This study was conducted to evaluate the effect of weight of the obturators on the supporting structures of acquired maxillary defects.Twelve maxillectomy patients class I Aramany classification were selected and were divided into two equal groups, six patients each.Hollowed maxillary obturators were constructed for each patient with same design.group I from titanium and group II from cobalt chromium.The acrylic resin used in both groups was visible light polymerized resin.Bone height and density of the supporting abutments were evaluated using the Digora com-puterized system the results showed that there was no significant difference between the two groups after six months regarding bone height and density, however.there was a highly significant difference after twelve months.
An attempt to prepare protein content and essential amino acids balanced flatbread for PKU patients was done in the present study.The novel developed flatbread was done to be below the allowable limit of phenylalanine for this category and its technological properties should be acceptable.The flatbread was prepared by a free phenylalanine mixture of selected amino acids, each separately, and then mixed according to the RDA at a ratio of 10 and 20% were wheat flour (WF), corn starch (CS), cassava starch (CSS) and potatoes powder (PP) chosen in 1and 2 formula.Banana powder (BP), PP, CS and CSS, as 3 and 4 formula, Arabic gum and Pectin, control from WF, CS and CMC, to produce low phenylalanine flatbread.Studding of the chemical composition of flatbread samples showed that protein contents were about two folds in 1 and 3 samples and three times in samples 2 and 4; while total carbohydrates were lowered compared with control samples.Moreover, increases were also found in essential amino acids and total amino acids in flatbread samples fortified with the lower phenylalanine selected amino acids.Besides, the sensory attributes evaluation by PKU patients, also, showed that the flatbread samples were more acceptable compared with control in all properties especially taste and total score.About staling, the best states were in the arabic gum, pectin and fat formula compared with CMC and pectin in the control.In addition, physical and texture properties were also improved by using such materials and free phenylalanine selected amino acids at a ratio of 10 and 20 % of the RDA.These findings may be help to prepare flatbread balanced in protein, amino acids, with a lower phenylalanine and more acceptability for PKU patients.
Background: Type 2 diabetes mellitus (T2DM) is a major health problem and its prevalence is increasing worldwide which results in high morbidity and mortality due to its wide spectrum of complications.Both diabetic nephropathy (DN) and diabetic retinopathy (DR) are serious microvascular complications and have been considered the major cause of blindness and end-stage renal failure.Objective: our study was conducted to assess the Monocytes to High-Density lipoprotein Cholesterol ratio (MHR) as a New Marker for DN and DR.Patients and methods: the study was conducted on 100 subjects 50 were healthy control and 50 had a diagnosis of T2DM according to American Diabetes Association Criteria (ADAC).Data were collected including, demographic, clinical, and laboratory data.Statistical analysis was carried out for all collected data using IBM SPSS.Statistical significance was determined at a p -value<0.05.Results: MHR was normal in the healthy control group with a median of 7.23 while it was high in patients with DN and DR with a median of (16.8) -(18.6)respectively.These patients had a longer duration of DM, higher lipid profile values, and bad control of DM which was assessed by HbA1c, associated metabolic syndrome, micro, and macro albuminuria.Conclusion: our current study suggests that MHR is associated with the presence of DN and DR so it can be used as a new marker for the progression and development of DN and DR.
Background: Hepatic fibrosis is one of the most common lesions during chronic hepatic diseases.It is a significant health issue in many countries because it can lead to cirrhosis and ultimately liver failure without careful treatment.No successful management to treat this condition has been established so far.Some medicinal plants are particularly important in this sense because of the intrinsic healing ability of their plants, as well as their long-term therapeutic capabilities and few side effects.The hepatoprotective role of desert date oil (DDO) is clearly indicated in recent studies; however, the accurate mechanisms are still unknown.Objectives: The present study was designed to investigate the hepatoprotective, antioxidant, and antifibrotic effects of desert date oil against the hepatic damage and oxidative stress induced by thioacetamide (TAA) administration in male rats.Material & Methods: In this study, 40 healthy adult albino rats were divided into four groups: group 1 (control), group 2 received orally DDO (500 mg/kg b.wt/orally every day), group 3 was injected intraperitoneally by TAA by intraperitoneal (I.P.) injection of 200 mg/kg b.wt, twice weekly to induce liver fibrosis, group 4 was injected by I.P. TAA and received DDO orally every day by the same doses as above.At the end of the experiment (8 weeks), the rats of different groups were sacrificed, and blood samples were collected for the determination of the liver function tests.Then, the abdomen of rats of different groups was opened, where the liver was removed, weighted and cut into small pieces; some pieces were homogenized to measure the oxidative (malondialdehyde [MDA]) (MDA) and antioxidative parameters (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), while other pieces were processed for different histological and immunohistochemical techniques.Results: The present study revealed that TAA administration to rats resulted in a significant decrease in body weight gain with an increased liver/body weight ratio (liver weight index).In addition, the levels of liver enzymes (ALT, AST, and ALP) and total bilirubin were significantly increased, while the levels of total protein and albumin were statistically decreased.TAA led to a significant increase in MDA, a lipid peroxidation marker, with a concomitant decrease in antioxidant enzymes (SOD, CAT, and GPx) when compared with the control group.The histopathological examination showed abnormal changes characterized by an obvious increase in the collagen content, and bridging fibrosis with the hepatic cells showed various degenerative changes in the cytoplasm and nucleus.The administration of DDO along with TAA resulted in improvements in all biochemical tests and histopathological changes and significantly attenuated TAA-induced oxidative damage.Conclusion: This study revealed that desert date oil has antifibrotic and hepatoprotective effects against the liver fibrosis, biochemical and structural changes induced by TAA administration in rats; possibly due to its antioxidant properties.Additionally, the obtained results
The hydrogen storage outside and inside carbon nanotube (CNT) has investigated at different positions using density functional theory (DFT) and applying 6-31g basis set.In addition, the effect of vacancy defects on hydrogen storage has been studied including mono-vacancy, di-vacancy and isolated monovacancy defects.The adsorption energy, HOMO (highest occupied molecular Orbital), LUMO (lowest unoccupied molecular orbital), energy gap, dipole moment and Mullikan Analysis are discussed.The results show that hydrogen molecule cannot be stored inside the CNT.However, the hydrogen molecule prefers to be stored outside the nanotubes.The most candidate CNT for hydrogen storge is found to be mono-vacancy defected CNT with hydrogen adsorption energy -3.8 eV.
Background: Chronic kidney disease (CKD) is an increasingly prevalent condition, recognized as a public health priority, affecting 10-12% of the population.Subclinical Hypothyroidism is a clinical condition with minimal symptoms or no symptoms of hypothyroidism.Early detection and management decrease the cardiovascular and metabolic complications in CKD patients.Objective:The study was conducted to evaluate serum FT4 / FT3 Ratio, as a Predictor of Subclinical Hypothyroidism in Patients with CKD.Patients and methods: The study was conducted at Tanta University hospitals, Internal Medicine outpatient clinics, inpatient wards of Nephrology and Endocrinology Units and clinical pathology department.From September 2021 to September 2022.100subjects were included; 50 normal healthy volunteers as controls and 50 patients suffering from CKD of varying etiology have been considered for the study after fulfilling the inclusion criteria.Data were collected including demographic, clinical, and laboratory data.Statistical analysis was carried out for all collected data using IBM, SPSS version 21.Statistical significance was determined at a P level ≤ 0.05.Results: TSH, and free T4 / free T3 ratio were significantly higher in CKD group compared to control group (P value <0.001).Free T3 was significantly lower in CKD group compared to control group (P value <0.001).Free T4 was insignificantly different between both groups.Free T4 / Free T3 ratio can significantly predict incidence of subclinical hypothyroidism with AUC=0.879 and P value <0.001.Free T3 can significantly predict incidence of subclinical hypothyroidism with AUC= 0.071 and P value<0.001.TSH can significantly predict incidence of subclinical hypothyroidism with AUC= 0.643 and P value=0.014.Free T4 was an insignificant predictor of incidence of subclinical hypothyroidism.Conclusion: free T4 / free T3 ratio can significantly predict incidence of subclinical hypothyroidism with AUC= 0.879 and P value <0.001.Free T3 can significantly predict incidence of subclinical hypothyroidism with AUC= 0.071 and P value<0.001.Free T4 was an insignificant predictor of incidence of subclinical hypothyroidism.
The AEC industry in Egypt is remarkably adopting cloud-based BIM technology at a fast pace, which eases effective information transfer among stakeholders and supports collaboration, communication, and real-time information sharing among project participants.This research aims to explore the actual status of using state-of-the-art cloud-based BIM technology during the construction process and to identify the obstacles facing its adoption.To achieve the research objectives, the researcher used quantitative and analytical approaches to reach conclusions.The researcher conducted the filed study in Egypt and was limited to those who have experience in using cloud BIM applications during the construction process, the study explores the adoption status of cloud-based BIM in Egypt, furthermore, benefits and barriers were identified and analyzed.Findings also prompt the suggestion of an action plan that enhances the adoption of cloud-based BIM technology in the industry.
Experiment was conducted during the spring seasons of 2021 and 2022 in the plastic house at North-South oriented at the experimental farm of Horticultural Research Stations Qaha, Qalyubia Governorate.The study aims to compare different methods of Management certain substances to the colored pepper crop in the greenhouse to the number of Western Flower Thrips (Franklaniella occidentalis (Pergande)) this pest was attacking a wide spectrum of economic plants, causing great losses in their yield.Results showed that, Franklaniella occidentalis (Pergande) nymphs and adults had two seasonal generations during two seasons, the first generation occurred between early-April to end-April and the second generation was occurred between early-May to early -June.Using different treatments systemic pesticide (Ochen soil applied, Ochen foliar applied, Lannate soil applied, Lannate foliar applied, Movento soil applied, Movento foliar applied, Super tox soil applied, Super tox foliar applied, Dimethoate soil applied and Dimethoate foliar applied) were recorded in 2022 season (Movento soil applied and Dimethoate soil applied shows high mortality Therefore, it is preferable to use soil spraying.Lannate foliar applied indicated a low mortality effect on pest population.
Thyroid disease is a leading public health problem that has increased globally over the past decades.Thyroid diseases have been observed in more than 100 countries and affecting approximately 1.6 billion populations worldwide.Musculoskeletal disorders (MSDs) are very common in thyroid disease patients and TH stimulates both protein synthesis and degradation.An alteration in TH levels is often responsible for a specific myopathy and the deposition of mucopolysaccharides, notably hyaluronic acid in articular and periarticular structures Various knee musculoskeletal ultrasound findings, osteophytes, enthesophytes, synovitis, cortical erosion, enthesitis, joint effusion.Thyroid dysfunction patients with associated risk factors such as aging female gender and hyperuricemia are at a greater risk of musculoskeletal disorders.
Background: Gout is a metabolic disorder characterized by disturbance in purine metabolism and urate excretion with manifestations of acute and chronic arthritis and tophus formation.Aim of work: To evaluate the role of musculoskeletal ultrasound (MSUS) in early detection of gout in CKD patients.Subject and methods: This study was carried out on 50 patients with CKD according to K/DOQI classification of CKD.Musculoskeletal ultrasound assessment for wrists, hands, feet and knees joints was done for all patients then they were divided into 2 groups according to presence or absence of MSUS specific findings of gout as double contour sign (DCS) and/or tophus formation.Statistical analysis carried out for all collected data using SPSS statistical significance was determined at as P value < 0.05.Results: Using MSUS revealed that 35 patients (70%) had positive ultrasound findings for gouty arthritis.10 of this group (28.6 %) were non hyperuricemic.The group of patients with positive sonographic findings had significant higher serum uric acid and older age than other group (P value =0.004), (P value < 0.001) respectively.MSUS reveled sensitivity 80 % and specificity 47 % in the detection of gout in patient with CKD.Conclusion: MSUS is considered a reliable tool with high sensitivity in screening of gouty arthritis in asymptomatic hyperuricemic patients.
Background: Hemodialysis is the most common method of renal replacement therapy for end stage renal disease (ESRD) patients and the AVF is the best vascular access of choice for hemodialysis as recommended by KIDGO.AVF failure is the leading cause of morbidity and mortality for emodialysis patients.It is a challenging process in which improvement of outcome of the AVF will improve quality of life of hemodialysis patients and minimize health care resources and costs related to vascular access dysfunction.Objective: This study shows the risk factors contributing to AVF dysfunction in order to find out some preventive measures to decrease the rate of AVF failure.Patients and methods: 300 patients with ESRD were divided into 2 groups: control group: 200 patients with functioning AVF.Case group: 100 patients with AVF dysfunction.All patients included in the study were subjected to laboratory investigations (CBC, blood urea and serum creatinine, cholesterol, triglycerides, HbA1C, serum albumin, Ca, Po4, PTH, PT, INR, CRP & ESR) and imaging in the form of Doppler ultrasound of the AVF.Results: Our study results show a significant relation between arterio-venous access and some risk factors as low hemoglobin level, high platelet count, high renal functions, dyslipidemia, hypoalbuminemia, and elevated CRP & ESR denoting the presence of inflammation.Conclusion: the most independent risk factors for AVF dysfunction were anemia, dyslipidemia, high platelets, high renal functions, hypoalbuminemia and elevated ESR & CRP.
Background: Assessing asthma control and early detection of children at risk is challenging due to discrepancy in symptom perception.Traditional spirometry requires children to perform forced expiratory maneuvers while IOS require minimal cooperation.The aim of this study was to determine sensitivity and specificity of IOS compared to clinical asthma control parameters among asthmatic children.Methods: 80 children were enrolled, Group 1 (patients) according to clinical manifestations in GINA (2019), Group 2 (Control), 40 healthy children with matched age, sex, and socioeconomic standard, subjected to history taking, general and chest examination.Family history of atopy and wheezing followed by SPT, IOS was performed in compliance with the ERS/ATS guidelines by Master Screen IOS system.Results: More than one third of group1 were positive to inhaled allergen.R5, R5-R20, Fres and Ax were significantly higher among asthmatics.Bronchodilator response was significant in both controlled and uncontrolled children.There was a significant association between asthma control clinically and IOS parameter AX < 7 (kPa/L).Assessing asthma control using IOS parameter AX < 7 kPa/L showed 68.18 % sensitivity and 88.89 % specificity.Conclusions: Impulse Oscillometry is a noninvasive, rapid, validated technique that helps in identification of asthma control among asthmatic children using R5, X5, AX as sensitive and specific indicators.
The primary objective of this study article is to analyze the effects of incorporating environmental, social, and governance (ESG) principles on the sustainable development of small and medium companies (SMEs) in Egypt.This study employs qualitative research methods to address research inquiries by conducting interviews and surveys with a sample size of 240 enterprises.The objective is to examine and moderate the association between the sustainability growth of small and mediumsized enterprises (SMEs) and their adoption of sustainability practices.This is achieved by integrating environmental, social, and governance (ESG) principles into their operational strategies, with the aim of enhancing the overall performance of the enterprises.The findings suggest that small and mediumsized enterprises (SMEs) in Egypt demonstrate a limited understanding of environmental, social, and governance (ESG) practices and innovation.Consequently, they may not fully recognize the significance of these practices in relation to achieving sustainability performance.The research findings have significant practical implications for various stakeholders, both internal and external.These stakeholders include managers, consultants, investors, credit agencies, lenders, policymakers, government entities, and the broader community.The implications pertain specifically to the potential impacts of environmental, social, and governance (ESG) practices on small and medium-sized enterprises (SMEs).
Background: The cerebellopontine angle (CPA) is a triangular subarachnoid space located within the posterior cranial fossa and centered at the level of the internal audiotary canal.Approximately 10%of intracranial tumors arise in the cerebellopontine angle and 80% of these are vestibular schwannomas.The majority of the remaining 20%are meningiomas, with rare incidance of facial or trigeminal schwannomas, epidermoid cysts(primarycholeseatomas), glomus jugular tumors, arachnoid cysts, giant cell tumors, metastatic deposits, and other masses.Objective: To evaluate the role of DWI, susceptibility and specrtroscopy in evaluation of cerebello pontine angle masses.Patients and methods: Our study included thirty cases with CPA masses that were subjected to advanced MRI techniques (DWI, SWi and, MRS) in addition to the conventional MRI techniques to evaluate their role in evaluation of CPA masses.Results: By using DWI in our protocol, we proved that; It can differentiate shwannomas, meningiomas and epidermoid cyst; where meningiomas are always restricted with low ADC values (mean ADC value < 1× 10-3 mm2 /s) while shwannomas have higher ADC values (mean ADC value >1× 10-3 mm2 /s) and epidermoid cysts are restricted with ADC values <1× 10-3 mm2 /s.By using SWI: SWI also proved to has an important value in differentiating meningiomas and shwannomas where in our study no meningiomas showed blooming on SWI while 61.5 % of shwannomas showed blooming (likely due to intra-lesional hemorrhage).Thus the presence of blooming within a lesion (after exclusion of calcifications) would rather the diagnosis of shwannoma than meningioma.By using MRS: 100% of shwannomas showed myo-inositol peak in our study and 87.5% of meningiomas showed alanine peak and 100% of meningiomas showed glutamate\glutamine peak, proving that MRS can be an accurate technique in differentiating the two entities.100% of metastatic lesions showed choline peak in our study so MRS has an important value in the diagnosis of metastatic lesions.Conclusion: Advanced MRI techniques as DWI, susceptibility and spectroscopy have a great value in evaluation of CPA masses.
Traditional agricultural practices, such as the use of synthetic pesticides, lead to numerous problems including environmental contamination, generating pest resistance and harmful effects on non-target organisms.Consequently, these negative effects have emphasized the need to develop new efficient safe and eco-friendly natural alternatives to synthetic insecticides.Algal products play a significant role as chemical substitutes in agricultural applications.The current study to bioassay biocide effects of ten commercial algal products as an natural and safe bio-pesticides on 4 th larval instar of cotton leafworm Spodoptera littoralis (Boisd.)(Lepidoptera: Noctuidae).A high level of corrected mortality was found for the algal product (Biocontra formulation) through exposure period of 96 hours under laboratory conditions.The toxicity against 4 th larval instar of cotton leafworm insect increased as exposure time and concentrations increasing.Biocontra formulation caused comparatively the highest potential toxic activities >90% mortality and achieved the same value (92.5%) after 72 and 96 hours.exposure time.The highest mortality of Biocontra (80.0, 82.5 and 93.0%) were recorded with the highest concentration (10 mg\ml) after 48, 72 and 96 hours exposure times, respectively compared to control treatments.The least mortality percentages were observed with other concentrations 2, 4, 6 and 8 mg\ml after 48, 72 and 96 hours from exposure.Biocontra formulation was found to be the most toxic with LC50= 27.8 mg/ml to 4 th larval instar of cotton leafworm after 96 hours from exposure.Results of treated larvae with LC50 of Biocontra formulation indicated that, the larval duration, female life span, fecundity and fertility are significantly affected by algae treatment.Moreover, protein content, Chitinase, β-esterase and GST significantly decreased compared to untreated larvae.Generally, algae are an important in agriculture system that they are been as biocontrol agent in the integrated crop managements, especially under modern climatic changes.
Background: The outbreak of novel Coronavirus Disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major pandemic situation and a catastrophe for humans.COVID-19 is a severe infectious disease particularly of the respiratory system characterized by fatal complications.In fact, the current crisis of COVID-19 has become an increasingly serious concern to public health.Since there are no specific drugs and/or vaccines available so far and continues gene mutations.COVID-19 patients showed several abnormal hematological findings.Including lymphopenia, neutrophilia, elevated levels of D-dimer and fibrinogen.COVID-19 remains to be a major challenge task.Objective: Our study was conducted to evaluate the prognostic value of peripheral blood counts in Covid-19 patients.Patients and methods: Our study was a Prospective cohort study.It was conducted on 100 patients with Covid -19 at and post admission Results: there was positive correlation between NLR and PLR with C-reactive protein (CRP), LDH, ferritin, Procalcitonin, IL 6 and D-dimer along course of the disease.However, LMR was found to be negatively correlated with them.It was found that if NLR and PLR increased there would be an increase in severity of the disease as long as the risk of ICU admission and intubation.Conclusion: Our study revealed that, NLR and PLR in addition to LMR are good prognostic factors in COVID 19 patients that are cost-effective, readily available, and easy to calculate and can be used instead of other inflammatory markers e.g.(CRP, IL6, D-dimer, ferritin and procalcitonin).
Background: Patients with chronic kidney disease (CKD) are predisposed to arrhythmia, including atrial fibrillation (AF)/atrial flutter, supraventricular tachycardias, ventricular arrhythmias, and sudden cardiac death (SCD).The aim of this study was to evaluate prevalence and types of arrhythmias and associated clinical characteristics in patients with end stage renal disease on maintainence hemodialysis.Patients and methods: This cross-sectional study was conducted on 100 patients with CKD on hemodialysis.12 leads ECG and Echocardiography were done to all patients.48-hour Holter monitoring was done if ECG showed no abnormality in the rhythm.Results: There was an insignificant correlation between heart rate and potassium, ionized calcium, magnesium, phosphate, PTH, BUN and creatinine.There was a significant negative correlation between heart rate and hemoglobin.There was a significant positive correlation between heart rate and sodium.There was an insignificant correlation between supraventricular arrhythmias and laboratory parameters.There was a significant negative correlation between potassium and atrial fibrillation.Hypernatremia and high Po 4 -2 and normal PTH were significantly different with SVT.(P value <0.001, 0.011 and 0.009 respectively).Conclusion: Hemodialysis may be responsible for the high rate of sudden mortality.Hypertension, coronary artery disease (CAD), and corrected QT interval (QTc) dispersion are independent predictors of complex ventricular Arrhythmia (CVA), and duration of dialysis therapy is an independent factor affecting APC development in these patients.
Background Periostin, originally identified in osteoblasts, functions as a cell adhesion molecule for pre-osteoblasts.It is categorized as a soluble extracellular matrix protein of 836 amino acids in length.Periostin is not observed in adult kidneys under normal conditions.It was prominently expressed in tubulointerstitial areas during renal injury and its urinary level indicates the loss of renal tubular cells in response to diverse renal injuries.Presently, information regarding the role of periostin in chronic kidney diseases remains scarce.This study aims to clarify the potential role of urinary periostin as a predictor of nephropathy in patients with type 2 diabetes mellitus and to evaluate its relation to clinical and laboratory parameters.Methods: This study was carried out on 60 type 2 diabetic patients, divided according to urinary albumin/creatinine ratio into 20 with normoalbuminuria, 20 with microalbuminuria and 20 with macroalbuminuria.Also, 20 healthy subjects were included as a control group.Urinary periostin level, glycosylated hemoglobin, urinary albumin/creatinine ratio and serum creatinine were measured.Estimated glomerular filteration rate (eGFR) was calculated.Results: The mean urinary periostin level was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups.Also, the mean urinary periostin level was statistically significantly higher in patients with microalbuminuria as compared to the control & normoalbuminuria groups.Moreover, it was statistically significantly higher in normoalbuminuric group as compared to control group.Urinary periostin level was positively correlated with duration of diabetes, fasting and postprandial blood glucose levels, glycosylated hemoglobin, urinary albumin/creatinine ratio, serum creatinine, total cholesterol and triglycrides but negatively correlated with eGFR.Conclusion: An increased urinary periostin level is considered as an early predictor for deterioration of renal function in diabetic patients, suggesting that periostin can be used to identify diabetics at risk for diabetic kidney disease development.Clearly, further well-designed prospective studies are required to prove this hypothesis.
Background: Musculoskeletal disorders are one of chronic kidney disease's most common complications, potentially affecting an individual's functional status and quality of life.A major concern of healthcare professionals caring for CKD patients is to improve their quality of life.Objective: The study was conducted to evaluate the prevalence of musculoskeletal disorders in CKD patients and possible risk factors.Patients and methods: The study was conducted on 100 patients aged 19-76 years with CKD diagnosis according to Kidney Disease Improving Global Outcomes (KDIGO) criteria, selected from the renal hemodialysis units, nephrology, and rheumatology outpatient clinics of Tanta University Hospitals.Patients were divided into two groups according to The CKD-EPI creatinine Equation estimated GFR: Group I: included 32 patients with stages II, III and Group II: included 68 patients with stages IV, V. Musculoskeletal disorders were evaluated by the (COPCORD) Questionnaire.Data were collected including demographic, clinical, and laboratory data.Statistical analysis was carried out for all collected data using IBM, SPSS version 21.Statistical significance was determined at a P level ≤ 0.05.Results: Among 100 patients with CKD, there was a high prevalence of chronic musculoskeletal pain which was detected in 89.7% of patients in group II and 78.1% of patients in group I. 46.9% and 75% of patients in group I and group II respectively, had radiological abnormalities detected by imaging studies such as subperiosteal bone resorption, periarticular osteopenia, knee osteoarthritis and Achilles tendinopathy.Possible risk factors for musculoskeletal pain was hypertension, diabetes mellitus (DM), ischemic heart disease(IHD), Mineral Bone Disease in CKD (CKD-MBD), and hyperuricemia.Conclusion: The study suggested that musculoskeletal disorders are highly prevalent in CKD patients, so evaluation of prevalence and related factors will help in early management and improvement of quality of life.
Background: Right ventricular pacing for the treatment of various conduction disorder, is associated with effects on left ventricular function leading to reduction in the left ventricular ejection fraction and causing pacing induced cardiomyopathy over time.Objective: To study the effects of dual chamber pacemaker on left ventricular function using 2D speckle tracking echocardiography.Patients and Methods: The present study was conducted on a cohort of 53 patients with conduction disturbances who underwent dual chamber pacemaker implantation at the Cardiology department of Tanta University Hospital.The study period spanned from December 1, 2021 to May 1,2022.Prior to pacemaker implantation, 2D Speckle tracking echocardiography was performed.Subsequent assessments were conducted at one week and three months intervals post implantation.Results: Our results demonstrated that at 3 months post pacemaker implantation (10) patients developed PIVD; 2 of them developed PICM.At one week follow up, GLS was significantly lower in patients who developed PIVD, compared to those who did not.Speckle tracking echocardiography provides angleindependent accurate measurements of LV strain.Global longitudinal strain at 1 week post pacemaker implantation can predict subsequent decline in LV contractility and ejection fraction, hence can be used to identify patients at risk to develop pacemaker induced ventricular dysfunction or cardiomyopathy.Conclusion: 2D-speckle tracking can be used as early predictor way for pacemaker induced ventricular dysfunction as well as pacemaker induced cardiomyopathy in patients who went dual chamber pacemaker.
