The RI of the renal artery at hilum significantly high in obstructive HN so, can be effectively used to distinguish obstructive from non-obstructive hydronephrosis.

Objective: To evaluate the surgical outcomes of endoscopic stapedectomy, comparing the results with a conventional stapes surgery under microscopic approach.Patients and Methods: This study was carried out in Otorhinolaryngology Head and Neck Surgery department of both Benha University Hospitals and Hearing & Speech Institute upon 30 patients divided into two groups, each consists of 15 patients, Group A underwent endoscopic stapedectomy, Group B underwent microscopic stapedectomy from June 2019 till March 2020 to evaluate the advantages of endoscopic stapedectomy in comparison to microscopic one.Results:We reported that 14 patients (93.3%) of the endoscopic group showed improvement in hearing, while only one patient (6.7%) complained of recurrent hearing impairment at the 6 th month follow up after lifting heavy object while hearing was very good at 1 st , and 3rd months follow up.All patients (100%) of the microscopic group showed improvement in hearing at 1 st , 3 rd and 6 th months post-operative with nearly closed ABG.Conclusion: Endoscopic surgery is particularly suitable for stapedial disease.Endoscopic stapes surgery can be performed despite a curved and narrow external auditory canal and is minimally invasive, being characterized by little drilling and almost no postoperative pain.

Background: Diabetic macular oedema (DME) is among the most prevalent vision problems, affecting about 21 million of the 93 million diabetic retinopathy patients. That work purposed to evaluate pre and post Anti-VEGF therapy response on DME by OCTA. Methods: That nonrandomized prospective comparative study was carried out on 40 eyes of 40 patients with diabetic retinopathy and macular oedema who were suitable for intravitreal anti-VEGF injection treatment, age between 18 to 70 years old. Results: There was significant improvement of the fovea (%) in the superficial capillary plexus measures after Anti-VEGF therapy (P < 0.05). There was a substantial linkage among patients' age and diabetes duration and superficial capillary plexus OCT readings prior to and following Anti-VEGF therapy (P < 0.05). Fovea (%) of the superficial capillary plexus (SCP) significantly improved after Anti-VEGF therapy in patients below 60 years (P <0.05), while there was no significant improvement in patients older than 60 years (P >0.05). Superficial capillary plexus Fovea (%) considerably improved following Anti-VEGF therapy in both patients with history of DM less and more than 10 years (P <0.05). Conclusions: OCT-Angio could be used to follow up patients of diabetes after single injection, especially foveal area at SCP level.

Objective: To evaluate the effectiveness of ab externo 360-degree suture trabeculectomy (ST) and deep sclerectomy (DS) in adults with primary open-angle glaucoma (POAG) in lowering intraocular pressure (IOP), lowering the number of antiglaucoma medicines needed, and reducing surgery and postsurgical problems. Patients and Methods: This research involved 20 eyes out of 20 cases with POAG classified into two equal groups according to surgical treatment modality. Group (1) performed an ab externo 360-degree suture trabeculotomy, and group (2) performed a deep sclerotomy. Visual acuities, gonioscopy, fundus examination, and fundus optical coherence tomography (OCT) were done. Results: Complete success was observed in 100%, 100%, 80%, and 70% in the ST group (1) in the first week, first month, third month, and sixth month, respectively, while it was 100%, 90%, 70%, and 60% in the DS group (2) in the first week, first month, third month, and sixth month, respectively. It was observed that failure occurred in only one instance (10%) in group (1) and in three instances (30%) in group (2) at the conclusion of the 6-month follow-up duration. Conclusion: The rate of success and IOP lowering was slightly better in the ab externo 360o suture trabeculotomy technique than the deep sclerectomy technique. Both techniques showed fewer complications; however, the complications were less in deep sclerectomy.

Background: Optical Coherence Tomography Angiography (OCTA) is a new, non-invasive imaging technique that generates angiography images in a matter of seconds and can detect posterior segment complications of high myopia. Objectives: Assessment of peripapillary changes in high myopia and to quantify vasculature parameters using Optical Coherence Tomography Angiography (OCTA) to determine the relation between retinal vasculature and peripapillary parameters in highly myopic eyes. Methods: This study is an observational cross-sectional study for high myopic patients, Study will include 130 eyes of 70 patients included 2 groups;group (A) of high myopic (N=100 eyes of 55 patients), group (B) (N=30 healthy eyes of 15 populations) of emmetropia. All patients were subjected to full ophthalmologic evaluation, AL measurement, OCTA and Fundus photo. Results : The results of the study revealed a statistically significant difference in the RNFL thickness (average, superior, inferior and nasal) (p value<0.001) in all but there was no statistically significant difference in temporal RNFL (p value=0.056). There was significant difference in (whole image, peripapillary, superior-hemi and inferior-hemi disc vessel density) between the cases of 2 study groups (P<0.001 in all), there was no significant correlation between superficial macular density and disc density (p=0.781), on the other hand; there was significant positive correlation between deep macular density and disc density (P=0.006) Conclusion: Eyes with high myopia have decrease macular and peripapillary perfusion in comparison with emmetropic eye. These vascular findings may raise the vulnerability to vascular associated eye disorders.

Background: Glaucoma is one of the leading causes that lead to blindness worldwide.Purpose: To compare the outcomes of sub-scleral trabeculectomy (SST) with subconjunctival Bevacizumab versus Mitomycin-C (MMC) in cases with bilateral primary open angle glaucoma (POAG).Study design: case series comparative study.Methods: We collected data from 60 eyes of 30 patients that were diagnosed as POAG and treated with SST and adjunctive therapy was used either with subconjunctival bevacizumab or topical intraoperative mitomycin-C, in the period from January 2021 to February 2022.We analyzed outcomes of this procedure as intraocular pressure (IOP), glaucoma medications reduction and bleb related complications.Results: The preoperative IOP improved significantly from 29.86±4.86mm Hg to 11.8±2.17mm Hg at 6th month and to 12.03±1.99mmHg at the last follow-up in the bevacizumab group, and from 31.3±4.03mm Hg to 10.8±2.24 mm Hg at 6th month and to 11.4±2.91 mm Hg after one year of follow-up in the MMC group.Both arms showed a significant decrease in the number of antiglaucoma eye drops used at 6 months compared with the preoperative data.In both groups, bleb show a horizontal extension of 2-3 hours, low to moderate height and mild to moderate vascularization.Conclusions: Trabeculectomy with adjunctive Bevacizumab is an effective and safe procedure in patients with POAG.The outcome of SST with MMC and with Bevacizumab was similar in lowering IOP.The complication rates were higher in MMC group than the Bevacizumab group.Bevacizumab is preferred in high risk bleb failure cases.

Clinical relevance Early detection of keratoconus (KC) progression and timing for retreatment. Background Q value (coefficient of corneal asphericity) reflects the shape of the cornea, its refractive power, and spherical aberration. In this study, we aimed to analyze the correlation between changes in Q value and progression of KC in children. Patients and methods In this retrospective cross-sectional study, clinical data of 18 eyes of nine children that were diagnosed as bilateral progressive KC (four boys, five girls: mean age of 11.3±1.6 years) were extracted from a Scheimpflug camera (Pentacam) for analysis before (baseline) and annually after bilateral transepithelial corneal collagen cross-linking (TE-CXL) up to 5 years of follow-up. Results At all follow-up visits up to 5 years, Kmax improved significantly (mean change at 5 years was 1.6 D) (P<0.001); uncorrected visual acuity and best-corrected visual acuity showed significant changes at all follow-up visits (P<0.001). In seven (38.8%) eyes, KC had progressed by more than 1.0 D by the last follow-up visit, despite corneal cross-linking. In the last visit, there was a significant negative correlation between mean Q value and Kmax in both 6 and 8 mm anterior corneal zones (Pearson correlation coefficient, r=−0.847, P<0.001, r=−0.605, P<0.001, respectively). Conclusion There is significant negative correlations between changes in corneal asphericity and progression of KC in children, which could be considered with other parameters in early detection of disease progression and timing for retreatment after transepithelial corneal collagen cross-linking.

Background: Diabetic retinopathy (DR) is one of the leading causes of visual impairment and blindness in patients aged 20-47 years. Clinically, DR has two stages: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). The aim of this work was to assess retinal microvasculature abnormalities in different stages of non-proliferative diabetic retinopathy using optical coherence tomography angiography. Methods: This cross-sectional case control study was carried out on 90 eyes of 55 subjects attending outpatient clinic of Ophthalmology department (35 of healthy non-diabetic, 15 of mild NPDR, 27 of moderate NPDR and 13 of severe NPDR). Results: At 3x3 size scan of OCTA, FAZ and PERIM were significantly more enlarged in case group compared to the control group (both p<0.001) however, superficial and deep VD% were significantly lower in case group compared to the control group (both p<0.001). There was a significant difference among the three subgroups (mild, moderate and severe) as regards FAZ, superficial and deep VD% (all p <0.001). Conclusions: OCT angiography can be effectively and efficiently used in diagnosis and follow up of non-proliferative diabetic retinopathy. In the presence of NPDR, OCTA shows progressive increase of FAZ area and reduction of VD in both superficial and deep plexus at increasing DR severity.

Background: Temporomandibular joint dislocation occurs when the condyle moves beyond the anterior surface of the articular eminence, stays locked, and is unable to reduce itself back to the original position in the glenoid fossa.Nonsurgical methods are preferred in management of TMJ dislocation.Aim: This study aims to compare between pericapsular injection of either platelet rich plasma or autologous blood for the management of recurrent dislocation of TMJ.Subjects and methods: Forty patients suffering from chronic recurrent TMJ dislocation were selected in this prospective cross-sectional study.Patients were divided into two groups: Group I for 20 patients who were treated by injection of autologous blood; 2 ml into the pericapsular tissues of the TMJ, and Group II for 20 patients were treated by injection of platelet rich plasma; 2 ml into the pericapsular tissues of the TMJ.Patients were evaluated as pain score and range of mandibular movements.Results:The mean age of patients was 30.2 years, 20% of patients were male and 80 % of patients were female.There is highly significant difference among studied groups as comparing preoperative and postoperative values after one or 3 months for pain assessment and lateral range of mouth opening.Conclusion: Both autologous blood and PRP are simple, low cost, and minimally invasive methods that allow a high concentrate of autologous growth factors in physiological proportions to be obtained from blood, which can be easily and safely injected directly into the TMJ.Higher levels of pain associated with whole blood injection.

The suitability of replacing Portland cement by dealuminated calcined kaolin as received waste obtained from an alum production factory through the extraction of aluminium, also by dealuminated samples treated with lime solution, is investigated. The chemical and mineralogical compositions of the samples are measured. Their pozzolanic reactivity and their surface areas were determined. The effect of replacement on setting time, flowability, rate of flowability loss and strength of mortars was tested and compared to control OPC samples and others containing silica fumes. It was found that the as received dealuminated kaolin and that treated with lime possess higher pozzolanic reactivity and show larger surface areas than silica fumes. The incorporation of the as received dealuminated kaolin (DK) in OPC paste accelerates the setting time; while the lime-treated samples lead to retardation. The flowability of the OPC mortar is little affected by the as received DK samples and is strongly reduced by the lime-treated one and silica fumes. The three admixtures cause strong flowability loss with time. The 56d-compressive and tensile strengths of the mortars improve with 5 and 10% OPC replacement by DK.

Purpose: The aim of this work is to investigate cases of recurrent visual loss and to verify its differential diagnosis with multiple sclerosis. Methods: Forty-three patients presented with recurrent visual loss were examined both ophthalmologically and systemically. Other diagnostic radiological, laboratory and ophthalmic tests were undertaken to verify the etiology of their recurrent visual loss, and to reach the proper diagnosis. Results: Among the 43 patients of recurrent visual loss, there were 20 cases diagnosed as having MS, 2 cases of Devic’s disease, 5 cases of Behcet’s syndrome, 6 cases of systemic lupus erythematosis, 2 cases of idiopathic vasculitis, 2 Sjogren syndrome, 2 cases of Antiphospholipid antibodies, 3 cases of retinal migraine, and one case of multiple cavernous hemangioma. Conclusion: Recurrent visual loss is a condition that needs the collaborative work of ophthalmologists and neurologists in order to reach the proper diagnosis and hence the proper treatment. (Egypt J. Neurol. Psychiat. Neurosurg., 2009, 46(1): 87-93)

This presentation is about the present hybrid fiber coax (HFC) network infrastructure and the incremental steps for increasing the bandwidth in HFC plant as the bandwidth demand increases due to new user applications.

In today’s intensely competitive market, service providers are faced with a number of challenges when determining how best to evolve and grow their networks.

This paper presents a new control approach for designing a coordinated controller for a synchronous generator excitation and static VAR compensator system. The objective is to extend the operational margins of stability, whilst satisfying control requirements by introducing an integrated multi- variable controller to control both the generator exciter and the firing angle of the thyristor-controlled reactor of TCR-FC compensator. The system dynamics are modelled in terms of measurable state variables and control inputs. This is achieved by using unbiased recursive least squares identification. On the basis of this identified model, the synthesis of a coordinated optimal controller is achieved by minimizing a quadratic performance index using dynamic programming techniques. This avoids the difficulties arising in coordination of static VAR compensator and synchronous generator. System behaviour under transient conditions is assessed by examining the response to three-phase short circuits, and dynamic transient stability boundaries. The results present comparisons of the system performance with different controllers, over a wide range of operating conditions and disturbances using a detailed non-linear simulation. It is shown the coordinated control arrangement can provide better stability, voltage control and damping than the other schemes.