A review of visual SLAM for robotics: evolution, properties, and future applications.

Visual simultaneous localization and mapping (V-SLAM) plays a crucial role in the field of robotic systems, especially for interactive and collaborative mobile robots. The growing reliance on robotics has increased complexity in task execution in real-world applications. Consequently, several types of V-SLAM methods have been revealed to facilitate and streamline the functions of robots. This work aims to showcase the latest V-SLAM methodologies, offering clear selection criteria for researchers and developers to choose the right approach for their robotic applications. It chronologically presents the evolution of SLAM methods, highlighting key principles and providing comparative analyses between them. The paper focuses on the integration of the robotic ecosystem with a robot operating system (ROS) as Middleware, explores essential V-SLAM benchmark datasets, and presents demonstrative figures for each method's workflow.

Evaluating the potential mediating role of ADAMTS13 activity in the relationship between obesity and the severity of COVID-19: A retrospective cohort study.

Obesity and low enzyme A disintegrin and metalloproteinase with thrombospondin type-1 motif-13 (ADAMTS13) activity have been linked to poor coronavirus disease 2019 (COVID-19). Given that obesity may influence ADAMTS13 activity, it is feasible; however, it remains unclear whether ADAMTS13 activity acts as a mediator between obesity and COVID-19 outcomes. We investigated the link between body mass index (BMI) and COVID-19 outcomes, using ADAMTS13 activity as a mediator. ADAMTS13 activity was measured in 86 hospitalized COVID-19 patients. BMI, ADAMTS13 activity, and COVID-19 outcomes were assessed. Obese patients had a high odds ratio for low ADAMTS13 levels. When different levels of ADAMTS13 activity were considered, the severity of COVID-19 in obese patients was 4.5 times that in the normal BMI group. Furthermore, increased coagulopathy indicators correlated with low ADAMTS13 activity. Patients with elevated ALT and AST levels showed a 3 to 4-fold increase in the chances of low ADAMTS13 activity (OR:3.19, 95% CI:1.22-8.90, P = .021; OR:2.17, 95% CI:0.91-5.27, P = .082, respectively). When ADAMTS13 activity was considered, obese patients had greater COVID-19 severity and slower viral clearance than those with normal BMI. Low ADAMTS13 activity and impaired liver function are associated with poor COVID-19 outcomes. These findings encourage researchers to use molecular component identification to study the effects of obesity on the von Willebrand factor (VWF)/ADAMTS13 axis, COVID-19 pathogenesis, and outcomes.

Toward Robust and Unconstrained Full Range of Rotation Head Pose Estimation.

Estimating the head pose of a person is a crucial problem for numerous applications that is yet mainly addressed as a subtask of frontal pose prediction. We present a novel method for unconstrained end-to-end head pose estimation to tackle the challenging task of full range of orientation head pose prediction. We address the issue of ambiguous rotation labels by introducing the rotation matrix formalism for our ground truth data and propose a continuous 6D rotation matrix representation for efficient and robust direct regression. This allows to efficiently learn full rotation appearance and to overcome the limitations of the current state-of-the-art. Together with new accumulated training data that provides full head pose rotation data and a geodesic loss approach for stable learning, we design an advanced model that is able to predict an extended range of head orientations. An extensive evaluation on public datasets demonstrates that our method significantly outperforms other state-of-the-art methods in an efficient and robust manner, while its advanced prediction range allows the expansion of the application area. We open-source our training and testing code along with our trained models: https://github.com/thohemp/6DRepNet360.

Grasping knowledge, attitude, and perception towards monkeypox among healthcare workers and medical students: an Egyptian cross-sectional study.

Background: Monkeypox (Mpox) is a re-emerging infectious disease representing a new global challenge. It poses a substantial threat to countries, particularly those with a low number of cases. Due to its popularity as a tourist destination and its proximity to many African refugees, Egypt is potentially at risk of Mpox importation. Therefore, effective disease management necessitates healthcare workers (HCWs) to possess adept knowledge, along with a positive attitude and behavior. The study aimed to assess the knowledge, attitude, and perception of Egyptian HCWs and medical students towards human Mpox. Methods: The present cross-sectional study data was collected from participants between October and December 2022 via a questionnaire. The questionnaire comprised 31 questions in the knowledge section, 11 questions in the attitude section, and 14 in the perception section. Results: The present study involved a total of 1,034 HCWs and medical students. It was found that 55.3% of the participants demonstrated adequate knowledge about Mpox, whereas 44.5% and 39.8% of the respondents exhibited favorable attitudes and perceptions towards the disease, respectively. Binary logistic regression analysis revealed that adequate knowledge was significantly observed in ages older than 40 years (p < 0.001), married participants (p < 0.001), and doctors (p < 0.001). The positive attitude was significantly observed among the male sex (p = 0.045), urban residents (p = 0.002), and nurses (p = 0.002). Conversely, married participants (p = 0.013), doctors (p < 0.001), and individuals employed in pharmacy and laboratory departments (p < 0.001) experienced an increase in positive perception. Conclusion: Knowledge, attitude, and perception towards Mpox among Egyptian HCWs and medical students exhibit suboptimal levels. Addressing these gaps is crucial to controlling and effectively preventing disease transmission.

Association of treatment satisfaction and physician trust with glycemic control among primary care patients with type 2 diabetes in Egypt.

Objectives: To evaluate the association of diabetes treatment satisfaction and trust in family physicians with glycemic control among primary care patients with type 2 diabetes mellitus. Methods: A cross-sectional study on 319 patients with type 2 diabetes mellitus from five primary healthcare centers in Egypt. Data were collected from February to August 2021 using a structured questionnaire that contained six parts: sociodemographic data, disease profile, the Diabetes Treatment Satisfaction Questionnaire (DTSQ), 8-item Morisky Medication Adherence Scale (MMAS-8), self-reported medication knowledge questionnaire (MKQ), and revised healthcare relationship trust scale (HCR). Multiple linear regression analysis was used to assess predictors of treatment satisfaction, physician trust, and HbA1c level. P values less than 0.05 were considered significant. Results: The mean age was 59.66 years (± 7.87 years) and 55.17% were females. Multiple linear regression analysis for predicting HbA1c showed that HbA1c level was lower in patients with higher treatment satisfaction scores (ß = - 0.289, p < 0.001) and higher medication adherence scores (ß = - 0.198, p = 0.001). Treatment satisfaction scores were positively predicted by higher physician trust scores (ß = 0.301, p < 0.001), increased medication adherence scores (ß = 0.160, p = 0.002), and longer duration of diabetes (ß = 0.226, p < 0.001). Positive predictors for physician trust included HbA1c level (ß = 0.141, p = 0.012), medication knowledge (ß = 0.280, p < 0.001), diabetes treatment satisfaction (ß = 0.366, p < 0.001) and medication adherence (ß = 0.146, p = 0.011). Conclusion: Optimizing diabetes treatment satisfaction and physician trust could have favorable associations with medication adherence and medication knowledge with a possible improvement in glycemic control. Family physicians should incorporate patients reported outcomes alongside traditional clinical measures in evaluating diabetes management in primary care.

Impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients: a systematic review and meta-analysis.

BACKGROUND: Prostate cancer (PCa) is a prevalent cancer with significant morbidity and mortality rates. In most cases, prostate cancer remains asymptomatic until advanced disease manifests with symptoms, such as benign prostate hyperplasia (BPH). Timely detection and better management have improved overall survival in patients with prostate cancer, and fatigue, reduced physical activity, and impaired quality of life (QoL) remain major challenges that impact daily life. OBJECTIVE: This study aimed to systematically review and conduct a meta-analysis to evaluate the impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients undergoing treatment. MATERIAL METHODS: A comprehensive literature search was conducted using the PubMed, Cochrane Library, and clinicaltrials.gov databases, adhering to the PRISMA guidelines. Twenty studies, involving 1393 participants, were included in the final analysis. The inclusion criteria were Studies that evaluated the effects of exercise interventions relative to passive controls in patients with prostate cancer were included. The primary outcomes of interest were fatigue, QoL, and PA.. Data from eligible studies were extracted, and a meta-analysis was performed using RevMan 5.40. RESULTS: Twenty studies met our inclusion criteria. Data Analysis of the included studies demonstrated a significant improvement in quality of life among prostate cancer patients in the exercise group compared to the control group (SMD=0.20, 95% CI=0.07 to 0.34, P=0.003). However, there was no significant association between exercise and fatigue (SMD=0.07, 95% CI=-0.13, 0.26, P=0.51). Sensitivity analysis did not alter these findings. Regarding physical activity outcomes, the control group exhibited superior performance in the 400-meter walk test (P<0.05). No significant associations were found between exercise and the 6-meter walk test or up-and-go time. CONCLUSION: This systematic review revealed that aerobic and resistance training enhance the quality of life of patients with prostate cancer, although it has a limited impact on fatigue and physical activity levels. These findings advocate a shift in clinical practice and positioning exercise as a core component of comprehensive cancer care. Tailoring exercise regimens according to individual patient needs and treatment stages should become the norm in treatment planning. This approach goes beyond physical wellness and addresses the psychological and emotional facets of cancer management. Moreover, there is an evident need for further research to develop holistic exercise interventions that effectively address the complex dynamics of fatigue, physical activity, and QoL in this patient group.

Primary Transscleral Diode Laser Cyclophotocoagulation for Management of Glaucoma in Nanophthalmic Eyes.

PURPOSE: The aim of this study was to assess the efficacy and safety of double-row transscleral cyclophotocoagulation in controlling intraocular pressure in patients with secondary angle closure glaucoma due to nanophthalmos, not being controlled by medical therapy. PATIENTS AND METHODS: A prospective case series study that included 13 eyes of 8 patients diagnosed with secondary angle closure glaucoma due to nanophthalmos at the Giza Eye Subspeciality Center, treated by 24 cyclodiode applications in a double-row technique. Success was defined as complete success by control of intraocular pressure <21 mm Hg without medication and qualified success in which control of pressure <21 mm Hg achieved with 1 or 2 medications. RESULTS: The average reduction in intraocular pressure at 3 months was 57.3±20.14% and at 6 months 44.5±32%, with an average eye drop intake of 1.3±0.8 drops. There was a significant reduction of intraocular pressure at 6 months compared with the preprocedure pressure ( P =0.01). Complete success achieved in 3 eyes, pressure controlled without any medication, and qualified success in 9 eyes. CONCLUSION: Transscleral cyclophotocoagulation is a safe and effective primary therapy for managing glaucoma in nanophthalmic eyes.

Patterns and Outcomes of Obesity Using Body Mass Index in Patients Hospitalized with Acute Cardiovascular Disorders: A Retrospective Analysis of 7284 Patients in a Middle Eastern Country.

BACKGROUND: We aimed to study the presentation and in-hospital outcomes of obese patients hospitalized for cardiovascular diseases (CVDs) in a Middle Eastern country. METHODS: This retrospective study included patients admitted to the Heart Hospital between 2015 and 2020. Patients were divided according to their body mass index (BMI): Group I (BMI 18.5-24.9), Group II (BMI 25-29.9), and Group III (BMI ≥ 30), by applying one-way ANOVAs and chi-square tests. The obese group (BMI ≥ 30) was graded and compared (Grade I (BMI 30-34.9), Grade II (BMI 35-39.9), and Grade III (BMI ≥ 40)). RESULTS: There were 7284 patients admitted with CVDs (Group I (29%), Group II (37%), and Group III (34%)). The mean age was higher in Group III than Groups I and II (p < 0.001). Male sex was predominant in all groups except for morbid obesity (Grade III), in which females predominated. Diabetes mellitus (DM), hypertension, and dyslipidemia were more common in Group III. Chest pain was more common in Group II, while shortness of breath was more evident in Group III (p < 0.001). Group II had more ST-elevation myocardial infarction (STEMI), followed by Group I (p < 0.001). Atrial fibrillation (AF) was observed more frequently in Group III (p < 0.001). Congestive heart failure (CHF) was common in Group III (19%) (p < 0.001). In the subanalysis, (Grade I (62%), Grade II (22.5%), and Grade III (15.5%)), Grade I had more STEMI, whereas AF and CHF were higher in Grade III (p < 0.001). Percutaneous Coronary Intervention was performed less frequently in Grade III (p < 0.001). In-hospital mortality was higher in Grade III (17.1%), followed by Grades II (11.2%) and I (9.3%) (p < 0.001). CONCLUSIONS: In this study, one third of the hospitalized CVS patients were obese. AF and CHF with preserved EF were the most common cardiovascular presentations in obese patients. In patients with CVDs, obesity was associated with higher rates of comorbidities and in-hospital mortality. However, obesity measured by BMI alone was not an independent predictor of mortality in obese cardiac patients.

The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients.

INTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era. METHODS: Patients who underwent Q-only imaging for pulmonary embolism between March 2020 and February 2021 were analyzed. Patients who underwent lung quantification analysis were excluded. Q-only test results were reported as per modified PIOPED II criteria and single positron emission tomography/computed tomography (SPECT/CT) imaging was performed as needed. Patients were considered concordant or discordant by correlating the Q-only results with CT angiogram (CTA) or clinical diagnosis made through chart review. The diagnostic accuracy was calculated after excluding intermediate probability and nondiagnostic studies. RESULTS: Four hundred and thirty-four patients were identified. One hundred and twenty-eight patients (29.4%) underwent ultrasound Doppler, 37 patients (8.5%) underwent CTA, and 16 patients (3.6%) underwent both. After excluding patients with intermediate probability or nondiagnostic studies and who did not have follow-up (a total of 87 patients [20%]), 347 patients were enrolled in the final analysis. The combined planar and SPECT/CT sensitivity and specificity were 85.4% (72.2%-93.9% confidence interval [CI]) and 98.7% (96.9%-98.6% CI), respectively. The positive predictive value (PPV) of the Q-only imaging was 89.1% (77.3%-95.1% CI) and the negative predictive value (NPV) was 98.2% (96.4%-99% CI). The sensitivity with SPECT/CT reached 100% (CI: 71.5%-100%) with a specificity of 92.3% (CI: 64%-99.8%). The PPV was 85.7% (CI: 62.1%-95.6%) and the NPV was 100%. CONCLUSION: Q-only imaging provides clinically acceptable results. The sensitivity of the Q-only scan is increased when coupled with SPECT/CT.

Therapeutic Impacts of Hyperbaric Oxygen Therapy and Risperidone on Children with Autism: A Clinical Trial.

Introduction: In this research, we investigated any possible effect of receiving hyperbaric oxygen therapy (HBOT) or risperidone on the core symptoms of autism in children diagnosed with autism spectrum disorder (ASD). Methods: This study was a randomized, controlled clinical trial in Minia and Assiut University hospitals in Egypt with three parallel groups. One hundred and eighty children with autism, aged 5-8 years were divided into three equal groups (n=60). Group 1 (G1) received 40 sessions of HBOT within two months, group 2 (G2) received risperidone (dose: 0.25 mg per day in children weighing less than 20 kg and 0.5 mg per day in cases weighing more) for six months, and group 3 (G3) as the control group, received a placebo for six months. The assessment was done using childhood autism rating scale (CARS) and autism treatment evaluation checklist (ATEC) at the beginning of the study (baseline) and after one year. Results: The mean total CARS and ATEC scores significantly decreased (improved) by varying degrees in the three groups after a year of follow-up compared to the baseline scores, but the best results were found in G1, G2, and G3, respectively. Conclusion: Using HBOT or risperidone is effective in treating the core symptoms of autism in children diagnosed with autism spectrum disorder, but using HBOT gives better results than risperidone therapy. Highlights: Non-pharmacologic therapy can be used for the treatment of the core symptoms of autism.Both hyperbaric oxygen therapy and risperidone reduce the core symptoms of autism.Hyperbaric oxygen therapy gives better effects than risperidone in reducing the core symptoms of autism. Plain Language Summary: Since the long-term use of drug therapy in children with autism leads to the occurrence of side effects in addition to the difficulty in complying with the drugs for long-term use, efforts have begun to use non-traditional alternative treatments, such as hyperbaric oxygen therapy. The current study assessed the therapeutic effect of hyperbaric oxygen therapy and risperidone on the core symptoms of autism. The results revealed that both hyperbaric oxygen therapy and risperidone reduced the core symptoms of autism, but hyperbaric oxygen therapy gave better therapeutic results than risperidone.

Palliative and Supportive Care for Patients with End-Stage Hepatocellular Carcinoma: Perspectives of Egyptian Domestic Caregivers.

OBJECTIVES: Palliative care is a holistic, patient-centered approach to improving the quality of life for those with terminal diseases and their families. The main objective of the current study was to evaluate the Egyptian domestic caregivers' knowledge, attitudes, and competencies related to palliative and supportive care. METHODS: Three hundred and thirty-five family caregivers in total were recruited. A descriptive research design was used. Four tools were used to collect data; structured interview questionnaire to collect demographic questions, palliative care knowledge questionnaire, Palliative Attitude Scale, and Competence Scale. The study was conducted in oncology outpatient and pain clinics located at the Damietta Cancer Institute in Damietta Governorate, Egypt. RESULTS: Nearly two-thirds of the informal family caregivers are aged between 30-40 years old; 54% are female, and 83% are married. Also, sixty-seven point eight of the informal family caregivers were working (part-time). Furthermore, 65 % of them had insufficient knowledge, 68 % had a positive attitude, and 58% of the informal family caregivers had non-competency skills regarding palliative and supportive care. CONCLUSION: Approximately two-thirds of informal care providers had insufficient total knowledge scores, more than half possessed a positive attitude, and more than half reported non-competency skills regarding palliative care of hepatocellular patients. RECOMMENDATION: It is highly advisable to launch extensive health education programs and campaigns aimed at all of the unpaid informal family careers of patients with serious terminal illnesses, including hepatocellular carcinoma, at various governments with greater sample sizes.

Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries.

BACKGROUND: The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in individual patients undergoing renal surgeries while lateral positions at various stages of anesthesia. PATIENTS AND METHODS: 12 patients older than 18 years, ASA I-III patients scheduled for elective renal operations, two BIS were placed on each patient, one on each side of the post-auricular region and one across the forehead, and each sensor was connected to a different BIS monitor. We gathered three pieces of data at each of the six-time points: BIS score, signal quality index (SQI) score calculating the signal's strength and electromyography (EMG) score: before the onset of anesthesia (awake) when the eyelash reflex is lost (LOC), after intubation (intubation), following the initial surgical incision, each 30 min throughout the procedure (maintenance), and at the moment the patient's eyes open naturally after waking up from anesthesia (emergence). RESULTS: The overall BIS value at the frontal position was significantly higher than the post-auricular position (52.5 ± 22.2 and 52.1 ± 22.1, respectively, P = 0.010). On the other hand, the BIS value was comparable between the frontal and post-auricular positions at LOC, intubation, 60, 120, and 80 min and at emergence. A strong link between the two sensor positions, as indicated by the correlation coefficient (r = 0.607, P < 0.001), and the Bland-Altman analysis revealed a small mean difference (-1.8) and a low (9.0/- 12.5) limit of agreement, with just 4.3% of the readings falling outside of it during the anesthetic maintenance period. CONCLUSION: Acceptable variation in BIS data was observed when obtained from the two different sensor positions for clinical usage. The post-auricular BIS sensor system may be a suitable substitute for an impractical frontal setup. PROTOCOL REGISTRATION: The study was registered in clinicaltrials.gov on 11/07/2022 (trial registration number: NCT05451823).

Virtual learning in maxillofacial surgery in the post-COVID world: where are we now?

During the COVID-19 pandemic we developed a post-graduate virtual learning environment (PGVLE) in the West Midlands region for higher trainees in oral and maxillofacial surgery. We continued to develop this following the pandemic and sought to examine the trainee experience with this resource as restrictions eased. The PGVLE comprises a total of nine semesters mapping General Medical Council (GMC) learning objectives in the specialty across a total of 63 events using BigBlueButton™. Webinars are delivered on a weekly basis by subspecialty experts. Trainee feedback was sought using SurveyMonkey™ examining self-assessed confidence levels using visual analogue scores (VAS) and Likert items regarding trainers and content. A focus group was convened and the transcript analysed using grounded theory analysis (GTA). Likert items revealed overwhelmingly positive responses, with 96.2% (n = 281) of responses being positive regarding content and 97.5% (n = 475) agreeing with positive comments regarding faculty. VAS scores improved by an average of 39.0% and improvements were statistically significant for most sessions. The focus group highlighted the relevance of teaching to GMC learning objectives, the achievement of consistently high standards, the potential for conflict with clinical commitments and issues surrounding peer interaction. Satisfaction scores remain high with the PGVLE programme, which is very much here to stay in the post-graduate education of our trainees. With the easing of restrictions, we have moved to a hybrid method of learning with the potential for 'flipped classroom' methodology moving forwards.

Incidence of Post Total Laryngectomy Hypothyroidism: Effects of Thyroid Gland Surgery and Post-Operative Radiotherapy.

To record the incidence of hypothyroidism in patients after total laryngectomy, whether with or without postoperative radiation therapy and to analyze the effect of hemithyroidectomy for the development of hypothyroidism. A retrospective study included patients who underwent total laryngectomy (with or without hemithyroidectomy) between 2018 and 2021 for laryngeal carcinoma and/or received postoperative radiotherapy. Thirty-six (45%) of the 80 enrolled patients developed hypothyroidism after a median follow-up of 16 months. In this study, adjuvant radiation and central neck dissection were found to be significantly linked with developing post-operative hypothyroidism (p values: 0.001, 0.007, respectively). The incidence of hypothyroidism in patients treated for laryngeal carcinoma is high, especially after combination treatment of surgery and radiotherapy.

Intrathecal Morphine versus Morphine-Dexmedetomidine Combination for Postoperative Pain Control After Total Knee Replacement: A Randomized Controlled Trial.

Objective: This prospective study aimed to compare the analgesic efficacy and adverse effects of intrathecal morphine, dexmedetomidine, and a combination of both in patients undergoing total knee replacement (TKR). Patients and Methods: This randomized prospective study was carried out in Tanta university hospital in orthopedic surgery for 6 months on 105 adult patients with American Society of Anesthesiologists Physical Status Class II and III, aged > 50 years, and scheduled for total knee replacement surgery randomly allocated into morphine group received 0.5% heavy bupivacaine plus 0.1 mg of morphine, morphine/ dexmedetomidine group, received 0.5% heavy bupivacaine plus 0.1 mg of morphine and 5 mcg of dexmedetomidine and dexmedetomidine group received 0.5% heavy bupivacaine plus 5 mcg of dexmedetomidine. The time of the first required analgesia, postoperative pain severity, the total dose of morphine, postoperative complication, and the patient's level of sedation were recorded. Results: About half of the patients in the dexmedetomidine group requested first rescue analgesia 6 hours after the operation, significantly shorter than the other two groups. On the other hand, the other two groups show no significant difference between them regarding the first required analgesia. At rest, the dexmedetomidine group have significantly higher VAS with a significant increase in patients who required morphine as rescue analgesia than the other two groups. While at movement, patients in the dexmedetomidine group felt pain at 4 hrs postoperatively with significantly higher VAS than the other two groups. At the same time, the sedation score was significantly lower in the dexmedetomidine group than in the other two groups. 22.2% of cases in the morphine group developed nausea and vomiting with a significant difference between the three groups. Conclusion: Despite the absence of substantial side effects, our findings did not suggest enhanced analgesia with the combination of intrathecal morphine and dexmedetomidine.

Efficacy and Safety of Sutureless Deep Sclerectomy in Juvenile and Adult Open Angle Glaucoma: 2-Year Outcomes.

PRCIS: Sutureless deep sclerectomy (SDS) achieved significant reduction in primary open angle glaucoma (POAG) and juvenile open angle glaucoma (JOAG). PURPOSE: To assess long-term results of SDS in cases with POAG and JOAG. PATIENTS AND METHODS: A prospective interventional study included 84 eyes of 54 patients underwent SDS with the superficial scleral flap left un-sutured. Changes in intraocular pressure (IOP) were recorded over 2 years. Success was defined according to the world glaucoma association criteria: Criterion A: IOP ≤18 mmHg and IOP reduction ≥30% from the preoperative status without medications [complete success (A1)], with and without medications [qualified success (A2)]. Criterion B: IOP ≤15 mmHg and IOP reduction ≥40% from the preoperative status without medications [complete success (B1)], with and without medications [qualified success (B2)]. RESULTS: There was statistically significant reduction in IOP compared with the preoperative IOP (mean IOP = 26.21± 10.46 mmHg) starting from 1 st postoperative day (mean IOP = 7.18 ± 1.8 mmHg) till the end of follow-up period at 2 years (mean IOP = 15.85± 4.46) ( P < 0.001). Also, number of medications dropped significantly from 3.27 ± 1.14 to 0.82 ± 0.97 at the end of follow up period. At 2 years complete success (A1) was achieved in 57.1% and qualified success (A2) was achieved in 91.6% of cases. Subgroup analysis into males and females, POAG and JOAG showed no statistically significant difference between subgroups regarding IOP reduction. CONCLUSION: SDS is an effective and safe modification to deep sclerectomy in cases with POAG and JOAG.

Bariatric surgery and reproduction-implications for gynecology and obstetrics.

As the rates of obesity continue to rise across the world, there has been an increasing resort to bariatric surgery amongst the options for treatment. Through the reproductive lifespan, between menarche and menopause, women might benefit from this surgical intervention, which may have a bearing on other aspects of their health. The consequences of bariatric surgery have been reported and evaluated from various perspectives in obstetrics and gynecology. Fertility and sexuality are enhanced, but not all gynecological diseases are ameliorated. There are also psychological and behavioral sequelae to be cognizant of. With multi-disciplinary and responsive care, most post-bariatric pregnancies have satisfactory outcomes. The effects of bariatric surgery on the babies conceived thereafter remains a subject of interest, whereas the possible effect on the climacteric is speculative.

Comparison of Caudal Block and Dexmedetomidine Infusion in Pediatric Patients Undergoing Hypospadias Repair Surgery: A Prospective, Randomized, Double-blinded Clinical Study.

Background: Many parents continue to reject caudal block since they worry about a rare neurological consequence that may happen. A parenteral surrogate is sought because it can induce recovery with features such as local analgesia. Objectives: To compare the efficacy and safety of intravenous dexmedetomidine versus caudal and general anesthesia (GA) in children undergoing hypospadias surgery repair. Methods: A randomized prospective study was conducted on 135 pediatric patients scheduled for hypospadias repair surgery in the hospital affiliated to Tanta University. The participants were divided into a control group (Group C) receiving GA, a caudal group receiving caudal block after GA, and a dexmedetomidine group (Group D) receiving intravenous dexmedetomidine after GA. The postoperative modified objective pain score (MOPS), the total pethidine received in the first 24 h postoperatively, and complications were recorded. Results: The patients receiving GA required a significantly higher pethidine dose than the other two groups without a significant difference between caudal and dexmedetomidine. The patients receiving dexmedetomidine were extubated significantly later than patients in the other two groups. Regarding the MOPS score, there was a significant difference between Group C and the other two groups 30 minutes and one hour after operation regarding movements, posture, and agitation. Moreover, a significantly larger number of patients developed tachycardia in Group C compared to the other groups. Conclusions: With the caudal block, the benefits of smooth emergency can be obtained by intravenous dexmedetomidine; however, it had less analgesic efficacy in the pediatric patients undergoing hypospadias repair surgery.

Disseminated Legionella Associated With Myocarditis in an Otherwise Immunocompetent Host: A Case Report and Review of the Literature.

Legionnaires' disease caused by the bacteria Legionella pneumophila, is considered a type of atypical pneumonia. The disease usually presents with dyspnea, cough, fever, muscle aches, headache, nausea, and vomiting. A milder form of the disease (Pontiac fever) with flu-like illness also exists. In addition to lung infection, extrapulmonary manifestations might occur including sepsis, rhabdomyolysis, neurological impairment, kidney, and liver damage. Myocarditis can be seen as a rare complication in Legionnaires' disease. Here, we are presenting a case of Legionnaires' disease associated with myocarditis in a patient with no predisposing risk factors for severe illness.