Gamal Karrouf

Prevalence of and risk factors for low back pain among dentists.

[Purpose] The purpose of this study was to determine the prevalence, symptoms of, and risk factors for low back pain among dentists as well as to discover the possible correlation of these factors with working posture and how to reduce their prevalence. [Subjects and Methods] The study was conducted among 60 dentists (28 male and 32 female) with a mean age of 25.7u2005years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. [Results] The data showed a 70% incidence of back pain among dentists, with low back pain predominating in 47.6% of cases. Most of the subjects (90.5%) had a mild-to-moderate level of severity, and only 9.5% had a severe level of low back pain. The majority of the dentists (57%) treated 1–3 patients per day. Only a few dentists (17%) exercised during their rest period even though 57% of them reported taking a break during their working hours. Although 63% of the dentists were aware of the advantages of assistive tools, only 40% of them used any kind of assistive devices. [Conclusion] Dental professionals demonstrate a high prevalence of low back pain.

Surgical Management of Penile and Preputial Neoplasms in Equine with Special Reference to Partial Phallectomy

Penile and preputial neoplasia in horses occurs infrequently and represents diagnostic and therapeutic challenges. The present study was carried out on a total number of 21 equids (14 stallions and 7 donkeys) suffered from different penile and preputial neoplasia. Diagnosis of neoplasms was based up on history of the case, clinical examination as well as histopathological evaluation. Animals with penile and preputial neoplasms were underwent local excision and partial phallectomy with a slightly modified version of the techniques described by Williams. The diagnosed neoplasms were penile and preputial squamous cell carcinomas (SCCs; n = 15); sarcoid (n = 4); a-fibrosarcoma; and a melanoma. Local excision was curative in all cases except 5 stallions with SCCs. These stallions had extensive damage of the glans penis, free part of the penis and the inner lamina of the internal fold of the prepuce, and they underwent a partial phallectomy with successful outcome. Follow-up information was obtained by visit and telephone inquiries. In conclusion, penile and preputial neoplasms are commonly encountered in elderly male horses and SCCs are the most common type affecting male external genitalia. Partial phallectomy is effective for management of equine neoplasia if they are confined to the glans and body of the penis and there is no proximal spread or involvement to regional lymph nodes.

Assessment of digital flexors tenorrhaphy in equine: a review

Although all of the tendinous structures can be injured, the digital flexor tendons are commonly affected. The goals of tendon surgical reconstruction are to provide a strong anastomosis site, re-establish normal vascularization, restore the tendon microanatomy, functional length and minimize formation of restrictive adhesions that adversely affect the gliding function of the injured tendons. Various techniques of digital flexors tenorrhaphy have been described; either by different suture pattern, prosthetic materials, natural bio-absorbable materials, tendon transplantation and tendon shielding. This review highlights the recent assessment of different techniques used for digital flexors tenorrhaphy in equine and evaluation of the extent and quality of the digital flexor tendons healing and case prognosis after these surgical manoeuvres by ultrasonography, magnetic resonance imaging (MRI), biomechanical properties and histopathological examinations. It could be concluded that the use of preserved bio-absorbable augmentation devices either glycerolized bovine pericardium (GBP) xenograft, allograft and allograft shielding with GBP were a good alternative technique accelerating digital flexor tendons repair with restoring their biomechanical properties. Ultrasonography and MRI have provided accurate methods in monitoring the status of healing progression after tenorrhaphy in equine.

Boronic acid disk diffusion for the phenotypic detection of polymerase chain reaction-confirmed, carbapenem-resistant, gram-negative bacilli isolates.

BackgroundThe Middle East is regarded as a secondary reservoir for OXA-48 and New Delhi metallo-β-lactamase (NDM) carbapenemases. One of the main challenges in clinical microbiology diagnostics is the detection of carbapenemases. For this reason simple screening methods have been sought to detect carbapenemase producers to determine appropriate therapeutic measures and implement infection control interventions. The present study aimed to evaluate the efficacy of the modified Hodge test (MHT) and a boronic acid-based combined disk test using carbapenems as substrates for the phenotypic determination of OXA-48 and NDM type carbapenemases in 45 epidemiologically unrelated carbapenem-resistant clinical isolates of Klebsiella pneumoniae (13 isolates), Acinetobacter baumanii (20 isolates), and Pseudomonas aeruginosa (12 isolates).ResultsBoronic acid disk test using meropenem as substrate and 600 µg of 3- aminophenylboronic acid (APB) was the most sensitive method (83.33 %) for detection of OXA-48, while the most specific method was MHT (100 %). As regards NDM carbapenemase, boronic acid disk tests using imipenem and 600 µg of APB per disk, and meropenem with 300 or 600 µg of APB were the most xa0sensitive methods (87.50 %), while the most specific method was the MHT (100 %).ConclusionsThe results of the present study indicate that phenotypic screening with the MHT and the boronic acid disk test may be used to detect OXA-48 and NDM carbapenemases in Gram-negative bacilli clinical isolates, and that these tests can be easily applied in tertiary care settings with minimal infrastructure.

Ultrasonography of normal reticulum in 30 healthy buffalo (Bubalus bubalis)

Reticulum is incriminated in most cases of gastrointestinal disturbances in bovines and should be firstly examined. The aim of the present study was to assess ultrasonographic appearance and relation of reticulum to its surrounding in a normal buffalo (N = 30). Sonographic examination was performed in a standing nonsedated buffalo using 3.5-MHz convex transducer. B and M modes of display were used for examination. Reticulum appeared as a half-moon-shaped structure with a smooth contour; it could be easily accessed from the left and right ventral thoracic region than from midline. Biphasic contraction was recorded in all examined buffalo while only four animals had a triphasic contraction. Four to five contractions were recorded during a 4-minute examination period. The mean distance between reticulum and left abdominal wall was 1.603±0.566 cm. The duration of the first and second reticular contractions were 3.080±0.43 and 4.407±0.796 sec, respectively. However, the duration of relaxation interval was 42.63±3.187 sec. The amplitude of first contraction was 6.341±1.600 cm. In conclusion, reticular appearance and characters of reticular motility in buffalo is similar to that reported in cows, but reticulum was best accessed from left and right ventral thorax than from midline. M mode of display is an alternative tool for evaluation of reticular motility. The result of the present study could be used as a reference for reticular examination in a healthy buffalo.

Synergistic efficacy of tramadol and meloxicam on alleviation of pain and selected immunological variables after sciatic nerve ligation in rats

Abstract This study was performed for evaluation of the effect of pre-operative and post-operative administration of tramadol and meloxicam combination on hyperalgesia and selected inflammatory responses after sciatic nerve ligation in rats. An eighty male Wistar rats (Rattus norvegicus) were divided into two groups; preemptive analgesic group, in which the rats received analgesic agents 30 min before nerve ligation. Also the nociceptive pain tests were detected before surgery, 120 and 150 min post-analgesics injection. The serum IL-6 and PGE-2 concentrations were detected at 150 min post-analgesics injection. The second group was post-operative analgesic group; in which the rats exposed for the nerve ligation then the rats received analgesic agents at 5 till 11 day’s post-operative. Behavioral tests were performed before surgery and on each even days post-operatively. The serum concentration of IL-6 and PGE-2 was determined at 5, 10 and 14 days post-operative. Tramadol and meloxicam combination had a statistically significant (P < 0.05) reverse hyperalgesia while preemptive administration of tramadol and meloxicam significantly decreased (P < 0.05) serum IL-6 production compared to post-operative treatment. In conclusion, the preemptive combination of tramadol and meloxicam produced a potent analgesic effect post nerve ligation in rats.

Ameliorative effects of l-carnitine on rats raised on a diet supplemented with lead acetate

Lead intoxication has been a major health hazard in humans. It affects people at all ages. Its toxicity is associated with various organs of the body and affects different metabolic pathways. Based on histological data, l-carnitine reduced the severity of tissue damage produced as a result of exposure of rats to lead acetate. The main objective of this study was to evaluate the underlying mechanism of protection offered by l-carnitine against lead acetate intoxication using male Sprague–Dawley rats. Forty male Sprague–Dawley rats were randomly divided into four groups with ten rats in each. The first group (G1) served as the control group and animals received standard diet only. The second group (G2) received lead acetate in their diet. The third group (G3) was the l-carnitine treated group and received the normal standard diet supplemented with l-carnitine. While the fourth group (G4) had a diet supplemented with both lead acetate and l-carnitine. At the end of each experiment, blood (serum and whole blood) were collected from each animal and analyzed for the following parameters: serum testosterone levels, serum nitric oxide and serum malondialdehyde. This is in addition to looking at the enzymatic activities of two important enzymes (superoxide dismutase and catalase) and on (glutathione reductase) which are indicative of the antioxidant activities in the whole blood. The results indicated that l-carnitine will counteract the undesirable effects of lead intoxication. It exerted its antioxidant potential by reducing the production of ROS and scavenging free radicals by maintaining and protecting the level of the of antioxidant enzymes SOD, CAT and glutathione peroxidase. Conclusion:l-Carnitine may play an important role in reversing the undesirable effects of lead intoxication. Future studies should be conducted to see whether such an effect is applicable in humans exposed to lead poising.

Helical computed tomography scanning of the larynx and upper trachea in rabbits

BackgroundComputed tomography (CT) is used to evaluate the human tracheobronchial tree because of its unsurpassed ability to visualize the airway and surrounding structures. To establish an ideal animal model for studying subglottic stenosis, we assessed the size and morphology of the normal rabbit’s laryngotracheal airway by helical CT. We measured luminal dimensions at the levels of the arytenoid and cricoid cartilages and the first, third, and eighth tracheal rings. At all levels, the axial slices were used to calculate the maximum anteroposterior (AP) dimension, transverse dimension, and cross-sectional areas. We measured the tracheal length from the cricoid to the third and eighth tracheal rings on sagittal reformation. We assessed the hyoid, thyroid, cricoid, arytenoid, and tracheal rings for the presence of calcific or soft tissue densities. We also addressed the presence or absence of pre-epiglottic and paraglottic fat.ResultsThe mean AP tracheal dimensionxa0±xa0standard deviation (SD) was 8.6xa0±xa00.5xa0mm at the arytenoid level, 8.2xa0±xa00.7xa0mm at the cricoid level, and 7.7xa0±xa00.2xa0mm at the first tracheal ring level. The transverse tracheal dimensionxa0±SD was 5.3xa0±xa00.1xa0mm at the arytenoid level, 5.5xa0±xa00.5xa0mm at the cricoid level, and 6.1xa0±xa00.6xa0mm at the first tracheal ring level. The mean tracheal areaxa0±SD was 35.7xa0±xa02.2xa0mm2 at the arytenoid level, 35.8xa0±xa05.1xa0mm2 at the cricoid level, and 39.2xa0±xa04.3xa0mm2 at the first tracheal ring level. The tracheal lengthxa0±SD was 10.7xa0±xa02.3xa0mm from the cricoid to the third tracheal ring and 19.1xa0±xa01.14xa0mm to the eighth tracheal ring. There was complete calcification of the hyoid in all rabbits. Only two rabbits showed complete thyroid, arytenoid, or tracheal ring calcification. The remaining airway components were otherwise either uncalcified or partially calcified. The uvula, epiglottis, aryepiglottic fold, vallecula, piriform sinus, true/false vocal cords, and pre-epiglottic/paraglottic fat were not seen in any rabbit.ConclusionsHelical CT investigation provides good, highly definitive anatomic details of the larynx and trachea in rabbits. Such results may be used in further evaluation of the normal airway and in cases of subglottic stenosis.

Prosthetics and Techniques in Repair of Animal’s Abdominal Wall

The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.