Myringosclerosis in hemodialysis patients with hyperparathyroidism.

Myringosclerosis is the final stage of the middle ear lamina propria inflammation or trauma; it starts with collagen production in excess amounts in the lamina propria of the middle ear mucosa. Then, hyalinization and calcification occur. Later on, metaplasia of bone or cartilage can occur. A similar sequence occurs with hyperparathyroidism in chronic kidney disease. This study is aimed to detect the prevalence of myringosclerosis in patients of our hemodialysis (HD) unit and find out any association between hyperparathyroidism and myringosclerosis in chronic HD patients. A total number of 86 patients were selected according to the inclusion criteria. They were divided into two groups: Group 1 (58 patients myringosclerosis free patients on regular HD), Group 2 (28 patients myringosclerosis-positive patients on regular HD). No statically significant difference was found in serum parathyroid hormone levels between the two studied groups. Serum creatinine was significantly higher in Group 2, serum ferritin was significantly lower in Group 2, and mean corpuscular volume of red blood cells was highly significantly lower in Group 2. Myringosclerosis affects 32% of our HD patients and we could not detect any strong correlation between myringosclerosis and hyperparathyroidism.

Comparison of the effect of nitroglycerin, magnesium sulphate and dexmedetomidine as hypotensive agents in lumbar spine surgery

Background: in orthopedic procedures more blood is lost from raw bone and muscle surface than from identifiable blood vessels. Moderate hypotensive anesthesia was found to significantly decrease the average blood loss by nearly 40%, reduce the need for transfusion by 45% and shorten the average operating time by nearly 10%. Objective: The aim of the current study was to compare magnesium sulphate and dexmedetomidine with nitroglycerin as regard hypotensive effect as primary outcome, volume of blood loss, blood substitution and pattern of recovery as secondary outcome during lumbar spine surgery. Patients and Methods: This prospective, controlled, comperative, randomized, double blind study included a total of ninty patients aged 21-50 years of both sex, ASA I-II scheduled for elective lumber spine surgery, attending at Department of Orthopedic, AL-Azher university Hospital in Assuit as single center study. Patients have received either dexmedetomidine, magnesium sulfate or nitroglycerine. Results: There were highly significant difference (P <0.000) with duration of surgery between different study groups with duration of surgery shortest in dexmedetomidine group followed by magnesium sulfate group and then nitroglycerine group. There were highly significant differences between different study groups with fluid maintenance with higher volume in nitroglycerine group then magnesium sulfate group and then dexmedetomidine group. There were highly significant differences (P <0.000) with systolic blood pressure between study groups at A1 and hypotensive agent discontinuation with lowest systolic blood pressure in dexmedetomidine group followed by magnesium sulfate group and then nitroglycerine group. Conclusion: nitroglycerine, magnesium sulfate and dexmedetomidine could induce hypotension, but dexmedetomidine showed more favorable hemodynamic profile as regard blood pressure and heart rate

Vector identification and clinical, hematological, biochemical, and parasitological characteristics of camel (Camelus dromedarius) theileriosis in Egypt.

The objectives of the present study were to identify a possible tick vector and to determine the prevalence of camel theileriosis in Egypt using blood smears stained with Giemsa's stain and PCR assay. Hemogram and serum biochemical constituents were also investigated. A total of 243 camels, aged 3-5 years, were examined. The results revealed that 75 (30.86 %) camels were infected with Theileria spp. of Giemsa-stained blood smears. Hyalomma dromedarii was identified as the carrier tick of Theileria spp. Multinucleated sporoblast and free sporozoite were observed in the salivary gland smears from collecting ticks. PCR result revealed that Theileria annulata was the most abundant in camels (60 %) followed by Theileria spp. (10 %). Macrocytic hypochromic anemia was recorded in the infected camels with T. annulata. Leukocytosis, neutrophilia, eosinophilia, and lymphopenia were also observed in the infected group. In the serum of infected camels, total proteins, albumin, ß-globulin, and A/G ratio were significantly decreased (P < 0.05); however, total globulins and α- and γ-globulins were markedly increased (P < 0.05). The activity of aspartate aminotransferase and the levels of glucose, creatinine, and high-density lipoprotein cholesterol were markedly increased (P < 0.05) in the infected group. In contrast, triglycerides and total cholesterol concentrations were significant decreased (P < 0.001) in the infected group. In conclusion, a high prevalence of camel theileriosis was recorded in apparently healthy camels. H. dromedarii commonly infested these camels and were found infected with the transmissible forms of Theileria, indicating a role in transmission. Camels infected with T. annulata induced alterations in the cellular and biochemical constituents.

Thermal analysis study of antihypertensive drugs telmisartan and cilazapril.

PURPOSE: The aim of the present work is to study the thermal analysis of telmisartan and cilazapril. METHODS: Thermogravimetry (TGA), derivative thermogravimetry (DTG) and differential thermal analysis (DTA) were used through the work to achieve the thermal analysis study of some antihypertensive drugs, telmisartan and cilazapril. RESULTS: The results led to thermal stability data and also to the interpretation concerning the thermal decomposition. Thermogravimetry data allowed determination of the kinetic parameters such as, activation energy and frequency factor. CONCLUSION: The simplicity, speed and low operational costs of thermal analysis justify its application in the quality control of pharmaceutical compounds for medications.

Modified genioglossus advancement and uvulopalatopharyngoplasty in patients with obstructive sleep apnea.

OBJECTIVE: To describe modification of the originally described genioglossus muscle advancement and its clinical assessment in the treatment of patients with obstructive sleep apnea. STUDY DESIGN: Prospective study. SETTING: University medical hospital. SUBJECTS AND METHODS: Twenty-three patients with obstructive sleep apnea underwent modified genioglossus muscle advancement with uvulopalatopharyngoplasty. All patients were evaluated before and 6 months after surgery by history taking, clinical examination, Epworth Sleepiness Scale evaluation, fiber-optic nasopharyngoscopy, cephalometry, panoramic X-ray, and nocturnal polysomnography. RESULTS: Postoperative mean ± SD apnea-hypopnea index (AHI) decreased from 40.7 ± 17.4 to 15.4 ± 10.7 (P = .00; 95% confidence interval [CI], 18.4 to 32.27). With a success rate defined as AHI <20 and a 50% decrease in AHI of the preoperative value, the surgical success rate was 86.9%. Cephalometry analysis showed a significant difference between preoperative and postoperative findings, including a posterior airway space that increased a mean ± SD from 8.1 ± 2.5 to 12.3 ± 3.7 mm (P = .00; 95% CI, -5.89 to -3.0), position of the mandible to the cranial base (SNB degree) that increased from 77.3 ± 2.7 to 78.5 ± 1.3 (P = .005; 95% CI, -2.11 to -0.4), and improved palatal parameters. The mean (SD) average depth of the osteotomy and genioglossus advancement was 11.8 ± 2.6 mm. None of the 23 patients had mandible fracture, aesthetic changes of the chin, or detachment of the advanced genioglossus muscle. CONCLUSION: The modification described in this technique permits complete and safe capture and advancement of the whole genioglossus muscle, leading to satisfactory expansion of the retrolingual airway without stripping, detachment of the advanced genioglossus muscle, mandible fracture, or aesthetic changes of the chin.