Search

AIM: This observational and cross-sectional study aimed to assess the orthodontic treatment need, oral health-related quality of life (OHRQoL), and self-esteem in relation to socioeconomic level as well as investigate the incidence of malocclusion and orthodontic treatment need in Egyptian school children. MATERIALS AND METHODS: Three hundred and twenty-four schoolchildren from governmental, private, and international schools representing different socioeconomic levels ranging from 11 to 14 years were recruited. Self-esteem and OHRQoL were measured using validated questionnaires. Clinical examination was used to assess the orthodontic treatment need represented by the index of orthodontic treatment need (IOTN) score as well as Angle’s classification of occlusion. RESULTS: International schools showed the lowest total IOTN scores than governmental and private schools (p = 0.031). Governmental scores showed the statistically significantly highest mean CPQ11-14 score (Worst OHR-QOL) followed by private schools then international schools (p = 0.035). There was no statistically significant difference between Angle’s classes of malocclusion as well as self-esteem between the three different socioeconomic level groups. CONCLUSION: Lower socioeconomic status (SES) was associated with higher orthodontic treatment need according to the total IOTN score and worst OHRQoL. Socioeconomic status did not affect the distribution of malocclusion according to Angle’s classification nor did it affect self-esteem.

This study evaluated the role of routine biopsy from the site of previously resected superficialbladder tumor three months following resection and intravesical BCG therapy in the presenceof negative urine cytology and cystoscopy. Thirty-two patients (21males and 11 females)with high-risk superficial transitional cell carcinoma (TCC) of the bladder were followed prospectively.All patients received a single six weeks course of intravesical Bacillus Chalmette-Guerin (BCG). Three months following resection, urine cytology was done. Cystoscopy wasthen performed and a routine biopsy from the previous resection site was taken. All patientsincluded in the study had negative urine cytology and cystoscopy at the time of biopsy. Four(12.5%) patients were having TCC although they had negative urine cytology and cystoscopyat the time of biopsy. The histological recurrence was corresponded to T1G1 in two patientsand T1G2 in the other two patients and the pathology after BCG treatment for the four patientswas the same as before instillation. There were no statistically significant differences betweenpatients with positive and negative biopsies with regard to the stage and grade of the tumor beforeresection, or the number of resected lesions.

Undoubtedly, the snake anti-venom is a medication made up of antibodies used to treat itsbites by venomous snakes. Repeated administration of snake venoms from Spitting cobra, ingradual sub-lethal doses into horses has been reported to cause various ill health conditions torecipient animals beside loss in the antibody titer in the plasma harvested from immunizedhorses. It could accordingly, propose some amendment in the immunization schedule usingdifferent adjuvants to choose the best one giving the maximal amount of antibody beside itsmax safety measures. Montanide ISA is an alternative to CFA for hyper-activation of immuneresponse in rabbits beside it is considered as adjuvant with high safety margin.

Objective Patients with drug‐resistant epilepsy (DRE) pose considerable management challenges for patients, their families, and providers. Both the vagus nerve stimulator (VNS) and the ketogenic diet (KD) have been shown to be safe and effective in treating DRE. Nevertheless, information is lacking regarding treatment with combination of both modalities. This study reports the efficacy and tolerability of combining VNS and KD in a pediatric cohort with intractable epilepsy. Methods This is a retrospective review of 33 patients (0‐17 years) with DRE treated with VNS and KD at a single pediatric level IV epilepsy center. We compared seizure reduction rates for each patient at baseline and at every clinic visit for 24 months after adding the second nonpharmacological therapy. The frequency of adverse events on the combined therapy was collected to assess safety and tolerability. Results There were a total of 170 visits for all patients while on the combined therapy. At 88% (95% CI: 83%‐93%) of the visits, patients reported some reduction in seizure frequency. The proportion of patients reporting a greater than 50% seizure reduction over all visits was 62% (95% CI: 55%‐69%). The proportion of a patient's visits with at least a greater than 50% reduction in seizure frequency had a median of 71% (IQR 33%‐100%). Continued improvement was seen over time of combined treatment; for every one‐unit time unit change (one month), there was a 6% increase in the odds of having a reduction in seizure frequency of >50% (OR = 1.06, 95% CI: 1.01‐1.11). Significance This study shows that combining the VNS and KD in patients with drug‐resistant epilepsy is well tolerated and reduces seizure frequency more than either one modality used alone and that the benefits in terms of seizure reduction continue to increase with the length of treatment.

Human hydatid disease is mainly caused by infection with the larval stage of dog tapeworm Echinococcusgranulosus. The disease is widely endemic in many sheep and cattle rearing locales such asAustralia, Latin America, Africa and Middle Eastern countries, and now worldwide. Hydatidosis is aserious pathogenic, zoonotic and parasitic infection of humans, following ingestion of tapeworm eggsexcreted in the feces of infected dogs. Children of all age groups are susceptible from pet dogs (Urbanarea) or stray dogs (Rural area) and localization of the disease in the lungs is more commonly seen.Multiple liver cysts in the pediatric age group were relatively uncommon. Surgery remains the primarytreatment and the only hope for complete cure. PAIR is considered an alternative treatment forcystic echinococcosis (hydatid disease) and is often indicated for patients who do not respond to opensurgery or drugs.

Influenza is a viral infection that attacks the respiratory system. For most people, the fludisappears on its own but sometimes the flu and its complications can be deadly. This studyestablished a new trend to treat Influenza virus by using bee venom and its fraction comparedwith the traditional flu drug. It was proved that bee venom (BV) has an antiviral effect. Thebee venom (BV), bee venom phospholipase A2 (BV-PLA2) and ribovinal as a control drugwere used. The cytotoxicity of the selected compounds was determined using MTT assay.Also, the cytopathic effect was measured after 24, 48 & 72 hours incubations anddetermination of gene expression of INF-gamma using SYBR Green. The IC50s of BV, BVPLA2and ribovinal were 87.8, 17.3 &137.5μg/ml after 24 hours incubation, 36.9, 9.6 &24.6μg/ml after 48 hours incubation, and 9.7, 7.45 & 31.6μg/ml after 72 hours incubation,respectively. In addition, the cytopathic effect of both BV and ribovinal was directlyproportional to its concentration and incubation time. Whereas, BV-PLA2 showed an increasein cytopathic effect after 48 hours in spite of its concentration in case of direct antiviral effect.However, the indirect antiviral effect for both BV and PLA2 showed the same cytopathiceffect in all concentrations and incubation times. So, the gene expression of INF-γ wassignificant increased after 48 hours incubation of either BV or ribovinal in direct and indirecteffects. While the INF-γ expression was (14.8 & 16.4) direct and in indirect antiviral effectsof BV-PLA2, respectively. These findings revealed the antiviral effect of both bee venom andBV-PLA2 against influenza virus.

This study aimed to compare the superimposed clinical value of topical tranexamic acid (TXA) application when it is simultaneously combined with intravenous (IV) administration versus the use of either IV TXA alone or IA TXA alone during primary total knee arthroplasty (TKA) in patients with moderate-to-high risk of bleeding. We hypothesized that the combined administration approach will result in a more adequate reduction in the perioperative blood loss and blood transfusion rate. Ninety-four patients undergoing primary TKA were randomly allocated into intra-articular (IA) alone, IV alone, and combined group. We used 2 g of IV TXA in the IV TXA alone and combined groups 10 minutes before tourniquet deflation. However, we applied 1.5 g TXA in 100 mL isotonic saline half topically before arthrotomy closure and half retrogradely after wound closure through the drain. Follow-up period was 6 weeks. The primary outcome measures included the drainage blood volume, total blood loss, hidden blood loss, intraoperative blood loss, and the allogenic transfusion rate. Secondary outcomes included postoperative hemoglobin drop, amount of transfused blood units, thromboembolism, and wound complications. Combined administration of TXA provided significantly better results in terms of blood volume collected by the drain, total blood loss, and hidden blood loss (p 0.05). The subgroup analysis revealed that a combined IA and IV TXA administration significantly reduced the total blood loss in patients with either moderate or high risk of bleeding. Moreover, the degree of hemoglobin drop was significantly lesser with the combined approach. No thromboembolic complications or wound infection occurred. In conclusion, the combined use of topical and IV tranexamic acid resulted in a significant reduction in postoperative blood loss and hemoglobin level following TKA but did not influence the rate of allogeneic blood transfusion. This is a Level I, therapeutic study.

This study aimed to investigate the relationship between acute kidney injury (AKI) in the first 2 weeks of life and brain injury on term-equivalent age magnetic resonance imaging in very preterm infants.We included 116 infants with a birth weight of 1500 g who were born at the King Saud Medical City at ≤ 32 gestational weeks. They were admitted to the neonatal intensive care unit and underwent term-equivalent age and pre-discharge brain magnetic resonance imaging. A negative binomial with generalized linear models and a robust variance estimator (Huber-White) was applied for univariate relative risk analysis. The Kidokoro score was then used to determine the effect of AKI on brain morphology and growth at term-equivalent age.Sixty-eight (64.2%) infants had developed an AKI in the first 2 weeks of life. AKI was significantly associated with cerebellum signal abnormalities, cerebellar volume reduction, and a high total cerebellum score (P = 0.04, P 0.001, P 0.001, respectively).AKI in the first 2 weeks of life is associated with brain insult, especially in the cerebellum. More well-designed studies are required to investigate the association and impact of AKI on the central nervous system. A higher resolution version of the Graphical abstract is available as Supplementary information.

A typical presenting concern in general practitioners' offices, emergency rooms, otolaryngology, and neurology departments are facial nerve paralysis. Penetrating injury to the facial nerve, especially iatrogenic damage, is one of the most frequent traumatic reasons of facial paralysis. The facial paralysis that results from blunt trauma that crushes the nerve frequently appears as an incomplete or delayed paralysis. The affected part of the nerve will determine how the injury manifests clinically. For adequate patient counseling with respect to prognosis and management, accurate diagnosis of facial nerve palsy must be achieved. The most often employed standardized instrument for determining the level of facial weakness is the House-Brackmann 6-grade instrument for facial nerve activity. The greatest success chances for reanimation occur in cases of a recent, sudden nerve transection i.e., less than 72 hours, where the nerve is quickly identified and repaired using direct coaptation or interposition grafts. The primary strategy of care is surveillance in situations with facial nerve paralysis where it is known that the nerve is physically intact such as blunt force trauma with incomplete or delayed complete paralysis. Neurological, muscular, static, and facial plastic treatments are some examples of facial reanimation approaches.