Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital

Neurological Sciences - COVID-19 is a pandemic disease which predominantly affects the respiratory system with high critical care mortality and morbidity; however, it also causes multi-organ...     

Effective use of simple computer programmes and clay models to demonstrate the planning and operative steps for teaching and presentations

Background:Presenting and demonstrating a surgical procedure in the current era is difficult without good intraoperative pictures and videos. A long, complex, multi-staged surgery is better illustrated by detailed intraoperative images at various stages. Although desirable, it may be difficult due to various reasons.Results:It is a simple technique with a moderate learning curve. Once familiar with technique, one can effectively use the technique to convey the details in much more clear manner.Conclusion:It is a simple and effective way of communicating through digital images, and gives the audience a 3 dimensional idea about the concept.KEY WORDS: Clay models in plasticine surgery, photography, presentations in plastic surgery, teaching and patient education, use of clay models for presentations     

The significance of clinical practice guidelines on adult varicocele detection and management

Varicoceles are the most common correctable etiology of male factor infertility. However, the detection and management of varicoceles have not been standardized. This has led to decades of debate regarding the effect of varicocele on male infertility and subsequently whether repair leads to an improved fertility status. The current body of evidence investigating the role of varicocele and varicocelectomy is weak and conflicting. The stance taken by the AUA and ASRM suggests that there is insufficient outcomes data to support evidenced-based guidelines, citing evidence used to provide current recommendations are generally of a low quality level. On the other hand, the EAU Guidelines give a level 1a of evidence for management of varicoceles that are clinically palpable, associated with subnormal semen analyses and having otherwise unexplained fertility. Besides aiding with clinical varicocele detection and management, clinical practice opinion statements and guidelines aim to direct and strengthen the infrastructure of future studies. We review the current status of opinion statements and guidelines in varicocele and management detection with focus on their application in practice.     

Contact (kallikrein/kinin) system activation in whole human blood induced by low concentrations of α-Fe2O3 nanoparticles

Iron-oxide nanoparticles (NPs) generated by environmental events are likely to represent health problems. α-Fe₂O₃ NPs were synthesized, characterized and tested in a model for toxicity utilizing human whole blood without added anticoagulant. MALDI-TOF of the corona was performed and activation markers for plasma cascade systems (complement, contact and coagulation systems), platelet consumption and release of growth factors, MPO, and chemokine/cytokines from blood cells were analyzed. The coronas formed on the pristine α-Fe₂O₃ NPs contained contact system proteins and they induced massive activation of the contact (kinin/kallikrein) system, as well as thrombin generation, platelet activation, and release of two pro-angiogeneic growth factors: platelet-derived growth factor and vascular endothelial growth factor, whereas complement activation was unaffected. The α-Fe₂O₃ NPs exhibited a noticeable toxicity, with kinin/kallikrein activation, which may be associated with hypotension and long-term angiogenesis in vivo, with implications for cancer, arteriosclerosis and pulmonary disease.     

Cost-Utility Analysis of Apixaban versus Warfarin in Atrial Fibrillation Patients with Chronic Kidney Disease

Background

Warfarin use for stroke prevention in atrial fibrillation (AF) patients with chronic kidney disease is debated. Apixaban was shown to be safer than warfarin, with superior reduction in the risk of stroke, systemic embolism, mortality, and major bleeding irrespective of kidney function.

Microtensile bond strength of resin composite bonded to caries-affected dentin with three adhesives

This study evaluated the ability of two self-etching adhesives (a two-step and a one-step) and a conventional 3-step adhesive to bond composite to both intact and caries-affected dentin with and without thermocycling. Thirty extracted human teeth with occlusal caries were randomly assigned to three groups according to the adhesive used: Scotchbond Multi-purpose (3M) (SBMP), ClearfilSE Bond (Kuraray) (SE) and Xeno IV (Dentsply) (XEIV). The occlusal surfaces of the teeth were sectioned to expose dentin. The adhesives were applied according to manufacturers' instructions, and a composite material (Herculite XRV, Kerr) was applied and cured in increments to form a core 3 mm high. The teeth were stored in distilled water for 24 hours, then sectioned using a micro-slicing machine to obtain sections 1 mm thick. The sections were further cut to obtain rods 6 mm long and 1 x 1 mm in thickness, with dentin/composite interface located at the center. The specimens were examined microscopically to separate the caries-affected (AD) and sound dentin (SD) into two groups. Half the specimens from each group were subjected to 3,000 thermocycles (5 degrees C to 55 degrees C) prior to testing. All the specimens were then subjected to microtensile bond strength (microTBS) testing in a special apparatus. Mean microTBS was determined for each group, and data were statistically analyzed with ANOVA and Tukey's tests. Mean microTBS and standard deviation values in MPa were: SBMP-SD = 22.19 (4.6), SBMP-SD-thermocycled = 15.7 (5.55), SBMP-AD = 18.6 (2.89), SBMP-AD-thermocycled = 16.62 (6.23), SE-SD = 24.25 (5.7), SE-SD-thermocycled = 22.3 (6.7), SE-AD = 20.7 (5.55), SE-AD-thermocycled = 20.23 (6.1), XEIV-SD = 21.43 (7.6), XEIV-SD-thermocycled = 18.3 (7.11), XEIV-AD = 15.45 (6.62), XEIV-AD-thermocycled = 14.8 (3.89). ANOVA revealed a significant difference among the groups (p < .0001). The two-step self-etch adhesive resulted in highest mean microTBS values under all test conditions. However, these mean values were significantly higher than the mean values obtained with the other two adhesives under some, but not all test conditions.     

Mid-term outcomes of surgical management of complex,isolated radial head fractures: a multicentre collaboration

European Journal of Orthopaedic Surgery & Traumatology - The available literature discussing optimal surgical management of Mason II and III radial head (RH) fractures without concomitant bone...