: Drug abusers are presenting a challenge to the anaesthetist because of the added potential risks involved in the administration of anaesthesia to this subset of patients. In this study, we aimed at ...screening all patients scheduled for elective orthopaedic, general, vascular, and plastic at the Cairo University Teaching Hospital during a set period of time for the most commonly abused drugs in Egypt.
: All patients included in the study were consented for taking part in this study. Each patient was asked to answer a form and submit a urine sample in order to be screened for the most commonly abused drugs in Egypt (hashish, tramadol, benzodiazepine, and morphine). Patients were then followed up both intra and post-operatively. Incidence of drug abuse among those patients was set as primary outcome, intraoperative hemodynamic, Richmond Agitation-Sedation Scale (RASS) scores as well as clinical recovery scores (CRS) were set as secondary outcomes.
: Out of a total of 1106 patients screened during the study period, only 500 met inclusion criteria and consented to be part of the study. Results showed evidence of drug abuse among 14.4% of study patients, with frequencies of drugs abused as follows: hashish (11.4%); tramadol (5%); benzodiazepines (1.6%); and morphine (0.4%). Most patients that showed evidence of drug abuse were among those scheduled for orthopaedic surgeries, and a higher percentage of them were males.
: Within the study group, cannabinoids were the most frequent substance of abuse, followed by tramadol and then other opioids.
The study was conducted in one of the fields of the Al-Yamja area, south of Mosul,
which is (5) km from the city Centre for the season (2020-2021). Five genotypes
of soft wheat were used, which were ...obtained from the Organization
(C.I.M.M.Y.T.), adding an approved local cultivar (Abu Ghraib). The cultivation
was carried out on lines with a length of (2) m and the distance between one line
and another (30) cm using a randomized complete block design (R.C.B.D.) with
three replications and in the manner explained by 1
.The study included the following traits: number of days to flowering at (50%), plant height (cm), spike length
(cm), number of grains/spike, number of spikes/plant, vital yield (g/plant) and
grain yield (g /plant), The weight of 100 grains and the harvest index %, where the
analysis of variance table shows that all the genotypes showed significance at the
probability level of 1% except for the trait number of spikes/plant, which was significant at the probability level of 5% and trait of the harvest index %. The statistical significance was not reached, and the studied phenotypic, genetic and environmental variance values showed that they were more significant than zero for all
studied traits except for the genetic variance for the characteristic of harvest index
%, Where it did not differ significantly from zero, it was noted that the values of
heritability in the broad sense were high and for all the studied traits except for the
trait number of spikes/plant was medium. The recipe of harvest index % was low.
The values of the expected genetic improvement were as an average percentage for
the traits of plant height, spike length and the number of grains/spike. The vital
yield, grain yield and weight of 100 grains were low for the characteristics of the
number of days to flowering at (50%), the number of spikes/plant and harvest index
%. We note that the values of the genetic variation coefficient were the highest for
a trait of spike length, number of grains/spike and biological yield, and the values
of the phenotypic variation coefficient were the highest for the traits of spike
length, number of grains/spike and biological yield.
Keywords: genetic parameters, bread wheat, Triticum aestivum L
The Peritoneal Dialysis Transfer Set Replacement Procedure Funes, Irma; Velasquez, Katherine; Doss-McQuitty, Sheila ...
Nephrology nursing journal : journal of the American Nephrology Nurses' Association,
07/2020, Letnik:
47, Številka:
4
Journal Article
Recenzirano
Peritoneal dialysis transfer sets (extension lines) are replaced every six to nine months to minimize peritoneal dialysis catheter complications. The aim of this study was to compare a revised ...non-bag transfer set exchange procedure with the standard bag exchange procedure on nursing time, costs, and safety. Thirty-three people were randomized to two groups--a standard bag exchange procedure group (n = 16) and a non-bag transfer set exchange procedure group (n = 17). The standard bag exchange procedure took a median of 32 minutes (interquartile range IQR 25 to 38 minutes) compared to the non-bag transfer set exchange procedure of 6 minutes (IQR 4 to 8 minutes) (p < 0.0001). There was one episode of peritonitis in each group within the 72-hour follow-up period. The average cost of the non-bag transfer set exchange procedure was $24.54 lower, a 37% cost reduction. This study has shown the revised non-bag transfer set replacement procedure appears to be safe, consume less participant and staff time, and decreases costs.
Objective: The present study aimed to evaluate the long-term results of combining spreader grafts with lateral suspension techniques for management of narrow internal nasal valves. Methods: This ...prospective study included 79 patients who underwent surgical interference for dysfunctional nasal valve. The surgical intervention was a combination of two commonly used techniques for management of internal nasal valve dysfunction: spreader graft insertion and lateral suspension of the upper lateral cartilages. The patients were assessed using the nasal obstruction symptom evaluation (NOSE) tool, computed tomography (CT) scans, and endoscopic examinations. Results: All patients reported initial improvement and satisfaction in nasal breathing. Seventy-two patients (91%) reported sustained relief of nasal breathing for at least 3 years postoperatively. The mean NOSE scores decreased from 69.8 to 20.65 postoperatively. The internal nasal valve angle, as measured endoscopically, increased from 7.23degrees to 13.05degrees on the right side and from 6.75degrees to 11.98degrees on the left side; the increase was statistically significant. The angle, as measured on axial CT scans, increased from 8.11degrees to 14.15degrees on the right side and from 6.98degrees to 12.13degrees on the left side' this increase, too, was statistically significant. Conclusion: Combining spreader grafts with lateral suspension sutures provide good, stable, and sustained repair of dysfunctional narrowed internal nasal valves. Keywords: Narrow nasal valve, nasal spreader graft, lateral cartilage suspension
Arabic translation and validation of SNOT-22 Elwany, Samy; Atef, Ahmed; Ibrahim, Ahmed A. ...
The Egyptian journal of otolaryngology,
10/2017, Letnik:
33, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Objective
The objective of the study was to translate the Sino-Nasal Outcome Test 22 (SNOT-22) into Arabic and to check its reliability and validity in Arabic-speaking patients.
Patients and methods
...The study included 178 patients with confirmed chronic rhinosinusitis (CRS) and 95 asymptomatic individuals as a control group. All participants completed the Arabic SNOT-22 (A-SNOT-22) questionnaire. The scores of the two groups were compared for validity analysis. Eighty-two patients completed the questionnaire twice, 1 week apart, for test-to-test reliability analysis. The A-SNOT-22 scores of 60 CRS patients were correlated with Lund–Mackay scores for criterion validity analysis. The preoperative and postoperative scores of 73 patients were compared for responsiveness analysis.
Results
All participants completed the questionnaire with no or minimal assistance. Internal consistency (
α
=0.90) and test-to-test reliability (intraclass correlation=0.78) were good. The differences between the scores of CRS patients and asymptomatic individuals were significant (
P
<0.005). There was a positive moderate correlation between A-SNOT-22 and Lund–Mackay scores. Preoperative A-SNOT-22 scores were significantly higher than postoperative scores.
Conclusion
A-SNOT-22 questionnaire is a reliable and valid outcome measure for CRS patients. The questionnaire is responsive to changes in the state of the disease and is recommended for clinical practice and outcome research.
Over the recent years, multimedia applications have begun to be used over wireless sensor networks (WSN), which hitherto has been primarily used to carry small amount of data. To meet the demand for ...higher throughput and real-time characteristics of multimedia contents, the routing protocol need to be simplified and optimized. In this paper, we present a routing algorithm that provides a low end-to-end packet delay and low packet loss, referred to as smart, greedy forwarding algorithm based on throughput and energy-awareness (SGFTEM). This algorithm routes multimedia packets across a WSN by choosing high- throughput paths rather than always choosing the shorter path to the sink. When it encounters network holes, a network void-bypass is applied, which enhances the reliability of the network. Energy management is also implemented to extend sensor node lifetime by way of reducing the radio transmission coverage to a suitable distance reachable by the sensor nodes The simulation results shows that, SGFTEM reduces the end-to-end delay by 40% and packet loss ratio by 35% and maintain energy consumption against other algorithms. With energy management, the residual energy of sensor nodes are made to be equally distributed across the entire network which results in load balancing. The performance of SGFTEM are also compared via simulation against AGEM, TPGF, GPSR, and AODV showing superior performance under similar scenarios i.e. low packet end-to-end delay, low packet loss and load balancing of routing paths.
The analysis and treatment of saddle nose have always been a surgical challenge. The study describes the three-stage classification of this deformity as well as a treatment algorithm adapted to each ...case.
A prospective study was carried out on 46 patients with saddle nose. The patients were divided into 3 groups according to the severity of saddling; minimal, moderate and major. The authors describe the treatment protocol adopted for each stage.
This series comprised 16 cases of minimal saddle nose, 20 cases of moderate saddle nose and 10 cases of major saddle nose. Minimal saddle nose was treated by enforcing and reconstructive septoplasty and dorsal septal augmentation grafts, conchal grafts were used to treat moderate saddle nose, and costal cartilage was used to reconstruct major saddle nose. We have used the open rhinoplasty approach to correct saddle nose in all cases. Surgical revision was never required.
Saddle nose is a condition that is quite commonly faced by Otolaryngologists. The proposed treatment strategy is based on a meticulous analysis of the saddle nose, resulting in a graduated reconstruction adapted to each stage according to the severity of deformity.
IV.
Background
Successful web space reconstruction is the most challenging in the treatment of syndactyly, and the choice of the ideal reconstructive technique is still controversial. The aim of the ...present study was to evaluate the use of the dorsal metacarpal artery perforator (DMAP) propeller flap for simple syndactyly reconstruction.
Methods
From May 2016 to May 2018, 14 consecutive children (8 male, 6 female) at a mean age of 5.3 years (2–7 years) with 16 syndactylous webs were included in this prospective study. They underwent web reconstruction using DMAP propeller flap. All patients had primary simple syndactyly. Simple syndactylies were incomplete in 8, complete in 6, unilateral in 12, and bilateral in 2 cases. Operative time and early post-operative complications were recorded. Objective assessment by 2 senior hand surgeons regarding web creep, the quality of scar, scar contracture, and the passive range of motion of the MCP was done. Parents’ satisfaction on esthetic outcome was assessed.
Results
Sixteen flaps (mean size, 1.8 × 4.9 cm) were used in 14 patients. Surgery time per web space ranged from 50 to 75 min (mean, 54.9 min). All flaps survived completely except for one developed distal tip partial necrosis and treated conservatively. All donor sites healed uneventfully. One patient had a hypertrophic scar which was treated by silicone gel. Full range of motion, no web creep, no scar contracture, and 78.6% subjective cosmetic satisfaction were noted, at a mean follow-up of 25.1 months (range, 12–42 months).
Conclusions
DMAP propeller flap is proved to be a reliable option for simple syndactyly reconstruction. It is easily performed and versatile without the need for skin grafts. Moreover, the final results are functionally and cosmetically good.
Level of evidence: Level IV, therapeutic study.
Sweet syndrome is a rare skin condition characterised by fever, neutrophilia, and tender erythematous skin lesions and has been reported to occur in association with anti-neutrophil cytoplasmic ...antibodies (ANCA) as well as complicate treatment with azathioprine therapy. Azathioprine, a relatively safe immunosuppressive, is frequently used to maintain disease remission in the treatment of ANCA-associated vasculitis. The occurrence of Sweet syndrome in a patient with ANCA-positive vasculitis and following treatment with azathioprine prompted us to present this clinical case and share this unusually rare occurrence. In doing so, we also wish to discuss current understanding of the disease and plausible associations.
Herein, we discuss the case of a 54-year old white male, who presented with features of ANCA vasculitis with haemoptysis, arthralgia, abnormal kidney function with active urine sediment and a positive p-ANCA titre. Standard immunosuppressive treatment with corticosteroids and intravenous rituximab resulted in disease remission. Due to significant steroid side effects, his steroid treatment was gradually tapered and switched to azathioprine over a 6-month period. Two weeks following initiation of azathioprine, he developed a painful maculo-papular erythematous skin rash and fever. A skin biopsy confirmed classical features consistent with Sweet syndrome. Withdrawal of azathioprine and treatment with oral corticosteroids and colchicine therapy resulted in complete resolution of the rash, although he continued to have high titres of MPO positive ANCA.
Sweet syndrome is a rare adverse reaction to azathioprine but has also been reported to occur in association with ANCA vasculitis. The temporal association with azathioprine in our case and the relatively rapid resolution of the skin vasculitis upon its withdrawal suggested a primarily drug-induced reaction rather than an associated feature of ANCA vasculitis.
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