An in vitro study on the cleaning ability on the root canal irrigation techniques using two rotary niti systems

Aim: To determine and compare the cleaning efficacy of two contemporary irrigation systems with conventional irrigation needles using two different rotary NiTi systems. Methods: 144 single rooted extracted human permanent teeth were divided randomly into four groups: EndoVac irrigation system, NaviTip FX irrigation needle, Conventional 25G needle and control. The groups were compared using TF and RaCe rotary systems. Four-micron-thick serial sections were prepared at 1.5 and 3.5mm from the apical foramen and the images were captured using optical microscopy and analyzed using Mirax software. The statistical analysis was performed using Kruskal-Wallis Test (p < 0.05) followed by intergroup comparison using Mann-Whitney Test (p < 0.008). Results: While the cleaning ability of EndoVac irrigation system was significantly better than conventional needle irrigation using both TF and RaCe rotary systems at 3.5 and 1.5mm (p < 0.008), there is no significant difference between NaviTip FX needle and conventional needle irrigation at both levels. With the exception of the cleaning ability at 1.5mm using TF, there is no significant difference between EndoVac system and NaviTip FX needle (p > 0.008). At both levels, the cleaning ability of TF and RaCe rotary systems with all irrigation systems was not significantly different. Conclusions: EndoVac irrigation system has better cleaning ability than NaviTip FX and conventional needle with both TF and RaCe rotary NiTi systems, especially at 1.5mm from the apical foramen. TF and RaCe rotary systems have similar cleaning ability with all irrigations systems

Offshore wind power integration to support weak grid voltage for industrial loads using VSC-HVDC transmission system

This paper investigates the integration of the offshore wind power plant into the grid using voltage source converter high-voltage direct current (VSC-HVDC). The paper proposes both offshore and onshore converter stations control to support voltage variation in grid. Heavy industrial loads result in a weak grid. In this paper, the effect on industrial loads by the grid strength is shown. Then the paper proposes a solution for the grid voltage support for industrial loads connected to weak grids. The results showed that the increase of grid voltage from 0.7 pu to 1 pu at full load condition that provides a continuous operation without any interruption. The system was modelled using MATLAB/Simulink package

The value of pericardial window in preventing pericardial effusion after cardiac surgery

Background: Pericardial window (PW) is a technique that allows the passage of fluid from the pericardial to the pleural cavity to reduce the postoperative pericardial effusion. The purpose of this study was to evaluate the effectiveness of the pericardial window in decreasing pericardial effusions after cardiac surgery. Methods: The study included 400 adult patients who underwent cardiac surgery from 2017 to 2020. Patients were randomly assigned into two groups; the pericardial window (PW) group included 200 patients who underwent posterior pericardiotomy, and the control group included 200 patients who did not undergo this procedure. Results: Preoperative data were comparable between both groups. More patients in the PW group had chest tube drainage more than 500 cc/ 24 hours (40 (20%) vs. 5 (2.5%), respectively; p=0.005). The drainage of 500 cc/24 hours or more in the mediastinal tube was lower in the PW group (10 (5%) vs. 40 (20%) patients in the PW and control groups, respectively; p&lt;0.001). Early pericardial collection occurred in 6 patients in the PW group (3%) vs. 46 (23%) in the control group (p&lt;0.001), and no patient had late effusion in the PW group vs. 26 (13%) in the control group (p&lt; 0.001). Six patients in the PW group (3%) had postoperative atrial fibrillation and 12 patients (6%) in the control group (p= 0.23). Pulmonary complications were nonsignificantly higher in the PW group (Lung collapse: 40 (20%) vs. 26 (13%); p=0.08 and pleural effusion: 34 (17%) vs. 26 (13%); p= 0.3, in the PW vs. control groups, respectively). Conclusion: Posterior pericardiotomy is a simple technique that could reduce postoperative pericardial effusion, atrial fibrillation, and the pericardial tamponade. The technique did not increase the postoperative complications compared to the standard method

Right mini-thoracotomy versus median sternotomy for mitral valve replacement

Background: The advantages of minimally invasive mitral valve surgery over the conventional approach is still debated. This study aimed to evaluate early outcomes after mitral valve replacement (MVR) using the right mini-thoracotomy (RMT) versus median sternotomy (MS). Methods: We prospectively included 60 patients who had MVR from May 2015 to June 2017. We classified patients into two groups; Group A (n= 30) had RMT, and Group B (n= 30) had MS. Postoperative pain score, wound satisfaction, and clinical and echocardiographic outcomes were compared between both groups. Results: The mean age was 39.90 ± 12.34 years in Group A and 45.75 ± 13.10 years in Group B (p= 0.08). Preoperative and echocardiographic data showed no statistical significance difference between the groups. Group A had longer aortic cross-clamp (118.85 ± 40.56 vs. 70.75 ± 24.81 minutes, p&lt;0.001) and cardiopulmonary bypass times (186.70 ± 67.44 vs. 104.65 ± 42.60 minutes, p&lt;0.001). &nbsp;Group B had more blood loss (565 ± 344.3 vs. 241.5 ±89.16 ml/24 hours, p&lt;0.001). The median pain score was 1 (range: 1- 3) in Group A and 4 (2- 8) in Group B (p&lt;0.001), and the median wound satisfaction was 1.5 (1- 4) in Group A and 4 (1- 7) in Group B (p&lt;0.001).&nbsp; Wound infection occurred in 1 (3.3%) patient in Group A and 6 (20%) patients in Group B (p=0.04). Conclusion: Mitral valve replacement through the right mini-thoracotomy could be a safe alternative to median sternotomy. The right mini-thoracotomy was associated with longer operative times but better pain and wound satisfaction scores and lower wound infection

Coronectomy of deeply impacted lower third molar : incidence of outcomes and complications after one year follow-up

Objectives: The purpose of present study was to assess the surgical management of impacted third molar with proximity to the inferior alveolar nerve and complications associated with coronectomy in a series of patients undergoing third molar surgery. Material and Methods: The position of the mandibular canal in relation to the mandibular third molar region and mandibular foramen in the front part of the mandible (i.e., third molar in close proximity to the inferior alveolar nerve [IAN] or not) was identified on panoramic radiographs of patients scheduled for third molar extraction. Results: Close proximity to the IAN was observed in 64 patients (35 females, 29 males) with an impacted mandibular third molar. Coronectomy was performed in these patients. The most common complication was tooth migration away from the mandibular canal (n = 14), followed by root exposure (n = 5). Re-operation to remove the root was performed in cases with periapical infection and root exposure. Conclusions: The results indicate that coronectomy can be considered a reasonable and safe treatment alternative for patients who demonstrate elevated risk for injury to the inferior alveolar nerve with removal of the third molars. Coronectomy did not increase the incidence of damage to the inferior alveolar nerve and would be safer than complete extraction in situations in which the root of the mandibular third molar overlaps or is in close proximity to the mandibular canal

The relation between the timing of coronary angiography and renal function post coronary artery bypass grafting

Background: Acute kidney injury is a serious complication after coronary artery bypass grafting (CABG). This work aimed to assess the impact of the timing of coronary angiography on kidney function after on-pump coronary artery bypass grafting. &nbsp; Methods: We included 60 patients who underwent elective isolated on-pump coronary artery bypass grafting from 2017 to 2018 at the National Heart Institute and Benha University Hospital. We divided the patients into two groups; group І included 30 patients with coronary angiography performed less than seven days prior to CABG, and Group ІІ included 30 patients who had coronary angiography more than seven days prior to CABG. Postoperative acute kidney injury was defined according to the consensus kidney disease: Improving Global Outcomes Definition and Staging criteria. Results: The mean body mass index was significantly higher in group I (35.89±5.15 Kg/ m² vs. 31.72±4.99 Kg/ m², P = 0.002). The mean preoperative hemoglobin was higher in group II (12.7 ± 1.5 g/dl vs. 13.9 ± 1.5 g/dl, P = 0.004). The frequency of acute kidney damage was higher in patients who had coronary angiography less than seven days before CABG but did not reach a significant level (46.7 % vs. 30%, P =0.184). There was no difference in the creatinine postoperatively between both groups (1.2 ±0.5 vs. 1 ±0.3 mg/dl; p= 0.214). Conclusions: We found no association between the timing of coronary angiography before on-pump coronary artery bypass graft surgery and postoperative acute kidney injury

Emotional and Behavioral Problems of Primary School Children With and Without Learning Disabilities: A Comparative Study

The aim of this study was to investigate the behavioral and emotional problems of children with and without learning disabilities. The study  sample consisted of 15 teachers and 424 primary school children  with and without  learning disabilities were selected from two governmental primary  schools at Beni-Suef City, using case –control research design. Data were collected by the teachers using the Strengths and Difficulties Questionnaire (SDQ) for children and adolescents aged 4-16 years. The results conducted that the  prevalence of total difficulties scores among primary school children with learning disabilities was 98.1% abnormal difficulties compared to 79.7% of normal children. Results also found that statistical significant differences were found between children with and without learning disability in all sub domains of emotional and behavioral disorders. This study documents that the high prevalence of difficulties among primary school children is an alarming condition that needs attention and early intervention. The study recommended that a periodic screening test should be provided  for early detection of emotional and behavioral problems for children with learning disabilities.          Key words: Primary school children, learning disabilities,  emotional and behavioral problem

A Clinical Score to Predict Acute Renal Failure after Cardiac Surgery in Egypt

Background: Acute Kidney Injury (AKI) after cardiac surgery is a serious complication. AKI could occur in 30% of patients, and 1-5% develop severe kidney injury. The present study aimed to evaluate the use of the Cleveland Clinic Score (CCS) to identify patients at higher risk of AKI after cardiac surgery. Methods: This study included 100 patients, 83 were males, and the mean age was 52.47±11.3 years. All patients had elective operations; 30% had isolated valve surgery, 64% had isolated coronary artery bypass grafting (CABG), and 6% had combined CABG and valve operation. Results: Creatinine serum level ranged between 0.5-2 mg/dL with a mean of 0.98±0.32 mg/dL. Seventy-four patients had good renal function postoperatively, and their CCS was 1.45±0.36, while 26 patients had renal impairment, and their CCS was 12.5±0.44 (P= 0.001). Patients who had AKI were older (62.87±8.7 vs. 49.9±13.9; P&lt;0.001) and had higher preoperative creatinine (1.1±0.32 vs. 0.94±0.31; P= 0.03). AKI was more common in diabetics (23 (88.5%) vs. 28 (37.85, P&lt;0.001) and patients with COPD (6 (23.1%) vs. 3 (4.1%); P= 0.004). CCS score was significantly higher among the different degrees of severity of AKI. Conclusion: Cleveland Clinic Score could be good for predicting acute kidney injury after cardiac surgery

Synthesis of some novel pyridine and naphthyridine derivatives

2-[1-(Furan- or thiophen-2-yl)ethylidene)malononitriles (1a,b) undergo dimerization reactions in ethanol catalyzed by sodium ethoxide to afford 2-[4,6-di(furan- or thiophen-2-yl)-3-cyano-6-methyl-5,6-dihydropyridin-2(1H)-ylidene]malononitrile derivatives (2a,b), respectively. Compounds 2a and 2b couple with arene diazonium salts (3a-c) to afford the hydrazo derivatives (4a-f). They react also with hydrazines (5a,b) to afford the pyrazolo[3,4-H][1,6]naphthyridine derivatives (6a-d) and with urea derivatives (7a-c) to afford the pyrimido[4,5-H][1,6]naphthyridine derivatives (8a-f), respectively

Penetrating chest trauma: A prospective study of prognostic factors for worse outcome after emergency surgery

Background: Even though chest penetrating injuries are common as well as challenging to treat, most of the time they can be dealt without surgery. This study aimed to evaluate contemporary outcome following emergent surgical interventions for penetrating chest trauma and possible factors associated with poor prognosis. Methods: This prospective study included 100 cases admitted to benha university hospital with either Stab Wound or Gunshot wound to the chest, with systolic blood pressure ≤90 mmHg and who underwent through Thoracotomy or sternotomy within duration of one hour of arrival. Results: This study included 81 patients (77 stabbings, 4 gunshots) underwent a thoracotomy and 19 underwent median sternotomy within 60 minutes after the penetrating trauma, the mean period of surgery was 3 ±0.9, There were 94 male and 6 female cases and their mean age was 25 ±10.14 years, the mean Intensive care unit stay was 2 ±0.83 days in addition mean hospital stay was 6 ±1.06 days, the individuals who died had trauma at mid-clavicular line of the chest (100%) compared to survivors (5.5%), lesser systolic blood pressure on presentation in the emergency room (71 ±11 mmHg) equated with those who survived (90 ±9 mmHg, P&lt;0.001) and lower hemoglobin level (6.4 ±0.5) compared with those who survived (8.4 ±1, P&lt;0.001). As a whole, the mortality rate was 9% (n=9). individuals' Death Rates with stab wounds was 5/96 (5.2%) compared with 4/4 (100%) for patients with gunshot wounds. Right ventricular injury (P=0.03) was associated with mortality. Conclusion: Early referral, within one hour, to emergency surgery results in acceptable postoperative mortality in patients with penetrating chest trauma. Anterior location of injury, initial hemodynamic instability, and gunshot wounds associated with poor prognosis