الكفاءة الذاتية للتعلم عبر الإنترنت لدى طلبة جامعة السلطان قابوس في ظل جائحة كورونا (كوفيد-19)

استهدفت الدراسة الحالية قياس مستوى الكفاءة الذاتية للتعلم عبر الإنترنت لدى طلبة جامعة السلطان قابوس في ظل جائحة كورونا (كوفيد-19)، وتمثلت أداة الدراسة في مقياس الكفاءة الذاتية للتعلم عبر الإنترنت (OLSES)، الذي طوَّره Zimmerman & Kulikowich (2016)، وقد تُرجم إلى اللغة العربية. وللتأكد من الخصائص السيكومترية للمقياس – ثباته وصدقه – طُبِّق على عينة استطلاعية قوامها 120 طالبًا وطالبة ممن يدرسون بكليات جامعة السلطان قابوس. وبعد الانتهاء من إجراءات الثبات والصدق للمقياس، طُبق على عينة قوامها (1560) طالبًا وطالبة بالجامعة نفسها. وقد أشارت النتائج إلى ارتفاع مستوى الكفاءة الذاتية للتعلم عبر الإنترنت لدى طلبة الجامعة، كما أشارت إلى وجود فرق دال إحصائيًا بين الذكور والإناث لصالح الإناث، في حين لا يوجد فرق دال إحصائيًا وفقا لمتغيرَي بيئة الطالب (ريف/حضر)، ونوع الكلية التي يدرس فيها الطالب (إنسانية/عملية). أما عن متغير عدد سنوات الدراسة بالجامعة، فقد أشارت النتائج إلى وجود فروق دالة إحصائيًا فيما يتعلق بالمحور الثاني فقط "إدارة الوقت" ولصالح أقدم الدفعات – من درسوا خمس سنوات أو أكثر

Intra-arterial chemoembolization with hepasphere 50–100 μm for patients with unresectable hepatocellular

Objective: This study examined the efficacy of transarterial chemoembolization of unresectable hepatocellular carcinoma using hepasphere 50–100 μm. Methods: A total number of 52 patients with radiologically documented HCC [Child–Pugh score A and B; 32 and 20 respectively] were embolized with hepasphere 50–100 μm. Forty-six patients were HCV positive and 6 patients were HBV positive. Local response of the tumor was evaluated radiologically after 1, 3, 6, 9 months and one year. Results: TACE with hepasphere 50–100 μm was tolerated by all patients with no major complications. The total number of lesions in 52 patients was 67 lesions. Complete response was seen in 40 patients (76.9%), while residual lesions seen in 12 patients (23.1%). As regards complications, 48 patients (92.4%) developed post-embolization syndrome, 2 patients (3.8%) had isolated partial IVC thrombosis while 2 patients (3.8%) showed combined partial IVC thrombosis and partial thrombosis of posterior branch of right portal vein. Conclusion: Hepasphere 50–100 μm is efficient for the treatment of hypervascular HCC. Further advances in drug-eluting beads including their size tailored to tumor anatomy may improve the results. Large series of patients, follow up for longer periods and comparison with conventional TACE and TACE with other DEB are needed

Uterine leiomyomas embolization with magnetic resonance imaging follow up

Introduction: Uterine artery embolization (UAE) has been used to treat symptomatic uterine leiomyomas, as women choose to preserve their uterus, uterus sparing techniques such as UAE have been developed. Magnetic resonance imaging (MRI) sequence signal characteristics and the degree of leiomyoma enhancement may be used to predict the response of leiomyoma to UAE.  Objective: to investigate role of UAE in different uterine myomas with follow up by MRI. Materials and methods: This prospective observational study was included 40 females with clinical criteria of symptomatic fibroid who weren’t suitable or refuse the other modalities of treatment and underwent UAE. All patients were undergone pre-procedure pelvic ultrasound and pelvic MRI, and post-procedure pelvic MRI.  Results: There was a significant decrease in the uterine volume post embolization in all patients with infarction more than 50% occurred in 38 (95%) patients. Bleeding and anemia in patients who had improved were significantly higher than those who were unchanged/recurrent (P value <0.05). Post embolization syndrome occurred in 10 patients (25%), only one patient (2.5%) had puncture site hematoma, two patients (5%) complained with pelvic infection and re-bleeding occurred in 5 (12.55%) patients.&nbsp

Efficacy and safety of carotid artery stenting for stroke preve

Background: Extracranial carotid artery stenosis is a leading cause of ischemic stroke. Carotid endarterectomy (CEA) is the gold-standard management for secondary stroke prevention yet carotid artery stenting (CAS) has emerged in the last decade as an alternative for high surgical risk patients. Purpose: To assess the effectiveness, safety and outcomes of CAS in extra-cranial carotid artery stenosis patients in terms of stroke prevention. Methodology: Twenty patients with symptomatic and asymptomatic carotid artery stenosis were enrolled between 2012 and 2014. Symptomatic patients were eligible for CAS if the internal carotid artery stenosis was ⩾50%, while 80% was the threshold in asymptomatic patients. Results: Symptomatic patients enrolled were fifteen (75%) and asymptomatic patients were five (25%). Two patients (10%) were excluded owing to target vessel occlusion. One patient (5%) underwent bilateral CAS. The procedure was successful in eighteen patients (90%) one of them complicated by distal embolization (5%). One patient died secondary to associated chronic liver disease (5%), otherwise no stroke or death was recorded along the follow-up period. Conclusion: Careful patient selection and technique optimization are crucial to improve clinical outcome which make it a safe alternative for surgical revascularization in stroke prevention

Outcomes of embolization of bone tumors in the pelvic and shoulder girdles: Initial experience

Purpose: To assess the effectiveness of transarterial embolization of bone tumors as preoperative technique to reduce blood loss or as a curative method in bone tumors of shoulder and pelvic girdles. Patients and methods: The study included 25 patients with different bone tumors which are benign tumors (n = 16) and bone metastasis (n = 9). Their ages ranged from 6 to 65 years. Embolization was a palliative treatment in bone metastasis (n = 9), non-ossifying fibroma (n = 2) and osteoblastoma (n = 1). In patients with ABCs (n = 12) and osteoblastoma (n = 1), the technique was used as a curative method. The effectiveness of the technique was assessed using plain X-ray of the affected region, CT scan, CT angiography. Results: In 7 patients operated, reduction of blood loss reached about 400 mL. No perioperative complication or wound complications. Additionally surgery was easier. In the remaining 18 patients tumor regression in (ABCs n = 12, osteoblastoma n = 1) and pain reduction (metastasis n = 5) were detected during the follow up period 1–2 years. Conclusion: Preoperative embolization is useful in reduction of intraoperative blood loss in tumors at shoulder and pelvic girdles. The technique is considered curative method in inaccessible lesions of pelvic and shoulder girdles with multiple interlacing vascular anastomosis. Keywords: Embolization, Bone tumors, Shoulder and pelvic girdle

Factors Affecting the Degree of Angular Remodeling in Stent-Assisted Coiling of Bifurcation Aneurysms

Background: Stent-assisted coiling (SAC) leads to significant changes in the vascular angle altering the bifurcation geometry and the hemodynamics at the bifurcation apex. It is believed that the stent alone exerts this effect, but other possible factors have not been studied. Purpose: To study the factors contributing to angular remodeling following SAC of bifurcation aneurysms including the anatomical, stent-related, and coil-related factors. Materials and Methods: We reviewed 43 basilar and carotid bifurcation aneurysms treated by SAC using Neuroform EZ (n = 28), Enterprise (n = 8), and Lvis Jr. (n = 7) stents. The bifurcation angle between the mother and stented daughter vessel was measured in 4 settings: pretreatment, poststenting, postcoiling, and at delayed follow-up (6-12 months). The degree of stent-induced angular remodeling was calculated by subtracting the poststenting bifurcation angle from the pretreatment one, while the coil-induced angular remodeling was calculated as the difference between the postcoiling and poststenting bifurcation angle. The immediate postprocedural degree of angular remodeling is the sum of the stent- and coil-induced angular remodeling. We studied the effect of several factors including the pretreatment bifurcation angle, aneurysm site, diameter of parent vessel, stent type, stent length in the daughter vessel, postoperative actual in situ coil size, and packing density. Results: The mean degree of stent-induced and coil-induced angular remodeling was 10.2 (0-47) and 4.53 (-7 to 30), respectively. The immediate postprocedural and delayed angular remodeling was 14.8 (-4 to 47) and 4.75 (-12 to 40), respectively. The degree of immediate remodeling was significantly affected by the actual in situ coil size (p = 0.017), and the pretreatment bifurcation angle (p = 0.024). Linear regression was carried out and the pretreatment bifurcation angle was defined as a predictor. The degree of delayed remodeling is significantly affected only by the pretreatment bifurcation angle (p = 0.011). Conclusion: Immediate angular remodeling following SAC of bifurcation aneurysms can happen after stenting or coiling or both. This is the first study reporting the role of the coils as an additional factor beside the stent in inducing immediate angular changes; this effect is correlated to the size of the coils. The pretreatment bifurcation angle is the most consistent factor affecting the degree of both immediate and delayed angular remodeling