Tibial Bone Loss: How to Treat without Circular Fixation?

Segmental tibial bone defects (STBD) represent a dilemma for the trauma surgeon; these defects could result from trauma, after debridement for infection, or after tumor resection. We aimed in this review to shed some light on the various reconstruction options without the need to use a circular fixator. Reconstruction options rely on various factors related to the patient, the surgeon, and the nature of the defect (location and size). Various reconstruction techniques include simple bone grafting (autograft or allografts), bone transport [distraction osteogenesis (DO)], induced membrane technique, and vascularized fibular graft. Fixation could be performed using either internal or external fixators; the latter could be a circular or a unilateral frame. Although circular frames (Ilizarov) fixators reported good results, they are still considered cumbersome, need special attention, carry pin tract infection risk, and could not be tolerated by patients. Hence, various other options were introduced, such as bone transport over an intramedullary nail (IMN), rail monolateral external fixator, and tibialisation of the ipsilateral fibula

Potential pro-arrhythmic effect of cardiac resynchronization therapy

AbstractA decline in mortality due to pump failure has been clearly documented after cardiac resynchronization therapy (CRT), however the impact on sudden cardiac death and the development of malignant ventricular arrhythmias remains questionable. Our study aims to investigate this alleged pro-arrhythmic effect of CRT using surface electrocardiogram (ECG) markers of pro-arrhythmia.MethodsSeventy five patients, who received CRT were included in this study. Manual measurement of corrected QT interval (QTc), Tpeak-end (Tp-e) interval, QT dispersion (QTd) and Tpeak-end dispersion during baseline 12 lead surface ECG and after applying atrial-biventricular pacing were done. Arrhythmias post CRT was recorded from ECG, 24h holter monitoring or pacemaker programmer event recorder.ResultsQTc interval showed significant prolongation after CRT (498.9±50.8 vs. 476.2±41.6msec, P=0.0001). Comparing patients with major arrhythmogenic events (MAE) and increased frequency of premature ventricular contractions (PVCs) post CRT pacing to those patients without arrhythmias, there was a significant prolongation of the QTc interval (527±63.29 vs. 496.95±45.2msec, P=0.043) and Tp-e interval (94.16±9 vs. 87.41±16.37msec, P=0.049). While in the arrhythmogenic group, there was an insignificant decrease in QTd and Tpeak-end dispersion.ConclusionQTc and Tp-e intervals are a potential predictor of occurrence of MAE and PVCs. On the other hand, Tp-e dispersion and QTd did not show a predictive potential for arrhythmia

Experimentally Comparative Study on Different Strengthening Methods of Reinforced Concrete Deep Beams

The aim of this study is to investigate the effect of strengthening reinforced concrete deep beams. An experimental study was done using six reinforced concrete deep beams have the same dimensions of 1150×800×150 mm, and subjected to mid-span concentrated load up to failure. Beams were different in the type, Location of strengthening and the ratio of reinforcement. Beams were divided into three groups. The first group included beams strengthened internally by single strut and either vertical or horizontal additional reinforcement. The second group included beams strengthened using double embedded strut or using CFRP as external strengthening. The third group included one beam strengthened using inclined stirrups. One of the specimens was tested without any strengthening and one specimen was strengthened by external CFRP sheets for comparison purposes the results of the experimental study shown remarkable improvement for using each type of strengthening. Results shown that using the mechanism of increasing stirrups by double rate and using single strut reinforcing is the optimum choice. This is due to the fact that this type of strengthening provides significant increase in the beam capacity in additional to the enhanced behavior of the beam. By this study comparison between each type of strengthening was done and the optimum type to be used in accordance with parameters of gained load capacity of tested deep beams

Effect of dietary moringa (Moringa oleifera) and rosemary (Rosmarinus officinalis) leaves or their mixture on productive performance, carcass characteristics and antioxidant enzymes of rabbits reared under heat stress conditions

Sixty growing New Zealand White (NZW) male rabbits aged six weeks, weighed 750.0±5g were used in a feeding experiment lasted 9 weeks. Rabbits were housed in controlled-climatic conditions at a mean ambient temperature 33.1°C and relative humidity 43% to keep rabbits under heat stress conditions. The rabbits were randomly distributed to four equal groups (five replicates each). The 1st group fed the control diet (R1), R2 group fed diet supplemented with 1% moringa leaves, R3 group fed diet supplemented with 1% rosemary leaves, while R4 group fed diet supplemented with a mixture of moringa and rosemary leaves of 0.5% each. Diets and water were provided ad-libitum over nine weeks. The results revealed that live body weight, average daily gain and feed conversion ratio were significantly improved with R4 and R2 diets, while daily feed intake was not affected among groups. Apparent digestibility of crude fiber and ether extract were increased (p≤0.05) with R2 diet. Nitrogen balance was positive for all groups, however improvement (p≤0.05) was detected with R2 than control. Carcass characteristics were not affected among experimental groups. Hemo-lysatic catalase, glutathione peroxidase and super-oxide dismutase levels were increased (p≤0.01) with supplemented diets, while malondialdehyde was obviously decreased in the experimental groups compared with the control. It could be concluded that, supplementing diets with 1% moringa dry leaves or mixture of moringa leaves and rosemary leaves by 0.5+0.5% can be used to improve growth performance, nutrient digestibility and antioxidant status of rabbits reared under heat stress conditions

Synthesis, Characterization and Biological Evaluation of some New Thieno[2,3-d]Pyrimidine Derivatives

10-Oxo-4,6,7,8,9,10-hexahydroprazolo[1,5-a][1]benzothieno[2,3-d]pyrimidine-3-carbaldehyde (2) was prepared by Vilsmeier-Haack reaction of 3-amino-2-methyl-5,6,7,8-tetrahydro[1]benzothieno[2,3-d]pyrimidin-4(3H)-one (1). Reaction of carbaldehyde derivative 2 with malononitrile afforded arylidene malononitrile 3. Cyclization of the latter compound with thiourea yielded pyrimidinethione 4. Interaction of carbaldehyde derivative 2 in presence of thiourea with keto- compounds such as ethyl acetoacetate, or acetylacetone, or dimedone or ethyl cyanoacetate gave pyrimidine derivatives 5-8. Hydrazinolysis of carbaldehyde derivative 2 gave the hydrazone 9. Reaction of the latter with phenyl isothiocyanate afforded thiosemicarbazone 10, which underwent cyclization with oxalyl chloride to give thioxoimidazolidinedione 11. Condensation of compound 2 with thiosemicarbazide furnished thiosemicarbazone derivative 12. Reaction of compound 2 with aminopyrazolone in the presence of an acid and/or a base afforded pyrazolones 13 and 14. Treatment of carbaldehyde derivative 2 with cyanoacetohydrazide gave acrylohydrazide 15. Interaction of the latter with carbon disulfide yielded mercaptooxadiazole 16.  Condensation of compound 2 with acetylpyridazinone 17 produced chalcone 18. Reaction of  compound 18 with malononitrile in pyridine gave cyanopyran 19, while its reaction with malononitrile in presence of ammonium acetate in ethanol yielded cyanopyridine 20. Structures of the newly synthesized products have been deduced on the basis of elemental analysis and spectral data. The synthesized compounds were screened for their antimicrobial activity.Â

Synthesis of Furopyrimidine Derivatives

Furopyrimidines have been known for many years and have been thoroughly examined in the recent years. The present review deals with description of the various synthetic routes for  furopyrimidine derivatives

Diagnostic value of portal venous pulsatility index in patients with high-risk nonalcoholic fatty liver disease

Background: As commonest form among liver diseases, nonalcoholic fatty liver disease (NAFLD) presents no symptoms. It is possible to use regular ultrasound scanning, which are always available in medical care centers everywhere, to quickly and quantitatively assess portal vein pulsatility. Objective: To evaluate the value of the portal venous pulsatility index for noninvasively diagnosing nonalcoholic fatty liver disease who are at high risk.Patients and Methods: The trial was a comparative cross-sectional trial involving 145 NAFLD patients, conducted in Radiodiagnosis Department, Faculty of Medicine, Zagazig University Hospitals. Abdominal ultrasound fibroscan, and Doppler US examinations of portal venous system were done to all patients.Results: Basal lab features, triphasic right hepatic vein flow pattern, and Doppler flow characteristics differed significantly between the two groups. Except for the BARD score, there was a high statistically significant difference between the two groups for venous pulsatility index values as well as all clinical risk scores. VPI, NAFLD-FS, and FIB-4 odds ratios all showed high significant differences between the two groups. Optimism-Corrected ROC AUC of VPI +NAFLD FS was 0.89, VPI + FIB-4 was 0.90, VPI+BARD score was 0.86 and VPI + APRI was 0.85. There was a high significant difference regarding VPI +NAFLD FS & VPI + FIB-4.Conclusion: High-risk NAFLD can be predicted using VPI and this could improve the effectiveness of frequently used clinical predictor tools

Comparison between Two Different Attachment Caps Used in Locator Attachments of Implant supported Overdentures (In-Vitro Study)

Purpose: To compare different retentive cap material used in LOCATOR attachments, namely the nylon retentive cap versus PEEK retentive caps, and measure the loss of retention over a period of two years, through 2880 cycles of insertion and removal. Materials and methods: Two implants 3.8mm x 10.5mm were inserted into a clear epoxy resin cast, through a surgical guide, with the implants being 23mm apart. Two LOCATOR attachments with 5 mm gingival height were screwed to the implants, custom made nylon caps were fabricated as an exact replica of the PEEK retentive caps, then two dentures were constructed and pick up were done with both retentive cap materials. A hook was attached to the geometric center of both dentures, and measurement of the retentive forces was accomplished with a universal testing machine, and the data was recorded and analyzed. Results: The amount of retention achieved from PEEK retentive caps was twice that of the nylon retentive caps, indicating high statistical significance (p \u3c 0.001) of the effect of the material and remained so throughout the repeated cycles with (p \u3c 0.001), however both caps showed similar rate of retention loss throughout the study, but the amount of wear was statistically higher in the PEEK group throughout the cycles, except after 2880 cycles. Conclusion: PEEK showed higher retentive properties throughout the cycles, but both materials showed similar rate of retention loss

Synthesis of some new pyrazolylfuropyrimidinethiones and triazolofuropyrimidinethiones

Some novel pyrazolylfuropyrimidinethiones were synthesized from cyclocondensation of 4-hydrazino-5,6-diphenylfuro [2,3-d] pyrimidine-2(1H)-thione (3) with different enaminones and 1,3-dicarbonyl compounds. Whereas the furotriazolo-pyrimidinethiones were synthesized from reaction of compound 3 with benzoyl chloride, p-chlorobenzaldehyde and carbon disulphide. Furthermore, furotetrazolo-pyrimidinethione and ditetrazolofuro pyrimidine were synthesized

Astaxanthin-Rich Haematococcus pluvialis Algal Hepatic Modulation in D-Galactose-Induced Aging in Rats: Role of Nrf2

Purpose: Aging is associated with hepatic morphological and physiological deterioration due to the accumulation of endogenous and exogenous free radicals and the resultant oxidative stress. The present study aims to investigate the effect of Haematococcus pluvialis microalgae on hepatic changes associated with D-galactose (D-Gal)-induced aging in rats. Methods: Aging was induced in rats by daily intraperitoneal injection of D-Gal (200 mg/kg/day) for eight consecutive weeks. D-Gal-injected rats were treated by astaxanthin (ATX)-rich H. pluvialis biomass, its carotenoid and polar fractions for two weeks. Twenty four hours after the last dose, blood samples were collected and the liver tissues were isolated for further biochemical and histopathological examinations. Results: D-Gal induced aging was associated with an elevation in serum liver function parameters, hepatic oxidative stress biomarkers viz., catalase (CAT), glutathione transferase (GST) and myeloperoxidase (MPO), as well as decreased expression of nuclear factor like-2 (Nrf2). Moreover, induction of aging exhibited an elevation of hepatic inflammatory cytokine; interleukin-6 (IL-6) and its modulator; nuclear factor Kappa B (NF-KB). However, treatment of D-Gal injected rats with ATX-rich H. pluvialis restored the serum liver function parameters as well as hepatic CAT, GST and MPO levels with an elevated expression of Nrf2. Treatment with ATX-rich H. pluvialis was also accompanied with a decrease in hepatic levels of NF-KB and IL-6. Histopathological examination emphasized all the previous results. Similarly, all trans-astaxanthin showed high affinity towards Nrf2 with -7.93 kcal/mol estimated free energy of binding as well as moderate affinities towards IL-6 and NF-KB through a docking study. Conclusion: ATX-rich H. pluvialis showed beneficial effects by ameliorating the hepatic changes associated with D-Gal induced aging in rats due to its modulatory role of the Nrf2/Keap pathway