Latakia University Journal -Medical Sciences Series
The authors retain the copyright and grant the right to publish in the magazine for the first time with the transfer of the commercial right to Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Under a CC BY- NC-SA 04 license that allows others to share the work with of the work's authorship and initial publication in this journal. Authors can use a copy of their articles in their scientific activity, and on their scientific websites, provided that the place of publication is indicted in Tishreen University Journal for Research and Scientific Studies - Health Sciences Series . The Readers have the right to send, print and subscribe to the initial version of the article, and the title of Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Publisher journal uses a CC BY-NC-SA license which mean You are free to: Share — copy and redistribute the material in any medium or format Adapt — remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms. Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
LUNG CANCER: Radiological Characteristics with Multislice Computed Tomography Imaging (MSCT)
Background and objectives: CT has an important role in detecting primary bronchial carcinoma and differentiating it from other focal pulmonary lesions, in addition to its importance in detecting secondary metastasis, staging the tumor, and investigating tumor recurrence after treatment. Lung cancer is a common cause of death worldwide, so early and accurate diagnosis contributes to early and appropriate treatment. Subjects and Methods: This was an analytic study, included 57 patients (79% male, 21% female) in Tishreen University Hospital, Latakia, Syria. Patients underwent Multidetector Computed Tomography MDCT scan and comparison with pathology results. Results: We found soft tissue mass (88%), speculated heterogeneous mass with heterogeneous enhancement (45%), without calcifications in all cases. We detect cavitations in 18%, pleural tail in 29%, curvilinear opacity that extends toward the ipsilateral hilum (11%), and toward both pleura and hilum in 16%. The accuracy of MDCT was 96% compared to pathology.
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Preparation And In-Vitro Evaluation For Captopril Floating Capsules
Floating drug delivery system (FDDS) is the gastro retentive system that can remain in the stomach for many hours and can significantly prolong the gastric residence time of drugs. The aim of this study was to obtain controlled release floating capsules of captopril, as one of the most ACE inhibitor used to manage hypertension and congestive heart failure. Therefore we investigated the effect of three excepients (HPMCK4M, HPMC K100M, ethyl cellulose) on the floating time and release rate of the drug. The drug: polymer ratio used was (1/6). The prepared capsules have shown good flowability for more than eight hours. It was observed that as the molecular weight of HPMC increased the floating time and dug release decreased. However, mixing of different grades of HPMC improved the floating time and sustained drug release in compare with high viscosity polymer alone. The results revealed that EC could improve the floating time as well as the drug release. According to the findings of this investigation, the superior dissolution profiles achieved by mixing the three used polymers and the prepared capsules could float and prolong the drug release for 10 hours.
The dangers of randomized use of amino acids (creatine) among university students and athletes
This research provides an idea on the risk of creatine and nutrition supplements for athletes in particular and for university students in general to gain body build and muscle mass in a short time without knowing the risks and contamination of healthy and legally prohibited substances without a declaration by the manufacturer or the exporter about it , This was proved by a practical study on two hundred athletes and university students divided into two groups according to the dose taken daily from 10 Gr- 20 Gr for a 3- 6 months period with their body weight average 75 Kg, After the clinical and laboratory tests, it testifies the existence of risks for some of users on the liver functions 3% , kidney 3% in addition to hyphemia 3% , hyperpiesia 3% , some digestive symptoms 5% and dermal allergies 4%, The appearance of protein in the urine by 2% which is an important pathogen
The effects of smoking on cervical lesions observed by colposcopy
This study aimed to find out the effect of smoking on cervical endoscopic and cytological findings. To achieve the aim of the study، the researcher conducted his study in the Department of Obstetrics and Gynecology at Al-Assad University Hospital in Lattakia during the period between 01/03/2011 and 30/06/2012. The study included 170 patients، who underwent Pap smear and cervical magnoscopy to investigate the effect of smoking on cervical endoscopic and cytological findings. The results were compared between a sample of smokers، 85 patients، and a sample of control، ie non-smokers، 85 patients. The study reached several results: - As we found by comparison between the two groups that there was a difference in the percentage of abnormal endoscopic findings: Where the percentage was in the sample of smokers: (31.76%). While the percentage was in the sample of non-smokers: (18.82%). - It was also found that there was a difference between the two groups in the percentage of abnormal cellular findings: Where the percentage was in the sample of smokers: (27.16%). While this percentage in the sample of non-smokers was: (16.51%). This confirms the role of smoking in increasing cervical endoscopic and cellular abnormalities، with an emphasis on the importance of periodic smear detection and magnified cervical endoscopy.
Evaluation of Enhancements in Trabeculectomy Technique Using a Self-Regulating Valve for Glaucoma Treatment
This study aimed to evaluate an innovative trabeculectomy technique that utilizes an inverted scleral flap functioning as a self-regulating valve for the treatment of glaucoma. The study included 50 patients (40% male, 60% female) with a mean age of 62.7 years. This technique was developed to overcome the challenges associated with traditional trabeculectomy, such as scar formation, canal blockage, and infections, which lead to failure rates of 5-10% within the first year. The innovative valve operates as a one-way mechanism, allowing aqueous humor outflow when intraocular pressure (IOP) is elevated and automatically closing under low IOP, thereby reducing the risks of hypotony and infection. Preoperative evaluations included measuring visual acuity, assessing the anterior chamber using the Shaffer and Van Herick classifications, and conducting a fundus examination. Postoperative results demonstrated statistically significant improvements in the visual field (notable enhancement in Mean Deviation [MD] and Pattern Standard Deviation [PSD], p<0.05), as well as a reduction in the need for medications from an average of three drops before surgery to one drop after surgery. The results indicate that the use of the self-regulating valve represents a significant advancement in glaucoma surgery, demonstrating effectiveness in reducing intraocular pressure while minimizing common complications. However, further studies with larger sample sizes and longer follow-up durations are necessary to determine the long-term benefits and the impact of this technique on patients' quality of life.
Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-sa/4.0
The Relationship Between Mental Imagery and Learning Basic Volleyball Skills for Beginners
This study aimed to explore the relationship between the level of mental imagery and the learning of basic volleyball skills among beginner students in the College of Physical Education. To achieve this, a descriptive approach was utilized with a sample of 50 male freshmen who had not regularly practiced volleyball or any other sport. The level of mental imagery was assessed using a standardized questionnaire, while skill performance was evaluated by five specialized judges using a carefully designed evaluation form. The results revealed a positive correlation between the level of mental imagery and the learning of basic volleyball skills. Additionally, it was found that the group with a high degree of mental imagery demonstrated better learning outcomes in basic volleyball skills compared to the group with lower levels. These findings suggest that students with higher levels of mental imagery were more capable of learning and performing volleyball skills effectively than those with lower levels of mental imagery.
Orthopaedic Implants Failure At Environment Of Infection
This study included (93) cases of Orthopaedic implant failure: (65) ORIF and (28) prostheses at environment of infection. Infection created suitable conditions for the failure of the orthopedic implant through different mechanisms, the most important of which is bone resorption around the implant. Several factors contributed to the high rate of failure in conditions of infection related to the type of implant, its efficiency, the condition of the bone in which it was implanted, some incorrect surgical techniques, and the level of health awareness of the patient. The study showed the existence of a negative two-way reciprocal relationship between the failure of the orthopedic implant and the development of infection around it. The orthopedic implant that failed was removed in most cases, and in some special cases where keeping the implant was an urgent requirement, the implant was kept (14) cases with all the usual measures taken to treat infection. These cases were of mild degrees that were detected early in conditions of low-effective infection and a good immune status of the patient.
Assessment Of Dental Caries And Oral Health Care In Children And The Impact Of School On Them (Cross-sectional study)
Introduction: Dental caries remains the most prevalent disease among humans and is particularly common in children aged 5 to 17 years, according to World Health Organization statistics from 2022. Schools and communities play a significant role in public and dental health by reducing the spread of diseases through awareness and timely management. Objective of the Study: To assess the impact of schools (public and private) on the prevalence of dental caries and caries risk assessment, frequency of tooth brushing, and number of dental visits. Materials and Methods: This cross-sectional study included 370 children from public and private schools in the city of Latakia, aged between 6 and 10 years. Their teeth were examined to evaluate the prevalence of caries and caries risk assessment using the DMFT/dmft index. Additionally, a questionnaire was used to assess oral healthcare practices. Results: There were no statistically significant differences in the prevalence of dental caries, caries risk assessment, frequency of tooth brushing, or number of visits to the dentist between public and private schools. Conclusion: The current study found that whether a child attends a private or public school does not affect the prevalence of dental caries, caries risk assessment, oral health care practices.
Analytical Study of Percutaneous Ultrasound-guided Biopsies of Solid Pancreatic Lesions
Background: solid pancreatic lesions are important clinical problem in terms of the difficulty of establishing the correct diagnosis (benign or malignant), the high mortality rate associated with malignant lesions. This paper presents a descriptive analytical study of ultrasound-guided percutaneous biopsies in terms of histopathological results, complications, and some factors affecting of obtaining a clear qualitative diagnosis. Methods: the study include 10 patients diagnosed with solid pancreatic lesions who underwent percutaneous biopsy from patients attending Tishreen University Hospital from July 2023 to July 2024. Results: the histopathological results of biopsies were as follows: (7) cases of adenocarcinoma (70%), one case of metastases of well-differentiated tumor, one case of fibrosis with non-specific inflammation and one case with a result: (No malignancy in the studied sample). As for complication, there is one case of intraperitoneal hemorrhage (10%). The rate of obtaining a clear specific diagnosis was (80%) and the rate of non-specific diagnosis was (20%). The group with clear diagnosis had an older mean age (57.5 years) and a larger lesion size (mean maximum diameter 5.8 cm). Conclusion: the study shows the importance of ultrasound –guided percutaneous biopsy as an effective method to obtain a clear qualitative diagnosis of solid pancreatic lesions, with a major complication rate (10%) and no biopsy-related deaths. We encourage further studies about this method as an effective method with short procedure time, low cost and low major complication rate.
Risk Factors of Perinatal Asphyxia in the Newborns at Tishreen University Hospital, Latakia
Background: Perinatal Asphyxia is one of the major contributors to neonatal morbidity and mortality in developing countries with an incidence rate of 1.5/1000 live births. It is the third most common cause of neonatal death. Several studies reported that there is a predisposing risk factor to asphyxia either before or at birth. Objective: To identify the various causes that result in asphyxia among neonates at Tishreen University Hospital in Latakia. Methods: The current study is an observational-analytical case-control study carried out in the period 2022 and 2023 in the Neonatal Intensive Care Unit of Tishreen University Hospital in Latakia. Only those neonates who had an Apgar score at 5 minutes less than 7 were included in the case group, while neonates who had an Apgar score of 7 or more than 7 were included in the control group. Data collection was done through a study-specific questionnaire and detail clinical history of the mother and neonate. All data were entered and analyzed using SPSS_25. Results: Fifty-six neonates in total were prospectively divided into case and control groups. Multivariate analysis in this series identified the following as risk factors for perinatal asphyxia: meconium stained amniotic fluid, ( p=0.0001, 95% CI 2.2-8.9, RR 4.1); preterm rupture of membranes, (p=0.0001, 95%CI 1.3-10.7, RR 2.9); obstructed labor with vaginal delivery, (p=0.0001, 95%CI 1.4-9.5, RR 2.2). Conclusion: Factors that include meconium stained amniotic fluid, preterm rupture of membranes, and obstructed labour with a vaginal delivery include some of the risk factors associated with perinatal asphyxia. Knowing these factors is an important step in taking early preventive measures, improving the quality of perinatal care, and optimal preparation for high-risk births.
Effect of Statins Therapy on Renal Function and CRP Levels in Chronic Kidney Disease Patients
Persistent, low-grade inflammation with increased inflammatory markers, like C-reactive protein (CRP), is now considered a hallmark feature of CKD, being involved in the development of cardiovascular and all-cause mortality of these patients. In this study, we aimed to investigate the possible anti-inflammatory effects of statins and their effect on kidney function in predialysis (stage 3-4) and hemodialysis CKD patients. Seventy-four CKD patients seen at the department of kidney disease and hemodialysis of Tishreen Hospital in Lattakia, were assigned into two groups (a statin group (N=44), and a control group (N=30)). Patients in statin group received either 40 mg of atorvastatin or 10 mg of rosuvastatin daily for 6 months. Serum levels of C-reactive protein (CRP) and estimated glomerular filtration rate (eGFR) were measured in both groups at baseline and at the end of the follow period. The levels of lipid profile parameters were also measured. In statin group, mean serum CRP levels decreased significantly in predialysis (from 5.3±1.9 to 4.7±1.6 mg/l, P <0.001) and in hemodialysis patient (from 5.3±1.6 to 4.6±1.5 mg/l, P<0.001) after 6 months of treatment with statin. In control group, mean CRP values were not significantly changed at the end of 6 months follow up. Statin therapy prevented the regression of eGFR rate with non-significant change after 6 months follow up in both, predialysis and hemodialysis patient CKD, while in control group eGFR declined significantly, from 37.13±15.6 to 30.63±11.4 mL/min/1.73 m2, P=0.046 in predialysed patients and from 6.4±2.6 to 5.2±1.6 mL/min/1.73 m2, P=0.039 in hemodialysis patients, at the end of follow up period. The anti-inflammatory and renoprotective effects were independent of lipid-lowering effect observed with statin therapy. In conclusion, in addition to their beneficial effects on lipid levels, administration of statins could present an anti- inflammatory effect, with a consequential renoprotective effect in CKD patients.
Comparison of the efficacy of microneedling in the combination with platelet-rich plasma versus microneedling alone in treatment of striae distensae
Background: Striae distensae is considered one of the most common popular aesthetic problem especially among younger women. There are many therapeutic options for management, but no consistently effective modality is available yet. Aim: The purpose of this study was to evaluate the efficacy of combination of microneedling and platelet-rich plasma (PRP) versus microneedling alone in treatment of striae distensae. Materials and Methods: This was a randomized clinical trial (prospective) conducted for the period one year (2022-2023) in the clinic of dermatology at Tishreen University Hospital in Lattakia. The study included 19 patients with striae distensae who received treatment with microneedling alone and 19 patients who treated with microneedling and platelet-rich plasma(PRP), and final outcome was compared between two methods. Results: Out of 38 patients, 8 patients (21.1%%) were male and 30 patients (78.9%) were female, with mean age of the patients was 29.34±7.4 years. Striae alba represented the most frequent type of striae (73.7%) and the most affected parts of body were abdomen (31.6%), flank (18.4%) and popliteal fossa (15.8%). There were no significant differences between two groups regarding of demographic and clinical characteristics(p>0.05). Good response occurred in 47.9% of the patients in combination group versus 26.3% in microneedling group, p: 0.03. There was significant difference between two groups regarding of satisfaction, in which 63.2% of the patients in combination group were highly satisfied versus 47.3% in microneedling group, p:0.01. In addition to, there was no association between improvement and the following variables: gender, age, Fitzpatrick skin type, type of striae, and its location (p>0.05). Conclusion: The current study showed that microneedling with platelet-rich plasma appears to be effective in treating striae distensae.
Studying the Effect of Artichoke Bracts and Leaves Extracts on Glucose Tolerance in Experimental Animals
Artichoke (Cynara Scolymus) displays many medicinal properties such as antioxidant, anti-inflammatory, hepatoprotective and cholesterol-lowering properties. In addition, it is traditionally used to improve the function of the digestive system. These numerous effects are attributed to its content of phenolic compounds such as chlorogenic acid derivatives and cynarine. Phenolic compounds are known for their positive effect on sugar metabolism in the body and due to fact that the plant is rich of these compounds, this study aimed to investigate the effect of pretreatment with artichoke leaves and bracts extracts on glucose tolerance in experimental animals. We used previously prepared ethanolic extracts. The extracts were prepared by maceration and they are of known concentrations. Experimental animals were divided into three groups, mice were treated with either leaf extract at a dose of 1g/kg or bracts extract at a dose of 1g/kg or distilled water (normal control group) for seven days and then fasted on the last day for 16 hours before intraperitoneal injection of 10% glucose solution at a dose of 1.5g/kg. Blood glucose levels were measured before glucose injection and after 30, 60 and 120 minutes of glucose loading. The groups treated with artichoke leaf or bracts extract showed similar glucose tolerance to the normal control group and no statistically significant difference was observed in blood glucose levels between the three groups at the four mentioned time points. The reduction in blood glucose levels in leaves extract -treated group was higher compared to the control but without statistical significance difference.
Clinical Leadership Practice in the Clinical Environment Among Heads of Nursing Divisions
Chief Nursing Officers play an important role in providing ongoing clinical leadership and accountability for quality care and quality improvement efforts. Therefore, this leadership is critical to achieving high-quality nursing outcomes, and therefore enhancing clinical leadership among front-line nurses is critical due to its potential impact on patient outcomes and experiences, team performance outcomes, nurse job satisfaction and retention, and the quality and effectiveness of nursing care. Therefore, the aim of this research was to evaluate the level of clinical leadership practices in the clinical environment among heads of nursing divisions. This research was conducted at Tishreen University Hospital and the National Hospital in the city of Lattakia on a sample of 40 nursing department heads. The results of the research showed that the level of clinical leadership practices of the nursing department heads was high. It also showed that all aspects of clinical leadership were at a high level, except for the axis of establishing a shared vision, which came at middle level. Therefore, the research recommends conducting training programs for heads of nursing divisions in order to improve their clinical leadership practices with regard to establishing a common vision among the work team, and conducting further studies and research on clinical leadership on larger samples.
A New Approach to Managing Ciliary Body and Choroidal Detachment After Trabeculectomy Surgery
Choroidal detachment (CD) is defined as the abnormal presence of fluid or blood in the space above the choroidal detachment, which is the area between the ciliary body and the sclera, and it has two forms: serous and hemorrhagic. Serous choroidal detachment is one of the recurrent complications of glaucoma surgery. The causes of choroidal detachment, especially in the context of glaucoma surgery, involve various factors, including the disruption of the normal fluid dynamics within the eye, as well as surgical factors; traumatic surgical maneuvers inside the eye and the use of anti-scarring agents during glaucoma surgery can be responsible. We utilized a specific type of glaucoma surgery (inverted pericardial graft in minimally invasive glaucoma surgery). This study was conducted at the Eye Department of Tishreen University Hospital in Lattakia during 2022, and the sample included 10 patients aged between 20 and 78 years. The standard surgical procedure was performed with a male-to-female ratio of 50/50. The mean intraocular pressure in the sample before surgery was 32.05 mmHg, and we reduced the intraocular pressure to a mean of 18 ± 2 mmHg preoperatively using diuretics. The following factors were evaluated: intraocular pressure after surgery (with a mean of seven readings using the Goldman applanation tonometer recorded for 7 consecutive days after the sclerostomy was cut). We used B-scan ultrasound and clinical diagnosis to detect choroidal detachment. Among the ten patients, we identified 4 patients (40%) who suffered from choroidal detachment. The average time between sclerostomy and choroidal detachment was 2 ± 1 days. The intraocular pressure at the time of choroidal detachment was significantly low. Patients with choroidal detachment were treated with serum (saline and mixed solution). Steroids were administered from the first day, and post-surgery all patients received subconjunctival injections of gentamicin and dexamethasone immediately. All patients showed improvement within 7 days. Sodium plays an important role in the production of aqueous humor, as it stimulates the ciliary body through its secretion of aqueous humor, which is initially suppressed by anti-glaucoma medications before surgery. Additionally, glucose plays a supportive role in rejuvenating the ciliary body as it serves as a vital fuel for it. In conclusion, serum helps in the treatment of choroidal detachment, reduces the required treatment duration, and, in addition, can aid in better recovery. We suggest conducting future studies on the administration of mixed serum during surgery and its immediate effects in preventing choroidal detachment following sclerostomy.
Changes in Blood Glucose and Electrolytes (Na-K-CL) During Transurethral Resection of the Prostate Using Dextrose 5% Solution as Irrigation Fluid
Background: As it has been shown in many studies, the rareness of changes in sreum glucose and electrolytes by using dextrose 5% solution during TURP leads to considering it as a good option for using due to its effectiveness, low pric, and lack of significant effects causes by other solutions. Thus we can adopt it as basic solution during TURP. Objectives: the main objective: Studying the level of serum glucose and electrolytes and its effect on TURP. Evaluation of the chemical Analysis results before and after surgery. Secondary objective: Studying the correlation of patient's clinical condition with the results of chemical analysis Materials and methods: Statistical Study ( cross-sectional) The research sample included 100 patients with benign prostatic hyperplasia who attended the Urological Surgery Clinic at Tishreen University Hospital in Lattakia during the period between 2023-2024 and met the inclusion criterions in the research.The diagnosis of BPH was made clinically .Serum glucose was measured in the central laboratory at Tishreen University Hospital using a semi – automatic HUMAN device, using the colorimetric test method and electrolytes was measured using Urit 910 plus device Results: Patients' ages ranged from 49 to 82 years, with a mean of 63.93±7.2 years. The mean volume of the prostate before surgery was 56.27±4.9 gram, the mean number of irrigation units used was 14.74±3.2 liter, the mean duration of surgery was 58.80±7.9 minute. The mean level of glucose before surgery was 103.34±24.56 mg/dL. One hour after the end of surgery, it increased and reached 120.45±40.4 mg/dL, and after two hours it decreased again and reached 104.21±30.8 mg/dL with p-value=0.0001 The mean level of sodium before surgery was 139.22±3.5 mmol/L. One hour after the end of surgery it decreased and reached 137.94±3.9 mmol/L, after two hours it returned to the rise ​​and the mean was 138.65±3.6 mmol/L with p-value = 0.01. The mean level of potassium before surgery was 4.12±0.3 mmol/L. One hour after the end of surgery, it increased slightly and reached 4.23±0.4 mmol/L, and after two hours it decreased slightly and reached 4.16±0.3 mmol/L, with p-value=0.03. The mean chloride level before surgery was 100.51±2.18 mmol/L. One hour after the end of surgery, it increased slightly and reached 102.00±2.19 mmol/L, and after two hours it decreased slightly and reached 101.18±2.0 mmol/L, with p-value=0.04. None of our patients had TUR Syndrome. The mean values of ​​ glucose were high in the presence of diabetes and high blood pressure, with statistically significant differences at each follow-up time point with p-value<0.05. The mean values ​​of sodium were low in the presence of diabetes with statistically significant differences at each follow-up time point with p-value<0.05 The mean values ​​of potassium were high in the presence of diabetes and hyperlipidemia, with statistically significant differences at each follow-up time point with p-value<0.05. The mean values ​​of chloride were high in the presence of diabetes, pulmonary disease, as well as the presence of hyperlipidemia, with statistically significant differences at each follow-up time point with a p-value < 0.05 Conclusion: We propose the use of 5% dextrose solution as an irrigation fluid during surgery. We recommend controlling glucose concentration before surgery, especially in diabetic patients
Evaluation of the Short-Term Functional Outcomes of Total Hip Arthroplasty with Hip Osteoarthritis
The importance and justification of the research: Prevalence of hip osteoarthritis in people over 40 years old. Functional disorders caused by hip osteoarthritis, which may lead to permanent partial disability in some cases. The great development that has occurred in surgical techniques and artificial materials which contributed to improving the results of total hip arthroplasty. The Aim: The aim of this study is to improve functional outcomes in patients with hip osteoarthritis who underwent total hip arthroplasty (THA), and to evaluate the clinical and radiological outcomes. Also to reduce the complications, and to correlate the results with the type of surgical approach. Patients and methods: Between 2018 and 2021, An analytical comparative study (retrospective), was done on 57 patients with hip osteoarthritis who underwent total hip arthroplasty was evaluated for functional results. We compare these results using many variables: age, sex, type of artificial joint, body mass index (BMI), and functional state of the patient and hip before and after surgery using WOMAC index (Western Onterio and McMaster Universities Osteoarthritis Index) and followed up for more than 12 months and evaluate the complications at Tishreen University Hospital, Lattakia, Syria. Results: 57 patients underwent total hip arthroplasty (26M,31F) with mean age 61.24 years. 40.3% of the studied research sample was within the age group of 60-69 years old. 33.3% of the studied research sample was in the overweight category according to the body mass index. The posterior surgical approach was used in 68.8% of the studied research sample. There was a significant increase in the mean values of WOMAC index one year after surgery. There is a decrease in WOMAC values with increasing age, and an increase in the body mass index (BMI). The most common complications were bleeding and the need for blood transfusion 84.2%, followed by limb-length discrepancy (LLD) 15.85 ,infection 5.8%, fracture 3.5%. Recommendations and Suggestions: We recommend using sementless components in total hip arthroplasty, and reserve the use of cement components for patients of advanced age, less active patients, and cases of severe osteoporosis. We encourage patients to lose weight before and after surgery to improve clinical and functional outcomes.
Study of Serum C - Reactive Protein / Albumin Ratio and its Relationship with Activity and Treatment of Rheumatoid Arthritis
Background: Rheumatoid arthritis is a chronic systemic disease that primary target the synovium leading to synovial inflammation and proliferation loss of articular cartilage and erosion of juxta articular bone. Acute phase reactants increase in rheumatoid arthritis and albumin levels decrease. due to proinflammatory cytokines effects. It is important to find a noval and easier.predictive marker to evaluate the severity of rheumatoid arthritis so we study the correlation between car and das28esr. The main objective: To study the relationship between CAR and disease activity of rheumatoid arthritis by using DAS28ESR. Secondary objectives: the study of the realationship between CAR and the treatment of Rheumatoid Arthritis. 1. Find Cut off values for CAR by dividing RA patients into two groups Early and Eastablished RA and dividing each group of them into another two groups by using DAS28ESR. Methods: This was a cross sectional study.involved 60 patients with proven diagnosis of rheumatoid arthritis admitted at the department of rheumatology Tishreen University Hospital Lattakia during 2023- 2024 We study the relationship between c reactive protein and albumin using das28 esr the patients were classified in two groups according to the duration of disease.early and established to study the value of cut of for car Results and discussion: the current study of 60 patients with rheumatoid arthritis showed that the proportion of females with rheumatoid arthritis was higher than men with rheumatoid arthritis 2.8:1, 73.3% female. And showed strong significant relationship between car and das28esr and esr and strong negative relationship between.das28esr and albumin levels No relationship between car and the medication used to treat rheumatoid arthritis and between car and rheumatoid factor.
Clinical Investigation About Traumatic Dental Injuries in Lattakia – Syria
Introduction: Dental intrusion is an apical displacement of the tooth into the alveolar bone This injury is accompanied by extensive damage to periodontal ligament, cementum, disruption of the neurovascular supply to the pulp, and communication or fracture of the alveolar socket.. The main goal of this study is determine reasons, species, treatments of dental injuries and to estimate assess of complication related to dental injuries In patients of national hospital in Lattakia city-Syria. Methods: This study depends on clinical data of 146 patients (males & females) .96 patients have dental injuries.we depend on investigation papers to report each case. 65 males and 31 females were agitators of this study with ach from 1 to 14 years. RESULTS: From total cases 44% in primary teeth, the highiest frequently of dental injuries was seen in ach from 6 to 12 years. Males and females ratio was 1/1.7 Discussion: The most common dental injuries according to this study is loxations that was seen in the deciduous & permanent teeth (to gether in ratio 42%) beside to enamel fractions in ratio 24% in central superior insicors. Falling accidants were the main readons of dental injuries (94 % in deciduous teeth & 80 % in permanent teeth) The most common injuries in primary teeth is soft tissues injuries in ratio 57.3% whereas 48.4% in secondary teeth. For deciduous teeth most treatments were extractions whereas fixed dentures and pulp therapy in permanent teeth. Conclusion: most complications were pulp gangrene and pulp absess. Immediate treatment & right diagonosis are the most importat factores to incries the therapy ratio& decrease complications.
Postoperative The Efficacy of a Regular Loading Dose of Ticagrelor with a 100 units/kg Dose of Unfractionated Heparin on Reperfusion (According to TIMI Flow Sensor) in Patients with ST Elevation Myocardial Infraction
Background: Acute ST-segment elevation myocardial infarction (STEMI) is one of the most important causes of mortality around the globe. The disease occurs following acute thrombotic occlusion of an epicardial coronary artery. Timely reperfusion through primary percutaneous coronary intervention (PPCI) is the most important treatment to improve the prognosis of patients with STEMI Platelet activation, followed by aggregation, plays a key role in the process of STEMI. Administration of platelet P2Y12 inhibitors on top of aspirin before PPCI is considered an important therapeutic strategy that helps restores the perfusion to the ischemic area and prevents stent thrombosis . Objective: To study the effectiveness of ticagrelor at the usual loading dose with unfractionated heparin in improving reperfusion of the affected artery in patients with acute myocardial infarction with ST-segment elevation, compared with clopidogrel with heparin at the usual loading dose, according to the flow grade index (TIMI) calculated during coronary imaging, in addition to studying the effectiveness of ticagrelor in improving the ejection fraction after six weeks of percutaneous coronary intervention . Data Collection: Data regarding the baseline demographics comprising age, sex, history of hypertension (HTN), diabetes mellitus (DM), dyslipidemia (DLP), and current cigarette smoking were collected. Baseline angiographic variables included pain-to-wire time, culprit vessel, initial TIMI fow. Ejection fraction was calculated in all patients on admission and after six weeks. Methods: patients with acute STEMI in whom PPCI was indicated and consented to participate in the study were included. The diagnosis of acute STEMI was made according to the electrocardiograms prepared at admission to the emergency department . After STEMI was confrmed, patients were given a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg) based on the discretion of the interventional cardiologist in charge of PPCI and prepared for emergency angiography and angioplasty. A loading dose of 325 milligrams of aspirin was prescribed for all patients .
The relationship between blood transfusion and atrial fibrillation in patients undergoing coronary artery bypass surgery
Abstract: New-onset atrial fibrillation after cardiac surgery contributes to increased morbidity, length of hospital stay, and resource utilization. Although many aspects of atrial fibrillation after cardiac surgery have been elucidated, the mechanism by which cardiac surgery predisposes patients to atrial fibrillation has remained unknown. Recent evidence supports the idea that blood transfusion enhances the inflammatory response, thereby increasing the incidence of postoperative atrial fibrillation. Objectives: To determine the association of perioperative blood transfusion with atrial fibrillation, thus allowing strategies to be developed to reduce the incidence of this complication. Patients and Methods: The study included 69 patients who underwent isolated coronary artery bypass grafting during 2023. The males percentage was 75.4% and females 24.6%. Patients were divided into two groups: Group 1 received blood units and Group 2 did not receive any blood units. Blood was transfused when hematocrit values ​​fell in less than 26%, then the two groups were compared in terms of the occurrence of atrial fibrillation. Results: CABG surgery was performed using cardio-polmunary bypass for 59 patients (85.5%) and on beating heart for 10 patients (14.5%). Blood was transfused for 56 patients (81.2%), while the number of patients who did not need blood transfusion was 13 (18.8%). 12 patients developed Atrial fibrillation in Group 1 and 2 in Group 2 with (P value >0.05). Conclusions: Blood transfusion does not affect the incidence of atrial fibrillation after coronary artery bypass surgery.
Evaluation study on the effect of different irrigants on the cyclic fatigue of two rotary file systems
Aim : Compairing cyclic fatigue resistance for two rotary file systems : Smart file from ( Ora dental ) , Fanta af blue from ( FANTA dental ) Beside evaluating the effect of hypochloride and chlorhexidine on the resistance of cyclic fatigue for the rotary systems used Methods and materials :48 rotary file were used: Group : contains 24 file from ( ora dental ) the system called smart file with 0,25mm tip size and taper 6% Group (2) : contains 24 file from (Fanta dental ) the system called fanta af blue with 0,25mm tip size and 6% taper The sample were divided randomly into three new groups : control group : no immersion Hypochloride group : immersed in 0,5% hypochloride irrigation solution for 24 hours Chlorhexidine group : immersed 0,12% chlorhexidine irrigation solution for 24 hours After immersion PRUETT cyclic fatigue test was done and we count TTF and NCF Results : Irrigation solutions negatively affect the files cyclic fatigue , the effect was statistically significant( p<0.05). Hypochloride affects ora smart file more than Fanta af blue with statistically significant difference Chlorhexidine similarly affected both systems Conclusions :Both irrigation solutions negatively affect cyclic fatigue for both systems Fanta files had the advantage over ora files in NCF after immersion in hypochloride 0,5% for 24 hours
Postoperative Pulmonary Complications after Coronary Artery Bypass Graft Surgery (CABG)
Background: Coronary artery bypass grafting (CABG) is the most common surgical treatment for ischemic heart disease, first discovered in 1954. It has undergone significant advancements, particularly with the advent of angiographic imaging that allows for direct intervention on the affected vessels. As surgical techniques, anesthesia, and postoperative care have evolved, the characteristics of patients undergoing this surgery have changed to include elderly individuals, women, patients with left heart failure (reduced left ventricular contractility), and those with stable angina. Due to these variations in patient profiles, an increase in the incidence of postoperative complications, especially pulmonary complications, has been observed. Despite considerable progress in surgical techniques and postoperative care, further research is needed to investigate the incidence of these complications, their impact on recovery duration and mortality rates, and their relationship with studied risk factors. Objective: To study the prevalence of pulmonary complications following CABG and their relationship with preoperative, intraoperative, and postoperative risk factors, as well as to examine the impact of pulmonary complications on recovery duration. Methods: The study included a sample of 287 patients who underwent CABG at the Bassel Center for Heart Diseases and Surgery and Tishreen University Hospital in Latakia. Patients were monitored throughout their recovery period via clinical history taking, physical examinations, and documentation of medical history and risk factors before, during, and after surgery. Results: All patients developed one or more of the studied pulmonary complications. The most common complication was pleural effusion 79.5%, followed by pulmonary atelectasis 38.5% and pneumonia 10.1%. The incidence of respiratory failure was 5.7%, while pneumothorax occurred in 5.3%. Independent risk factors for developing these complications included: for pleural effusion—heart failure and bilateral thoracotomy; for pulmonary atelectasis—advanced age, diabetes mellitus, and prolonged surgery duration; for pneumonia—extended duration of surgery, mechanical ventilation, and hospital stay; for pneumothorax—COPD, bronchiectasis, and prolonged ventilation; and for respiratory failure—smoking and previous COPD history. Conclusion: This study highlights the prevalence of pulmonary complications following coronary artery bypass graft surgery, as well as identifying the risk factors associated with each complication. Understanding these relationships can contribute to improving preoperative assessment and postoperative care strategies, which may help reduce complications and enhance outcomes. Additionally, further research is needed to explore interventions that could decrease the occurrence of complications in high-risk patients.
Evaluation of adhesive residues after removing metal brackets attached to a zirconium surface treated by different methods
The aim of this study is to evaluate the adhesive residue index when removing metal orthodontic brackets attached to zirconium etched with a CO2 laser and by sandblasting. Materials and methods: The research sample consisted of 20 slices of zirconia (3Y_TZP) (Zyttria, Z401white translucent, concept ®, Italy) milled by (CAD_CAM) method. After milling, all zirconia samples were sintered, a layer of glazing ceramic was applied to all slices (Glazing). The sample was divided into two equal groups randomly. In the first group, the zirconia surface was treated with a carbon dioxide laser with settings (wavelength 10.6 um and power 4w), in the second group, the surface was treated by sandblasting with aluminum oxide particles of 50 microns and a pressure of 2.5 bar at a distance of 10 mm for 30 seconds. The surface was washed with abundant water spray and the surface was dried and then Z-prime plus primer was applied according to the manufacturer's instructions. It was applied to the surface and left to dry and then the steps of sticking the brackets were completed. Then all samples were removed by Tecnotest mechanical testing device and then the samples were examined and evaluated for the adhesive residue index. Results: Most of the bonding failure in the samples was concentrated in the area of ​​contact of the zirconium surface with the adhesive. Conclusions: The bonding forces (mechanical fixation) between the adhesive and the bracket base, and the internal bonding forces within the resin itself were greater Including between the resin and the zirconium surface
An In-vitro Comparative Study Of The Efficacy Of Two Preparation Techniques For Doing Nonsurgical Root Canal Retreatment
Aim:To compare the percentage of space occupied by residual root canal flling material after using HyFlexTMRemover preparation system and RECIPROC® system for non-surgical root canal retreatment. Materials and methods: 30 mandibular premolars underwent initial root canal treatment and filled using the hydraulic condensation technique then stored in an incubator with 100% humidity and a temperature of 370 for 30 days. The specimen were then removed from the incubator and randomly divided into two groups (N=15), then non-surgical retreatment was performed. Each specimen were cleaved into two longitudinal sections and photographed using a light microscope connected to a digital camera and then analyzed by the computer. Results:Significant differences (p-value >0.05) were found between the two groups. The mean percentage of the area occupied by remaining filling material was (7%) in the HyFlexTMRemover group which was 32.70% lower than RECIPROC® group which scored (11%). Conclusion:Within the limitations of this study, it can be concluded that using HyFlexTMRemover for non-surgical retreatment resulted in a more clean root canals regarding the amount of residual flling material compared to RECIPROC®.
Evaluation of the Effectiveness of the "Modified Frenectomy Technique with Papilla preservation flap" in Upper Lip Frenectomy Accompanied by Diastema Between central Incisors
Introduction: Cosmetic concerns among patients have led to an increased interest in seeking dental treatment in order to achieve an ideal smile. Diastema between central incisors is a common cosmetic problem that affects the functional aesthetics of teeth. Aim: looking for new technique for upper lip frenectomy for patients who suffer of diastema between upper central incisors and avoiding negative effects of the traditional technique. Material & Methods: 10 patients were treated by modified frenectomy and papilla preservation flap. Scar formation was observed after 3 months and pain was observed in the first week after surgery. Results: modified frenectomy and papilla preservation flap technique helped by avoided scar formation in region of between central incisor papilla in 9 patients of 10. Patients didn’t suffer from severe pain and its rate was 1.5 for the first day, 4.5 for third day and 0.7 for seventh day. Conclusion: modified frenectomy and papilla preservation flap technique is a good substitute for conventional technique and easy for work in cases of frenectomy with diastema between central incisors.
Comparison of cyanoacrylate adhesive and silk sutures in open flap debridement of periodontal pockets
Background: Sutures are the most commonly used method for closing wounds inside the mouth; however, the complications associated with them have prompted the search for new methods and materials. One of these materials that has shown promising results is tissue adhesive (cyanoacrylate). Objective: This research aims to compare tissue adhesive and traditional sutures in terms of healing and patient satisfaction after surgical treatment for periodontal pocket (open flap debridement). Materials and Methods: The study included 20 surgical sites in 10 adult patients (4 females and 6 males) from the Department of Periodontology at the Faculty of Dentistry, Tishreen University. A split-mouth technique was used, dividing each jaw into two equal halves. To compare the tissue adhesive group and the traditional suture group, healing indices and patient satisfaction scores were utilized. Results: The healing index results indicated a statistically significant difference between the two groups in both the inflammatory phase (after 5 days) and the proliferative phase (after 14 days), with the tissue adhesive group performing better. But in the remodeling phase (after 6 weeks), the results were similar between the two groups. there were differences in patient satisfaction scores between the adhesive and suture groups at the 5-day, 14-day, and 6-week intervals, favoring the tissue adhesive group. Conclusions: The study concluded that initial healing is better when using cyanoacrylate compared to silk sutures after flap closure during open flap debridement. particularly after 5 and 14 days, and that the use of tissue adhesive provides patients with greater satisfaction and less pain due to the absence of needle prick.
Evaluation of the effectiveness of local Tramadol in pain relieving following surgical removal of impacted lower third molars
Aim:To investigate the local analgesic and anesthetic effect of applying tramadol via injection during the surgical extraction of impacted lower third molars.. Material and methods: Study Type: A prospective, randomized, controlled, and blinded (to the patient) study. Study Sample: The research was conducted on 34 cases involving 17 patients who visited the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry, Tishreen University, and patients visiting the minor surgery and dental implant clinic at Tishreen University Hospital in Latakia. The patients' ages ranged between 18 and 25 years, and they required surgical extraction of bilateral, symmetrical impacted third molars. The study sample was divided into two groups using a dice method (experimental group and control group). Experimental Group: A local injection of 100 mg tramadol (50 mg vestibularly and 50 mg lingually for the impacted molar to be extracted) will be administered before the surgical procedure. Control Group: The surgery was performed in the conventional manner with an injection of physiological saline as a placebo and without any local analgesic measures. Conclusion: The local application of tramadol provides good analgesic results during the first hour after the surgical extraction of impacted lower third molars and is considered an effective method to reduce post-operative pain. The local application of tramadol in conjunction with lidocaine during the surgical extraction of impacted lower third molars increases the duration of anesthesia
Evaluating the Efficiency of Using the Alar Flap in Primary Repair of Complete Unilateral Cleft Lip
Objective of the Study: The study aims to provide an initial evaluation of the effectiveness of the nasal wing flap technique in the primary repair of unilateral complete cleft lip. Materials and Methods: The study included 10 patients (5 males and 5 females) aged between 3 to 6 months, who had not undergone any prior surgical intervention on the lip. The study aimed to assess lip and nasal symmetry 15 days and 6 months postoperatively. This small sample size was selected to conduct an exploratory study focusing on the clinical feasibility of the technique before conducting larger studies. Clinical monitoring involved taking frontal photographs of the patients to evaluate lip and nasal symmetry at 15 days and 6 months after the surgery. Results: The results showed an improvement in the height of the cutaneous lip 15 days after surgery, with the mean value of the difference in cutaneous lip height between the cleft and non-cleft sides being 15.10. This improvement persisted at 6 months postoperatively, with no statistically significant difference in the cutaneous lip height difference between 15 days and 6 months post-surgery (p-value > 0.05). The results also demonstrated vertical symmetry of the nasal wings 15 days after surgery, which was maintained at 6 months postoperatively. Conclusion: This preliminary study suggests that the nasal wing flap technique may be promising but requires further evaluation in future studies with larger sample sizes and longer follow-up periods.
In Vitro Evaluation of Shear Bond Strength with OrthGuide Computer-Aided Indirect Bonding Variables: Tray Design Versions and Composite Texture
Objective: This laboratory study aims to conduct a comparison between two indirect adhesive methods that share modern computer-assisted design and manufacturing with regard to measuring the ability of orthodontic brackets to resist shear forces applied to them during the treatment period , in addition to investigating the existence of a correlation between the quality of the adhesive used and its ability to reach the top resistant to the aforementioned forces. Materials and Methods: The research sample consisted of 60 newly extracted upper premolars that were distributed into 4 groups according to the method of designing the orthodontic bracket molds and the type of adhesive material used in them. American mini master 0.022 MBT brackets were affixed to all of them using 3D printed resin holders and trays of Thermally plasticized polyvinyl siloxane, using two types of light curing composites and dual curing ones. Then, the resistance of these adhesive brackets to shear forces was tested through a set of appropriate laboratory tests. Results: The results of this study showed that the greatest value of resistance to shear bond strength was in the group of brackets affixed via 3D printed resin holders and light cured composite, while there were no significant differences between the rest of the groups. Conclusions: Bonding metal orthodontic brackets using 3D-printed holders produced sufficient bond strengths to meet clinical needs. Also, brackets bonded to thermoplastic trays did not show adequate strength when it tested, even with the use of two types of adhesive materials in the study.