Imaging Update of Congenital Hearing Loss: A Recent Insight Imaging Including 3D MRI Cisternography Prior to Cochlear Implant.

SNHL in children is an important issue. Cochlear implant is a highly technological device that is surgically inserted in the cochlea to solve this issue. To evaluate types of anomalies of the inner ear in children with sensorineural hearing loss in a tertiary care hospital and confirm that the routine MRI, MR cisternography and HRCT provides the surgeon with the imaging finding and criteria of patients candidates for CI. Patients and method: 600 patients with SNHL underwent HRCT and MRI. CT examinations were normal in 457 patients (76.2%) and 143 patients (23.8%) with inner ear anomalies. MRI examinations were normal in 440 patients (73.3%) and had inner ear anomalies in 160 patients (26.7%). 3D bFFE and 3D DRIVE was summarized. The 3D bFFE sequence was statistically significantly better than the 3D DRIVE for the demonstration of the cochlear vestibule. Superior, inferior vestibular nerves and facial nerves while 3D DRIVE is superior to 3D bFFE in the visualization of the semicircular canals. HRCT and MRI provide accurate anatomical delineation of complex inner ear structures and 3D improves pre-implant evaluation.

Combined therapy of plantar warts with topical bleomycin and microneedling: a comparative controlled study .

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group .Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion .

A comparative study of topical cantharidin and intralesional PPD to treat molluscum contagiosum.

Background: The immune system plays an important part in the clearance of molluscum contagiosum (MC) and, therefore, there has lately been a trend in using immunotherapy in MC therapy. Tuberculin-purified protein derivatives (PPDs) and topical cantharidin have not earlier been compared with their effectiveness in therapyAim: The aim of this research was to determine the effectiveness and security of intralesional immunotherapy in the therapy of MC with tuberculin PPD versus topical cantharidinPatients and methods: Twenty patients with various MC lesions received topical cantharidin as control (group A) and 20 MC patients received intralesional tuberculin PPD following prior intradermal immunity tests (group B ).Results: Complete clearance of lesions was detected in 90.0% of patients in the cantharidin group; the partial response was detected in10.0% of the patients. However, in the PPD group, 85% of the patients showed a complete response and 15% showed a partial response, with no significant difference in the clinical response between the two groups. Mild side effects were detected .Conclusion: The results suggest that intralesional PPD and topical cantharidin 0.7% are effective and safe treatment modalities, but benefits of intralesional PPD is being a simple, effective and safe treatment with tolerable pain and can be an alternative treatment for multiple resistant types .

Early Results of an Innovative Modified Central Pancreatectomy Technique Without Gastroenteric Drainage: Achieving Normal Pancreatic Function.

PURPOSE: Central pancreatectomy (CP) has been used sparingly because the spectrum of indications is quite narrow. The author has modified the procedure of CP in such a way to avoid distal pancreatic segment drainage, in addition to reserving the patient euo-insulinemic. MATERIALS AND METHODS: Between March 2010 and January 2015, 41 cases have been recruited. Cases presented with blunt abdominal trauma showing central pancreatic transection with or without duodenal transection have been recruited. Technique of CP has been modified to enable sparing distal pancreatic drainage procedure. The study describes a case series where the modified technique in the field of pancreatic surgery is applied on trauma patients through both laparoscopic and open approaches according to patients' hemodynamic stability. RESULTS: There was no pancreatic fistula, deficiency nor any of the major complications related to the traditional CP technique. CONCLUSIONS: None of the cases developed pancreatic necrosis or fistula, steatorrhea or showed picture of diabetes mellitus. The new technique has used the available anatomic and functional pancreatic facts to revolute sparing the distal pancreatic drainage procedure.

The accuracy and sensitivity of diffusion-weighted magnetic resonance imaging with Apparent Diffusion Coefficients in diagnosis of recurrent cholesteatoma.

OBJECTIVE: To evaluate the accuracy and sensitivity of diffusion-weighted magnetic resonance imaging with ADC value combined with MDCT in evaluating recurrent cholesteatoma. PATIENTS: Thirty patients (20 females and 10 males), their age ranged from 10 to 40years, had undergone a tympanomastoid surgery for a cholesteatoma of the middle ear underwent MDCT and MR DWI examination before second- or third-look surgery from May 2015 to October 2016. RESULTS: CT showed partial opacification of the tympanomastoid cavity in 10 ears and complete opacification in 21 ears. CT detects 10 cases out of 20 cases of recurrent cholesteatoma with sensitivity 47.6%, specificity 100%, and NPP 47.6%. DWI depicted 21 out of 20 cases proved cholesteatoma patients (sensitivity 100%, specificity 90%, PPV 95.2% and P value is 0.001). All MRI of patients without cholesteatoma were correctly interpreted as showing negative findings for cholesteatoma (specificity = 100%). The ADC of cholesteatoma group (21 ears) were ranged from 553 to 759 × 10-3 mm2/s and the ADCs of non cholesteatoma group (10 ears) was ranged from 1495.8 to 1766.8 × 10-3 mm2/s. Cut off value of cholesteatoma is ≤759 × 10-3 mm2/s. CONCLUSION: MR DWI with ADC combined with MDCT has high sensitivity, specificity, accuracy in detecting recurrent cholesteatoma.

Serum Thymus and Activation Regulated Chemokine (TARC), IL- 18 and IL-18 Gene Polymorphism as Associative Factors with Atopic Dermatitis.

Atopic dermatitis (AD) is a worldwide chronic inflammation of skin.Many factors and chemokines play role in pathogenesis of AD. Identifying the reliable biomarkers to diagnose and assess severity of AD is important. In this study we aimed to find a reliable biomarker to determine the severity of AD and monitor treatment as well as, examining the possible association between IL-18 gene [rs 187238] promoter polymorphism and AD disease. The study included 30 Egyptian patients with AD and 30 healthy controls. Patients were clinically evaluated according to SCORAD scoring system. For each subject levels of Thymus and activation regulated chemokine (TARC), IL-18, total IgE and Lactate dehydrogenase enzyme (LDH) in serum were measured and Polymorphism in IL-18 gene was analyzed using restriction fragment length polymorphism (RFLP). Patients were reevaluated after treatment. Serum levels of TARC, IL-18, IgE and LDH were significantly higher in patients than controls, and were associated with high SCORAD score. G allele was risk factor with OR 2.31 (1.10- 4.85) and significant p-value < 0.05 for AD. GG genotype was significantly associated with elevated serum levels of TARC, IL-18 and IgE. After treatment serum level of TARC showed significant decrease and was associated with low SCORAD score. We concluded that TARC, IL-18, total IgE and LDH are potential markers of severity in AD. G allele in IL-18 gene [rs 187238] is risk factor for AD while C allele is considered protective. TARC is also a reliable marker formonitoring treatment.

Detection of toxic elements using laser-induced breakdown spectroscopy in smokers' and nonsmokers' teeth and investigation of periodontal parameters.

A laser-induced breakdown spectrometer (LIBS) was built and optimized to detect levels of toxic elements such as lead, cadmium, and arsenic present in the roots of extracted teeth of smokers and nonsmokers. Sixty extracted teeth from patients having a history of chronic periodontitis were divided into two groups of 30 teeth each for smoker and nonsmoker patients and, as controls, a third group of 30 patients who did not have a history of chronic periodontitis. The respective elemental concentration (Pb, Cd, and As) 23-29, 0.26-0. 31, and 0.64-11 ppm are for nonsmokers, 35-55, 0.33-0.51, and 0.91-1.5 ppm are for smokers, and lastly 0.17-0.31, 0.01-0.05, and 0.05-0.09 ppm are for control group. In order to test the validity of the results achieved using our LIBS system, a standard inductively coupled plasma (ICP) technique was also applied for the analysis of the same teeth samples, and ICP results were found to be in excellent agreement with our LIBS results. In addition to this, the gingival index, plaque index, clinical attachment loss (CAL) and probing pocket depth were also recorded. Our LIBS spectroscopic analysis showed high levels of lead, cadmium, and arsenic concentration on root surfaces of teeth, which may be due to CAL.

Laparoscopic Pyloroduodenal Wrap Utilizing the Lesser Omentum: A Novel Emergency Surgery Technique.

BACKGROUND: It has been a long time since Roscoe Graham in 1938 started his technique using the greater omentum patching perforated peptic ulcers. The traditional technique was suitable for the open surgical access but not for the laparoscopic one. The lesser omentum offers a more readily potent tissue flap that is both anatomically and surgically optimistic to the laparoscopic technique. MATERIALS AND METHODS: This is a preliminary case series pilot study describing a new surgical technique for repair of perforated peptic ulcer. Between February 2013 and April 2014, 27 adult patients were recruited for the study. RESULTS: All patients were operated by laparoscopy with no case conversion to open. Patient's data and results are scheduled in tables. Neither postoperative complication nor reperforation was recorded. CONCLUSIONS: Gastroduodenal wrap utilizing the lesser omentum is a novel technique based on solid concepts that suits laparoscopic specialty as a separate identity from open surgery.

Closed-tube thoracostomy: a novel emergency surgery technique.

BACKGROUND: The practice of tube thoracostomy entails high risk as it is a closed technique. Open thoracostomy and closed minithoracostomy techniques have been approved worldwide as safe modalities. Applying the concept of a new closed thoracostomy technique with high safety and simplicity is a major advancement in this regard. MATERIALS AND METHODS: This was a case series pilot study introducing a new technique for closed-tube thoracostomy. Thirty-one patients with primary unilateral pneumothorax were selected for the study. All patients coming to the Emergency Department at Security Forces Hospital, Dammam City, Kingdom of Saudi Arabia, between January and August 2012, matching the study criteria were recruited to undergo the new technique. The surgical set required for the technique was defined and prepared sterile. Preinsertion and postinsertion chest x-ray and chest computed tomography scans were obtained for the entire study sample. RESULTS: We recruited the first 31 patients requiring tube thoracostomy who visited the Emergency Department. All procedures were performed by the author, assisted by on-call registrars. No complications were observed with the new technique. Moreover, advantages of the technique were demonstrated and documented. CONCLUSIONS: The new technique provides safe tube introduction and precise tube positioning, saves time, and involves no technical precautions. The technique has been applied on selected simple cases as the first trial and requires further testing in cases of hemothorax, empyema thoracis, traumatic chest injuries, and complicated pulmonary diseases that require drainage. Further evaluation of the technique by randomized studies is required.

Detection of lead in paint samples synthesized locally using-laser-induced breakdown spectroscopy.

A laser-induced breakdown spectroscopy (LIBS) setup was developed to detect lead and other toxic contaminants such as chromium in paint emulsion samples manufactured in Saudi Arabia. The lead concentration detected in these samples was in the 327.2-755.3 ppm range, which is much higher than the safe permissible limit set by Saudi regulatory agencies. Similarly, chromium concentration (98.1-149.5 ppm) was found in high concentrations as well. The results obtained with our LIBS setup are comparable with the sample analysis utilizing a standard technique such as ICP, and our LIBS results are comparable to ICP with in an accuracy limit of 2-4 %.

Determination of trace elements in volcanic rock samples collected from cenozoic lava eruption sites using LIBS.

Trace elements of environmental significance present in the volcanic rock samples collected from sites of the Cenozoic era flood basalt flows and eruptions were detected using locally developed laser-induced breakdown spectrometer. For spectro-chemical analysis of these samples, the plasma was generated by focusing a pulsed Nd: YAG laser radiation at 1064 nm wavelength on the target rock samples. These samples were collected from four widely separated locations surrounding the volcanic eruption sites belonging to the Harrat Hutaymah volcanic field in the vicinity of Taba town, situated to the east of Hail city of northern Saudi Arabia. These samples represent the scoria basalt lava flows as well as a large tuff-ring crater and it contains xenoliths. These flows occur widespread over the Earth's surface in this region, and their contained xenoliths are brought up from depths of a few tens of kilometers. This volcanic field has received much less attention in the previous geological studies; and consequently, its effects on the environment are not well defined. The concentration of different elements of environmental significance like Cr, Pb, Mn, Cd, Sr and other trace metals like Cu, Al, Ca, Mg, Zn, Ti and Fe in these rock samples were determined by spectral analysis. Parametric dependence for improvement of LIBS sensitivity for detection of these elements was also carried out. The highest concentration detected of environmentally significant elements like Cr, Mn, Pb, Sr and Ni are 1910, 1399, 90.5, 12412 and 461.5 ppm, respectively in four different lava samples which are considered to be much higher than the safe permissible limits. The LIBS results were compared with the results obtained using other analytical techniques such as the inductively coupled plasma atomic emission spectroscopy (ICP-AES).