Low-temperature cluster spin glass transition in the single-domain NiCr2O4nanoparticles.

NiCr2O4nanoparticles with average particle size ∼15 nm, a single-domain size maintains the bulk canted antiferromagnetic ground state, were synthesized by a microwave combustion method. The magnetic behavior was carefully investigated by static and dynamic magnetic susceptibility measurements. In addition to a spin-glass-like behavior below paramagnetic-ferrimagnetic transition atTC, the NiCr2O4nanoparticles demonstrate a low-temperature cluster spin glass transition below the spin canting transitionTS, which manifests itself as a magnetic anomaly peak around ∼12 K (at 100 Oe) in the zero-field cooled magnetization with a relatively stronger field dependence in a 'de Almeida-Thouless' line for spin glasses. The AC susceptibility analyses in different approaches demonstrate a larger relative peak temperature variation per frequency decade and a longer characteristic relaxation time in the order of 0.04 and 10-7s, against 0.01 and 10-9s for the high-temperature blocking, indicating the slow spin dynamics for the low-temperature cluster glassy phase. A field-temperature magnetic phase diagram is proposed for the single-domain NiCr2O4nanoparticles.

The association between antiplatelet therapy and changes in intraplaque hemorrhage in patients with mild to moderate symptomatic carotid stenosis: a longitudinal MRI study.

INTRODUCTION: Carotid atherosclerotic intraplaque hemorrhage (IPH) predicts stroke. Patients with a history of stroke are treated with antiplatelet agents to prevent secondary cardiovascular events. A positive association between previous antiplatelet use and IPH was reported in a cross-sectional analysis. We investigated changes in IPH over two years in patients who recently started versus those with continued antiplatelet use. METHODS: In the Plaque at Risk (PARISK) study, symptomatic patients with <70% ipsilateral carotid stenosis underwent carotid plaque MRI at baseline and after two years to determine IPH presence and volume. Participants were categorized into new users (starting antiplatelet therapy following the index event) and continued users (previous use of antiplatelet therapy before the index event). The association between previous antiplatelet therapy and the presence of IPH at baseline MRI was investigated using multivariable logistic regression analysis. IPH volume change over a period of two years, defined as the difference in volume between follow-up and baseline, was investigated in each group with a Wilcoxon signed-rank test. The IPH volume change was categorized as progression, regression, or no change. Using multivariable logistic regression, we investigated the association between new antiplatelet use and 1) newly developed ipsilateral or contralateral IPH and 2) IPH volume progression. RESULTS: A total of 108 patients underwent carotid MRI at baseline and follow-up. At baseline, previous antiplatelet therapy was associated with any IPH (OR=5.6, 95% CI: 1.3-23.1; p=0.02). Ipsilateral IPH volume did not change significantly during the two years in patients who continued receiving antiplatelet agents (86.4 mm3 [18.2-235.9] vs. 59.3 mm3 [11.4-260.3]; p=0.6) nor in the new antiplatelet users (n=31) (61.5 mm3 [0.0-166.9] vs. 27.7 mm3 [9.5-106.4]; p=0.4). Similar results of a nonsignificant change in contralateral IPH volume during those two years were observed in both groups (p>0.05). No significant associations were found between new antiplatelet use and newly developed IPH at two years (odds ratio (OR)=1.0, 95% CI:0.1-7.4) or the progression of IPH (ipsilateral: OR=2.4, 95% CI:0.3-19.1; contralateral: OR=0.3, 95% CI:0.01-8.5). CONCLUSION: Although the baseline association between IPH and previous antiplatelet therapy was confirmed in this larger cohort, the new onset of antiplatelet therapy after TIA/stroke was not associated with newly developed IPH or progression of IPH volume over the subsequent two years.

Refined Residual Deep Convolutional Network for Skin Lesion Classification.

Skin cancer is the most common type of cancer that affects humans and is usually diagnosed by initial clinical screening, which is followed by dermoscopic analysis. Automated classification of skin lesions is still a challenging task because of the high visual similarity between melanoma and benign lesions. This paper proposes a new residual deep convolutional neural network (RDCNN) for skin lesions diagnosis. The proposed neural network is trained and tested using six well-known skin cancer datasets, PH2, DermIS and Quest, MED-NODE, ISIC2016, ISIC2017, and ISIC2018. Three different experiments are carried out to measure the performance of the proposed RDCNN. In the first experiment, the proposed RDCNN is trained and tested using the original dataset images without any pre-processing or segmentation. In the second experiment, the proposed RDCNN is tested using segmented images. Finally, the utilized trained model in the second experiment is saved and reused in the third experiment as a pre-trained model. Then, it is trained again using a different dataset. The proposed RDCNN shows significant high performance and outperforms the existing deep convolutional networks.

Clinical Application of Chest Computed Tomography (CT) in Detection and Characterization of Coronavirus (Covid-19) Pneumonia in Adults.

To analyze diagnostic accuracy of chest computed tomography (CT) and RT-PCR (real-time polymerase chain reaction) for COVID-19 (coronavirus disease 19) pneumonia in early and progressive stages. To evaluate if combination of chest CT with RT-PCR can supplement the shortage of RT-PCR in diagnosis of COVID-19 pneumonia. We conducted a prospective study on 103 male patients. The study population were divided into two groups; early COVID-19 stage (number = 50 patients, with positive RT-PCR but mild symptoms) and progressive COVID-19 stage (number = 53, positive RT-PCR and sever symptoms including fever > 37.5 °C, cough, and shortness of breath). All patients underwent CT imaging. The early stage included typical category; 34% (17 out of 50 cases), 6% indeterminate category (3 cases), 10% atypical category (5 cases) and 50% (25 cases) were normal CT imaging. The progressive stage included typical category that was further divided to five subgroups; (i) peripheral bilateral lower lobe ground-glass opacity (GGO) in (37.7%), (ii) peripheral bilateral lower lobes GGO with peribronchovascular consolidation and bronchiolar dilatation in (18.8%), (iii) peripheral bilateral lower lobes GGO with crazy paving appearance in (15%), (iv) bilateral diffuse GGO in (18.8%), and (v) peripheral bilateral GGO with mediastinal lymph node enlargement (9.4%). Chest CT imaging could aid to supplement the shortages of PCR for clinically suspected patients of COVID-19 in the epidemic area as CT was positive in 50% of patients. Chest CT is very effective in detecting pulmonary parenchymal abnormalities in the progressive stage of COVID-19 patients in 100%.

Total hip replacements following acetabular fractures. 7 to 15 years clinical and radiological results.

This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirty patients (66.7%) needed autogenous acetabular bone grafting. There has been a statistically significant improvement from a preoperative mean Oxford hip score of 16 to a postoperative mean score of 39.8 (p < 0.001). At the end of follow up, two cases had revision for cup loosening. The complications included one case of transient sciatic nerve palsy, and two cases of heterotopic ossification. Currently, total hip replacement remains the best option for end stage post traumatic arthritis. There are technical challenges associated with this replacement surgery which the surgeon should be aware of.

High-volume, multilevel local anesthetics-Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia.

BACKGROUND AND AIMS: Local anesthetic (LA) infiltration is one of the analgesic techniques employed during scoliosis correction surgery. However, its efficacy is controversial. In the present study for optimizing analgesia using the infiltration technique, we proposed two modifications; first is the preemptive use of high volume infiltration, second is applying three anatomical multilevel infiltrations involving the sensory, motor, and sympathetic innervations consecutively. MATERIAL AND METHODS: This prospective study involved 48 patients randomized into two groups. After general anesthesia (GA), the infiltration group (I) received bupivacaine 0.5% 2 mg/kg, lidocaine 5 mg/kg, and epinephrine 5 mcg/mL of the total volume (100 mL per 10 cm of the wound length) as a preemptive infiltration at three levels; subcutaneous, intramuscular, and the deep neural paravertebral levels, timed before skin incision, muscular dissection, and instrumentation consecutively. The control group (C) received normal saline in the same manner. Data were compared by Mann-Whitney, Chi-square, and t-test as suitable. RESULTS: Intraoperatively, the LA infiltration reduced fentanyl, atracurium, isoflurane, nitroglycerine, and propofol consumption. Postoperatively, there was a 41% reduction in morphine consumption, longer time to the first analgesic request, lower VAS, early ambulation, and hospital discharge with high-patient satisfaction. CONCLUSION: The preemptive, high-volume, multilevel infiltration provided a significant intra and postoperative analgesia in scoliosis surgery.

Classification of Skin Lesions into Seven Classes Using Transfer Learning with AlexNet.

Melanoma is deadly skin cancer. There is a high similarity between different kinds of skin lesions, which lead to incorrect classification. Accurate classification of a skin lesion in its early stages saves human life. In this paper, a highly accurate method proposed for the skin lesion classification process. The proposed method utilized transfer learning with pre-trained AlexNet. The parameters of the original model used as initial values, where we randomly initialize the weights of the last three replaced layers. The proposed method was tested using the most recent public dataset, ISIC 2018. Based on the obtained results, we could say that the proposed method achieved a great success where it accurately classifies the skin lesions into seven classes. These classes are melanoma, melanocytic nevus, basal cell carcinoma, actinic keratosis, benign keratosis, dermatofibroma, and vascular lesion. The achieved percentages are 98.70%, 95.60%, 99.27%, and 95.06% for accuracy, sensitivity, specificity, and precision, respectively.

Sagittal Resection Osteotomy With Bone Block Distraction Subtalar Fusion for Treatment of Malunited Calcaneal Fractures.

The aim of this prospective study was to evaluate the results of combined lateral sagittal resection osteotomy with subtalar distraction fusion in heels with painful malunion of the os calcis. This case series included 22 patients (23 feet). The mean age of the patients was 37.52 years. Sixteen (69.6%) patients were initially treated conservatively, 5 (21.7%) patients were treated surgically, and 2 (8.7%) patients were missed. The mean time lapsed before surgery was 11.43 months. A wedge of bone was resected to reduce the width of the malunited os calcis and was used as a local graft for subtalar joint fusion and to increase the height of the os calcis. The mean follow-up period was 56.83 ± 6.09 months. According to the scoring system, satisfactory results were found in 18 (82.6%) patients, and 4 (17.4%) patients had unsatisfactory results. Postoperative radiographic assessment revealed an average increase in the heel height of 7.70 ± 1.22 mm and an average decrease in heel width of 8.39 ± 1.47 mm. The average correction in the coronal axis was approximately 8.04° ± 1.26°. Complications included infection and nonunion in 3 (13%) heels. Two heels still had residual varus postoperatively, and 1 patient had injury to the sural nerve. The restoration of heel height, the reduction in heel width, and the primary fracture pattern had a significant relation with the final score. This method is a successful method for the management of subtalar arthritis caused by malunited calcaneal fractures with broadening leading to lateral abutment.

Enhanced Solubility and Dissolution Rate of Lacidipine Nanosuspension: Formulation Via Antisolvent Sonoprecipitation Technique and Optimization Using Box-Behnken Design.

Lacidipine (LCDP) is a highly lipophilic calcium channel blocker of poor aqueous solubility leading to poor oral absorption. This study aims to prepare and optimize LCDP nanosuspensions using antisolvent sonoprecipitation technique to enhance the solubility and dissolution of LCDP. A three-factor, three-level Box-Behnken design was employed to optimize the formulation variables to obtain LCDP nanosuspension of small and uniform particle size. Formulation variables were as follows: stabilizer to drug ratio (A), sodium deoxycholate percentage (B), and sonication time (C). LCDP nanosuspensions were assessed for particle size, zeta potential, and polydispersity index. The formula with the highest desirability (0.969) was chosen as the optimized formula. The values of the formulation variables (A, B, and C) in the optimized nanosuspension were 1.5, 100%, and 8 min, respectively. Optimal LCDP nanosuspension had particle size (PS) of 273.21 nm, zeta potential (ZP) of -32.68 mV and polydispersity index (PDI) of 0.098. LCDP nanosuspension was characterized using x-ray powder diffraction, differential scanning calorimetry, and transmission electron microscopy. LCDP nanosuspension showed saturation solubility 70 times that of raw LCDP in addition to significantly enhanced dissolution rate due to particle size reduction and decreased crystallinity. These results suggest that the optimized LCDP nanosuspension could be promising to improve oral absorption of LCDP.

Lyophilized sustained release mucoadhesive chitosan sponges for buccal buspirone hydrochloride delivery: formulation and in vitro evaluation.

This work aims to prepare sustained release buccal mucoadhesive lyophilized chitosan sponges of buspirone hydrochloride (BH) to improve its systemic bioavailability. Chitosan sponges were prepared using simple casting/freeze-drying technique according to 3(2) factorial design where chitosan grade was set at three levels (low, medium, and high molecular weight), and concentration of chitosan solution at three levels (0.5, 1, and 2%). Mucoadhesion force, ex vivo mucoadhesion time, percent BH released after 8 h (Q8h), and time for release of 50% BH (T50%) were chosen as dependent variables. Additional BH cup and core buccal chitosan sponge were prepared to achieve uni-directional BH release toward the buccal mucosa. Sponges were evaluated in terms of drug content, surface pH, scanning electron microscopy, swelling index, mucoadhesion strength, ex vivo mucoadhesion time, and in vitro drug release. Cup and core sponge (HCH 0.5E) were able to adhere to the buccal mucosa for 8 h. It showed Q8h of 68.89% and exhibited a uni-directional drug release profile following Higuchi diffusion model.

HPLC-fluorescence method for the enantioselective analysis of propranolol in rat serum using immobilized polysaccharide-based chiral stationary phase.

A stereoselective high-performance liquid chromatographic (HPLC) method was developed and validated to determine S-(-)- and R-(+)-propranolol in rat serum. Enantiomeric resolution was achieved on cellulose tris(3,5-dimethylphenylcarbamate) immobilized onto spherical porous silica chiral stationary phase (CSP) known as Chiralpak IB. A simple analytical method was validated using a mobile phase consisted of n-hexane-ethanol-triethylamine (95:5:0.4%, v/v/v) at a flow rate of 0.6 mL min(-1) and fluorescence detection set at excitation/emission wavelengths 290/375 nm. The calibration curves were linear over the range of 10-400 ng mL(-1) (R = 0.999) for each enantiomer with a detection limit of 3 ng mL(-1). The proposed method was validated in compliance with ICH guidelines in terms of linearity, accuracy, precision, limits of detection and quantitation, and other aspects of analytical validation. Actual quantification could be made for propranolol isomers in serum obtained from rats that had been intraperitoneally (i.p.) administered a single dose of the drug. The proposed method established in this study is simple and sensitive enough to be adopted in the fields of clinical and forensic toxicology. Molecular modeling studies including energy minimization and docking studies were first performed to illustrate the mechanism by which the active enantiomer binds to the ß-adrenergic receptor and second to find a suitable interpretation of how both enantiomers are interacting with cellulose tris(3,5-dimethylphenylcarbamate) CSP during the process of resolution. The latter interaction was demonstrated by calculating the binding affinities and interaction distances between propranolol enantiomers and chiral selector.

Clinical study on the therapeutic role of midodrine in non azotemic cirrhotic patients with tense ascites: a double-blind, placebo-controlled, randomized trial.

BACKGROUND: Midodrine is an α-agonist prodrug of desglymidodrine used for the management of hypotension. Midodrine has demonstrated usefulness in hepatorenal syndrome. OBJECTIVE: The objective of the present work was to study the role of midodrine in patients with non-azotemic cirrhosis with tense ascites. METHODS: This prospective randomized double blind placebo-controlled study was conducted on 67 non azotemic inpatients with liver cirrhosis and tense ascites (52 men and 15 women; age range, 45-72). One patient declined to participate in the study, 33 patients were randomly assigned to take midodrine hydrochloride, and 33 patients were randomly assigned to take placebo. Out of 67 enrolled patients, 60 patients (30: in midodrine group; 30: in placebo group) completed the study and 6 patients lost to follow up. Patients were assessed for patients' characteristics, history of tapping their ascetic fluid, laboratory values, and Doppler parameters before and after the study. Average 24-h urine volume was assessed before and after the start of the study. RESULTS: significant reduction in body weight and abdominal girth was observed after 2 weeks of midodrine therapy. CONCLUSION: Midodrine appeared to be effective in lowering body weights and abdominal girths of non azotemic cirrhotic patients with tense ascites.

Automated system for classifying uni-bicompartmental knee osteoarthritis by using redefined residual learning with convolutional neural network.

Knee Osteoarthritis (OA) is one of the most common joint diseases that may cause physical disability associated with a significant personal and socioeconomic burden. X-ray imaging is the cheapest and most common method to detect Knee (OA). Accurate classification of knee OA can help physicians manage treatment efficiently and slow knee OA progression. This study aims to classify knee OA X-ray images according to anatomical types, such as uni or bicompartmental. The study proposes a deep learning model for classifying uni or bicompartmental knee OA based on redefined residual learning with CNN. The proposed model was trained, validated, and tested on a dataset containing 733 knee X-ray images (331 normal Knee images, 205 unicompartmental, and 197 bicompartmental knee images). The results show 61.81 % and 68.33 % for accuracy and specificity, respectively. Then, the performance of the proposed model was compared with different pre-trained CNNs. The proposed model achieved better results than all pre-trained CNNs.

Percutaneous autogenous bone marrow injection for delayed union or non union of fractures after internal fixation.

The aim of this study was to assess the results of percutaneous injection of autologous bone marrow in the treatment of fractures presenting with delayed union or non union after internal fixation. Twenty consecutive patients presenting to our outpatient clinic with internally fixed fractures with delayed union or non union were included in the study. The time between the index surgery and the bone marrow injection ranged from 4 to 24 months with a mean of 9.65 months. The bone marrow aspirate was injected percutaneously into the fracture site under fluoroscopy control. Nineteen out of the twenty fractures achieved clinical and radiological union, on average after 2.95 months. In this series, percutaneous bone marrow injection appeared as a simple and effective method to accelerate fracture healing in patients with delayed union and nonunion of fractures.

Assessment of serum CXCL9 and pentraxin 3 as novel markers for hepatocellular carcinoma in cirrhotic hepatitis C patients.

Aim of the study: Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver. It is also one of the world's most common cancers and an important leading cause of cancer mortality in many parts of the world. As a result, it is essential to look for efficient markers for early and accurate HCC diagnosis. CXCL9 and pentraxin 3 are involved in the pathway of many cancers. The aim of the study was to assess the value of serum CXCL9 and pentraxin 3 as diagnostic markers of HCC among cirrhotic hepatitis C virus (HCV) patients. Material and methods: The current study was conducted on 90 candidates divided into 3 groups: group I - 30 patients with HCV induced liver cirrhosis without HCC; group II - 30 patients with HCV induced liver cirrhosis with HCC; group III - 30 healthy subjects (control group). All candidates were subjected to detailed history taking and thorough clinical examination, laboratory investigations, serum CXCL9, serum pentraxin 3, ultrasound abdomen and CT triphasic liver in group III. Results: Serum CXCL9 and serum pentraxin 3 levels were significantly higher in group II than group I and significantly higher in group I than group III. Conclusions: Serum CXCL9 and serum pentraxin 3 could be utilized as diagnostic markers for HCC.

Reliability and performance evaluation of a solar PV-powered underground water pumping system.

The operation and effectiveness of a solar-powered underground water pumping system are affected by many environmental and technical factors. The impact of these factors must be investigated to be considered when developing these systems and to ensure their dependability. This study evaluated the dependability and performance of photovoltaic water pumping system (PVWPS) under real operating conditions by examining the effects of solar irradiance, panels' temperature, and components' efficiency. From December 2020 to June 2021, experiments were conducted on a 10 hp PVWPS located in Bani Salamah, Al-Qanater-Giza Governorate, Egypt, at latitude 30.3° N, longitude 30.8° E, and 19 m above sea level. The irradiance values reached 755.7, 792.7, and 805.7 W/m2 at 12:00 p.m. in December, March, and June, respectively. Furthermore, the irradiance has a significant impact on the pump flow rate, as the amount of pumped water during the day reached 129, 164.1, and 181.8 m3/day, respectively. The panels' temperatures rose to 35.7 °C, 39.9 °C, and 44 °C, respectively. It was observed that when the temperature rises by 1 degree Celsius, efficiency falls by 0.48%. The average efficiency of photovoltaic solar panels reached its highest value in March (13.8%) and its lowest value in December (13%).

Classification of Cervical Spine Fracture and Dislocation Using Refined Pre-Trained Deep Model and Saliency Map.

Cervical spine (CS) fractures or dislocations are medical emergencies that may lead to more serious consequences, such as significant functional disability, permanent paralysis, or even death. Therefore, diagnosing CS injuries should be conducted urgently without any delay. This paper proposes an accurate computer-aided-diagnosis system based on deep learning (AlexNet and GoogleNet) for classifying CS injuries as fractures or dislocations. The proposed system aims to support physicians in diagnosing CS injuries, especially in emergency services. We trained the model on a dataset containing 2009 X-ray images (530 CS dislocation, 772 CS fractures, and 707 normal images). The results show 99.56%, 99.33%, 99.67%, and 99.33% for accuracy, sensitivity, specificity, and precision, respectively. Finally, the saliency map has been used to measure the spatial support of a specific class inside an image. This work targets both research and clinical purposes. The designed software could be installed on the imaging devices where the CS images are captured. Then, the captured CS image is used as an input image where the designed code makes a clinical decision in emergencies.

Higher Leukocyte Count Is Associated with Lower Presence of Carotid Lipid-Rich Necrotic Core: A Sub-Study in the Plaque at RISK (PARISK) Study.

BACKGROUND: Increasing evidence suggests that inflammation inside the vessel wall has a prominent role in atherosclerosis. In carotid atherosclerosis in particular, vulnerable plaque characteristics are strongly linked to an increased stroke risk. An association between leukocytes and plaque characteristics has not been investigated before and could help with gaining knowledge on the role of inflammation in plaque vulnerability, which could contribute to a new target for intervention. In this study, we investigated the association of the leukocyte count with carotid vulnerable plaque characteristics. METHODS: All patients from the Plaque At RISK (PARISK) study whom had complete data on their leukocyte count and CTA- and MRI-based plaque characteristics were included. Univariable logistic regression was used to detect associations of the leukocyte count with the separate plaque characteristics (intra-plaque haemorrhage (IPH), lipid-rich-necrotic core (LRNC), thin or ruptured fibrous cap (TRFC), plaque ulceration and plaque calcifications). Subsequently, other known risk factors for stroke were included as covariates in a multivariable logistic regression model. RESULTS: 161 patients were eligible for inclusion in this study. Forty-six (28.6%) of these patients were female with a mean age of 70 [IQR 64-74]. An association was found between a higher leukocyte count and lower prevalence of LRNC (OR 0.818 (95% CI 0.687-0.975)) while adjusting for covariates. No associations were found between the leucocyte count and the presence of IPH, TRFC, plaque ulceration or calcifications. CONCLUSIONS: The leukocyte count is inversely associated with the presence of LRNC in the atherosclerotic carotid plaque in patients with a recently symptomatic carotid stenosis. The exact role of leukocytes and inflammation in plaque vulnerability deserves further attention.

Pattern of hereditary renal tubular disorders in Egyptian children.

BACKGROUND: Hereditary renal tubular disorders (HRTD) represent a group of genetic diseases characterized by disturbances in fluid, electrolyte, and acid-base homeostasis. There is a paucity of studies on pediatric HRTD in Egypt. In this study, we aimed to study the pattern, characteristics, and growth outcome of HRTD at an Egyptian medical center. METHODS: This study included children from one month to < 18-years of age with HRTD who were diagnosed and followed up at the Pediatric Nephrology Unit of Sohag University Hospital from January 2015 to December 2021. Data on patients` demographics, clinical features, growth profiles, and laboratory characteristics were collected. RESULTS: Fifty-eight children (57% males; 72% parental consanguinity; 60% positive family history) were diagnosed with seven HRTD types. The most commonly encountered disorders were distal renal tubular acidosis (distal renal tubular acidosis [RTA] 27 cases, 46.6%) and Bartter syndrome (16 cases 27.6%). Other identified disorders were Fanconi syndrome (6 cases with cystinosis), isolated proximal RTA (4 cases), nephrogenic diabetes insipidus (3 cases), and one case for each RTA type IV and Gitelman syndrome. The median age at diagnosis was 17 months with a variable diagnostic delay. The most common presenting features were failure to thrive (91.4%), developmental delay (79.3%), and dehydration episodes (72.4%). Most children showed marked improvement in growth parameters in response to appropriate management, except for cases with Fanconi syndrome. Last, only one case (with cystinosis) developed end-stage kidney disease. CONCLUSIONS: HRTD (most commonly distal RTA and Bartter syndrome) could be relatively common among Egyptian children, and the diagnosis seems challenging and often delayed.

Effect of Different Occlusal Tooth Forms of Mandibular Overdenture Retained by an Immediate Loaded Single Implant on the Masticatory Efficiency and Oral Health-Related Quality of Life.

Aim: To study the masticatory efficacy and oral health-related quality of life (OHRQoL) of participants wearing a mandibular overdenture retained by an immediate loading single implant with different occlusal tooth forms. Materials and Methods: For this nonrandomized controlled trial study, 27 edentulous participants were selected and randomly divided into three groups (n = 9) based on occlusal tooth forms of the mandibular implant overdenture (MIOD). Group I: participants received an MIOD with an anatomical tooth form; Group II: participants received an MIOD with a semianatomical tooth form; and Group III: participants received an MIOD with a nonanatomical tooth form. For each participant, a single implant (screw root form) was inserted into the midline of the mandibular ridge to support the MIOD. For each group, the masticatory efficiency was evaluated after 3 months, and the OHRQoL of the participants was evaluated after 3 and 6 months. One-way ANOVA and post hoc Tukey's test were used for data analysis (P < 0.05). Results: The masticatory efficiency of the anatomic and semianatomic tooth forms was higher than that of the nonanatomic (P < 0.05). Moreover, the improvement in the participants' OHRQoL in the anatomic group was more significant than that of other groups (P < 0.05). Conclusion: There was a greater improvement in masticatory efficiency and participants' OHRQoL when fitted with an anatomic tooth form mandibular overdenture retained by an immediate loading single implant than with a semianatomic or nonanatomic tooth form.