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 …

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

Background

Few data about women's sexuality practices post-acute COVID-19 syndrome are available. Many women who have had the disease experience sexual dysfunction; hence, the adverse effect of COVID-19 on sexual function has generated interest. We aimed to clarify the impact of COVID-19 on female sexual function 6 months after the illness and possible risk factors and to evaluate the relationship between psychiatric problems and female sexual dysfunction 6 months after COVID-19. Sixty-two patients were enrolled in this cross-sectional study and assigned according to female sexual function index scores to two groups: those with and without sexual dysfunction. For all participants, we documented socioeconomic status, sexual history, symptoms of COVID-19, vaccination data, and Symptom Checklist 90.

Results

Sexual dysfunction was 58% of all participants after 6 months COVID-19. Sexual frequency and sexual problems except pain were decreased in both groups with more affection in sexual dysfunction women. Sexually dysfunctional women were more likely to obtain oxygen therapy during COVID-19, received AstraZeneca, had post-vaccination myalgia and headache, and recurring COVID-19 after vaccination. No significant SCL-90 subscale differences. Sexual dysfunction was associated with renal illness, fatigue, COVID-19-related oxygen therapy, post-vaccination myalgia, and headache.

Conclusions

After 6 months COVID-19, there was a decline in the frequency of sexual intercourse and scores on all FST subscales in both groups except pain, with more affection in sexual dysfunction women. No statistical difference in psychiatric problems between both groups. Sexual dysfunction was associated with renal illness, COVID-19-related oxygen therapy and fatigue, post-COVID-19-vaccination myalgia, and headache.

Telemedicine platforms are ideal for managing several challenges facing healthcare systems in response to global infectious outbreak as COVID-19 Pandemic, however uncontrolled usage of telemedicine may associate with the development of ethical and legal risks in the context of health. Aim of the study: evaluate the extent, purposes, of increased telemedicine services during COVID-19 among physicians in Egypt Governorates assessing the associated ongoing ethical, legal and professional challenges. Material& Methods: The study is a cross sectional questionnaire-based study consisting of two sections designed to evaluate the extent, purposes, of telemedicine regarding health services in the period of COVID-19 pandemic with measuring the extent of the public's awareness of seeking medical advice through telemedicine also, assessment of the implementations of professional and ethical standards of such process and associated inherent ethical and professional risks of the telemedicine. Results: (84.8%) of participants prefer the use of telemedicine during the period of COVID-19 pandemic, most participants satisfied about their usage of telemedicine especially what’s app application, great majority of the physicians (67.7%) expressed the presence of multiple risks (Ethical, Legal, Professional, Personal) associated with providing the health care services by this process. the great majority of the participants (78.6%) are satisfied with the service
Conclusion: Telemedicine provides great remote health services during COVID-19 pandemic, but also carries greater risks of ethical, legal, personal, and professional aspects. physicians and medical students using telemedicine should pay attention to the ethical sensitivity in their relationships with patients.

Synthetic cannabinoids are one of the largest groups of new psychoactive substances that invaded Egypt’s drug abuse market over the past few years. Aim Randomized controlled trial study to demonstrate the effects of acute and chronic toxicity by synthetic cannabinoid (Strox) on the brain, liver, heart, and testes in adult male albino rats through histopathological examination by light microscope and immunohistochemistry. Methods Total number of fifty male albino rats were divided into five different groups, two control and three treated groups. Negative and positive control groups received distilled water and dimethyl sulfoxide, respectively, acute group received LD50 (lethal dose 50) once and observed for 14 days, chronic group received 1/10 LD50 for 3 months, and finally chronic withdrawal groups received 1/10 LD50 for 3 months and then left 2 weeks without the substance to observe the withdrawal manifestations. Results The current study revealed various histopathological changes in all organs with increased expression of cannabinoid receptor 1. The most important findings observed by light microscope examination were shrinkage and degenerative changes in Purkinje cells in brain sections, abnormalities in blood sinusoids and architecture in liver section, disruption in cardiac muscle fiber in heart sections, and finally testes showed irregularities in seminiferous tubules and germinal cells. Immunohistochemical staining for caspase-3 in the brain, liver, and heart showed weak-positive reaction in acute group and a strong reaction with chronic groups. Additionally, increase in collagen fiber was observed in sections of the liver and heart of chronic group. Conclusions Synthetic cannabinoid sample (Strox) toxicity caused adverse effects on the brain, liver, heart, and testes as shown by increasing cannabinoid receptor 1 and caspase-3 expression.