Hind-foot correction and stabilization by pins in plaster after surgical release of talipes equino varus feet in older children

Congenital talipes equino varus (CTEV) is a three dimensional deformity and is one of the most common congenital abnormalities affecting the lower limb and can be challenging to manage. Hind-foot deformity is considered the most difficult to treat. Unfortunately, the calcaneus is often small and thus difficult to control during casting after surgical release in severe or relapsed cases. We used three pins to control and maintain the hind foot correction, after surgical release, during casting in 47 cases (59 feet). We introduced a modified, coronal plane, transverse calcaneal pin. This pin is inserted from medial to lateral through the calcaneus to correct the varus mal-positioning of the calcaneus in the sagittal plane and to provide a better control on the small sized, hind-foot during casting. We paid special attention to the final hind-foot deformity after surgery, and the results were favorable after the application of this transverse pin

Finite element analysis of dynamic structure-medium interaction with some reference to underground nuclear reactor containments

A finite element solution is developed for the problem of time-history response of reinforced underground cavity subjected to dynamic disturbances of the underground environment. The cavity can be of any shape, reinforced by either rock bolts or any elastic liner, with bending stiffness taken into consideration. Available methods that can solve the cavity problem are examined and an available computer programme (plane stress) modified. Introduction of a new reinforcing plate element necessitated development of two new subroutines and the extension of a third one along with certain modifications in the other subroutines and the main programme for matching requirements. The modifications enable the determination of displacements and the internal forces - time histories of the liner. -- A quantitative study of the following parameters that affect the response of the cavity reinforcement and the surrounding medium is carried out: 1) cavity reinforcement, 2) cavity shape, 3) isolation of the entire structure from the surrounding medium by a soft, energy absorbing material and 4) properties of the filling material in the cut-and-cover structural type. The modified computer programme has applications to problems outside the field of two-dimensional rock-structure interaction such as the dynamic analysis of beams, plane frames and arches. -- A finite element model is developed to simulate the dynamic analysis of infinite space. The results of the study indicate that reinforcing the cavity by a steel liner decreases the stresses in the medium by about 10% while the use of a rock bolting pattern with about 80% of the amount of steel required in a reinforcing liner decreases the stresses around the cavity by 25% and more. The horseshoe shape proves to be the best among the various shapes considered decreasing the stresses by 10-15%. Large reductions (of the order of 80%) in shell (liner) membrane forces and bending moments are reached by isolating the entire structure from the surrounding medium by a soft, energy absorbing material, which agree with the results from another investigation. It is also pointed out that a proper selection of the properties of the filling material in the cut-and-cover structure can reduce the internal forces in the structure and the stresses in the adjacent medium. It is shown that a significant reduction cannot be achieved by a single property variation but only through a proper combination of different properties (Figs. 33 to 36). The results obtained from the new model indicate the need for further modelling work in the solution of earthquake interaction problems for underground cavities

Evaluation of in vitro effect of Fosfomycin on resistant Gram-negative pathogens in urinary tract infection

Background:Urinary tract infection (UTI) is considered one of the most common infections occurring in different ages. The increasing emergence and rapid spread of multidrug-resistant (MDR) pathogens has led to reuse older antimicrobials like Fosfomycin. This study aimed to evaluate the activity of Fosfomycin on MDR pathogens beside its effect on biofilm formation. Methods: A total of 116  MDR Gram -negative isolates  from  ICU patients suffering from UTI has been included in this study. Standard microbiological tests were done to identify the isolates. Susceptibility to various antibiotics was detected by disk diffusion method. Phenotypic tests for determining variousβ-lactamases were done. Minimal inhibitory concentration (MIC) for Fosfomycin was detected by agar dilution method. Formation of biofilm by the isolates with and without adding Fosfomycin was assessed by microtiter plate method. Results: The most frequently isolated pathogen was E. coli (70/116); 60.3% followed by Klebsiella spp. (31/116); 26.7%. Fosfomycin showed a high level of inhibitory effect on most of tested isolates ; E. coli revealed low resistance rate of 4.2%,while Klebsiella spp < /em>, Pseudomonas aeruginosa and Acinetobacter baumani showed resistance rate of 16% ,36%), and 50%, respectively.  A total of 72 (62.1%) isolates was ESBL producers, of which 92% isolates were Fosfomycin - sensitive , while 25(22%) isolates were MBL-positive, of which 88% were sensitive to Fosfomycin. Eighty-seven (75%) isolates were biofilm producers. Fosfomycin inhibited biofilm formation in 67(77%) isolates. Conclusion: ESBL and MBL producing Gram negative urinary pathogens showed high sensitivity level to Fosfomycin. Also, Fosfomycin had good inhibitory effect on their biofilm formation

Role of Corticosteroids versus Hyaluronic Acid in Healing of Sciatic Nerve Injury in Male Albino Rats

Background: Peripheral nerve lesions are common and severe injuries that impact about 2.8% of traumatic patients annually, and result in lifetime disability if untreated. Objective: This study aimed to investigate the effect of corticosteroids vs hyaluronic acid in peripheral nerve healing in rats. Patients and methods: This was experimental and histopathological study that had included (18) Sprague-Dawley rats with an average weight of 300–350 gm. All rats were divided into three groups (n=6 per group). Group 1; Corticosteroids was injected under epineurium after primary repair. Group 2; Hyaluronic acid group: the site of anastomosis was coated by hyaluronic acid after primary repair. Group 3; Primary repair only was done. Results: 100% of cases in group 1 and group 2 showed satisfactory wound healing and 83.3% in group3 showed satisfactory wound healing with no significant difference between them. Conclusion: There was an increase in the number of regenerated nerve fibers in the corticosteroids and hyaluronic acid especially on the distal end in comparison to the control group

Correlation between Coronary Artery Diseases and Dyslipidemia in Type 2 Diabetic Patients

Background: Premature atherosclerotic cardiovascular disease (CVD) has a significant association with diabetes mellitus. There are numerous studies showing that decreasing cholesterol is effective in improving cardiovascular outcomes in people with diabetes. Objective: This study aimed to identify the correlation between coronary artery diseases (CADs) and dyslipidemia in diabetic patients.Patients and methods: In the Cardiology Department of Zagazig University Hospitals we conducted this case-control study. 140 patients with type 2 DM were divided into two groups: Group 1 included 70 people with type 2 diabetes who had CADs and group 2 that included 70 patients with type 2 DM who had no signs of CADs (admitted complaining of symptoms of angina or CA showing no significant stenotic lesions). Angiographic examination and fasting and 2-hour postprandial blood glucose levels were performed for all patients. Moreover, comprehensive history was taken, cardiovascular risk profiles and laboratory investigations such as glycosylated hemoglobin (HbA1c) were done.Results: CAD group were significantly higher regarding BMI as it was distributed as 28.77 ± 2.3 and 30.04 ± 3.03 between No-CAD and CAD respectively. There was no significant difference or association between smoking or hypertension and CAD. SBP and DBP were significantly higher among CAD. Fasting blood glucose and HbA1c were significantly higher among CAD group than in No-CAD group. CAD group showed significantly higher TG and LDLc distribution than No-CAD group.Conclusion: Increased triglycerides and decreased HDL levels were associated with CVD among diabetic patients