Background: Ambulatory Blood pressure parameters suggested that had a relationship with subclinical Left ventricular systolic dysfunction assessed by speckle tracking echocardiography. Objectives: To know the relationship between ambulatory Blood pressure parameters and subclinical Left ventricular systolic dysfunction assessed by speckle tracking echocardiography. Material and Methods: we enrolled 70 consecutive patients with hypertension. All patients will be evaluated for parameters of Arterial blood pressure monitoring & speckle tracking echocardiography. ECG was done to show LVH. Ambulatory blood pressure monitoring showed different blood pressure parameters and AASI. Conventional Echocardiography showed mainly LV systolic function, Speckle Tracking Echocardiography showed subclinical LV systolic dysfunction. Results: The study consisted of 70 patients 30% were men. The mean age of the patients was 46.7±12 years. Fifty nine patients were on antihypertensive drugs, 31 patients (44%) were controlled on treatment, and 56 patients (80%) were compliant. forty-two patients (60%) showed LVH by ECG criteria. ABPM Mean SBP: Day time134.5±15 mmHg, ABPM Mean SBP: night time: 128.4±16 mmHg, ABPM Mean DBP: Day time: 79.6±19 mmHg, ABPM Mean DBP: night time: 75.3±11mmHg and mean AASI: 0.66±0.16. Study population were divided into 2 groups according to blood pressure control; controlled (n=31%), and uncontrolled (n=39%). Baseline characteristics data were compared between both groups. The rate of LVH in ECG was significantly higher in the uncontrolled group (p< 0.05). There were significant differences in both day-time and night-time mean ABPM (p<0.05). However, there were no significant difference between AASI and dipping pattern between both groups (p= 0.3, and 0.1 respectively). Posterior wall thickness LV mass, as well as LV relative wall thickness were significantly higher in uncontrolled patients (p<0.05 for all). Interestingly only GCS and not GLS were significantly different between both groups (p< 0.05, p=0.3 respectively). Also, there was significantly more concentric hypertrophy and remodeling in uncontrolled patients group (p<0.05). --), ASSI was significantly, but moderately, associated with most ambulatory blood pressure parameters. It was also significantly associated with GLS; on the other hand, AASI did not show significant association with GCS. Mean GLS and mean GCS in hypertensive individuals were -16.4±3, -17.1±4 respectively. GLS varied significantly according to the presence of altered LV geometry, particularly reduced longitudinal systolic strain in those with concentric remodeling. Furthermore, longitudinal systolic strain parameters were significantly reduced in individuals with increased LA Volume index, and severity of diastolic dysfunction. Age was significantly higher in the high AASI group (AASI>0.5) (p<0.5). Most ABPM parameters were higher with the higher AASI values. Significantly more uncontrolled hypertensive patients were encountered in the high AASI group (p<0.05). Interestingly, only LAVI was significantly higher among the high AASI group (p<0.05). Gender and AASI are predictors of impaired GLS by a univariate analysis (Beta=-0.288, CI= -3.5:-0.06 and p = 0.04 for gender & Beta=0.319, CI= 0.82:11and p = 0.02 for ASSI), however ASSI was the only predictor of impaired GLS by multivariate analysis (Beta=0.3, CI= 0.2:12, and p = 0.04). Age is the only predictor of impaired GCS by a univariate and multivariate analysis.Conclusion: ASSI was the only predictor of impaired GLS .Age is the only predictor of impaired GCS. so, there were a strong relationship 2 between blood pressure parameters especially ASSI and GLS measured by speckle tracking echocardiography.

Purpose To report 4 cases of undiagnosed Descemet membrane detachment (DMD). Ophthalmologists should always look for DMD in any case of post cataract surgery persistent corneal edema. Early management of DMD with air descemtopexy could spare the patient a penetrating keratoplasty (PK). Methods All 4 cases were referred for management of persistent corneal edema (case 1,2) and corneal scarring (case 3,4). Cases 1 and 2 presented 1 month after cataract surgery while cases 3 and 4 presented 3 months and 1 year after surgery respectively. Cases 1-3 had visible DMD on presentation while case 4 had dense scarring. Cases 1 and 2 underwent air descemtopexy and 1 week of postoperative supine positioning while cases 3 and 4 underwent PK. DMD was diagnosed intraoperatively in case 4. Cases 1 and 4 had Fuch's Ednothelial Dystrophy (FECD) in the other eye. Results Cases 1 and 2 had complete resolution of corneal edema within 1-2 weeks after air descemetopexy with improvement of best corrected visual acuity BCVA to 6/60 and 6/12 respectively. Cases 3 and 4 improved to BCVA of 6/60 and 6/36 3 and 1 months postoperative respectively. Conclusion DMD is frequently overlooked as a cause of post cataract surgery corneal edema. DMD can be easily corrected with air descemetopexy. DMD can lead to significant corneal scarring within 3 months postoperative necessitating a PK for visual improvement. Patients with FECD are particularly vulnerable to DMD due to easy separation of Descemet membrane.

Purpose To report 4 cases of undiagnosed Descemet membrane detachment (DMD). Ophthalmologists should always look for DMD in any case of post cataract surgery persistent corneal edema. Early management of DMD with air descemtopexy could spare the patient a penetrating keratoplasty (PK). Methods All 4 cases were referred for management of persistent corneal edema (case 1,2) and corneal scarring (case 3,4). Cases 1 and 2 presented 1 month after cataract surgery while cases 3 and 4 presented 3 months and 1 year after surgery respectively. Cases 1-3 had visible DMD on presentation while case 4 had dense scarring. Cases 1 and 2 underwent air descemtopexy and 1 week of postoperative supine positioning while cases 3 and 4 underwent PK. DMD was diagnosed intraoperatively in case 4. Cases 1 and 4 had Fuch's Ednothelial Dystrophy (FECD) in the other eye. Results Cases 1 and 2 had complete resolution of corneal edema within 1-2 weeks after air descemetopexy with improvement of best corrected visual acuity BCVA to 6/60 and 6/12 respectively. Cases 3 and 4 improved to BCVA of 6/60 and 6/36 3 and 1 months postoperative respectively. Conclusion DMD is frequently overlooked as a cause of post cataract surgery corneal edema. DMD can be easily corrected with air descemetopexy. DMD can lead to significant corneal scarring within 3 months postoperative necessitating a PK for visual improvement. Patients with FECD are particularly vulnerable to DMD due to easy separation of Descemet membrane.

Purpose To report 4 cases of undiagnosed Descemet membrane detachment (DMD). Ophthalmologists should always look for DMD in any case of post cataract surgery persistent corneal edema. Early management of DMD with air descemtopexy could spare the patient a penetrating keratoplasty (PK). Methods All 4 cases were referred for management of persistent corneal edema (case 1,2) and corneal scarring (case 3,4). Cases 1 and 2 presented 1 month after cataract surgery while cases 3 and 4 presented 3 months and 1 year after surgery respectively. Cases 1-3 had visible DMD on presentation while case 4 had dense scarring. Cases 1 and 2 underwent air descemtopexy and 1 week of postoperative supine positioning while cases 3 and 4 underwent PK. DMD was diagnosed intraoperatively in case 4. Cases 1 and 4 had Fuch's Ednothelial Dystrophy (FECD) in the other eye. Results Cases 1 and 2 had complete resolution of corneal edema within 1-2 weeks after air descemetopexy with improvement of best corrected visual acuity BCVA to 6/60 and 6/12 respectively. Cases 3 and 4 improved to BCVA of 6/60 and 6/36 3 and 1 months postoperative respectively. Conclusion DMD is frequently overlooked as a cause of post cataract surgery corneal edema. DMD can be easily corrected with air descemetopexy. DMD can lead to significant corneal scarring within 3 months postoperative necessitating a PK for visual improvement. Patients with FECD are particularly vulnerable to DMD due to easy separation of Descemet membrane.

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Background: Female genital mutilation (FGM) was defined as the partial or total removal of the female external genitalia for non-medical reasons The Demographic and Health Survey in Egypt in 2000 showed that 97% of married women included in the survey had experienced female genital mutilation. Methods: This is a cross sectional study to evaluate the current prevalence of FGM, current attitude of our society towards it after illegalization of it as a cross sectional survey of Upper Egypt. The most important point in this study is our evaluation of intention of these women whom exposed to FGM toward mutilation of their daughters or not and reasons for that. Statistical analysis was done using SPSS software version 21. Results: The study included 1175 women, from whom 89.1% were circumcised. Type 1 FGM was the most prevalent type practiced in about 58% of participants. Immediate complications occurred in 42.5% of women. Primary hemorrhage during circumcision was the most commonly reported immediate complication among 38.5% of them. Sexual problems were found in 40.5% of participants. Sixty-four women reported occurrence of hepatitis virus infection after the procedure. Moreover, 44 women were suffered from infertility and 72 women had an episode or chronic PID. Women who intend to circumcise their daughters are mostly those coming from rural areas (p=0.000) and housewives (p=0.000). Most of women (45.8%) who have the intent to circumcise their daughters claiming that it is religious based. Conclusions: The prevalence of FGM did not differ between urban and rural or between house wives and employee, lastly did not differ between different educational levels as most of them were encourage it thinking that it is of traditional, religious base and protect the girl from any abnormal sexual excitation. The women who intent not circumcise their daughters were from low educational level in its highest percentage and this was explained by occurrence of higher percentage of complications in spite of the highest percentage of operator was physician.

Background: Female genital mutilation (FGM) was defined as the partial or total removal of the female external genitalia for non-medical reasons The Demographic and Health Survey in Egypt in 2000 showed that 97% of married women included in the survey had experienced female genital mutilation. Methods: This is a cross sectional study to evaluate the current prevalence of FGM, current attitude of our society towards it after illegalization of it as a cross sectional survey of Upper Egypt. The most important point in this study is our evaluation of intention of these women whom exposed to FGM toward mutilation of their daughters or not and reasons for that. Statistical analysis was done using SPSS software version 21. Results: The study included 1175 women, from whom 89.1% were circumcised. Type 1 FGM was the most prevalent type practiced in about 58% of participants. Immediate complications occurred in 42.5% of women. Primary hemorrhage during circumcision was the most commonly reported immediate complication among 38.5% of them. Sexual problems were found in 40.5% of participants. Sixty-four women reported occurrence of hepatitis virus infection after the procedure. Moreover, 44 women were suffered from infertility and 72 women had an episode or chronic PID. Women who intend to circumcise their daughters are mostly those coming from rural areas (p=0.000) and housewives (p=0.000). Most of women (45.8%) who have the intent to circumcise their daughters claiming that it is religious based. Conclusions: The prevalence of FGM did not differ between urban and rural or between house wives and employee, lastly did not differ between different educational levels as most of them were encourage it thinking that it is of traditional, religious base and protect the girl from any abnormal sexual excitation. The women who intent not circumcise their daughters were from low educational level in its highest percentage and this was explained by occurrence of higher percentage of complications in spite of the highest percentage of operator was physician.

Background: Female genital mutilation (FGM) was defined as the partial or total removal of the female external genitalia for non-medical reasons The Demographic and Health Survey in Egypt in 2000 showed that 97% of married women included in the survey had experienced female genital mutilation. Methods: This is a cross sectional study to evaluate the current prevalence of FGM, current attitude of our society towards it after illegalization of it as a cross sectional survey of Upper Egypt. The most important point in this study is our evaluation of intention of these women whom exposed to FGM toward mutilation of their daughters or not and reasons for that. Statistical analysis was done using SPSS software version 21. Results: The study included 1175 women, from whom 89.1% were circumcised. Type 1 FGM was the most prevalent type practiced in about 58% of participants. Immediate complications occurred in 42.5% of women. Primary hemorrhage during circumcision was the most commonly reported immediate complication among 38.5% of them. Sexual problems were found in 40.5% of participants. Sixty-four women reported occurrence of hepatitis virus infection after the procedure. Moreover, 44 women were suffered from infertility and 72 women had an episode or chronic PID. Women who intend to circumcise their daughters are mostly those coming from rural areas (p=0.000) and housewives (p=0.000). Most of women (45.8%) who have the intent to circumcise their daughters claiming that it is religious based. Conclusions: The prevalence of FGM did not differ between urban and rural or between house wives and employee, lastly did not differ between different educational levels as most of them were encourage it thinking that it is of traditional, religious base and protect the girl from any abnormal sexual excitation. The women who intent not circumcise their daughters were from low educational level in its highest percentage and this was explained by occurrence of higher percentage of complications in spite of the highest percentage of operator was physician.