Sternal fractures are rare accounting for about 3–8% of traumatic chest. There are many lines of treatments for sternal fractures which can be classified as conservative or surgical. Surgical techniques include wire fixation and sternal plating. There are no standardization of indications for each line of management. We explore if sternal reconstruction using locking titanium plates and self-tapping screws provide the patient with the best chance of proper sternal healing avoiding chronic pain and its complications and allow the patient early mobilization and rapid restoring of his normal life at its maximum. Methods: Our inclusion criteria are patients of both gender from 20 to 60 years of age presented with traumatic sternal fracture at any site or pathological fracture due to metastatic or primary tumors infiltrating the sternum. High Associated Injury Scale scores were excluded. Exclusion criteria also included patients younger than 20 years or older than 60 years. Primary outcome is post-operative pain score and is measured using numerical pain scale ranging from zero to 10 where zero means there is no pain at all and ten is the worst imaginable pain ever. Results: Sternal reconstruction using titanium plates has proven to be an efficient method of stabilization with tremendous immediate relief of pain showed by the differences between pre-operative and post-operative pain scale scores in our patients (n = 5) with Median scores being 7 and 1.5 with range being from 7 to 9 and 1 to 3 respectively (p-value = .039). Operative time range between 150 min and 90 min with median of 120 min. Extubation of patients was smooth with no events with median time of extubation being 120 min. From our experience, there were no observed wound complications except at the third patient who suffered a small wound hematoma that was resolved by gentle compressing only and needed no further intervention. Conclusion: We recommend adopting sternal reconstruction using titanium plating systems more readily encouraging even larger clinical trials on the way to a clear guidelines. Plating systems show promising results with least pain, better stability, less complications and rapid, smooth recovery.

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Abstract Background: Diabetes is a metabolic disorder characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action, or both. Resistin is described as a potential factor in obesity mediated insulin resistance and type 2 diabetes mellitus. Aim: To evaluate the relationship of resistin levels with estimated glomerular filtration rate (e GFR) and albuminuria in type 2 diabetic patients and to elucidate the role of resistin as an early biomarker for early detection of diabetic kidney disease. Patients and methods: The study included 70 patients with type 2 diabetes mellitus, as well as 18 healthy participants as a control group who were age and sex matched with the patients. Serum resistin levels were assessed using an ELISA kit measured in ng/ml, albumin/creatinine ratio (ACR), eGFR by MDRD formula, and glycated hemoglobin (HbA1C). Results: There was a significant positive correlation between serum resistin level and both HbA1C and ACR but a significant negative correlation with eGFR. Conclusion: There was a significant increased level of HbA1C, resistin, and ACR (mg/g), whereas there was decreased level of eGFR in the patient group compared with the control group (P 0.001).

Abstract Background: Diabetes is a metabolic disorder characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action, or both. Resistin is described as a potential factor in obesity mediated insulin resistance and type 2 diabetes mellitus. Aim: To evaluate the relationship of resistin levels with estimated glomerular filtration rate (e GFR) and albuminuria in type 2 diabetic patients and to elucidate the role of resistin as an early biomarker for early detection of diabetic kidney disease. Patients and methods: The study included 70 patients with type 2 diabetes mellitus, as well as 18 healthy participants as a control group who were age and sex matched with the patients. Serum resistin levels were assessed using an ELISA kit measured in ng/ml, albumin/creatinine ratio (ACR), eGFR by MDRD formula, and glycated hemoglobin (HbA1C). Results: There was a significant positive correlation between serum resistin level and both HbA1C and ACR but a significant negative correlation with eGFR. Conclusion: There was a significant increased level of HbA1C, resistin, and ACR (mg/g), whereas there was decreased level of eGFR in the patient group compared with the control group (P 0.001).

Abstract Aim: was to identify the prevalence and risk factors of vascular access failure among hemodialysis patients. Patients and method: A descriptive exploratory research design was utilized. This study was conducted in dialysis unit at Assiut University Hospital. The study sample consisted of 200 consecutive adult patients attended to dialysis unit at Assiut University Hospital within a period of 6 months their age ranged from 20 to 65 with mean age (40.76±13.24) years. Tools: Tool 1: Patient interview questionnaire sheet. Tool 2: Risk factors and causes of vascular access failure. Results: Incidence of vascular access failure among hemodialysis patients at Assuit University Hospital in over six month was (34.5%). Their age ranged from 40-65 year. Aging, diabetes, obesity, and infection were the major risk factors for vascular access failure. Conclusion: There was statistical significant relationship were found between the vascular access failure and duration of dialysis. Recommendation: Simple illustrated guidelines about vascular access and risk factors for failure should be available for patients in all dialysis units.

Abstract Aim: was to identify the prevalence and risk factors of vascular access failure among hemodialysis patients. Patients and method: A descriptive exploratory research design was utilized. This study was conducted in dialysis unit at Assiut University Hospital. The study sample consisted of 200 consecutive adult patients attended to dialysis unit at Assiut University Hospital within a period of 6 months their age ranged from 20 to 65 with mean age (40.76±13.24) years. Tools: Tool 1: Patient interview questionnaire sheet. Tool 2: Risk factors and causes of vascular access failure. Results: Incidence of vascular access failure among hemodialysis patients at Assuit University Hospital in over six month was (34.5%). Their age ranged from 40-65 year. Aging, diabetes, obesity, and infection were the major risk factors for vascular access failure. Conclusion: There was statistical significant relationship were found between the vascular access failure and duration of dialysis. Recommendation: Simple illustrated guidelines about vascular access and risk factors for failure should be available for patients in all dialysis units.

Abstract Aim: was to identify the prevalence and risk factors of vascular access failure among hemodialysis patients. Patients and method: A descriptive exploratory research design was utilized. This study was conducted in dialysis unit at Assiut University Hospital. The study sample consisted of 200 consecutive adult patients attended to dialysis unit at Assiut University Hospital within a period of 6 months their age ranged from 20 to 65 with mean age (40.76±13.24) years. Tools: Tool 1: Patient interview questionnaire sheet. Tool 2: Risk factors and causes of vascular access failure. Results: Incidence of vascular access failure among hemodialysis patients at Assuit University Hospital in over six month was (34.5%). Their age ranged from 40-65 year. Aging, diabetes, obesity, and infection were the major risk factors for vascular access failure. Conclusion: There was statistical significant relationship were found between the vascular access failure and duration of dialysis. Recommendation: Simple illustrated guidelines about vascular access and risk factors for failure should be available for patients in all dialysis units.