Validity of sphenoid ostium in relation to posterior wall of maxillary sinus by computed tomography

Background: Sphenoid sinus is the most inaccessible paranasal sinus, enclosed within the sphenoid bone and intimately related to numerous vital neural and vascular structures. Anatomic variation of the sphenoid sinus is well documented and may complicate surgery in such a place.Objective: To assess the reliability of preoperative computed tomography (CT) in determination of the distance between the posterior wall of maxillary sinus (PWMS) and the sphenoid sinus ostium (SSO) in the coronal plane.Patients and methods: This was a prospective study of the distance between the SSO and the PWMS in the coronal plane, which was measured both radiologically in preoperative CT and intraoperatively during endoscopic sinus surgery for patients in need for middle meatal antrostomy and sphenoid sinusotomy at the same side. Distances obtained by both techniques have been tested for the degree of correlation. Number of the included patients was 25.Results: Forty four nasal sides were included in the study. The mean distance between the sphenoid sinus ostium and posterior wall of maxillary sinus in the coronal plane was 6.6 ± 1.8 mm when measured by preoperative CT and 6.9 ± 1.9 mm when measured directly during surgery. No significant difference was found between the mean distances measured by both techniques (p = 0.246) with good agreement between them (r = 0.864).Conclusion: Preoperative CT may be a reliable tool to preoperatively determine the difference in depth between the PWMS and the SSO

LOCUS OF CONTROL THEORY IN TREATING TOURIST BEHAVIOR: THE THEORY ROOTS AND RESEARCH DIRECTION IN DESTINATION BRANDING FIELD

We aim to shed light on this issue by reviewing the roots and development of the locus of control theory. Moreover, we will introduce how we can use this development, in theory, to provide a new research direction in the tourism service field. A theory-based review was conducted to investigate the locus of control theory roots and its potential implications in the tourism industry using the Australian Business Deans Council (ABDC) list to explore the current literature. We followed the PRISMA methodology to collect the data from the Scopus database as well as Google Scholar and ResearchGate. The study found that the locus of control theory has its roots in social psychology and has been developed over the years to explain individual differences in behavior and decision-making. In the tourism service field, we found that understanding the locus of control can help service providers tailor their services to meet the needs and expectations of different types of tourists. This will contribute to attribution literature in psychological aspects and tourism literature with a deep understanding of how tourists behave and interpret differently

THE IMPACT OF RELIGIOUS TOURISTS’ SATISFACTION WITH HAJJ SERVICES ON THEIR EXPERIENCE AT THE SACRED PLACES IN SAUDI ARABIA

To identify the impact of satisfaction with the provided services (food quality, transportation, accommodation, medical services and the religious guidance) on the spiritual experience of religious tourists, as well as the potential moderating role of pilgrims’ demographic characteristics on the relationship between service satisfaction and experience. A structured survey was distributed among the domestic pilgrims in Mecca, Saudi Arabia who performed Hajj under the control of three licensed agencies. Results showed that the satisfaction with transportation services and religious guidance were independent antecedent predictors of the spiritual experience. Furthermore, pilgrims’ age had significantly moderated the relationship between satisfaction with medical services and experience. National authorities can effectively improve the spiritual experience by providing comfortable means of transportation and reliable religious scholars to guide the pilgrims at different sacred destinations

Rheumatic tricuspid valve disease: Repair versus Replacement

Background: Tricuspid valve disease is most commonly functional, however, organic affection still accounts for one fourth of cases. Rheumatic fever which is endemic in Egypt is a main cause of organic affection. Current practice largely relies on tricuspid valve repair; however, it has been difficult to determine optimal procedure. Objectives: Herein, we study the outcome of replacement versus repair in such patients. Patients and methods: A prospective study was conducted on 300 consecutive patients with rheumatic heart disease showing severe tricuspid valve affection underwent tricuspid valve surgery, between 2014 and 2018. The patients were divided into two groups; TVR group (n=150) which included patients who underwent tricuspid valve replacement and TVr group (n=150) which included patients who underwent tricuspid valve repair. Diagnosis and follow up were done by echocardiography. Peri-operative variables, clinical outcome, morbidity, mortality, and follow up data were recorded. Results: Mean follow-up was 4±1.32 years. In-hospital mortality was 6 patients (4%) in TVR group and 3 patients (2%) in TVr group (P value ≥ 0.05). Postoperative low cardiac output syndrome and stroke were significantly higher in the repair group. Postoperative RV dysfunction, renal impairment, renal failure and chest re-exploration were significantly higher in the replacement group. Severe tricuspid regurgitation was reported in 19 patients (12.6%) of the repair group on follow up. Conclusion: Tricuspid valve repair is preferable to replacement to avoid the drawbacks of prosthesis. However, tricuspid valve replacement is feasible with comparable survival outcome and the progressive nature of the rheumatic disease may recommend replacement

Pattern of Vascular Involvement in Egyptian Patients with Budd-Chiari Syndrome: Relation to Etiology and Impact on Clinical Presentation

Introduction and aim. Budd-Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction. This work aims to analyze the pattern of vascular involvement in Egyptian patients with BCS, demonstrates its relation to etiology and shows its impact on clinical presentation.Material and methods. The current retrospective study was conducted at The Tropical Medicine Department, Ain Shams University on one hundred Egyptian patients with confirmed diagnosis of primary BCS who were presented to the Budd-Chiari Study Group (BCSG) from April 2014 to May 2016 by collecting clinical, laboratory and radiological data from their medical records.Results. Isolated hepatic vein occlusion (HVO) was the most common pattern of vascular involvement (43%), followed by combined HVO and inferior vena cava (IVC) compression by enlarged caudate lobe (32%), then combined HVO and IVC stenosis/webs (21%), and lastly isolated IVC occlusion (4%). Ascites was more significantly encountered in BCS patients with HVO than in those with isolated inferior vena cava (IVC) occlusion and patent HVs (P = 0.005). Abdominal pain was significantly encountered in patients with occluded three major HVs (P = 0.044). Behcet’s disease was significantly detected in isolated IVC occlusion. Protein C deficiency was significantly detected in patients with combined HVO and IVC compression.Conclusion. Isolated HVs occlusion was the most common pattern of vascular involvement in Egyptian patients with primary BCS. Vascular pattern of involvement affected the clinical presentation and was related to the underlying thrombophilia in those patients

The effects of hesperidin and quercetin on serum tumor necrosis factor-alpha and interleukin-6 levels in streptozotocin-induced diabetes model

Background: Diabetes mellitus (DM) is a metabolic disorder that occurs as a result of absolute or relative insufficiency of insulin release and/or insulin effect due to impairment of carbohydrate, fat and protein metabolism, and it is characterized by hyperglycemia and leads to various complications. Objective: In this study, it was aimed to investigate the effects of hesperidin (HP) and quercetin, which are natural flavonoids, on serum malondialdehyde (MDA), glutathione (GSH), tumor necrosis factor alpha (TNF‑α), and interleukin‑6 (IL‑6) levels in rats with streptozotocin (STZ)‑induced diabetes. Materials and Methods: The experimental animals were divided into four groups, each group comprising ten rats designated as follows: Group 1 served as control rats (C); Group 2 served as diabetic rats (DM); Group 3 served as diabetic rats administered HP (DM + HP) (100 mg/kg b. w.); and Group 4 served as diabetic rats administered quercetin (DM + Q) (100 mg/kg b. w.). Results: Serum MDA and GSH levels were significantly higher in STZ‑induced DM group than control group (P < 0.05). In DM + HP and DM + Q groups, MDA levels were significantly decreased compared to DM groups (P < 0.05), but there was no significant difference GSH levels between DM, DM + HP, and DM + Q groups (P > 0.05). TNF‑α levels in STZ‑induced DM group were significantly decreased compared to control group (P < 0.05), and groups of DM + HP and DM + Q had higher serum TNF‑α levels than STZ‑induced DM group (P < 0.05). In STZ‑induced DM group, serum IL‑6 levels were decreased compared to control group (P < 0.05). Conclusion: As a result, in this study, we determined that HP and quercetin may play an effective role in regulating insulin metabolism metabolism in diabetes. However, considering the incompatibility of various results in the literature as well as our own results, we think that the actual role of cytokines in the pathogenesis of diabetes is one of the issues that need to be clarified in further studies.This work was supported by Coordinator of Scientific Research Projects (2015.M80.02.05) at University of Artvin Coruh