Abstract
Background
 Obese women with preeclampsia have risky outcomes. This 
study assessed the efficacy and safety of the standard dose of intravenous
MgSo4
infusion
in
obese vs.
non-obese women
with
preeclampsia.
Materials and Methods
 This Randomized control trial was conducted in Women’s Health 
Hospital, Obstetrics and Gynecology Department, Assiut University
from January 2020 to August 2021. A total of 200 women with severe
preeclampsia
were
enrolled
and
randomly subdivided
based

on
body mass index into
two equal groups:
non-obese and
obese.
Both
groups received
a
loading dose
of
4 gm of MgSo4 infusion
as

4
grams of magnesium sulphate,
then a maintenance dose
of 1 gm
MgSo4
/hour for 24 hours. The
primary outcome was assessment
of
maternal
serum magnesium level at 30
minutes (after the
end
of
the
loading dose)
and 2,4 and 8 hours after the start. Also,
adverse
events
and maternal and fetal outcomes were recorded.
Results
 Based on classes of BMI, both groups had insignificant differences
regarding the
majority of baseline data.
The
non-obese group

had

significantly higher serum magnesium at different assessment
times during follow-up. Body mass index negatively correlated with 

Background

Despite the marked increase in the anatomical success rates of macula-off rhegmatogenous retinal detachment (RRD) surgery, patients may still complain about unsatisfactory visual outcome. This study aims to correlate the postoperative corrected distance visual acuity (CDVA) with the mf-ERG (multifocal electroretinogram) and OCT (optical coherence tomography) findings following vitrectomy surgery for RRD.

Patients and methods

This retrospective observational study included 40 eyes of 40 patients who underwent successful vitrectomy surgery for macula-off RRD. CDVA, mf-ERG amplitudes, mf-ERG latencies, the central macular thickness (CMT) and the integrity of the inner segment/outer segment (IS/OS) junction assessed by OCT, were evaluated 6 months postoperatively. The correlations between CDVA with mf-ERG amplitudes, mf-ERG latencies, central macular thickness, and IS/OS junction integrity were analyzed.

Results

There was a statistically significant moderate positive correlation between CDVA of the studied eyes with mf-ERG amplitudes of N1, P1 and N2 in ring 1 (P = 0.008; P < 0.001 and P = 0.004, respectively), CMT (P < 0.001), and the integrity of IS/OS junction (P < 0.001). There was no significant correlation between CDVA and mf-ERG latencies in ring 1 (P > 0.05). Linear regression analysis revealed that CDVA was significantly associated with mf-ERG amplitudes and the IS/OS junction integrity. In addition, there was a strong positive correlation between mf-ERG amplitudes in ring 1 and the IS/OS junction integrity.

Conclusions

The integrated interpretation of postoperative CDVA, multifocal ERG parameters, and OCT findings provides useful information about functional visual recovery and retinal microstructural changes following vitrectomy for macula-off RRD surgery. The positive correlation between the IS/OS junction integrity and the mf-ERG amplitudes was stronger than the correlation between the IS/OS junction integrity and CDVA suggesting that mf-ERG may be superior to CDVA in reflecting the extent of microstructural damage in the photoreceptor layer.

Transatrial approach is the standard method in repairing ventricular septal defects (VSD) in the pediatric population. However, the tricuspid valve (TV) apparatus might obscure the inferior border of the VSD risking the adequacy of repair by leaving residual VSD or heart block. Detachment of the TV chordae has been described as an alternative technique to TV leaflet detachment. The aim of this study is to investigate the safety of such a technique.

The discrimination between multiple sclerosis (MS) and other white matter lesions in adults is still problematic as multiple diseases have similar clinical and radiological findings, especially at the disease onset. This case–control study aimed to evaluate the efficacy of diffusion tensor imaging (DTI) and brain morphometry in the differentiation between adult MS and its magnetic resonance imaging (MRI) mimics.

Background/Objective(s)

In recent years, several studies have reported vascular abnormalities in patients with multiple sclerosis (MS). Epidemiological data suggest that patients with MS might have an increased risk of developing ischemic stroke. Imaging studies in patients with MS suggest a decrease in cerebral perfusion that affects widespread areas including the normal-appearing white matter (NAWM). In addition, MS has been associated with reduced CNS venous blood drainage, which is referred to as chronic cerebrospinal venous insufficiency (CCSVI).

Material(s) and Method(s)

Two groups were recruited in the present study:

First group: 30 patients from inpatient and outpatient Neuropsychiatry department in Assuit university hospital were diagnosed with MS according to the revised 2017 McDonald's criteria.

Second group: 30 healthy volunteer subjects matched with age, sex and education level.

Inclusion criteria: Patients diagnosed with MS or with clinically isolated syndrome (CIS) highly suggestive of MS according to revised 2017 McDonald's criteria; MS patients aged 18-60 years of both sexes; Expanded Disability Status Scale (EDSS) score 1-7.

Exclusion criteria: History or current evidence of CNS diseases; psychiatric or other drugs which may affect brain volume and cognition.

An assessment of cerebral circulation hemodynamics for both sides was done by the high resolution color duplex Philips Envisor C Ultrasound System with L 12-3 MHz linear transducer probe. Hamilton Depression Rating Scale (HDRS) and Mini-mental State Examination (MMSE) were used as neuropsychiatric assessment scales.

Result(s)

Cerebrovascular hemodynamic insufficiency was significantly prominent in patients with MS mainly in the anterior and posterior parts with lower affection of carotid circulation. Different significant correlation levels found between HDRS, MMSE, and EDSS and affected vessels indicated that the cerebral vessels changes affect the MS-related progression and disability.

Conclusion(s)

Patients with MS seem to have an increased risk for ischemic stroke. Endothelial dysfunction secondary to inflammatory responses or raised homocysteine concentrations might play a part, but reduced cerebral blood flow might predispose patients to the development of these ischemic brain lesions. The widespread cerebral hypoperfusion in MS seems not to be secondary to axonal degeneration, but might be a result of reduced axonal activity, reduced astrocyte energy metabolism, and perhaps increased blood concentrations of endothelin-1(ET-1). Impaired cerebral perfusion can be related to the cognitive manifestation of the disease, which is a common symptom associated with substantial decline in activities of daily living.