work showed that patients with IDDM showed a significant increase in frequency of HLA-A2, HLA-B8 and HLA-B15. These findings are in accordance with the genetic heterogeneity of IDDM which is in turn in harmony with the modern concept on the complex aetiology of the disease. On the other hand, HLA-A3, HLA-B5 and HLA-B7 have been found significantly decreased in patients with IDDM, thus suggesting that these alleles may confer a protective effect from acquiring the disease. When HLA specificities have been studied in relation to the age of onset of the disease, HLA-A29 have been found in higher frequency in the age group after 15 years, while HLA-B15 in that before 15 years. This variability may be related to variation in the viral agents responsible for the infectious mechanism.