This research studied the coastal changes along the region between Rosetta promontory to El Burullus fishing port with approximate length 58 km at Nile Delta Mediterranean coast, Egypt. Rosetta ...seawall was successfully built to protect the city from high erosion rate (-121 m/y), however erosion translocated eastward for 3 km with rate −64 m/y. So, a protection system of five groins was built eastward of the seawall. This has decreased the rate of erosion in the area to −45 m/y. After 2016, Ghalyon fish farm (GFF) manmade structures affected the balance of the coastline. So, a new groin protection system was built. This study aims to evaluate shoreline change pattern before and after the construction of GFF structures and to assess the gain and loss in land area. This was accomplished through the delineation of the shorelines from satellite imagery. The shoreline change statistics were calculated by the Digital Shoreline Analysis System software (DSAS). The research studied also the predicted shoreline and the impact of the GFF jetties’ lengths on the down drift side using 1-D model (LITPACK). The results revealed that by changing the length of the jetties, no notable change occurred in the eroded area.
New EL Alamein city (NAC) is located on the northwestern coast of Egypt 110 km western of Alexandria and just west of Marina resort. The city layout includes internal artificial lagoons circulated by ...jetties’ inlets connected to the Mediterranean Sea. Intermediate and multigrade groynes have been proposed to reduce intermediate and downdrift expected erosion. Shoreline erosion at the downdrift area of coastal jetties and sedimentation at lagoons inlets are considered critical issues which shall be balanced and modeled. Marina resort lagoons and protections are considered a prototype for NAC coastal structures and inlets. For Marina resort lagoons case study, shoreline changes have been digitized from Google Earth historical images and field measurements data between 1988 and 2021 by using the Digital Shoreline Analysis System (DSAS) software. Cutting natural longshore sediment deposits by Marina jetties has significantly eroded the downdrift area eastern of Marina border. Most of Marina downdrift area was under accretion(up to + 10 m/year) and little erosion areas before the protection work from 1985 to 1988 and with an average rate of −1.00 m / year from 1988 to 2001 during the construction of the jetties and groynes and with an average rate of −1.20 m/ year after the construction stages between 2005 and 2018. High rates of erosion with an average rate of −4.30 m/year were identified between 2019 and 2021 with the start of NAC coastal proposed structures. This research aims to assess the historical and current situation of NAC shoreline changes and use the similar near project of Marina resort to identify and mitigate the side effects of the proposed protection works of New EL Alamein City.
Purpose
This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction.
Methods
Eighty-four patients ...undergoing ACL surgery were randomized into two groups: the tourniquet (A) group and the non-tourniquet (B) group. Post-operative pain, need for analgesics, the volume of blood obtained in the drain, girth diameter changes in the thigh and calf, muscle strength and amount of haemarthrosis were used as outcome measures to compare the two groups.
Results
Fifty-eight patients were available for analysis. In the A group, the degree of pain and need to analgesics was significantly higher at 4 and 10 h. The volume measured in the surgical drain, at 24 h post-operative, was higher in the A group (
p
= 0.001). The calf and thigh girth diameters at 2 weeks showed a highly significant girth difference between the two groups (
p
= 0.001).
Conclusion
This study showed that tourniquet use in ACL reconstruction increases immediate post-operative symptoms of pain and haemarthrosis and that the effects on muscle strength are only temporary. The tourniquet can be replaced by using of a mixture of morphine and adrenaline with no interference with the quality of visibility, nor operative time.
Level of evidence
I.
Abstract In most anterior cruciate ligament (ACL) tears, the tear is at the femoral side leaving a robust stump attached to the tibia. Stump-preserving ACL reconstruction carries the advantage of ...rapid reinnervation and revascularization of the graft. In this technique, the femoral tunnel is created after exposing the femoral footprint. The ACL tibial stump is split and the tip of the ACL tibial guide is introduced through this split to reach the center of the tibial footprint. The tibial tunnel is then created and the ACL stump is bored to allow the passage of the graft. After the passage of the graft inside the stump and femoral and tibial fixation, 1 or 2 sutures are used to suture the graft to the stump by a suture passing device (Expressew II; Depuy Mitek, Raynham, MA). This technique, in addition to preservation of the mechanoreceptors and vascular channels for revascularization and reinnervation of the graft, allows preservation of the shape and surface area of the wide tibial origin of the ACL.
Abstract Using a posterolateral portal in passing and tying the inferior knot allows good labral reduction and adequate capsular shift to treat anterior shoulder instability. In this technique, the ...most inferior anchor is placed through a low anterolateral portal. A penetrating grasper is introduced from a posterolateral portal situated 2 to 3 cm distal and lateral to the viewing portal. This portal is used to pass the 2 limbs of the anchor suture as inferior as possible through the labrum and capsule close to 6 o'clock position to form the 2 limbs of the first mattress suture. Finally, knot tying is performed through this posterolateral portal, thus allowing better superior shift of the capsulolabral tissue. The other 2 anchor sutures are passed and tied through the low anterolateral portal.
Background
Rotator cuff disorders are the main causes of chronic shoulder instability and pain. Diagnostic imaging is important to guide treatment decisions with magnetic resonance imaging, which is ...considered the reference standard for rotator cuff evaluation. Sono-elastography is a noninvasive and reliable ultrasound technique that provides qualitative as well as quantitative assessment of tendon quality through alteration in the tissue composition before alteration in tendon echogenicity or thickness on the conventional US.
Purpose
To assess the role of shear wave sonoelastography in the evaluation of supraspinatus tendon abnormalities.
To assess the association between SWE and grades of tendon abnormalities on MRI (the standard imaging in the evaluation of rotator cuff abnormalities).
Results
The shear wave velocity (SWV) was notably low (reduced tendon stiffness) in patients with supraspinatus tendinopathy and tear (mean SWV for the supraspinatus tendon in cases of tendinopathy/tear was 3.91 m/s with a standard deviation of 0.67, while the mean SWV for normal supraspinatus tendons was 6.93 m/s with a standard deviation 0.57), and a significant difference was found in SWV values between cases and controls (
P
< 0.001).
Also, there were significant differences between the patients with different grades of tendon abnormalities (
P
< 0.001), with a highly significant inverse correlation observed between the measured SWV and grades of tendon abnormalities on MRI (
P
< 0.001).
Conclusions
Sonoelastography showed tendon softening in supraspinatus tendinopathy and tear with a good correlation to the MRI, making it a reproducible and low-cost imaging modality that can be a complementary tool to the US in the evaluation of shoulder disorders, especially when MRI is not allowed.
Background. This work was constructed in order to assess the nutritional and functional status in hospitalized elderly and to study the associations between them and sociodemographic variables. ...Methods. 200 elderly patients (>65 years old) admitted to Internal Medicine and Neurology Departments in nonemergency conditions were included. Comprehensive geriatric assessments, including nutritional and functional assessments, were done according to nutritional checklist and Barthel index, respectively. Information was gathered from the patients, from the ward nurse responsible for the patient, and from family members who were reviewed. Results. According to the nutritional checklist, 56% of participants were at high risk, 18% were at moderate risk of malnutrition, and 26% had good nutrition. There was a high nutritional risk in patients with low income and good nutrition in patients with moderate income. Also, there was a high nutritional risk in rural residents (61.9%) in comparison with urban residents (25%). Barthel index score was significantly lower in those at high risk of malnutrition compared to those at moderate risk and those with good nutrition. Conclusions. Hospitalized elderly are exposed to malnutrition, and malnourished hospitalized patients are candidates for functional impairment. Significant associations are noticed between both nutritional and functional status and specific sociodemographic variables.
Background: Stroke remains the second leading cause of death worldwide which cause severe disability. Serum vitamin D has been reported to be associated with stroke.Aim: To study the role of vitamin ...D in acute ischemic stroke patients.Patients and methods: The present prospective cohort study was conducted on 58 patients presented with acute ischemic stroke within 48 hours which is diagnosed clinically and confirmed by cerebral imaging, computed tomography (CT). All patients were subjected to clinical assessment using Glasgow Coma Scale (GCS) and National Institute of Health Stroke Scale (NIHSS) to assess stroke severity. Also, they were subjected to assessment of vitamin D and CT scan.Results: The Mean ± SD. Of vit d was 14.01 ± 8.94, 65.5% of studied patients had deficiency in Vit D, while 22.4% of studied patients had insufficient in Vit D. There is significant relation between S. Vitamin D and each of GCS and NIHSS at admission and after 30 days. Conclusion: This study suggests that serum 25(OH)D level is decreased in patients with acute ischemic stroke with significant relation with stroke severity.
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