Background and Purpose: To detect sensitivity and specificity of diffusion-weighted imaging (DWI) as a non-invasive technique in the detection of de-novo cases of cancer larynx
Patients and methods: Patients included in this research were patients suspected of de-novo cancer larynx; This study is a prospective randomized comparative clinical trial.
Results: The mean apparent diffusion coefficient (ADC) of laryngeal lesions (0.73± SD 0.23 x10-.3 mm2) was lower (p < 0.001) than the mean of the normal part of the larynx in the same patients (1.09± SD 0.099 x 10-.3 mm2), The cut-off value of the ADC using receiver operating characteristics was Conclusion: DWI is an easily reproducible and non-invasive technique that can accurately explore the larynx and became a very important diagnostic tool of laryngeal diseases. This study demonstrated the cut-off point of ADC value for discrimination of malignant lesion is <0.87x 10-.3 mm2/s with restricted diffusion in DWI images.
Background: Pulmonary hypertension associated with COPD varies greatly among studies, and accounts for increased morbidity and mortality among patients with COPD. This study aims to evaluate prevalence of pulmonary hypertension, possible predictors and effect on exercise capacity.
Methods: 73 COPD patients were grouped into 2 groups according to presence of pulmonary hypertension. Assessment included full clinical history, mMRC dyspnea scale and COPD assessment test. Transthoracic echocardiography, cardiopulmonary exercise testing (CPET) using incremental treadmill exercises protocol.
Results: 43 COPD patients (58.9%) suffered from pulmonary hypertension, 58.1% of them were males. COPD patients with pulmonary hypertension had significantly lower parameters of pulmonary function tests either pre or post-bronchodilator; significantly lower pH, PO2 and SO2 either before or after CPET. Mean pulmonary artery pressure had significant negative correlations with FEV1 (r= -0.27, p= 0.02), pre-test PaO2 (r= -0.38, p< 0.001), post-test PaO2 (r= -0.28, p= 0.01), predicted VO2 (r= -0.62, p< 0.001), predicted BR (r= -0.42, p< 0.001) and oxygen pulse (r= -0.48, p< 0.001). Predictors of pulmonary hypertension among COPD patients were oxygen saturation before the test (OR= 0.59, 95%CI= 0.39-0.90) and oxygen pulse (OR= 0.55, 95%CI= 0.35-0.87).
Conclusion: pulmonary hypertension is negatively correlated with exercise capacity, specifically peak VO2 percent predicted. Predictors of pulmonary hypertension among COPD patients were oxygen saturation before the test and oxygen pulse.
Cholesteatoma is a common disease of the middle ear cleft associated with several complications, Surgery is the mainstay for the management of such a pathological condition, however, complications may occur including intracranial ones due to violation of middle cranial fossa dura. Anatomical variations have been reported and High-resolution CT scan is the major tool for detecting such variations. In this study, we aim to determine if there is a difference between tegmen height between both sides of patients with unilateral cholesteatoma. 21 patients were recruited for such study all underwent HRCT and the tegmen height was determined in two coronal planes, the first between the central point of the Henle spine and the tegmen, the other between the plane of both lateral canals and the roof of the middle ear. The tegmen height measurements showed that the affected side had significantly lower tegmen height …
| Abstract | |
| Background: Intraoperative bleeding is thought to be a significant barrier to endoscopic vision. Blood obstructs the surgical field's anatomy and stains the endoscope lens, making visibility more challenging. The likelihood of consequences, such as brain injuries, orbital or optic nerve damage, and catastrophic haemorrhage from significant arteries, is increased in this circumstance. Objectives: To investigate the effects of adding verapamil and bisoprolol to general anaesthetic to reduce heart rate and blood loss at endoscopic sinus surgery, to explore the surgeon's evaluation of the surgical field and hemodynamics, and to investigate the effects of adding verapamil and diltiazem to general anaesthetic to investigate serum cortisol and norepinephrine levels at endoscopic sinus surgeries. Patients and methods: This quasi-experimental investigation was conducted at Assiut University Hospital. A convenience sample of 135 adult patients, both males and females, was divided into three equal groups: the control group (45 patients), who were given a placebo orally (PO) three hours before surgery; the Bisoprolol group (45 patients), who were given Bisoprolol 10 mg PO preoperatively; and the verapamil group (45 patients), who were given 80 mg PO of verapamil three hours before surgery. The primary goal was to determine how adding oral verapamil or Bisoprolol to general anaesthesia affected intraoperative hemodynamics and blood loss during endoscopic sinus surgery. The secondary goal was to determine how adding oral verapamil or Bisoprolol to general anaesthetic affected serum cortisol and norepinephrine levels throughout endoscopic sinus surgeries and the surgeon's evaluation of the surgical field. Results: The three investigated groups showed statistically substantial differences in the mean heart rate, mean systolic blood pressure, and blood loss at various intraoperative times. Groups 1 and 2 (p< 0.001), 2 and 3 (p <0.001), and 1 and 3 (p <0.001) all showed statistically substantial differences. Conclusion: Verapamil and Bisoprolol are reliable and secure medications for this use. However, Bisoprolol was superior since it allowed for ideal surgical conditions while slightly lowering blood pressure. Additional benefits included decreased intraoperative bleeding and tachycardia during the procedure. |
Background
Otitis Media with Effusion (OME) is defined as the presence of a middle ear fluid in the absence of symptoms of acute infection. The adenoid plays an important role in the pathogenesis of OME. Management of OME consisted of many choices, including auto inflation and medical treatment. Surgery was indicated in cases where the effusion does not resolve spontaneously or has failed medical treatment for 3 months.
Aim
The purpose of this study is to compare the outcome of secretory otitis media in patients with adenoids hypertrophy who underwent adenoidectomy alone, adenoidectomy and myringotomy, or adenoidectomy with tympanostomy tube (TT) application.
Patients and methods
This study included a total of 150 patients who suffered from persistent OME due to adenoid enlargement and were planned for adenoidectomy alone, with myringotomy or with TT insertion. The included patients were divided randomly into three groups.
Results
The results of the tympanogram after six months of healed myringotomy were significantly improved in group III compared to group I and group II. According to age class, 18 cases <4 years old, 23 cases between 4 and 8 years old, and 21 cases >8 years old were cured, and these differences were statistically significant. Regarding other factors, there were no statistically significant results.
Conclusion
Below the age of 4 years old, Clinicians may perform adenoidectomy as an adjunct to TT insertion for children with symptoms directly related to the adenoids, while above age of 4 years old, adenoidectomy and TT insertion has the best results.
We report a case of concomitant skull base and atlanto-axial hyperpneumatization complicated by symptomatic pneumorrachis and cervical emphysema. A computed tomography (CT) scan of brain and spine highlighted a hyperpneumatization of the right temporal bone, the sphenoidal and occipital clivus, the occipital bone, and the first two cervical vertebrae, associated with epidural pneumorrrachis and cervical emphysema. A dehiscence in the right spheno-petrosal cleft as the site of abnormal communication between the hyperpneumatized cells and the epidural space was identified and repaired through an endoscopic transnasal transethmoidal approach. Postoperative course was uneventful and a 3-month postoperative CT scan of brain and spine showed a reduction of free air around the spinal cord, brainstem, and the cervical soft tissues and complete closure of the spheno-petrosal dehiscence. A comprehensive literature review focusing on pathogenesis, radiologic findings and treatment of cranio-cervical hyperpneumatization and its complications is herein presented.
Laryngeal cancers are equivalent to one-third of head and neck cancers and are considered an important source of morbidity and mortality. Early-stage disease is highly curable with either surgical or radiation monotherapy, whereas late-stage disease has a worse outcome. The p53 protein is situated in the cell nuclei and play role in cell cycle checkpoint regulation, apoptosis, DNA repair, and the regulated repairing process of the damaged DNA caused by chemicals, radiation, and ultraviolet rays. If this process is arrested due to any cause, the p 53 transmits a signal to trigger cell apoptosis and prevents the cell from replication and hence tumor development. About 14 SNPs have been identified in the wild-type TP53 gene, which could change the function of the p53 protein. One of the most common SNPs of the TP53 gene is TP53c215C>G(Pro72Arg) (rs1042522), located in the proline-rich domain of p53, which is important in normal p53 function. Studies show that the arginine (Arg) variant is able to induce apoptosis faster and more efficiently than proline (Pro), while the Pro variant is better for inducing cycle arrest. It has been reported that Arg72Pro SNP in the TP53 gene can increase the risk of cancers.
DIFUSSION MRI involves acquisition of signal of movement of water proton in cellular spaces of body (Brownian motio
It includes qualitative method either restricted or facilitated and quantitive method which is apparent diffusion coefficient value(ADC) which is related to proportion of extracellular and intracellular components of the tissue., ADC is calculated with use of at least two b value more accurate using more DWI with different b value,ADC levels is low in increased tissue cellularity, as malignancy., ADC levels is high in non-tumoral tissue alterations such as direct endoscopy oedema, radiotherapy necrosis are expected to have minimal cellularity. ADC is most accurate in the detection of malignancy versus tissue edema or radionecrosis the aim of study to assess value of ADC as regarding measuring sensitivity and specificity and accuracy to differentiate tumor recurrence from radionecrosis.
Background
Alopecia areata (AA) has multiple aetiology such as genetic and environmental triggers.
Aims
To assess the recovery rate of AA and examine the associated psychiatric problems. Additionally, the relationship between clinical, psychiatric, and laboratory biomarkers and alopecia outcomes were investigated, along with potential risk factors that could aid in treating alopecia.
Patients and methods
A prospective cohort research included 42 AA patients and 45 healthy controls. Group A (active disease), group B (inactive disease), and group C (healthy control) were based on illness outcomes after 3 months of treatment. The Severity of Alopecia Tool (SALT), treatment regimens, laboratory investigation Interleukins 19 and 33 (IL-19 and IL-33), Symptom Checklist 90, and post-traumatic stress disorder Checklist for DSM-5 (PCL-5) were evaluated.
Results
After 3 months of therapy, the incidence of inactive AA was found to be 57.14%. Being females with family history of dermatitis were highly related with active illness, while smoking and unmarried patients were associated with inactive disease. After 3 months of treatment, active illness had the highest mean IL-33 and IL-19 levels. Conclusion
The active disease group exhibited the highest mean IL-33 and IL-19 levels at baseline following three months of treatment. Our patients had 7.1% somatization, 7.1% obsessive-compulsive symptoms, 4.8% depression, 4.8% anxiety, 15.9% anger-hostility, 35.7% phobic-anxiety, 26.2% paranoid ideation, 4.8% psychoticism, and 61.9% post-traumatic stress disorder. AA outcomes were linked to females, a family history of dermatological disorders, smoking, being single, and higher mean IL-33 and IL-19 levels. Psychosis was highly linked with active AA. Only khellin and Ultraviolet A improved AA results.
Keywords:
alopecia areata, clinical evaluation and treatment, immunohematology, psych dermatology
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