Effect of Hyaluronic Acid on Socket Healing After Lower Impacted Third Molar Tooth Extraction in 40 Dental Patients.

BACKGROUND Surgical extraction of impacted mandibular third molars is the most commonly performed procedure in oral surgery; its associated complications include sensory nerve damage, swelling, and trismus. This study aimed to evaluate the effects of hyaluronic acid (HA) on healing of the socket following extraction of the lower impacted third molar tooth in 40 dental patients. MATERIAL AND METHODS This prospective, double-blind, randomized, controlled study was carried out on 40 adult healthy patients indicated for surgical removal of bilateral impacted mandibular third molars with equal surgical difficulty (moderate surgical difficulty according to the Koerner index. Patients with right mandibular third molars were included into the study (HA) group and those with left mandibular third molars were included into the control group. Surgical removal of impacted teeth was performed at different times for each patient for proper measurement of postoperative clinical variables, including pain, swelling, and mouth opening. RESULTS Postoperative pain evaluation results using the visual analog scale (VAS) showed reduced pain levels at all observation periods. Postoperative swelling peaked in intensity within 12-48 hours, resolving between the 5th and 7th days, and there was no significant difference in pre- and postoperative measurements of interincisal opening between both groups (P>0.05). CONCLUSIONS We found that intra-socket application of hyaluronic acid after surgical extraction of impacted mandibular third molars promoted normal wound healing, and there was a clinical benefit of reduced postoperative pain and swelling.

Does volumetric measurement of ADC values achieve higher diagnostic performance in bladder cancer MRI?

BACKGROUND: Apparent diffusion coefficient (ADC) value is an important part of bladder cancer magnetic resonance imaging (MRI) assessment and can predict the aggressive and invasive potentials. There is growing interest in whole tumor volume measurements. PURPOSE: To investigate if the volumetric ADC measurement method will significantly exceed the diagnostic performance of the selected region of interest (ROI) method in everyday practice. MATERIAL AND METHODS: A prospective evaluation was carried out of 50 patients with bladder cancer by two radiologists. The mean and the minimum ADC values were measured using both methods. The inter-reader agreement was determined by the intraclass correlation coefficient. The ADC values were compared between different grades, states of muscle invasion, and lympho-vascular invasion (LVI); then, validity was evaluated using receiver operating characteristic (ROC) curves. Areas under the curve (AUC) were then compared for the level of statistical significance. RESULTS: The inter-observer agreement was excellent for the ADC values using both methods. The volumetric measurement provides higher mean and lower minimum ADC values with statistically significant differences (P <0.00001). The highest diagnostic accuracy for differentiating tumor grade and predicting muscle invasion was for the minimum ADC by a selected ROI. However, the differences between the achieved AUCs were of no statistical significance. None of the ADC values predicted LVI with statistical significance. CONCLUSION: The selected ROI and volumetric measurement methods of mean and minimum ADC in bladder cancer yield different values, still having comparable diagnostic performance with accurate ROI sampling. The minimum ADC value by ROI is preferred in everyday clinical practice.

Management strategy for children with ovarian immature teratoma: results from a tertiary pediatric oncology center.

OBJECTIVES: We present an Egyptian study on pediatric ovarian immature teratomas (ITs), aiming to clarify our treatment strategy selection. METHODS: A retrospective review of all children with pure ovarian ITs who were treated at our institution between 2008 and 2023. The analysis included clinical characteristics, tumor staging according to Children's Oncology Group (COG), grading based on the Norris system, management, and outcomes. RESULTS: Thirty-two patients were included, with a median age of 9 years. All patients underwent primary surgery. Unilateral salpingo-oophorectomy was performed in 31 patients. Surgical staging was completed in all patients. Based on COG staging, there were 28 patients (87.5%) stage I, 1 (3%) stage II, and 3 (9.5%) stage III. According to Norris classification, 16 patients (50%) were classified as grade I, 9 (28%) grade II, and 7 (22%) grade III. All patients in stage I were treated using surgery-alone approach, whereas the remaining four (12.5%) received adjuvant chemotherapy. Five patients in stage I had gliomatosis peritonei (GP), and none of them underwent extensive surgery. At a median follow-up of 86 months, two patients had events. The first patient (stage III/grade I) developed IT relapse on the operative bed, and the second (stage I/grade I) had a metachronous IT on the contralateral ovary. Both patients were successfully managed with surgery followed by second-line chemotherapy. Five-year overall survival and event-free survival for all patients were 100% and 93.4%, respectively. CONCLUSIONS: Surgery-alone strategy with close follow-up achieves excellent outcomes for localized ovarian ITs in children, irrespective of the Norris grading or the presence of GP. However, adjuvant chemotherapy is questionable for patients with incompletely resected or locally advanced tumors, and its role requires further evaluation through prospective multicentric studies with a larger sample size.

Comprehensive approach integrating water quality index and toxic element analysis for environmental and health risk assessment enhanced by simulation techniques.

Due to water shortages and the potential impact of Ethiopia's new dam on the Nile River, Egypt is seeking new water resources. This study assesses the drinking water quality and associated risks from potentially toxic elements (PTEs) in the Quaternary aquifer (QA) in Beni-Suef, Egypt. Using a comprehensive approach, including PHREEQC geochemical modeling, ionic ratios, multivariate statistical analyses, and the integrated weight water quality index (WQI), the study evaluated the sources of ion contamination and the mixing of Nile water with QA. Various indices, such as the Heavy Metal Pollution Index (HPI), ecological Risk Index (RI), Hazard Quotient (HQ), and Hazard Index (HI), were used to assess ecological and health risks. Monte Carlo simulations provided probabilistic assessments of non-carcinogenic risks for adults and children. GIS tools were used to map risk indices, identifying the most deteriorated locations for sustainable management. The hydrochemical analysis revealed water facies including Na-Cl, Ca-Mg-HCO3, and mixed types, influenced by carbonate dissolution, ion exchange, and silicate weathering. Contamination sources, particularly in the north and south, were linked to agricultural activities, irrigation return flow, municipal waste, and evaporation. The WQI indicated that 10.14% of samples were extremely poor, 21.7% were poor, 26% were medium, and 42% were good to excellent. PTE contamination varied, with HPI values indicating good water quality in the central area in 53.6% of the collected samples (HPI < 30), but contamination in the north and south is high (HPI > 51). Ecological Risk Index values were below the threshold in 100% of samples (RI < 30), confirming water safety regarding PTEs. In comparison, for hazard index (HI) through oral/ingestion, adults exhibited HI values ranging from 0.012 to 2.16, while children showed higher values, ranging from 0.045 to 8.25. However, the hazard index for oral/ingestion exceeded safe limits in the north and south (HI oral > 1), posing non-carcinogenic risks. Monte Carlo simulations revealed significant risks from oral exposure to manganese (HQ oral > 1), particularly in El-Wasta and El-Fashn, necessitating further treatment and management.

Morpho-physiological mechanisms of two different quinoa ecotypes to resist salt stress.

BACKGROUND: Quinoa (Chenopodium quinoa Willd.) is a facultative halophyte showing various mechanisms of salt resistance among different ecotype cultivars. This study aimed to determine salt resistance limits for a Peruvian sea level ecotype "Hualhuas" and a Bolivian salar ecotype "Real" and elucidate individual mechanisms conferring differences in salt resistance between these cultivars. The plants were grown in sandy soil and irrigated with various saline solutions concentrations (0, 100, 200, 300, 400, and 500 mM NaCl) under controlled conditions. RESULTS: High salinity treatment (500 mM NaCl) reduced the plant growth by 80% and 87% in Hualhuas and Real cultivars, respectively. EC50 (water salinity which reduces the maximum yield by 50%) was at a salinity of 300 mM NaCl for Hualhuas and between 100 and 200 mM NaCl for Real plants. Both cultivars were able to lower the osmotic potential of all organs due to substantial Na+ accumulation. However, Hualhuas plants exhibited distinctly lower Na+ contents and consequently a higher K+/Na+ ratio compared to Real plants, suggesting a more efficient control mechanism for Na+ loading and better K+ retention in Hualhuas plants. Net CO2 assimilation rates (Anet) were reduced, being only 22.4% and 36.2% of the control values in Hualhuas and Real, respectively, at the highest salt concentration. At this salinity level, Hualhuas plants showed lower stomatal conductance (gs) and transpiration rates (E), but higher photosynthetic water use efficiency (PWUE), indicative of an efficient control mechanism over the whole gas-exchange machinery. CONCLUSION: These results reveal that Hualhuas is a promising candidate in terms of salt resistance and biomass production compared to Real.

Comparison of in-hospital outcomes and complications of leadless pacemaker and traditional transvenous pacemaker implantation.

AIMS: Since their introduction in 1958, traditional cardiac pacemakers have undergone considerable upgrades over the years, but they continue to have a complication rate of ∼3.8%-12.4%. There are no randomized controlled trials comparing outcomes of leadless pacemakers (LPM) with single-chamber transvenous pacemakers (TV-VVI). The aim is to assess the differences in the procedural complications and in-hospital outcomes between LPM and TV-VVI implants. METHODS AND RESULTS: We queried the national inpatient database from 2016 to 2019 to include adult patients undergoing LPM and TV-VVI. Admissions for leadless and single-lead transvenous pacemakers were identified by their appropriate ICD-10 codes. Complications were identified using ICD-10 codes that mostly represent initial encounter. The difference in outcomes was assessed using multivariable logistic regression and 1:1 propensity score matching between the two cohorts. Thirty-five thousand four hundred thirty expanded samples of admissions were retrieved of which 27 650 (78%) underwent TV-VVI with a mean age 81.3 ± 9.4 years and 7780 (22%) underwent LPM with a mean age of 77.1 ± 12.1 years. The LPM group had a higher likelihood of in-hospital mortality [adjusted odds ratio (aOR): 1.63, 95% CI (1.29-2.05), P < 0.001], vascular complications [aOR: 7.54, 95% CI (3.21-17.68), P < 0.001], venous thromboembolism [aOR: 3.67, 95% CI (2.68-5.02), P < 0.001], cardiac complications [aOR: 1.79, 95% CI (1.59-2.03), P < 0.001], device thrombus formation [aOR: 5.03, 95% CI (2.55-9.92), P < 0.001], and need for a blood transfusion [aOR: 1.54, 95% CI (1.14-2.07), P < 0.005]. The TV-VVI group had higher likelihood of in-hospital pulmonary complications [aOR:0.68, 95% CI (0.54-0.87), P < 0.002] and had a need for device revisions [aOR:0.42, 95% CI (0.23-0.76), P < 0.004]. CONCLUSION: There is a higher likelihood of all-cause in-hospital mortality and complications following LPM implantation in comparison to TV-VVI. This could be related to higher co-morbidities in the LPM group. Clinical trials aimed to accurately compare these two groups should be undertaken.

TEMPORARY REMOVAL: Prevalence of Non-Proteinuric Preeclampsia at Mansoura University Hospitals.

The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at: https://www.elsevier.com/about/policies/article-withdrawal.

Evaluation of the scabicidal effect of a single dose of fluralaner in a rabbit model of crusted scabies.

Recently, scabies was included in the WHO roadmap for neglected tropical diseases 2021-2030. Till now, ivermectin is the only available oral drug that is currently approved for treating crusted scabies in humans. Concerns regarding its efficacy and safety have prompted research efforts to find new alternatives. Our study aimed to evaluate the therapeutic effect of a single dose of fluralaner in cases of crusted scabies in comparison with that of repeated weekly high doses of ivermectin. For the in vitro study, twenty adult female mites were exposed to 50 µg/ml and 100 µg/ml ivermectin and fluralaner to evaluate their effects on mites' survival. For the in vivo study, thirty-five male crossbreed rabbits were divided into 4 groups: group I (non-infected, non-treated), group II (infected, non-treated), group III (infected and treated with ivermectin in a weekly oral dose of 0.4 mg/kg body weight/rabbit for 4 weeks, starting 8 weeks post-infection), and group IV (infected and treated with fluralaner given as a single oral dose of 25 mg/kg body weight/rabbit, starting 8 weeks post-infection). Clinical, parasitological, histopathological, and biochemical assessments were done. Clinical and parasitological assays were accomplished to all infected groups starting from day 0, then on days 2, 4, 6, 8, 10, 12, 14, 21, 28, 35, 42, 49 and 56 post-treatment, while histopathological and biochemical assessments were done at the end of the 8th week post-treatment (day 56). Our results showed that fluralaner exhibited a higher acaricidal effect on adult Sarcoptes scabiei var. cuniculi when compared with ivermectin applied in the same concentration (50 µg/ml or 100 µg/ml). Concerning the in vivo study, both clinical cure and parasitological cure were noted in both treated groups, evidenced by complete absence of all clinical signs of infestation and absence of mites in all skin scrapings. However, the ivermectin-treated group showed incomplete histopathological and biochemical resolution. Interestingly, both clinical cure and negative skin scrapings were noticed earlier in the fluralaner-treated group, with no apparent side effects. Also, no significant differences were noticed in the skin sections and serum biochemical parameters when compared with those of the negative control group. We concluded that fluralaner is a promising scabicidal agent that is recommended to be studied for possible human use, especially in control programs.

The impact of ß-glucan on the therapeutic outcome of experimental Trichinella spiralis infection.

Trichinellosis is a cosmopolitan zoonosis that is caused mainly by Trichinella spiralis infection. The human disease ranges from mild to severe and fatality may occur. The treatment of trichinellosis still presents a challenge for physicians. Anti-inflammatory drugs are usually added to antiparasitic agents to alleviate untoward immuno-inflammatory responses and possible tissue damage but they are not without adverse effects. Thus, there is a need for the discovery of safe and effective compounds with anti-inflammatory properties. This study aimed to evaluate the activity of ß-glucan during enteral and muscular phases of experimental T. spiralis infection as well as its therapeutic potential as an adjuvant to albendazole in treating trichinellosis. For this aim, mice were infected with T. spiralis and divided into the following groups: early and late ß-glucan treatment, albendazole treatment, and combined treatment groups. Infected mice were subjected to assessment of parasite burden, immunological markers, and histopathological changes in the small intestines and muscles. Immunohistochemical evaluation of NF-κB expression in small intestinal and muscle tissues was carried out in order to investigate the mechanism of action of ß-glucan. Interestingly, ß-glucan potentiated the efficacy of albendazole as noted by the significant reduction of counts of muscle larvae. The inflammatory responses in the small intestine and skeletal muscles were mitigated with some characteristic qualitative changes. ß-glucan also increased the expression of NF-κB in tissues which may account for some of its effects. In conclusion, ß-glucan showed a multifaceted beneficial impact on the therapeutic outcome of Trichinella infection and can be regarded as a promising adjuvant in the treatment of trichinellosis.

CT-guided radiofrequency ablation of painful intra-articular osteoid osteoma in children: Is there a concern for cartilage damage?

OBJECTIVE: To evaluate the safety and efficacy of computed tomography-guided percutaneous radiofrequency ablation (PRFA) in the management of uncommon and technically challenging intra-articular osteoid osteoma in children. MATERIAL AND METHODS: From December 2018 to September 2022, 16 children with intra-articular osteoid osteoma, including ten boys and six girls, were treated at two tertiary centers with percutaneous CT-guided RF ablation using a straight monopolar electrode. The procedures were carried out under general anesthesia. Post-procedural clinical outcomes and adverse events were assessed through clinical follow-up. RESULTS: Technical success was achieved in all of the participating patients. Clinical success with relief of symptomatology throughout the period of follow-up was achieved in 100% of the patients. No persistence or recurrence of pain occurred during the follow-up period. No immediate or delayed adverse effects were observed. CONCLUSION: PRFA is shown to be technically feasible. Clinical improvement can be achieved with a high rate of success in the treatment of children with difficult-to-treat intra-articular osteoid osteomas.

Investigating the impacts of heavy metal(loid)s on ecology and human health in the lower basin of Hungary's Danube River: A Python and Monte Carlo simulation-based study.

This study aimed to determine the environmental and health risks of the heavy metal levels in the Danube River in Hungary. The metals, including Fe, Mn, Zn, Cu, Ni, Cr, Pb, and As, were measured in the period from 2013 to 2019. The Spearman correlation and heatmap cluster analysis were utilized to determine the origin of pollution and the factors that control surface water quality. Several indices, such as the heavy metal pollution index (HPI), metal index (MI), hazard quotient oral and dermal (HQ), hazard index oral and dermal (HI), and carcinogenic risk (CR), were conducted to evaluate the potential risks for the environment and human health. The values of the HPI were between the range of 15 < HPI < 30, which indicated moderate pollution; however, the MI results showed high pollution in Dunaföldvár and Hercegszántó cities. The ecological risk (RI < 30) and HI values (< 1) showed low environmental risks and non-carcinogenic impacts of the existing metals, either on adults or children. The mean CR value of oral arsenic was 2.2E-04 and 2.5E-04 during April-September and October-March, respectively, indicating that children were the most vulnerable to arsenic-carcinogenic oral effects. While lead's CR oral values for children during April-September exceeded the threshold of 1.0E-04, chromium's oral and dermal CR values for both adults and children were 2.08E-04, 6.11E-04, 1.97E-04, and 5.82E-04 during April-September and October-March, respectively. These results demonstrate the potential carcinogenic risks related to chromium exposure within the two pathways in Hungary and highlight the need for effective measures to mitigate these risks.

Laparoscopic Sleeve Gastrectomy with Roux en-Y Bypass (A Novel Modification) for Morbid Obesity: A Prospective Observational Study.

Background: Recently, obesity witnessed a dramatic increase and its related comorbidities have grown. Bariatric surgeries were developed to reduce weight. However, all techniques had their advantages and shortages. In this work, we aimed to assess our new modification of combining sleeve gastrectomy with Roux en-y bypass for the management of obesity, hoping to gain benefits from both techniques to increase the excess bodyweight loss (EBW%). Methods: The study was a prospective observational study on 23 Morbidly obese patients. The study was held from January 2020 to April 2022. The recruited patients were submitted to detailed clinical assessment and investigations to check fitness for surgery. Besides operative data, any intra- or post-operative complications were recorded. Each patient was followed up for at least one year. The follow-up visits were scheduled at regular intervals (one week, one month, six months, and twelve months). Results: The mean operative time was 113.91 minutes (65-150). No intraoperative complications or conversion. There was intraluminal bleeding in one patient within 48 hours postoperatively with successful conservative management. There was a complete cure of diabetes mellitus (DM) for 5, 2, and 3 patients and antidiabetic drugs were reduced for 64.3%, 21.43%, and 7.14% at 1, 6, and 12 months follow up respectively. Hypertension was cured in 1,1,2 patients, and antihypertensives were reduced for 2,1,1 patient, at 1, 6, and 12 months follow up respectively. EWL% was 14.4%, 40.78%, and 73.74% at 1,6,12 months follow up respectively. Hemoglobin concentration and ionized calcium improved over time. Finally, serum albumin at 1, 6, and 12 months follow-up was 3.64, 3.58, 3.78 g/dL respectively. Conclusion: New modifications of combining LSG and LRYGB have shown to be safe and effective procedures. In addition, it is associated with minimal postoperative nutritional complications and permits complete visualization of the biliary system using endoscopy.

Role of percutaneous CT-guided radiofrequency ablation in treatment of intra-articular, in close contact with cartilage and extra-articular osteoid osteomas: comparative analysis and new classification system.

PURPOSE: We investigated procedural safety, technical and clinical outcomes of the percutaneous image-guided radiofrequency ablation (PRFA) of intra-articular (IA), intra-articular close to cartilage (IACC), and extra-articular (EA) osteoid osteomas (OO). We proposed a new radiologic classification for osteoid osteoma depending on the degree and location of sclerosis which may correlate with technical failure and/or difficulties. MATERIAL AND METHODS: According to the inclusion criteria, we enrolled consecutive patients who were referred to the investigation center from June 2018 to January 2022. After clinical and CT imaging features were suggestive for the diagnosis of OO, all the patients were treated by percutaneous CT-guided RFA with a standardized technique. Biopsy of the lesion was not performed in all patients. A retrospective analysis was conducted to assess the procedure's technical, primary clinical, and secondary clinical successes, recurrence rate, and complications. We classified all the OOs according to a new proposed classification of the site and the amount of sclerosis. RESULTS: A total number of 55 patients were enrolled in our study according to the inclusion criteria. The mean age of the enrolled patients was 24.07 ± 14.71 years (ranges from 7 to 57 years). The M/F ratio was roughly 2:1. The mean follow-up was 20.18 ± 12.60 months (ranges from 2 to 44 months). EA group included 36 patients, IA included 5 and IACC included 14 patients. Technical success was achieved in all cases of IA and IACC groups. Technical success in the EA group was 97.22% (1 technical failure). Primary clinical success was 100%, 92.85%, and 91.66% for IA, IACC, and EA groups, respectively. Accordingly, the recurrence rate was 5.88% in EA, and 7.14% in IACC, while no recurrence occurred in the IA group. No complications occurred. The secondary success rate of the 3 cases of recurrence was 100%. CONCLUSIONS: PRFA proved to be a safe procedure with a high rate of success for OO treatment even in intra-articular lesions in close contact with cartilage. This study showed that the results in terms of technical and clinical success are comparable for IA OO, IACC OO, and EA OO, even if the recurrence rate was higher in EA OO. Our proposed new classification of the degree and location of sclerosis may correlate to technical failure, but further studies with a larger number of patients are needed for validation.

An innovative konjac glucomannan/κ-carrageenan mixed tensile gel.

BACKGROUND: Konjac glucomannan (KGM) showed a synergistic interaction with κ-carrageenan (CAR), which led to the formation of a promising compound hydrocolloid gel in the food field (such as jelly). Nevertheless, the mixed gels formed by adding KGM to CAR still displayed defects in gel strength and syneresis, and would hardly meet the quality requirements of some gel foods. However, deacetylated KGM and maltodextrin (MD) have always been used in gel foods and affect their viscosity and rheological properties. RESULTS: In our paper, different amounts of MD were first used to alter the textural properties, and the results showed that both tensile strength and elongation exhibited first an increasing and then a decreasing trend with the increasing MD proportion and achieved a maximum at a final maltodextrin proportion of 4 g kg-1 in the KGM/CAR/MD system. Based on the above results, we further explored the effects of deacetylation degree of KGM on the gel properties of mixed gel system. The results revealed that, compared to the native KGM, the partial deacetylated KGM was capable of significantly improving the tensile strength and elongation of KGM/CAR mixed gel. CONCLUSION: Our study found that the appropriate addition of MD (0.4%) and DKGM were able to alter the tensile properties of KGM/CAR mixed gel, with potential to meet the needs of consumers and further design innovative tensile gel products in the soft gel industry. © 2021 Society of Chemical Industry.

A state-of-the-art-review on grey water management: a survey from 2000 to 2020s.

Water reuse can contribute to reducing pressures on water resources, as an important approach and practice, reducing the demand for potable water for purposes not requiring high quality water. With water resources being depleted and the demand for water increased, grey water reuse becomes more popular in order to preserve water worldwide. This paper presents a comprehensive review of all significant research and reviews existing case studies to review the present knowledge with respect to the characteristics of grey water. The main summary table covers 63 works that focus on the application of these methods to different fields of sustainable building design. Key fields are reviewed in detail: grey water, including water reuse; grey water recycling; water sustainability; building design optimization; and wastewater of several areas simultaneously, with particular focus on buildings. This research aims to introduce the review of the research that covered the grey water management. Various engineering databases, international journals, and conference proceedings were searched. International journals were searched for relevant research papers. This paper provides perspectives on grey water context in order to frame the breadth and multiple dimensions it encompasses, to summarize recent activities on selected relevant topics, and to highlight possible future directions in research and implementations.

Serological and molecular screening of umbilical cord blood for Toxoplasma gondii infection.

BACKGROUND: Human umbilical cord blood has proven to be a successful alternate source of hematopoietic stem cells for pediatric patients with major hematologic disorders. Toxoplasma gondii is a global opportunistic protozoan which cause fatal complications in immunocompromised individuals. AIM: Our goal is to study the prevalence of toxoplasmosis in umbilical cord blood (UCB) and to assess the sensitivity of ELISA and PCR for Toxoplasma infection screening. MATERIAL AND METHODS: One hundred cord blood samples were collected immediately after delivery. Anti-Toxoplasma IgG and IgM antibodies were determined using ELISA method; Toxoplasma DNA was detected using nested PCR technique. Total nucleated cells (TNC) and HB were also determined. Demographic data and risk factors data related to the transmission of toxoplasmosis, were collected from mothers. RESULTS: Among 100 cord blood samples, 36 (36%) were positive for anti-Toxoplasma IgG antibodies and 6 (6%) were positive for anti-Toxoplasma IgM antibodies. The nested PCR showed 11 (11%) samples containing Toxoplasma DNA from which, 6 (55%) samples were IgM positive. There was no significant association between the risk of Toxoplasma transmission and cord blood positivity for toxoplasmosis. CONCLUSION: Owing to the prevalence of toxoplasmosis, its rapid progression and its fatal outcome in immunocompromised patients, cord blood screening for toxoplasmosis with nested PCR should be incorporated into cord blood bank screening protocols.

Effect of twister wrap orthosis on foot pressure distribution and balance in diplegic cerebral palsy.

OBJECTIVES: To evaluate the effectiveness of twister wrap orthosis (TWO) on foot pressure distribution and postural balance in children with spastic diplegic cerebral palsy (CP). METHODS: Thirty children with spastic diplegic CP, with ages ranging from 6 to 8 years, were assigned randomly into two groups. The control group received the conventional physical therapy and ankle foot orthosis (AFO), whereas the study group received the same program as the control group in addition to TWO. Measurement of foot pressure distribution using a pressure platform as well as stability indices using the Biodex Stability System was performed before and after 12 weeks of the treatment program. RESULTS: Both groups showed a significant increase in mean and peak planter pressure on forefoot and rear foot with a significant decrease on mid foot after treatment (P⟨0.05). The study group showed a significant improvement in balance after treatment (P⟨0.05) while there was no significant difference in the control group. After treatment, the study group showed significant improvement in planter pressure and balance compared with the control group (P⟨0.05). CONCLUSIONS: TWO could provide correction of foot pressure distribution and improve postural balance in children with spastic diplegic CP.

Combined Unilateral Posteroventral Pallidotomy and Ventral Intermediate Nucleus Thalamotomy in Tremor-Dominant Parkinson's Disease versus Posteroventral Pallidotomy Alone: A Prospective Comparative Study.

BACKGROUND: The optimum target in surgery for Parkinson's disease (PD) is still controversial, especially in patients with tremor-dominant PD. We aim to compare results in tremor-dominant patients undergoing pallidotomy vs. those undergoing simultaneous posteroventral pallidotomy (PVP) and ventral intermediate nucleus (VIM) thalamotomy. METHODS: Twenty-four patients with tremor-dominant PD were included in this study. Twelve patients received unilateral PVP contralateral to the most affected side. The other 12 patients received simultaneous unilateral PVP and VIM thalamotomy contralateral to the most affected side. Assessment of results in both groups was achieved using both UPDRS "off" motor scores and UPDRS rest tremor subscores. RESULTS: The mean UPDRS off motor score improved in the pallidotomy group from 61.3 preoperatively to 36.8 at 12 months. In the combined group, it improved from 59.6 to 35.2 at 12 months, with no statistically significant difference between both groups. On the other hand, while the mean tremor subscore in the pallidotomy group improved from a mean of 2.3-0.8, the tremors were abolished in all of the patients in the combined group except for 1 patient who showed slight infrequent tremors at 12 months. CONCLUSION: Patients with tremor-dominant PD achieve more improvement in tremor control after combined PVP and VIM thalamotomy.