The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studi... more The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studied radiologically, antroscopically and histopathologically. Sixty per cent of the patients showed thick bony walls and a small cavity of the maxillary sinus on X-ray and on antroscopy. On the other hand, 25 per cent of the cases revealed signs of infection including mucopurulent secretion on antroscopy associated with corresponding histopathological changes. It is concluded that poor pneumatization of the antrum plays a more important role in the pathogenesis of ozaena than infection.
To assess the effects of applying a tight vs. a less tight control of mild chronic essential or g... more To assess the effects of applying a tight vs. a less tight control of mild chronic essential or gestational non-proteinuric hypertension in pregnancy. A randomized trial was conducted in 2006-2007 in the University of Ain Shams, Egypt. Eligible participants (n=125) were randomly assigned to either tight or less tight control of mild chronic (essential) or gestational (non-proteinuric) hypertension. The primary outcome measure was the development of severe hypertension during follow-up. Analysis was by intention-to-treat. In the tight target group, adjustment of the dose with an increment of 191 mg yielded a mean dose of methyldopa of 1267+/-406 mg. Both systolic and diastolic BP levels were significantly less than in the tight target group. More women in the less tight group had severe hypertension during follow up (RR 3.167 and 95% CI 1.36-7.37). The rate of antenatal hospitalization was significantly higher in the less tight target group with a relative risk of 2.57 and 95% CI 1.16-5.70. The gestational age at delivery was significantly better in the tight target group. Preterm delivery and birth weight were not significantly different between the study groups. Tight control of blood pressure reduces the rate of antenatal hospitalization and does not adversely affect perinatal outcomes in women with mild essential or gestational hypertension.
Weierstrass points are special points on a Riemann surface that carry a lot of information. Ogg s... more Weierstrass points are special points on a Riemann surface that carry a lot of information. Ogg studied such points on X0(pM) (for M such that X0(M) has genus zero and p prime with p \ M), and he proved that if Q is a Q-rational Weierstrass point on X0(pM), then its reduction ...
Background: Diabetic patients have a high prevalence of coronary atherosclerosis, once CAD is man... more Background: Diabetic patients have a high prevalence of coronary atherosclerosis, once CAD is manifested clinically; diabetic patients continue to have a worse prognosis compared with non-diabetic patients both acutely after the event and ...
Since good ventilation of the middle ear is a prerequisite to successful myringoplasty, it was ou... more Since good ventilation of the middle ear is a prerequisite to successful myringoplasty, it was our policy to study the tubal function in dry central perforation of the drum and to correlate the manometric with the endoscopic findings. Normal manometric results with patency of the tube (as proved by fluorescein-endoscopy) indicated good tubal function, with good prognosis for myringoplasty. Abnormal manometric results with failure of fluorescein to pass into the nasopharynx indicated mechanical tubal obstruction that was, in most cases, correctable. Nasal endoscopy proved to be indispensable in diagnosing, localizing, and even treating "hidden" lesions in their key areas that may be responsible for the obstruction. Thus, the correction of the mechanical tubal obstruction must precede ear surgery. Whenever tubal obstruction is diagnosed as functional or idiopathic, the ventilation of the middle ear should be facilitated during ear surgery by addition of a tympanostomy tube t...
The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine for... more The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine foramen and to ligate its artery in 9 patients with intractable posterior epistaxis. Immediate and complete cessation of the bleeding uniformly occurred, except in 1 case, in which there was persistent bleeding on endoscopic examination of the nasal cavity at the end of the procedure. The ligature was checked and the artery was reclipped. Thereafter, the patient's recovery was uncomplicated and free of further epistaxis. Endoscopic transseptal sphenopalatine artery ligation offers a reliable option in the treatment of intractable posterior epistaxis. The submucoperiosteal dissection reduces bleeding, shortens operation time, and allows relatively easy identification of the sphenopalatine foramen. The procedure allows direct positive control of the major vessel supplying the posterior nasal cavity. It avoids the complications associated with transantral and pterygopalatine fossa surgery.
Iatrogenic lesions of the superior laryngeal nerve (SLN) are much more common than is generally r... more Iatrogenic lesions of the superior laryngeal nerve (SLN) are much more common than is generally recognized. Since injury to this nerve may cause transient or even persistent changes either in quality of voice or in deglutition, an attempt should be made to localize and identify the nerve during surgery. This study included 74 patients who underwent surgical dissection near the thyroid apex in the neck. Effective prevention of SLN injury during surgery was achieved by anatomical localization of the nerve in the viscerovertebral angle and its functional identification with the nerve stimulator. Post-operative analysis consisted of subjective interview, rigid laryngoscopy, acoustic analysis, laryngeal videostroboscopy and cricothyroid electromyography. Four patients complained of post-operative voice changes; two were diagnosed as SLN injury (2.4 per cent), one as reflux laryngitis and the fourth as intubation granuloma. Surgical access to the SLN in the periapical area may be achieved through mobilization of the viscerovertebral angle. The use of a nerve stimulator during difficult situations should keep SLN injury at a minimum.
The use of the rigid endoscope has been investigated in the management of 63 cases with posterior... more The use of the rigid endoscope has been investigated in the management of 63 cases with posterior nasal obstruction. It was found to be a true advance in rhinology, since it visualizes and localizes the site of the obstruction which is classified into pre-choanal, and post-choanal. Moreover, the nasal endoscope allowed complete and safe removal of most of the obstructing lesions under direct endoscopic vision.
The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studi... more The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studied radiologically, antroscopically and histopathologically. Sixty per cent of the patients showed thick bony walls and a small cavity of the maxillary sinus on X-ray and on antroscopy. On the other hand, 25 per cent of the cases revealed signs of infection including mucopurulent secretion on antroscopy associated with corresponding histopathological changes. It is concluded that poor pneumatization of the antrum plays a more important role in the pathogenesis of ozaena than infection.
To assess the effects of applying a tight vs. a less tight control of mild chronic essential or g... more To assess the effects of applying a tight vs. a less tight control of mild chronic essential or gestational non-proteinuric hypertension in pregnancy. A randomized trial was conducted in 2006-2007 in the University of Ain Shams, Egypt. Eligible participants (n=125) were randomly assigned to either tight or less tight control of mild chronic (essential) or gestational (non-proteinuric) hypertension. The primary outcome measure was the development of severe hypertension during follow-up. Analysis was by intention-to-treat. In the tight target group, adjustment of the dose with an increment of 191 mg yielded a mean dose of methyldopa of 1267+/-406 mg. Both systolic and diastolic BP levels were significantly less than in the tight target group. More women in the less tight group had severe hypertension during follow up (RR 3.167 and 95% CI 1.36-7.37). The rate of antenatal hospitalization was significantly higher in the less tight target group with a relative risk of 2.57 and 95% CI 1.16-5.70. The gestational age at delivery was significantly better in the tight target group. Preterm delivery and birth weight were not significantly different between the study groups. Tight control of blood pressure reduces the rate of antenatal hospitalization and does not adversely affect perinatal outcomes in women with mild essential or gestational hypertension.
Weierstrass points are special points on a Riemann surface that carry a lot of information. Ogg s... more Weierstrass points are special points on a Riemann surface that carry a lot of information. Ogg studied such points on X0(pM) (for M such that X0(M) has genus zero and p prime with p \ M), and he proved that if Q is a Q-rational Weierstrass point on X0(pM), then its reduction ...
Background: Diabetic patients have a high prevalence of coronary atherosclerosis, once CAD is man... more Background: Diabetic patients have a high prevalence of coronary atherosclerosis, once CAD is manifested clinically; diabetic patients continue to have a worse prognosis compared with non-diabetic patients both acutely after the event and ...
Since good ventilation of the middle ear is a prerequisite to successful myringoplasty, it was ou... more Since good ventilation of the middle ear is a prerequisite to successful myringoplasty, it was our policy to study the tubal function in dry central perforation of the drum and to correlate the manometric with the endoscopic findings. Normal manometric results with patency of the tube (as proved by fluorescein-endoscopy) indicated good tubal function, with good prognosis for myringoplasty. Abnormal manometric results with failure of fluorescein to pass into the nasopharynx indicated mechanical tubal obstruction that was, in most cases, correctable. Nasal endoscopy proved to be indispensable in diagnosing, localizing, and even treating "hidden" lesions in their key areas that may be responsible for the obstruction. Thus, the correction of the mechanical tubal obstruction must precede ear surgery. Whenever tubal obstruction is diagnosed as functional or idiopathic, the ventilation of the middle ear should be facilitated during ear surgery by addition of a tympanostomy tube t...
The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine for... more The rigid nasal endoscope was used through a transseptal approach to reach the sphenopalatine foramen and to ligate its artery in 9 patients with intractable posterior epistaxis. Immediate and complete cessation of the bleeding uniformly occurred, except in 1 case, in which there was persistent bleeding on endoscopic examination of the nasal cavity at the end of the procedure. The ligature was checked and the artery was reclipped. Thereafter, the patient's recovery was uncomplicated and free of further epistaxis. Endoscopic transseptal sphenopalatine artery ligation offers a reliable option in the treatment of intractable posterior epistaxis. The submucoperiosteal dissection reduces bleeding, shortens operation time, and allows relatively easy identification of the sphenopalatine foramen. The procedure allows direct positive control of the major vessel supplying the posterior nasal cavity. It avoids the complications associated with transantral and pterygopalatine fossa surgery.
Iatrogenic lesions of the superior laryngeal nerve (SLN) are much more common than is generally r... more Iatrogenic lesions of the superior laryngeal nerve (SLN) are much more common than is generally recognized. Since injury to this nerve may cause transient or even persistent changes either in quality of voice or in deglutition, an attempt should be made to localize and identify the nerve during surgery. This study included 74 patients who underwent surgical dissection near the thyroid apex in the neck. Effective prevention of SLN injury during surgery was achieved by anatomical localization of the nerve in the viscerovertebral angle and its functional identification with the nerve stimulator. Post-operative analysis consisted of subjective interview, rigid laryngoscopy, acoustic analysis, laryngeal videostroboscopy and cricothyroid electromyography. Four patients complained of post-operative voice changes; two were diagnosed as SLN injury (2.4 per cent), one as reflux laryngitis and the fourth as intubation granuloma. Surgical access to the SLN in the periapical area may be achieved through mobilization of the viscerovertebral angle. The use of a nerve stimulator during difficult situations should keep SLN injury at a minimum.
The use of the rigid endoscope has been investigated in the management of 63 cases with posterior... more The use of the rigid endoscope has been investigated in the management of 63 cases with posterior nasal obstruction. It was found to be a true advance in rhinology, since it visualizes and localizes the site of the obstruction which is classified into pre-choanal, and post-choanal. Moreover, the nasal endoscope allowed complete and safe removal of most of the obstructing lesions under direct endoscopic vision.
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