MRI of the posterolateral corner of the knee, please have a look

The knee PLC injuries are frequently seen, with other major knee injuries, such as ACL and PCL.Objective: This article aimed to clarify PLC injuries that could be diagnosed by MRI, and may have an impact on the management of the associated major knee injuries.Patient and methods: It was conducted through retrospective MRI revision of 1000 patients who were presented with post-traumatic knee complaints, from January 2011 to March 2016.Results: ITB band injuries were seen in 113 patients (11.3%), biceps tendon injury in 59 patients (5.9%), FCL injuries in 223 patients (22.3%), popliteus muscle injury in 53 patients (5.3%), PFL in 17 (1.7%), arcuate ligament injury in 38 patients (3.8%) and arcuate bone fracture (fibular styloid fracture) in 22 patients (2.2%). Overall PLC injuries recorded 283 patients, either as separate or combined PLC items. Of these 283 patients, 96 patients had associated ACL tear (33.9%), 19 had PCL tear (6.7%), 73 had medial corner injury (25.7%), 55 combined injuries (19.4%) and 40 isolated PLC injuries (14.1%).Conclusion: Different types of PLC injuries may occur in association with other major knee sectorial injuries that may require repair before the associated injured major sector correction, in an attempt to avoid early ACL or PCL graft failure.Keywords: posterolateral corner; ITB band; biceps tendon; FCL; Popliteus; PF

MR arthrogram for shoulder microinstability and hidden lesions

AbstractShoulder joint pain due to anterior microinstability is not an unusual complaint of young active individuals. Different etiologies of such shoulder microinstability are encountered, mainly affecting the anterior–inferior labro-ligamentous capsular structures. These injuries include Perthes lesion, ALPSA, GLAD, RIT, SLAP and glenohumeral ligamentous injuries.The aim of this studyThe aim of this study is to enhance the role of MR arthrogram over routine MRI in the diagnosis of such subtle lesions.Patients and methodsThis is a prospective study, involving 30 consecutive patients of shoulder microinstability complaints, evaluated by MR arthrogram of the affected shoulder.ResultsPerthes lesions were diagnosed in 6 patients, ALPSA in 3 patients, GLAD in 2 patients, RIT in 2 patients and SLAP in 11 patients. Ligamentous injuries that include tear of MGHL, were found in 2 patients and IGHL in 4 patients.ConclusionMR arthrogram is highly recommended for the management of young patients with shoulder microinstability or unexplained painful movement complaints

64 MS-CTU: Review of techniques and spectrum of the ureteric diseases

Objective: The study aims to clarify the sensitivity of the CTU, and if is it coast effective and time effective to be used as first and the one-stop shop imaging modality for the diagnosis of the different ureteric diseases.Patients and methods: 400 patients with different urinary tract complaints (hematuria and/or renal colic) did triphasic CTU examinations, for diagnosis of suspected obstructive or traumatic ureteric uropathy from January 2014 to October 2016. These patients were filtered from a larger number of patients – who were presented with urinary tract complaints by plain KUB X ray and US, which showed no explaining kidneys or urinary bladder pathology.Results: Ureteric duplication was detected in 5 (1.25%) patients, ectopic ureter in one patient (0.25%), UPJ stricture in 4 patients (1%), PUJ vascular impression in 2 patients (0.5%), ureteric calculus in 103 patients (25.75%), pyogenic ureteritis in 8 patients (2%), ureteritis cystica in one patient (0.25%) TCC in 3 patients (0.75%), PRPF in one patient (0.025%) and Trauma in one patient (0.025%).Conclusion: CTU is very sensitive tool of imaging and could be confidently considered the one-stop shop imaging tool for accurate diagnosis of the different ureteric lesions

Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis

Background: Despite acute appendicitis is the most common underlying etiology of the acute abdomen, a considerable list of other pathologies should be considered; despite sharing almost the same clinical presentation. This study aimed to re-enhance the importance and sensitivity of CT scan as a solitary imaging tool, in the evaluation of patients with acute right lower abdominal pain. Patients and methods: It is a retrospective study of the last 1000 patients, referred with acute right lower abdominal pain for CT scan examination. Biphasic CT scan abdomen protocol was applied for all. Results: Cecal carcinoma was detected in three patients (0.3%), epiploic appendicitis in five (0.5%), omental infarct in two (0.2%), appendicular mucocele in two (0.2%), appendicular NET in one (0.1%), cecal diverticulitis in four (0.4%), Chron’s disease in six (0.6%), intussusception in one (0.1%) and FB in one (0.1%) and appendicular perforation in one (0.1%), acute simple appendicitis 398 (39.8%) and 577 (57.7%) were unremarkable. Conclusion: Despite acute appendicitis is the most common cause of the acute abdomen, many other surgical and non-surgical etiologies should also be considered, with a higher sensitivity of CT as a solitary diagnostic tool of imaging

Problems of Teeth and Gums Expert System

Our gums (gingiva) act as a significant barricade in guarding our teeth and their neighboring support structures. A tiny known fact is that gum disease is the foremost cause of tooth loss in grown persons. Healthy, strong, teeth are reliant on on healthy gums. The core culprit for gum problems is bacteria in dental plaque. The bacteria in plaque yield harmful toxins that generate an inflammatory process that happens in the gum tissue. If left for a sufficient period of time, bacterial plaque causes hurt to our teeth as well as our gums. In this paper, we present a knowledge based system that help people with teeth and gums problems to diagnose their problems and get recommendation for the treatment. This expert system was designed and implemented using SL5 Object language for knowledge based system

Evaluation of inappropriate prescribing to the hospitalized elderly patients in Al Shifa hospital, Gaza, Palestine

Background: The current study aimed to assess the prevalence of inappropriate prescribing (IP) for hospitalized elderly patients at Al Shifa Hospital, Gaza, Palestine.Methods: This study was a retrospective cross-sectional study. A total of 2385 prescribed drugs for 380 elderly inpatients in internal, cardiology, and respiratory departments were screened for IP. Four criteria were used to detect IP using chart review method; Drug-drug interactions (DDIs), drug contra-indications (CI), duplication of therapy and Beers' criteria 2012.Results: The results showed that 44.2% of patients had at least one IP. Around 33.2% of the patients had DDIs, 19.2% had IP according to Beers' criteria and 1.1% had drug CI. There was no duplication of therapy. A total of 323 IP instances were detected. Of them, 74% for DDIs and 24.8% for Beers' criteria. The prevalence of overall IP was significantly influenced by age (p-value=0.024), polypharmacy (p-value<0.001), degree of morbidity (p-value<0.001), and departments (p-value=0.018). The prevalence of DDIs was influenced by polypharmacy (p-value<0.001), degree of morbidity (p-value=0.001), and departments (p-value=0.005). Finally, the prevalence of IP according to Beers' criteria was significantly influenced by departments with the highest in the cardiology department (29.7%) (P-value=0.007).Conclusions: Although the overall IP was common, it was not far higher than that reported worldwide. The majority of IP was DDIs. Age, polypharmacy, degree of morbidity and departments influenced the occurrence of IP

Assessment of academic departments efficiency using data envelopment analysis

Purpose: In this age of knowledge economy, universities play an important role in the development of a country. As government subsidies to universities have been decreasing, more efficient use of resources becomes important for university administrators. This study evaluates the relative technical efficiencies of academic departments at the Islamic University in Gaza (IUG) during the years 2004-2006. Design/methodology/approach: This study applies Data Envelopment Analysis (DEA) to assess the relative technical efficiency of the academic departments. The inputs are operating expenses, credit hours and training resources, while the outputs are number of graduates, promotions and public service activities. The potential improvements and super efficiency are computed for inefficient and efficient departments respectively. Further, multiple linear -regression is used to develop a relationship between super efficiency and input and output variables. Findings: Results show that the average efficiency score is 68.5% and that there are 10 efficient departments out of the 30 studied. It is noted that departments in the faculty of science, engineering and information technology have to greatly reduce their laboratory expenses. The department of economics and finance was found to have the highest super efficiency score among the efficient departments. Finally, it was found that promotions have the greatest contribution to the super efficiency scores while public services activities come next. Research limitations/implications: The paper focuses only on academic departments at a single university. Further, DEA is deterministic in nature. Practical implications: The findings offer insights on the inputs and outputs that significantly contribute to efficiencies so that inefficient departments can focus on these factors. Originality/value: Prior studies have used only one type of DEA (BCC) and they did not explicitly answer the question posed by the inefficient departments "Which of the resources should be given priority so that these inefficient DMUs become efficient?". This study uses both (BCC) and (CCR) in addition to relating efficiencies to input and output variables.Peer Reviewe

Assessment of academic departments efficiency using data envelopment analysis

Purpose: In this age of knowledge economy, universities play an important role in the development of a country. As government subsidies to universities have been decreasing, more efficient use of resources becomes important for university administrators. This study evaluates the relative technical efficiencies of academic departments at the Islamic University in Gaza (IUG) during the years 2004-2006. Design/methodology/approach: This study applies Data Envelopment Analysis (DEA) to assess the relative technical efficiency of the academic departments. The inputs are operating expenses, credit hours and training resources, while the outputs are number of graduates, promotions and public service activities. The potential improvements and super efficiency are computed for inefficient and efficient departments respectively. Further, multiple linear -regression is used to develop a relationship between super efficiency and input and output variables. Findings: Results show that the average efficiency score is 68.5% and that there are 10 efficient departments out of the 30 studied. It is noted that departments in the faculty of science, engineering and information technology have to greatly reduce their laboratory expenses. The department of economics and finance was found to have the highest super efficiency score among the efficient departments. Finally, it was found that promotions have the greatest contribution to the super efficiency scores while public services activities come next. Research limitations/implications: The paper focuses only on academic departments at a single university. Further, DEA is deterministic in nature

Sickle cell anemia: Imaging from head to toe

AbstractSCA is hemolytic anemia with deformed RBCs leading to frequent hemolytic crisis, extramedullary hematopoiesis and multisystem repeated emboli.AimTo emphasize the role of different imaging modalities in early accurate diagnosis.Patients and methodsWe present different types of complications of SCA, encountered in patients of Eastern Province-KSA, between 2009 and 2013.ResultsComplication may involve any system of the body, thus different types of imaging modalities are needed for correct diagnosis.ConclusionBeing familiar with radiological signs of expected complications of SCA in different systems, helps much to control advance of the disease and protect against early organ damage

P-15 Passive Housing Systems:A Comparative Analysis against Timber Manufacturing and the Feasibility of Implementation in the United Kingdom

Passive Houses are a new sustainable development option that has been appearing more frequently across the UK in the last 25 years. The houses offer huge benefits in terms of energy saving, comfort and host a multitude of sustainable technologies within. The houses use an increased amount of timber in the structure and there is a question on whether this increased use of timber combined with the current UK timber shortage could potentially mitigate the sustainability of the house. The research assesses the problem from both the worker and consumer viewpoints using collected primary data and analyzes the feedback well as this alternate solution Passive Houses are explored and compared and the market for these kinds of technologies is researched to conclude whether these houses could potentially become a widespread product across the UK. This research concludes that making passive houses more widespread is possible, but it would rely on a countrywide push to make it happen. Standards need to be raised and an increased level of continuing professional development in this specialised field would need to be put in place to allow for sustainable innovations to become more common