Background Pheochromocytoma and paraganglioma (PPGLs) are rare, catecholamine-secreting tumors derived from chromaffin cells, which are diagnosed with paroxysmal or sustained hypertension. The disease can occur as sporadic or as part of a familial syndrome, which needs genetic testing, and is sometimes discovered as an adrenal incidentaloma. The definitive treatment is surgical removal of the tumor. Objective To assess the data of patients with PPGLs in the Faiha Specialized Diabetes Endocrine and Metabolism Center in Basrah, Iraq. Patients and methods A cross-sectional retrospective study involved Electronic Medical Records from 57 patients with PPGLs referred to Faiha Specialized Diabetes Endocrine and Metabolism Center between August 2017 and January 2025. Data analysis was conducted from January to May 2025. We assessed the patients’ general characteristics, biochemical, radiological, and histopathological features. Results This study found that the mean age of patients was 41.8 ± 17 years, with equal sex distribution (1: 1). About 40.4% were incidentally discovered, 57.9% by symptomatic screening, and 1.8% via family screening. Pheochromocytomas constitute 89.5% of PPGLs, and 10.5% are paragangliomas. A 10.5 and 70.2% of patients had ischemic heart disease and hypertension, respectively. Tumor size more than 4 cm in 79%. Biochemically, 25.5% of patients were positive for mild autonomous cortisol secretion. Syndromic features were reported in 15.8%. Metastases were found in 10.5% of tumor. Adrenalectomy with open surgery was performed in 90%, compared to about 10% with the laparoscopic approach. Among the histopathological data analyzed, only 10.5% had a Pheochromocytoma of the Adrenal Gland Scaled score more than or equal to 4. Conclusions A substantial proportion of patients with PPGLs in Basrah were incidentally diagnosed on imaging. Most tumors were large (>4 cm), and approximately one-quarter of patients had mild autonomous cortisol secretion. Open surgery was the predominant resection approach. This represents the first descriptive study of PPGLs in Iraq.
Background Prostate cancer is a leading malignancy in men, and multiparametric MRI (mpMRI), particularly dynamic contrast-enhanced (DCE)-MRI, plays a key role in identifying and characterizing lesions. While prostate imaging reporting and data system (PI-RADS) v2.1 standardizes mpMRI reporting, it relies mainly on T2W and diffusion-weighted imaging, assigning DCE-MRI a secondary, qualitative role. This study explores whether quantitative perfusion parameters from DCE-MRI can enhance lesion assessment and improve PI-RADS scoring. Results This study included 53 patients with 58 total lesions. PI-RADS alone demonstrated strong diagnostic performance with an area under the curve (AUC) of 0.978, achieving 100% sensitivity and 84.21% specificity. Ktrans exhibited the highest individual performance among DCE-MRI parameters (AUC = 0.964), while Kep and Ve had moderate accuracy (AUC = 0.850 and 0.795, respectively). The combination of Ktrans with PI-RADS achieved perfect classification (AUC = 1.000), with 100% sensitivity, specificity, and accuracy. Conclusion While PI-RADS alone demonstrated excellent diagnostic performance, combining Ktrans with PI-RADS significantly enhanced accuracy, particularly in resolving diagnostic uncertainty for PI-RADS category 3 lesions, suggesting their potential as reliable complementary diagnostic tools.
Background Adolescents face increasing social, emotional, and academic pressures, so it is important to know how common emotional and behavioral problems (EBPs) are and what factors put them at risk so we can support their mental health during this formative period. The study aimed to determine the prevalence of EBPs and to identify associated risk factors among intermediate and high school students in the southern region of Saudi Arabia. Patients and methods A cross-sectional study was conducted from September to December 2024 among 234 randomly selected intermediate and high school students aged 11–17 in Khamis Mushait, Saudi Arabia, in both public and private schools. Data were collected using a self-administered questionnaire that included demographic variables and the Arabic version of the Strengths and Difficulties Questionnaire. Results Among the 234 students (mean age 14.23 years), 60.3% were females, and 56.4% lived in urban areas. Most were Saudi nationals (95.7%) with no chronic conditions (97%) or prior psychological support (97.4%). EBPs were present in 40.6% of students, with peer problems being the most common (56.4%), followed by emotional/prosocial issues (18.4%), hyperactivity (15.8%), and conduct problems (15.4%). No significant associations were found between these problems and students’ age or sex, though higher rates were noted among older and female students. Conclusions In southern Saudi Arabia, over a third of students dealt with emotional and behavioral challenges, the majority of which were caused by their peers. No significant links were found between demographic characteristics and the concerns; however, there were higher frequencies among female learners and older students. The majority of pupils show signs of lacking prior psychological care, making it necessary to implement early intervention and comprehensive school-based mental health initiatives. It is recommended that further study be conducted to examine additional risk variables besides age and sex.
Introduction Texture analysis (TA) has developed as a significant tool for the study of medical images, especially those of lung cancer. In this study, we aimed to assess the diagnostic value of TA data extracted from intratumoral and peritumoral parenchyma in predicting mutational alteration, mediastinal lymph node involvement, and distant metastasis in lung adenocarcinomas. Patients and methods The study included pretreatment computed tomography images of 45 patients aged 18–99 years for whom mutational and clinical information were accessible. Images obtained using a 16-detector computed tomography device were segmented with the Olea Sphere software. Three types of segmentation were performed: intratumoral, rim, and peritumoral parenchyma. TA data were extracted from each segmentation and evaluated based on genetic alterations [e.g. anaplastic lymphoma kinase gene rearrangement, epidermal growth factor receptor (EGFR) mutation, and wild-type], distant metastasis, and mediastinal lymph node metastasis. Results Statistically significant relationships were found between TA data and genetic variations, distant metastasis, mediastinal lymph node metastasis, except for intratumoral texture parameters in EGFR mutated lesion. Logistic regression analysis was performed with three segmentation datasets, the statistical model’s estimated accuracy rates were measured to be 57.1% for anaplastic lymphoma kinase gene rearrangement, 76.9% for EGFR mutation, 100% for wild-type tumors, 97.1% for distant metastasis, and 96.9% for mediastinal lymph node metastasis. Conclusions Our results indicated the potential of predicting genetic alterations, distant metastasis, and mediastinal lymph node metastasis by evaluating intratumoral TA data together with TA data obtained from the peritumoral area.
Background Benign bone lesions are a heterogeneous group of conditions with variable biological behaviour. Although open curettage has been traditionally used for simple and aneurysmal bone cysts, it is associated with notable morbidity, while percutaneous techniques may limit adequate visualization. Endoscopic-assisted curettage has emerged as a minimally invasive alternative that combines reduced surgical morbidity with direct visualization for accurate lesion clearance. Objective The aim of the study was to assess the functional and radiological outcomes of endoscopically-assisted curettage of benign cystic bone lesions. Patients and methods This prospective study included 30 patients admitted to El-Hadra University Hospital with symptomatic contained intraosseous benign cystic bone lesions. All patients were treated surgically by endoscopically-assisted intralesional curettage. Patients were followed up for at least 1 year. Functional results were assessed using musculoskeletal tumor society (MSTS) scoring system and radiological healing was assessed using the Modified Neer Classification system after 1 year. Results A total of 29 (96.7%) patients had satisfactory MSTS scores and Modified Neer Classification outcomes, but one (3.3%) patient had an unsatisfactory score and radiological outcome with recurrent aneurysmal cyst. The mean MSTS score was 29.43 ± 1.61. Conclusion Endoscopic assisted curettage is a safe and effective minimally invasive option for treating benign cystic bone lesions in pediatric and adolescent patients, providing reliable radiological healing, excellent functional outcomes, and a low complication rate.
Background The objective of this study was to assess the amount of radiation received by specific areas of interest and organs at risk (OARs) in three different types of radiotherapy: 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc treatment (VMAT). This study examines the variations in dosimetry across three radiation modalities used for concurrent chemoradiation in patients with stage III–IVA, B oral cavity squamous cell carcinoma. Patients and methods In this retrospective investigation on treatment planning, we selected computed tomography data of 46 patients with stage III–IVA, B oral cavity cancer, who underwent prior treatment using the VMAT approach with chemoradiation. Results and conclusion The study findings revealed that IMRT and VMAT exhibited enhanced target coverage and effectively minimized damage to OARs. There were no notable variations in the doses administered between IMRT and VMAT in target volumes or OARs. Both IMRT and VMAT demonstrated a considerable enhancement in the homogeneity index and conformity index when compared with 3D-CRT. While both IMRT and VMAT necessitate a higher Monitor Units per fraction compared with 3D-CRT, VMAT requires a lower average Monitor Units than IMRT. These findings support the adoption of IMRT or VMAT for optimizing treatment outcomes and minimizing radiation-related toxicity in treating oral cavity cancers.
Background Lung cancer remains a leading cause of cancer-related mortality globally and in Egypt. The process of diagnosis usually includes a survey of clinical data, radiologic assessment, and histopathologic evaluation of tissue. Noninvasive differentiation of histological subtypes is crucial for personalized management. While computed tomography is the standard for screening and staging, it lacks functional tissue characterization and carries increased risk of radiation exposure. This study aimed to analyze the relationship between pathological subtypes of lung cancer and diffusion-weighted imaging via the apparent diffusion coefficient (ADC) value. Results Small cell lung cancer (SCLC) exhibited significantly lower mean ADC values (0.62 ± 0.11 × 10-3 mm2/s) compared to nonsmall cell lung cancer (NSCLC) (0.99 ± 0.16 × 10-3 mm2/s) (P < 0.001). Among NSCLC subtypes, adenocarcinoma showed the highest ADC values (1.08 ± 0.13 × 10-3 mm2/s), followed by squamous cell carcinoma (0.84 ± 0.08 × 10-3 mm2/s). An ADC cut-off value of more than 0.786 × 10-3 mm2/s demonstrated 93.18% sensitivity and 100% specificity for distinguishing NSCLC from SCLC. Conclusion Diffusion-weighted imaging and ADC measurements provide quantitative biomarkers that effectively differentiate SCLC from NSCLC and help distinguish between NSCLC subtypes, serving as a valuable noninvasive adjunct to standard diagnostic workflows.
Objective To study the predictability of ratio of oxygen saturation (ROX) index for the need of mechanical ventilation (MV) in coronavirus disease 2019 pneumonia patients treated using high frequency nasal cannula (HFNC). Design A prospective observational study. Setting Isolation units of the Critical Care Medicine Department of Alexandria Main University Hospital during the period from January to December 2021. Patients We included only those who received HFNC early (<48 h) after admission. Patients and methods We calculated the ROX index at 1, 2, 6, 12, 24, 36, and 48 h following application of HFNC. Primary outcome was predicting MV after HFNC failure, while the secondary outcome was predicting 30-day mortality. Results A total of 107 patients were included. Successful HFNC was recorded in 60 patients, 47 patients needed MV, and 23 patients died. ROX index measured at the first four intervals predicted HFNC failure and need for MV with significant accuracy of 77–88%, sensitivity of 80–90%, and specificity of 76–87%, trending up with time. It could predict 30-day mortality with significant accuracy of 82–99.7%, sensitivity of 74–95%, and specificity of 60–94.2%. Conclusion ROX index, when calculated at multiple intervals as early as first hour after HFNC application, could predict need for MV and 30-day mortality with remarkable accuracy.
Background Otosclerosis is a primary osteodystrophic disorder of the otic capsule that leads to stapes fixation and conductive hearing loss. Both microscopic and endoscopic stapedotomy improve hearing outcomes, yet comparative data on intraoperative visibility and postoperative complications remain limited. Objective To compare audiological outcomes, intraoperative findings, and postoperative complications between endoscopic and microscopic stapedotomy. Patients and methods This prospective randomized study included 40 patients diagnosed with otosclerosis. Patients were randomly assigned to group A (endoscopic stapedotomy, n=20) or group B (microscopic stapedotomy, n=20). Demographic data, intraoperative observations, and postoperative outcomes were analyzed and compared using descriptive and statistical methods. Results The endoscopic approach offered superior visualization with minimal complications in both groups. Stapes footplate injury occurred in four microscopic cases, while one case of footplate subluxation and avulsion occurred endoscopically. Dizziness was similar in duration but shorter in the endoscopic group. One chorda tympani transection occurred in the endoscopic group, and postoperative dysgeusia affected 30% of patients in both groups, resolving within three months. Postoperative pain occurred only in the microscopic group. No cases of incus subluxation or facial paralysis were recorded. Both techniques produced significant postoperative improvement in air conduction thresholds and air-bone gap closure at all tested frequencies, with comparable hearing outcomes. Conclusion Endoscopic stapedotomy is a safe and effective alternative to the microscopic approach, offering enhanced visualization, comparable hearing results, and similar complication rates.
Background Lower respiratory tract infections are among the most common causes of fatality in children, particularly in critically ill patients in the PICU. Rapid and targeted antimicrobial therapy is crucial to improve their outcomes. The study aimed to assess the validity of the rapid molecular detection of respiratory pathogens using the Biofire FilmArray pneumonia panel plus. Methods This is a prospective observational study carried out in the pediatric intensive care of a tertiary hospital, including all mechanically ventilated pediatric patients with suspected pneumonia [either community-acquired pneumonia (CAP, or hospital-acquired pneumonia (HAP), or ventilator-associated pneumonia (VAP)] from September 2019 till August 2022. We compared the clinical and laboratory results across different types of pneumonia and the percentage agreement between the Biofire FilmArray pneumonia panel plus results and conventional microbiological results. Results In all, 157 pneumonia episodes were reported: 40.1% were CAP, 24.2% were HAP, and 35.7% were VAP. Viral pneumonia was the commonest among CAP and HAP (46.0, 42.0%, respectively), while combined bacterial and viral infection was the most common in VAP. Klebsiella pneumoniae (31.2%) was the most detected bacteria, and human rhino/enterovirus (39.1%) was the most common among viral etiology. Diagnostic accuracy testing of Biofire results revealed positive percent agreement (35.8%), negative percent agreement (99.9%), and an overall percent agreement of 97.1% with conventional microbiology. Conclusion The rapid molecular detection of respiratory pathogens causing pneumonia improves the yield of the diagnostic techniques and thus secures a timely and appropriate guide for the antimicrobial therapy.
Background Human papillomavirus (HPV) is a common sexually transmitted infection linked to cervical cancer, which ranks as the sixth or higher prevalent cancer among women aged 15-44 in Saudi Arabia. Although an effective HPV vaccine exists, uptake remains low. Objective To assess parental knowledge and acceptance of the HPV vaccine, barriers to vaccine uptake, and explore demographic and socioeconomic factors affecting HPV, HPV vaccine, and vaccination willingness. Patients and methods This cross-sectional, population-based study surveyed parents in Al-Baha city over two months. A self-administered electronic questionnaire was distributed via social media platforms. Descriptive statistics summarized demographics and knowledge regarding HPV. Associations between variables were analyzed using chi 2 and Fisher's exact tests, with statistical significance set at P less than 0.05. Results Among 398 eligible respondents, the majority were Saudi (98.2%), female (86.4%), and married (93.0%). Awareness about HPV and its vaccine was moderate, with 65.8% aware of HPV and 56.3% aware of the vaccine. Social media (81.7%) and doctors (15.2%) were key information sources. Knowledge of the vaccine was significantly higher among those with greater education, employment, and income (P < 0.001). Only 13.1% had vaccinated their children, but 43.9% expressed a willingness to do so. Barriers included lack of awareness (22.1%), ignorance about vaccine importance (16%), and vaccine safety worries (15.7%). Misconceptions were common; 18.8% believed HPV spreads through the blood, and 27.9% recognized the sexual transmission method. Conclusion While awareness is moderate, vaccine uptake in Al-Baha remains low due to knowledge gaps and limited guidance. Enhanced health education and official recommendations could improve vaccine acceptance.
Background There is ongoing controversy regarding the role of the hypertriglyceridemic-waist phenotype in coronavirus disease 2019 (COVID-19) morbidity and mortality outcomes. This study aimed to evaluate the association between HTGW phenotypes and the incidence of COVID-19. Patients and methods This study was conducted using data from the Yazd Health Study, a prospective cohort study involving a representative population of 9578 adults aged 20-70, which began in 2014. Data on demographics, blood pressure, anthropometric measurements, and biochemical variables were collected during the first phase (2014-2015) and again during the second wave (2022-2024), with annual follow-ups conducted on a yearly basis. The association between HTGW phenotypes and COVID-19 was analyzed using logistic regression in crude and multivariate models, utilizing SPSS, v20.0. Results In the study, 3673 participants - 1721 (46.8%) men and 1952 women (53.2%). There was a significant association between COVID-19, participants who had enlarged waist circumference (odds ratio=1.33, 95% confidence interval: 1.04-1.72) and HTGW (odds ratio=1.46, 95% confidence interval: 1.12-1.89), compared with someone who had normal waist circumference and normal triglyceride in total participants after adjustment for all potential cofounders. Also, the P value was significant (P=0.002). The same results were found in women, but not in men. Conclusion This study found a significant positive association between HTGW and COVID-19 in total participants and women. Addressing metabolic risks, particularly in adults, may help reduce the overall impact of COVID-19 and improve long-term health outcomes.
Tailgut cysts (or hamartomas) are rare congenital anomalies, typically occurring in females due to incomplete regression of the embryonic tailgut. While often asymptomatic, they can transform malignantly if untreated. Preoperative MRI plays a crucial role in diagnosis and determining the approach to the tumor. A complete excision ensures long-term disease-free survival, preventing recurrence and reducing malignancy risks. This study presents two successful surgical cases of tailgut cysts at Hanoi Medical University Hospital, accompanied by a literature review on their diagnosis and treatment. Case 1: a 50-year-old male presented with a 10-year history of constipation and flattened stools. MRI revealed a 9.5 & times; 7 cm cystic mass originating from the external anal sphincter at the 3 o'clock position, extending posteriorly to the left, traversing the levator ani at the 9 o'clock position, and reaching the S2 vertebra. The mass was excised laparoscopically via an abdominal and perineal approach. Case 2: a 49-year-old male was incidentally found to have a perineal cystic mass during a routine checkup. MRI showed a 2.5 & times; 2.5 cm cyst near the anus. The cyst was excised via a perineal approach. Histopathology confirmed benign tailgut cysts in both cases. Both patients recovered well with symptom resolution and no recurrence at 1-month follow-up. Both cases emphasize the crucial role of MRI in diagnosis and in selecting the optimal approach to the tumor (the relationship between the tumor and the levator ani muscle). Early detection and appropriate surgical intervention are key to preventing complications of tailgut cysts.
Purpose: This study evaluated acute toxicity, tumor response, and disease-free survival (DFS) between simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and sequential boost IMRT (SEQ-IMRT). Patients and methods: The research comprised 50 patients, split into two groups of 25, one receiving the SIB technique and the other the SEQ technique, with monitoring of acute toxicities and utilization of the European Organization for Research and Treatment of Cancer-translated QLQ-H and N 43 questionnaire to evaluate health-related quality of life during radiotherapy course, followed by a 12-month interval to assess tumor response and DFS duration. Results: Acute toxicity assessments indicated a preference for the SIB technique, with no statistically significant differences observed in various side effects during the initial weeks, except for mucositis at week two (P = 0.031). Evaluations from weeks 3 to 7 showed consistent nonsignificance for most parameters, while significant differences in xerostomia, weight loss, anorexia, and dermatitis were noted at specific intervals. A detailed analysis of QLQ-H and N 43 symptoms in head and neck cancer patients revealed minimal differences between SEQ and SIB at week 2, with significant variations favoring SIB emerging by weeks 5 and 7, reflected in P values below 0.001 across numerous parameters. All patients demonstrated a complete response at the 12-month follow-up, with no occurrences of local or distant recurrence. Conclusion: The SIB methodology reduces acute radiation toxicity and improves QOL during the radiotherapy course, but does not significantly affect tumor response or DFS.
Background: Preeclampsia is a systemic disorder characterized by new-onset hypertension and proteinuria after 20 weeks of pregnancy. Neurological involvement is one of the most serious complications, as it can lead to significant morbidity or even death if not recognized and treated properly on time. Objective: To evaluate the correlation between ultrasonographic optic nerve sheath diameter (ONSD) with neurological complications of severe preeclampsia before and after delivery. Patients and methods: This was a prospective observational repeated-measures cohort study of 30 parturients with severe preeclampsia undergoing cesarean delivery under spinal anesthesia. Systolic blood pressure, heart rate, ONSD, and presence of neurological complications were assessed just before delivery and at 12 h and 24 h after delivery, and initiation of ICU preeclampsia management protocol (magnesium sulphate and antihypertensive medications). Results: Mean ONSD before delivery was significantly higher than normal values. Both ONSD measurements and neurological complications showed significant improvement after delivery. ONSD showed a significant correlation with neurological complications of severe preeclampsia all through the study time points. Conclusion: Ultrasonographic measurement of ONSD provides a noninvasive, readily available tool for evaluation of cerebral involvement with neurological complications and raised intracranial pressure in preeclampsia as well as following up the severity of the disease and assessing the response to management.
Background The retro-sigmoid approach is a popular surgical method for excision of cerebellopontine angle tumors. The technique ensures appropriate exposure to the cerebellopontine angle while limiting brain retraction, preserving hearing, and allowing facial nerve detection. Nevertheless, one of the major disadvantages of this operation is facial nerve palsy. Objective To determine the frequency of facial nerve palsy after the retro-sigmoid approach for cerebellopontine angle tumors. Patients and methods This descriptive case series study was carried out at the Department of Neurosurgery, PIMS, Islamabad, for 6 months from August 10, 2022, to February 9, 2023. Patients aged 18-70 years of either sex diagnosed with cerebellopontine angle tumors were included. After taking informed written consent from all patients', the operative procedure (retro-sigmoid approach) was performed as per hospital protocols. Patients were kept and followed in the ward postoperatively till considered fit to be discharged and the stay period was recorded on the Performa. Patients and methods This descriptive case series study was carried out at the Department of Neurosurgery, PIMS, Islamabad, for 6 months from August 10, 2022, to February 9, 2023.Patients aged 18-70 years of either sex diagnosed with cerebellopontine angle tumors were included. After taking informed written consent from all patients', the operative procedure (retro-sigmoid approach) was performed as per hospital protocols. Patients were kept and followed in the ward postoperatively till considered fit to be discharged and the stay period was recorded on the Performa.ResultsOverall, 85 patients were studied, and out of these 37 (43.5%) were males while 48 (56.5%) were female patients, with an overall mean age of 49.48 +/- 9.59 years. Out of all 21.2% (18 cases) were found to have facial nerve palsy, while the majority, 78.8% (67 cases), did not present with this condition. Facial nerve palsy was significantly more common in patients over 50 years of age (P = 0.001) and was strongly associated with diabetes and hypertension (P = 0.001 for both). There was no significant association with sex (P = 0.655) or obesity (P >= 0.05). Conclusion The retro-sigmoid approach for cerebellopontine angle tumors is observed to be a safe, reliable, and effective technique with a low frequency of facial nerve palsy. However, a more careful consideration should be given, particularly to patients with diabetes and hypertension, to achieve optimal outcomes.
Background Inflammatory bowel disease (IBD) is a chronic condition characterized by immune-mediated inflammation of the gastrointestinal tract, which significantly impacts bone growth and bone mineral density (BMD). Objective This study aims to study BMD in pediatric patients with IBD. Patients and methods The study included 30 children diagnosed with IBD attending Pediatric gastroenterology department at El-Shatby Children's Hospital. BMD was assessed using dual-energy radiography absorptiometry scans of the lumbar spine, femur neck (FN), and total body less head (TBLH). Results Among the 30 IBD cases, there were 18 cases of Crohn's disease (CD) and 12 cases of ulcerative colitis. The mean age at diagnosis was 10.13 +/- 3.49 years. The median age at the time of the BMD scans was 12.25 (interquartile range, 10-14) years. Chronic diarrhea was the most common presenting symptoms in 76.7% of the cases followed by abdominal pain (63.3%) and bleeding per rectum (60%). The mean BMD Z score in cases at lumbar spine, FN, and TBLH were -1.29 +/- 1.03, -1.37 +/- 0.77 and -1.37 +/- 0.87, respectively. Low BMD Z scores (<-1) were observed in the highest prevalence at the lumbar spine level (76.6%) followed by the FN level (66.7%) and TBLH BMD (63.3%). Conclusion This study demonstrates a high prevalence of low BMD in children with IBD.
Purpose To compare the effects of preservative-containing versus preservative-free postoperative topical medications on lacrimal punctal anatomy and tear drainage function following uneventful phacoemulsification using anterior segment optical coherence tomography (AS-OCT). Patients and methods This prospective, randomized interventional study included 54 eyes undergoing uncomplicated phacoemulsification. Eyes were randomly allocated into two equal groups: group I received preservative-containing Levofloxacin 0.5% and Dexamethasone 0.1%, while group II received preservative-free formulations of the same medications. AS-OCT measurements of external punctal diameter, internal punctal diameter, and punctal depth were performed preoperatively and at 1 and 3 months postoperatively. Tear drainage function was assessed using the fluorescein dye disappearance test at the same time points. Results No statistically significant differences were found between the two groups regarding external punctal diameter, internal punctal diameter, or punctal depth at any postoperative interval (P > 0.05). Within-group analysis also demonstrated no significant changes in punctal parameters over time. Fluorescein dye disappearance test results remained normal (grades 0–1) in all cases throughout follow-up, with no significant intergroup or intragroup differences. Conclusion Short-term postoperative use of either preservative-containing or preservative-free antibiotic-steroid eye drops following phacoemulsification does not induce significant anatomical or functional changes in the lacrimal punctum. AS-OCT is a valuable, noninvasive modality for objective assessment of punctal morphology in postoperative cataract patients.
Background Parkinson’s disease (PD) is a neurodegenerative disorder causing progressive dopaminergic loss, oxidative stress, and mitochondrial dysfunction. Gum Arabic (GA), from Acacia senegal and Acacia seyal, is a potent antioxidant and anti-inflammatory product. We examined GA neuroprotection in the rotenone-induced rat model, examining motor performance, oxidative stress, and neuronal integrity. Materials and methods In all, 40 male Wistar rats were used: 10 in a pilot study and 30 in the main experiment (n = 6): group 1 (Rot+GA), group 2 (Rot+GA+L-DOPA), group 3 (Rot), group 4 (Rot+L-DOPA), and group 5 (Control). GA was administered for 4 weeks before rotenone. Rotenone was infused intrastriatally, and L-DOPA was administered after rotenone treatment. Motor performance was assessed using the rotarod, grip strength, and open-field tests. Superoxide dismutase activity and histopathology were conducted. Results Rotenone significantly impaired motor function (rotarod: 3.50 ± 0.55 s, P = 0.018). GA with L-DOPA improved motor outcomes (7.33 ± 8.69 s, P = 0.246) in rotarod and open-field tests. Rotenone-induced oxidative stress caused elevated superoxide dismutase activity (1565.75 ± 120.44 U/mg protein, P = 0.049), while GA attenuated this (1293.75 ± 154.62 U/mg protein, P = 0.221), although not statistically significant. GA reduced neuronal loss, indicating neuroprotective effects.
Background Accurate staging and response assessment are critical in the management of pancreatic cancer. This study evaluates the role of positron emission tomography/computed tomography (PET/CT) in initial staging, detection of occult metastases, assessment of treatment response, and postoperative follow-up. Patients and methods A total of 103 patients with pancreatic cancer who underwent FDG PET/CT between 2021 and 2023 were included in this retrospective analysis. Eighty patients were evaluated at initial presentation; 22 received neoadjuvant therapy and underwent pre- and post-treatment PET/CT assessment. An additional 23 postoperative patients were assessed for local recurrence and distant metastases. PET/CT results were correlated with histopathology, CT imaging, and clinical outcomes. Results Pancreatic adenocarcinoma was the most common diagnosis (85.4%), with the pancreatic head being the most frequently involved site (48.5%). PET/CT demonstrated high sensitivity for detecting primary tumors, with pathological FDG uptake in 98.8% of initial cases. A significant association was found between higher baseline SUVmax and metastatic disease (P=0.004). Following neoadjuvant therapy, metabolic response was significant (P=0.027), often preceding morphologic changes. Postoperative PET/CT identified local recurrence in 26.1% and distant metastases in 60.9% of patients. Conclusion FDG PET/CT is a respected complementary imaging tool in pancreatic cancer, enhancing initial staging, detecting occult metastases, guiding biopsy, evaluating treatment response, and distinguishing recurrence from postoperative changes.
