Background: There is an interesting growing evidence for a relation between bronchiolitis and vitamin D. This suggests a possible benefit from Vitamin D therapy to children with bronchiolitis. Methods: We performed a double-blind, randomized clinical trial on 89 infants with bronchiolitis. Patients were randomized to receive vitamin D or placebo. Results: The intervention group, which received vitamin D therapy, had significant improvement in 3 parameters: The mean time taken for resolution of the disease, the mean time taken for the improvement of oral feeding and the duration of hospitalization. All these outcomes in the intervention group (vitamin D) were significantly better than the control (placebo) group with p 0.001, 0.05 and 0.01 respectively. Our study supported the efficacy of vitamin D therapy in bronchiolitis. Conclusion: This double-blinded, randomized placebo controlled trial of vitamin D supplementation 100 IU/kg daily in Egyptian children with bronchiolitis found a clinically and statistically significant reduction in hospitalization with rapid recovery of the disease. Our study suggested that short term supplementation with Vitamin D given daily during the course of illness, starting from day one, may help in resolution of bronchiolitis. Trial of Vitamin D Supplementation in Infants with Bronchiolitis: A Randomized, Double-Blind, Placebo-Controlled Study. Available from: https://www.researchgate.net/publication/274699981_Trial_of_Vitamin_D_Supplementation_in_Infants_with_Bronchiolitis_A_Randomized_Double-Blind_Placebo-Controlled_Study [accessed Jun 3, 2015].

Abstract: Objective: To evaluate the clinical outcome and advantages of the Percutaneous plate fixation for complex distal tibial fractures using locking compression plate- distal tibial plate (LCP-DTP). Design: This is a prospective case series study Setting: Urban, level I trauma center. Patients and methods: 27 adult patients; who met the inclusion criteria; with closed traumatic distal tibia with or without fibular fractures were treated using minimally invasive plate osteosynthesis MIPO technique with LCP-DTP. According to the AO fracture classification, there were 12 AO 43A fractures, 15 AO 43B fractures. The fibula was fractured in 15 patients and it was fixed in all of them. Main outcome measurements: Peri-operative complications following percutaneous fixation of the distal tibia as infection, deformity, leg length discrepancy, ankle joint function, bony union and metal failure within one year after surgery. Results: This study included 27 adult patients with traumatic fracture distal third tibia, 21 of them were males and 6 females. They were followed up for a period ranging from 14 to 19 months with an average of 16. None of the patients developed early peri-operative complications. Deep venous thrombosis occurred in 3 patients, who were treated medically, residual loss of a few degrees ankle motion in 6 and late infection related to the proximal screws was also observed in 3 obese uncontrolled diabetic patients. Union was achieved in all of them within 12- 20 weeks with an average of 16. Conclusions: MIPO for the distal tibia using the LCP-DTP is safe and effective in the treatment of complex distal tibial fractures.

Background: There is growing evidence for a gut-brain connection associated with autism spectrum disorders (ASD). This suggests a potential benefit from introduced digestive enzymes for children with ASD. Methods: We performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years. ASD patients were diagnosed according to DSM-IV-TR diagnostic criteria. Structured interviews of at least one hour each both with the parents and the child were performed. Later on, another two hours-session was conducted applying the Childhood Autism Rating Scale (CARS). ASD patients were randomized to receive digestive enzymes or placebo. Results: The ASD group receiving digestive enzyme therapy for 3 months had significant improvement in emotional response, general impression autistic score, general behavior and gastrointestinal symptoms. Our study demonstrated the usefulness of digestive enzyme in our population of ASD patients. Conclusion: Digestive enzymes are inexpensive, readily available, have an excellent safety profile, and have mildly beneficial effects in ASD patients. Depending on the parameter measured in our study; we propose digestive enzymes for managing symptoms of ASD. Digestive enzyme therapy may be a possible option in treatment protocols for ASD in the future A randomized, Placebo-Controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders. Available from: https://www.researchgate.net/publication/273063768_A_randomized_Placebo-Controlled_Trial_of_Digestive_Enzymes_in_Children_with_Autism_Spectrum_Disorders [accessed Jun 3, 2015].

Background: There is growing evidence for a gut-brain connection associated with autism spectrum disorders (ASD). This suggests a potential benefit from introduced digestive enzymes for children with ASD. Methods: We performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years. ASD patients were diagnosed according to DSM-IV-TR diagnostic criteria. Structured interviews of at least one hour each both with the parents and the child were performed. Later on, another two hours-session was conducted applying the Childhood Autism Rating Scale (CARS). ASD patients were randomized to receive digestive enzymes or placebo. Results: The ASD group receiving digestive enzyme therapy for 3 months had significant improvement in emotional response, general impression autistic score, general behavior and gastrointestinal symptoms. Our study demonstrated the usefulness of digestive enzyme in our population of ASD patients. Conclusion: Digestive enzymes are inexpensive, readily available, have an excellent safety profile, and have mildly beneficial effects in ASD patients. Depending on the parameter measured in our study; we propose digestive enzymes for managing symptoms of ASD. Digestive enzyme therapy may be a possible option in treatment protocols for ASD in the future A randomized, Placebo-Controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders. Available from: https://www.researchgate.net/publication/273063768_A_randomized_Placebo-Controlled_Trial_of_Digestive_Enzymes_in_Children_with_Autism_Spectrum_Disorders [accessed Jun 3, 2015].

Background: There is growing evidence for a gut-brain connection associated with autism spectrum disorders (ASD). This suggests a potential benefit from introduced digestive enzymes for children with ASD. Methods: We performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years. ASD patients were diagnosed according to DSM-IV-TR diagnostic criteria. Structured interviews of at least one hour each both with the parents and the child were performed. Later on, another two hours-session was conducted applying the Childhood Autism Rating Scale (CARS). ASD patients were randomized to receive digestive enzymes or placebo. Results: The ASD group receiving digestive enzyme therapy for 3 months had significant improvement in emotional response, general impression autistic score, general behavior and gastrointestinal symptoms. Our study demonstrated the usefulness of digestive enzyme in our population of ASD patients. Conclusion: Digestive enzymes are inexpensive, readily available, have an excellent safety profile, and have mildly beneficial effects in ASD patients. Depending on the parameter measured in our study; we propose digestive enzymes for managing symptoms of ASD. Digestive enzyme therapy may be a possible option in treatment protocols for ASD in the future A randomized, Placebo-Controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders. Available from: https://www.researchgate.net/publication/273063768_A_randomized_Placebo-Controlled_Trial_of_Digestive_Enzymes_in_Children_with_Autism_Spectrum_Disorders [accessed Jun 3, 2015].

Background: There is growing evidence for a gut-brain connection associated with autism spectrum disorders (ASD). This suggests a potential benefit from introduced digestive enzymes for children with ASD. Methods: We performed a double-blind, randomized clinical trial on 101 children with ASD (82 boys and 19 girls) aged from 3 to 9 years. ASD patients were diagnosed according to DSM-IV-TR diagnostic criteria. Structured interviews of at least one hour each both with the parents and the child were performed. Later on, another two hours-session was conducted applying the Childhood Autism Rating Scale (CARS). ASD patients were randomized to receive digestive enzymes or placebo. Results: The ASD group receiving digestive enzyme therapy for 3 months had significant improvement in emotional response, general impression autistic score, general behavior and gastrointestinal symptoms. Our study demonstrated the usefulness of digestive enzyme in our population of ASD patients. Conclusion: Digestive enzymes are inexpensive, readily available, have an excellent safety profile, and have mildly beneficial effects in ASD patients. Depending on the parameter measured in our study; we propose digestive enzymes for managing symptoms of ASD. Digestive enzyme therapy may be a possible option in treatment protocols for ASD in the future A randomized, Placebo-Controlled Trial of Digestive Enzymes in Children with Autism Spectrum Disorders. Available from: https://www.researchgate.net/publication/273063768_A_randomized_Placebo-Controlled_Trial_of_Digestive_Enzymes_in_Children_with_Autism_Spectrum_Disorders [accessed Jun 3, 2015].

Abstract: Purpose: This study was designed to evaluate the functional and radiological results of biplanar medial opening wedge high tibial osteotomy using Tomofix plate. Patients and Methods : This study included 69 patients with medial unicompartmental osteoarthritis of the knee joint, their age ranged from 35 to 54 years with an average of 47 years, 38 were males and 31 females. Partial weight bearing exercises were allowed after the first week of surgery. Results: Patients were followed up for a period ranging from 24 to 38 months with an average of 31 months. The American Knee Society Score was markedly improved in all patients from 61+/- 10 to 92+/- 5. The constitutional tibia vara angle improved from 5- 15 degrees to normal valgus angle 5-7 degrees. There was no recorded case of infection, non-union or metal failure. Conclusions: The medial biplanar opening wedge high tibial osteotomy is a successful tool in correction of mal-alignment of the knee joint, early weight bearing, no bone grafting was required and complication free. Key words: High tibial osteotomy, Tomofix plate, osteoarthritis, knee

Abstract: Purpose: This study was designed to evaluate clinical outcomes and complications following minimally invasive plate osteosynthesis (MIPO) with the proximal humeral internal locking system (PHILOS) for treating proximal humeral shaft fracture. Patients and Methods: Between March 2012 and March 2013, 37 patients with unilateral proximal humeral shaft fractures were treated using the MIPO technique with the PHILOS through the transdeltoid approach. All fractures were closed with no associated injuries and classified as 2-part (n=13), 3-part (n=19), and 4-part (n=5), according to the Neer's classification. Patients were followed up for 16.9 months (range, 12– 24), radiologically and functionally. Postoperative complications and functional Constant Shoulder Score were used for evaluation. Results: No intraoperative complications occurred. Postoperative complications included subacromial impingement in 3 patients. There was no deep infection, neurovascular damage, breakage or implant loosening. All fractures united in an average time of 10 (8–12) weeks. In terms of function, the Constant–Murley score was 89 points on average (range75–100). The range of motion of the involved shoulder was satisfactory, and pain-free in 84 % of patients. Conclusions: Using the MIPO technique with the PHILOS plate through the transdeltoid approach is a valid and safe method of treating proximal humeral shaft fractures.

Abstract: Background: Intra-articular fractures of the proximal tibia can often be troublesome because of the early and late arthritic complications of damage of the articular surface, and intra-articular lesions. There are some potential benefits of arthroscopy in solving some of the pitfalls of these fractures. The purpose of this work is to study these benefits of arthroscopy in treatment of those patients, and the benefits of adding an anti-glide screw. Patients and methods: Fifty patients with tibial plateau fractures were treated in Assiut University Hospitals. Of these patients only 16 were included in this study. Fourteen were men and 2 women. The age ranged between 27 and 60 years (mean 43 years). The inclusion criteria were patients with split, split depression, or local depression uni-condylar fractures according to Schatzker classification. The mean follow up was 15 months (6-24 months). The postoperative clinical evaluation depended up on Rasmussen scoring system. The radiological evaluation was according to Honkonen and Jarvinen. Results: Complete anatomical reduction of the fragments was achieved in 14 knees (87.5%). Up to 2 mm displacement or step off was accepted in two knees (12.5%). Clinical assessment according to Rasmussen classification was: 10 knees (62.5%) excellent, 4 knees (25%) good, 2 knees (12.5%) fair, and none was poor. Radiological results were: 13 (81.25%) grade one, 2 knees (12.5%) grade two, and one knee (6.25%) grade three. None of the cases were grade four at the final follow up radiographs. Conclusions: The use of arthroscopy allowed precise anatomic reduction of the articular surface of the knee joint. It is particularly helpful in type two and three injuries with central articular depression which are often difficult to assess on preoperative imaging studies. It is also helpful in assessing other intra-articular injuries and their management if possible. The anti-glide screw may help in prevention of loss of reduction.