Tishreen University Journal -Medical Sciences Series

Functional outcomes of total knee arthroplasty In patients with knee osteoarthritis

2023-12-04T14:18:35+00:00

Introduction: Osteoarthritis of the knee is the main cause of functional disability in the elderly, as pain and limited movement are among the main reasons for their decreased quality of life. Due to the progressive nature of the disease, many patients with osteoarthritis of the knee require surgical intervention, and the first goal of total knee arthroplasty is to relieve pain. Which is caused by severe degenerative inflammation.

Research objective: Improving functional outcomes for patients with knee osteoarthritis who underwent total joint arthroplasty by establishing a post-operative rehabilitation program and reducing complications occurring during and after surgery. Materials and methods: A cross-sectional study that included 38 patients (26 females, 12 males) who underwent total knee arthroplasty following advanced grades of osteoarthritis of the knee and with severe symptoms in the third and fourth grades, in the Orthopedic Surgery Department at Tishreen University Hospital in Lattakia during the time period 2021. -2019 Who met the criteria for inclusion in the research.

The ages of the research sample patients ranged from 55 to 75 years, with an average of 65.82±5.5 years.

Results: The number of females in our study was greater than the number of males. We note that osteoarthritis of the knee joint is common in the age group 66-75. Most of the patients in our study were overweight, with a total of 29 cases, at a rate of 76.3%, and the right side was the most affected, at a rate of 62.2%. Most of the patients in our study had grade 4 osteoarthritis at a rate 57.8%.

The results of the KFS functional score were excellent for the majority of patients, with a total of 28 cases. The results of the KCS clinical score were excellent for a larger percentage of patients, with a total of 37 cases. By comparing the results of the functional assessment with the clinical score, there were 38 cases according to the clinical score with excellent results and consistent with the functional score. In 28 cases.

The most common complication observed in patients was joint stiffness in 4 patients (8.9%), while anterior knee pain occurred in 3 patients (6.7%), superficial wound infection occurred in 2 patients, and one case of deep venous thrombosis (DVT) occurred. While no case of vehicle loosening was observed, no case of joint replacement was recorded.

By studying the relationship of the KSS index with the body mass index, it was revealed that there is a statistically significant relationship with p-value=0.001. We did not notice cases of excellent improvement with obesity, and the poor evaluation was found only with cases of obesity, which amounted to 66.7%.

Conclusion: We have found that total knee arthroplasty improves the patient's function and returns it almost to the condition it was in before the patient developed the degenerative disease; Which improves the quality of life, as the patient is able to move the joint without pain, as was shown by the Knee Clinical and Functional Score after surgery, and the KSS is an effective indicator that evaluates the clinical and functional results following total knee arthroplasty.

Study of cardiovascular manifestations in patients with rheumatoid arthritis

2023-12-12T08:22:16+00:00

Introduction: Cardiovascular manifestations are considered one of the most common extra-articular manifestations of rheumatoid arthritis, and they are one of the main causes of death in these patients. Therefore, it was necessary to shed light on these manifestations for the purpose of early diagnosis and management.

Research objective: To study the effects of rheumatoid arthritis on the cardiovascular system and shed light on the pathophysiological mechanisms of these manifestations.

Materials and methods: A cross-sectional study that included 52 cases (43 females, 9 males) of patients with rheumatoid arthritis who were referred and admitted to the Department of Joint Diseases at Tishreen University Hospital in Lattakia during the time period 2021-2022. Laboratory evaluation of inflammatory markers (CRP and ESR),ECG with 1-minute recording strip to evaluate heart rate variability ,and transthoracic echocardiography were performed for all study patients.

Results: The average age of the study patients was (51.84 ± 12.03) and the average duration of the disease was 6.5 years. The ECG was normal in 82.7% of patients. The most noticeable ECG changes in the study patients were T/ST changes in 15.3% patients, most of whom were asymptomatic. We also observed in ECG presence of QTc prolongation and decrease in heart rate variability consistent with the severity of inflammation.

42.3% of patients had a normal echocardiography, and the most common echo abnormalities seen were diastolic dysfunction at 51.9%, followed by mitral insufficiency at 23.1%, pericardial effusion at 17.3%,and aortic insufficiency at 13.5%.

Conclusion: We found in patients with rheumatoid arthritis electrographic changes that included prolongation of the QT interval values, decrease in heart rate variability, and the prevalence of ischemic changes in the ST segment and the T wave. We also found by echocardiography the prevalence of diastolic dysfunction, mitral and aortic insufficiency, as well as pericardial effusion.

Most of the cardiac injuries in the study patients were subclinical, and were associated with: the severity of the inflammatory activity, the age of the patient, and the duration of the rheumatoid arthritis .

Psychological compatibility and its relationship to the social status of orphan children

2023-12-10T11:30:05+00:00

The research aims to identify psychological compatibility and its relationship to the social status of orphan children.
The study was conducted on a sample of orphan children (12 children),who are in Orphanage in Lattakia, their ages range from 7 to 11.
The research used the descriptive method, and the general psychological compatibility questionnaire, designed by Ijlal Muhammad Seri(1986), and to know the nature of the relationship between psychological compatibility and social status, we used arithmetic averages and standard deviations, Pearson correlation coefficient, Wilcoxon test, and Mann-Winley test. The results showed that there were no differences in the psychological compatibility of orphan children aged (7-11) years according to the marital status variable, and there is a weak non-significant inverse correlation between psychological compatibility and marital status (missing one or both parents).

Position and Shape of the Mental Foramen in a Coastal Syrian population (Radiographic study by CBCT)

2023-12-04T15:20:46+00:00

Aim of the study: This study aimed to evaluate the position and the shape of the mental foramen radiographically by CBCT in a selected Coastal Syrian population, and to study the relation between these variables and individual factors (gender, age and side).

Materials and Methods: This Retrospective Radiographic study concluded 200 CBCT scans (104 Female, 96 Male), 400 hemimandibles were evaluated, The individuals were categorized into 3 Age groups: [20-35],[36-50],[51-65] ,CS 3D Imaging software was used to view the CBCT scans, then the statistical analysis was done by IBM SPSS Statistics 25.

Results: The most common position of the mental foramen was between the two premolars (52.61% prevalence percentage), followed by the position along the long axis of the second premolar (34.7% prevalence percentage), and the most common shape of the mental foramen was round (59% prevalence percentage), followed by horizontal oval shape (36.5% prevalence percentage).

Conclusions: Within the limitations of this study, it can be concluded that the age has an effect on the position of the mental foramen, The gender has no effect on the position and the shape of the mental foramen in the studied population.

( The comparison between transurethral resection of bladder tumor (TURB) and electrovaporization (TUVB) in terms of complications in Treatment of bladder tumor bigger than 2 cm)

2024-01-17T09:51:14+00:00

* The importance and justification of the research:

The importance of this study comes in proving the importance and effectiveness of transurethral vaporization of bladder tumors due to the benefits and advantages it provides, including better hemostasis, thus reducing the need for blood transfusion, reducing the recovery period, avoiding bladder perforation, reducing the volume of irrigation fluids, and a quick recovery time. Electrical vaporization of bladder tumors is characterized by reducing the high cost and complications associated with electrosurgical curettage treatment on the one hand, and the possibility of treating high-risk patients, especially those who take anticoagulant medications, on the other hand.

* The Aim:

Comparison between transurethral curettage of bladder tumors (TURB) and electrical vaporization of bladder tumors (TUVB) for the treatment of bladder tumors larger than 2 cm in terms of complications (bleeding, perforation, and TUR syndrome) at Tishreen University Hospital in the period 2022-2023.

* Patients and methods:

Study type: Randomized Clinical Trail Study (Prospective)1- Description StatisticalExpressing quantitative variables with measures of central tendency and measures of dispersion, and qualitative variables with frequencies and percentages.2- Inferential Statistical based on the laws of statisticsIndependent T student test to compare the means of two independent groups.Chi-square test to study the relationship between qualitative variables.The results are considered statistically significant with a p-value >0.05.Adopting the IBM SPSS statistics (Version20) program to calculate statistical coefficients and analyze the results.

• The research sample included 150 patients who were admitted to the Urology Department with a history of a bladder tumor at Tishreen University Hospital in Latakia during the time period extending between the years 2022-2023. Of them, 53 patients were excluded who had a bladder tumor smaller than 2 cm and did not meet the inclusion criteria. Of them, 97 patients were studied.The first group: Transurethral curettage of bladder tumors included 64 patients (65.9%).The second group: electrical vaporization of bladder tumors included 33 patients (34.1%). *Results:1_The incidence of bleeding that required a blood transfusion in electro-fumigation patients was (0%), while it was (14%) in curettage patients, where there was a significant statistical difference, as the value was:P-value=0.003 2_ The incidence of bladder perforation in electro-vaporization patients was (0%), while it was (7%) in curettage patients, where there was a significant statistical difference, as the value was:P-value=0.043_ As for curettage syndrome (TUR), it is a rare syndrome and has not been observed to occur during the surgical procedure, whether with curettage or electrical vaporization techniques.4_The results also show that the length of stay of the urinary catheter in fumigation patients ranged between (2-3) days, while in curettage patients it was between (4-6) days, with a statistically significant difference, as the P-value was 0.0001. The recovery period for fumigation patients after surgery was between (1-2) days, while for curettage patients it was between (2-4) days, with a statistically significant difference, as the P-value = 0.0001.When discussing the previous results, it becomes clear that postoperative complications in patients treated with the electrovaporation technique (TUVB) are significantly less than those in patients treated with the electrovaporization technique (TURB).The study confirms that the electrical fumigation technique is a safe and effective surgical technique with few complications, a lower economic cost, and a shorter recovery period than the electrical curettage technique.

*Recommendations and Suggestions:

It is recommended to use the electrical vaporization technique in the treatment of bladder tumors, as the electrical vaporization technique is characterized as a safe and effective technique in the treatment of bladder tumors. This technique provides a clear view of the surgical area, and this helps in avoiding complications and removing all tumor foci.

Electrovaporization reduces the length of stay of the urinary catheter and the duration of postoperative hospitalization and thus reduces the economic cost.

The role of laboratory evaluation of umbilical cord blood in diagnosing early onset neonatal sepsis

2024-01-16T10:25:27+00:00

Background: Early onset sepsis(EOS) remains a common disease in neonates admitted to neonatal intensive care unit(NICU) with poor outcome, especially in cases that associated with diagnostic delay.

Objective: The aim of this study was to evaluate the role of umbilical cord blood in diagnosis early onset neonatal sepsis.

Materials and Methods: An observational descriptive study (cross-sectional) was conducted for the period one year (May 2022–May 2023) at Tishreen University Hospital in Lattakia -Syria. The study included two groups of neonates were compared: group I consisted of 56 neonates with a proven diagnosis of EOS , whereas group II consisted of 66 neonates without EOS. Complete blood count(CBC) and C-reactive protein(CRP) were performed immediately after delivery on umbilical blood cord, and on peripheral blood samples after 24 hours with comparison values between two groups.

Results: The results showed that 45.9% of the study population had EOS . There were no significant differences in means of WBC, Neut, Lym, PLT and CRP values on umbilical cord blood analysis between two groups(p>0.05). In addition to , means of WBC ,Neut ,Lym, PLT and CRP values on peripheral blood samples between two groups were significantly different(group I versus group II);(30.57±16.1 versus20.52±19.5,p:0.003),(70.60±13.6 versus 55.46±9.2,p:0.0001), and (9.82±14.3 versus4.07±1.9,p:0.002) respectively without significant difference regarding PLT.

Conclusion: Analysis of CBC, CRP in umbilical cord blood samples immediately after delivery can't help in distinguishing neonates with EOS whereas WBC count, Neut, and CRP on peripheral blood were superior in diagnostic accuracy for EOS.

Determination of ascorbic acid in Navel and Valencia oranges content grown in syrian Lattakia city

2024-01-22T08:10:27+00:00

Vitamin C is one of the vitamins play vital roles for human health. Because human body is not able to make it, it is very necessary to get vitamin C from foods. Orange is one of the best sources of vitamin C.

However, vitamin C concentration in oranges may be affected by different factors.

The aim of this study was to determine ascorbic acid concentration in Navel and Valencia oranges grown in different areas in Lattakia city, during different stages of maturity and using two analytical methods.

The results obtained from this study showed that both of growth area and the stages of maturity had a statistically significant effect on ascorbic acid concentration in studied oranges, while the cultivation difference and the analytical method didn´t have any significant impact on its concentration.

Comparing the effect of disinfection using some vegetable oils and sodium hypochlorite on others Mechanical and physical properties of heat-treated acrylic

2024-01-19T16:04:39+00:00

Introduction: Disinfection of removable prosthetic dentures is essential for the success and continuity of these dentures, and the fact that the disinfection process prevents the patient carrying the removable prosthetic denture from contracting opportunistic mouth infections. The most prominent challenge in the home disinfection process for removable prosthetic dentures lies in using effective,biologically acceptable methods and have as little negative impact as possible on the structure and properties of the removable prosthetic denture.

Objective: Present a new method for disinfecting removable prosthetic dentures and to study whether this new method ,which is the use of tested essential plant oils, has a less negative effect on removable prosthetic dentures than sodium hypochlorite, which is the most widely and traditional disinfectant used in this field. Materials and methods: The study sample included 160 samples of heat-treated acrylic resins in the shape of rectangular cuboids with dimensions 3*10*30 mm. They were divided into four main groups, and each main group was divided into four sub-groups (A, B, C, D), of which the groups (B, C, D) were immersed for a period of (one month, 3 months, 6 months) in order in each disinfection solution (cinnamon oil 3%, rosemary oil 3%, garlic oil 3%, sodium hypochlorite 0.5%) This was for 20 minutes daily, and after completing the immersion in the disinfectant solution, each group of samples was washed, dried, and kept in distilled water, while group /A/ was immersed in distilled water. At the end of each time period, the weight of each of the tested groups was measured, then a shear test was conducted for 5 samples from the group, and tensile test for the other five samples.

Results: It was shown that the weight of the samples increased after immersion in all groups of solutions used as the immersion period increased, and the increase was the highest in group /D/. The highest increase was when using a sodium hypochlorite solution, followed by a rosemary solution, followed by a garlic oil solution, and finally when a cinnamon oil solution was used. .

No statistically significant differences were observed between the average values of tensile forces and shear forces separately between the groups in the four solutions or between the time groups in each solution separately.

Conclusions: There were no significant differences between the effect of immersion with the four solutions during the three time periods on the shear bond and tensile bond of the samples used.

Tested solutions of essential plant oils can be used to disinfect removable prosthetic dentures.

Evaluation of the reliability of periapical radiographs in determining working length in the context of endodontic treatment

2024-01-11T06:51:07+00:00

Aim: This research aims to evaluate the reliability of periapical radiographs in determining the working length of the root canal in the context of endodontic treatment

Materials and Methods: This study was designed as a laboratory radiological study. The research sample included 40 single-canal teeth with complete apex. The true working length was determined by inserting a file until it was seen from the apex with a magnifying glass at 2.5 magnification. Then, to take radiographs, the teeth were placed in a wax tray and the apical images of each tooth were taken. Limit after inserting the coolant until the top of the coolant is seen at the root apex

Results: It was observed that there were statistically significant differences in the average measurements between the periapical radiography and the actual length, as this method gave a higher average, and its average was 1.25% higher than the average true length of the root canal.

Conclusions: The study concluded that the reliability of periapical radiography in determining the working length is poor and the need to combine it with another method to determine the working length more accurately in the context of endodontic treatment.

Evaluating outcomes of percutaneous nephrolithotomy (PCNL)

2024-01-02T21:44:54+00:00

Objective: Urinary stone disease is the third most common urinary system disease. Laparoscopic surgery (PCNL) is one of methods of treating large kidney stones, which is less invasive than others. The aim of research is evaluating outcomes of percutaneous nephrolithotomy (PCNL)
Methods:The research sample consisted of (52) patients in the period between 1/8/2019 – 1/8/2021 at Tishreen University Hospital in Latakia. The patients were divided into two groups:1st group: The stone size 2 to 4 cm, 2nd group > 4 cm, Guy Score used to study location of the stone. Clavien dindo classification used to study complications of PCNL.
Results: The research included 52 patients .The stone-free rate reached 82.7% of sample, while 17.3% had residual stones (greater than 6 mm). Although the success rates were lower at a stone size larger than 4 cm compared to the other group (2-4 cm in size), there were no significant differences regarding the size of the stone and the result of the procedure .The percentage of complications was 21.1%.11.5% of them are primarily G1 and we have not observed any cases in the fourth and fifth grades Bleeding (5.7%), fever and urinary tract infection (3.9%).All patients with G1 and G2 complications were managed with appropriate conservative treatment, patients with G3 complications were treated by performing ureteroscopy and installing DJ ureteral catheterization with subsequent follow-up. The percentage of complications occurring according to the clavien dindo classification increased with increasing stone size, with p-value = 0.01. The percentage of complications occurring according to the clavien dindo classification also increased according to the location of the stone with increasing grade, with statistically significant differences with p-value = 0.0001.
Conclusion: The percutaneous endoscopic removal of large renal stones (PCNL) is an effective method with minimal trauma and complications.

A Chemical study of the thistle plant Tribulus terrestris L., widespread in the Hama countryside in Syria

2023-12-04T13:26:08+00:00

The aim of the current study is a chemical study on Tribulus terrestris: phytochemical screening was conducted on its’ various parts (leaves, flowers, fruits) to evaluate a few secondary metabolites, total phenol and flavonoid content assays. Extracts were prepared using established methods. Phenol content was quantified using Gallic acid (G.A) (500 Mcg/ml) using Folin-ciocaltu method, and flavonoid assay using Rutin (0.0161 mg/ml) using Aluminium trichloride method via spectrophotmeter. The screening revealed differences in the composition according to the used part, tannins, phenols, cardiac glycosides, and coumarin found in all parts, alkaloids detected in leaves, flavonoids and saponins in flowers and leaves, terpenoids were absent in all parts. Phenol content reached in flowers: 16.0034 mg equivalent to G.A/1g dry powder, leaves: 22.3434 mg/1g, fruits: 10.151 mg/1g. Whereas, flavonoid content reached in flowers: 0.024 mg equivalent to Rutin/1g dry powder, leaves: 0.0444 mg/1g, fruits: 0.00953 mg/1g.

Measurement of copper serum level in Acute Myocardial Infarction patients and comparing with CKmb and Troponin

2024-02-05T19:58:40+00:00

Background: Proving the presence of a significant increase in serum copper values in acute myocardial infarction patients and finding a relationship between high levels of copper and cardiac marker CKmb enables us to distinguish high risk acute myocardial infarction patients who need more stringent control of cardiac risk factors , intensive treatment , and close medical follow up .

Identifying the group of high risk patients enables us to make the decision to perform invasive interventions faster . .

Objectives: the main objective: Measuring the level of serum copper and CKmb in patients with acute myocardial infarction compared with normal people .

Secondary objective: Study of the relationship between the level of copper in serum and the level of CKmb in patients with acute myocardial infarction .

Materials and methods: Statistical study ( Case – Control ) , The research sample included 50 patients who were admitted to the emergency department at Tishreen University Hospital in Latakia within 12 hours of the appearance of clinical symptoms that indicate decreased myocardial ischemia during the time period between April 2022 – 2023 . The investigators included the research inclusion criteria .

A sample of 25 patients attending the hospital for other reasons was taken during the same time period , with the aim of comparing the serum copper level with them and studying the correlation between the serum copper level and CKmb .

The diagnosis of acute myocardial infarction was made by the doctors of the cardiology department at Tishreen University Hospital based on the clinical examination and symptoms , in addition to the results of the electrocardiogram and laboratory test values . Copper was also calibrated in the central laboratory at Tishreen University Hospital using the semi – automated HUMAN device using the colorimetric method , As for CKmb the calibration was done on automated devices in the hospital using the kinetic method .

Results: Serum copper values are higher in patients with acute myocardial infarction compared to normal people.

The value of serum copper in patients with acute myocardial infarction increases as the value of the cardiac marker CKmb increases

Conclusion: Measuring the level of serum copper in patients with acute myocardial infarction to help assess the severity of the injury and thus help speed up appropriate treatment procedures and prevent the occurrence of serious complications.

Further studies into the possibility of using copper chelators to reduce signs or slow the progression of ischemic heart disease .

Measurement of Zinc Serum Level In Acute Myocardial Infarction Patients and Comparing With CKmb and Troponin

2024-01-17T11:28:39+00:00

Background: Zinc is an important trace element that has been increasingly implicated in coronary artery disease. The study was designed to compare serum zinc levels in patients of coronary artery disease and healthy controls.

Methods: It was a prospective, case control study. A total of 100 participants were divided into healthy controls (n = 50), Ischemic subjects with myocardial infarction (n = 50) were included in the study. The serum zinc was analyzed by atomic absorption spectrophotometry.

Results: The mean age in the ischemic heart disease patients with infarction was comparable to the mean age of control group. Family history of ischemic heart disease and history of smoking were more common among disease as compared to controls.

Serum zinc levels were found to be significantly low in study group (71.64) as compared to control group (104.90) and remaining study groups showed insignificant

differences.

Conclusion: Decreased serum zinc levels are associated with coronary artery disease especially the

acute myocardial infarction.

Preparation and characterization of cefixime-loaded liposomes""

2023-07-22T14:05:19+00:00

This research aimed to prepare liposomes containing cefixime. The phospholipids forming liposomes envelopes were extracted locally from egg yolk. Cefixime was chosen as an active drug because of its anti-cancer properties, by inhibiting the biosynthesis of nucleic acids and proteins in cancer cells and by its binding to cellular DNA.

Liposomes were prepared by Bingham method (hydration of thin film) and they were homogeneous and almost spheric. The prepared liposomes were investigated for structure, particle size and encapsulation efficiency (EE). Different factores were studied (eg: cefixime and cholesterol quantites).

The dimensions ranged between 1and 50 microns and the EE_(s) were between 94 and 98%. An increase in the particles size and EE was observed by increasing cholesterol and cefixime quantities (p < 0.05). However when the amount of cefixime was reduced, the EE was reduced (p > 0.05).

Comparing radiographic changes associated with fixed retainer and bisphosphonate (zoledronic acid) injection for retention after fixed orthodontic treatment.

2024-02-06T03:32:44+00:00

Relapse is considered one of the most common problems after completing orthodontic treatment for both the patient and the doctor, and it usually occurs in the lower jaw more than the upper jaw, especially in the anterior region. Therefore, research has recently increase aiming to find a technique that has less relapse, more effectiveness, and more accepted by the patient.

Objective: Evaluation of radiographic changes associated with retention by bisphosphonate injection compared with cemented permanent lingual retainer.

Materials and methods: The research sample consisted of 8 patients who had completed fixed orthodontic treatment. They were divided into two groups; each group consisted of 4 patients, the first group had a lingual fixed retainer, and the second group was injected with zoledronic acid for retention.

Results: The results of the current study showed that there were no significant differences regarding the angle formed between the axis of the right and left lower incisors for both methods.

Conclusion: There is no difference in the rate of relapse between retention using a fixed retainer and retention using bisphosphonate injection.

Obstacles facing the application of physical education in schools in Lattakia Governorate

2024-01-02T00:17:30+00:00

The research aimed to identify the differences in the obstacles to the application of physical education and sports in the schools of Lattakia Governorate from the point of view of some of those in charge of the educational process according to the gender variable. It also aimed to identify the differences in the obstacles to implementing physical education and sports in schools in Lattakia Governorate depending on the workplace variable, The study was conducted in some schools in Latakia Governorate through a questionnaire that was distributed to a sample of (8) counselors and (400) teachers and schools from the research community who were selected by a random stratified method, The descriptive approach was used using the survey method due to its suitability to the nature and requirements of the research, and to identify the differences in the obstacles to the application of physical education and sports, we used mathematical methods and standard deviations. Pearson correlation coefficient, Sieberman-Brown correction factor, Mann-Whitney test, and Kruskal and Liss test, according to the results, there are no differences in the obstacles related to financial capabilities and the curriculum for implementing physical education and sports in schools in Lattakia Governorate according to the gender variable, and there are no differences according to the work variable.

Evaluation for Color Matching of Single Shade and Multi Shade Composite with Enamel before and after Home Bleaching (A Comparative In-vitro Study)

2024-01-15T08:44:34+00:00

Objective: To investigate the effect of home bleaching on color matching between two type of dental restoration materials and the adjacent tooth structure.

Material and Methods: 40 intact premolars were used. After preparation, the teeth were restored with single shade composite resin (Group A), and conventional composite resin (Group B) (n=20). After that, the bleaching process was performed for 14 days. The color matching was investigated before and after the bleaching process. Paired t-test was employed to compare the color of the intact tooth and the dental restoration before and after the bleaching processes. The level of significance was set at 5%.

Results: The specimens restored with conventional composite resin exhibited a significant change in color matching after home bleaching (P < 0.05). However, non-significant reduction in color matching observed in specimens restored with single shade composite resin (P > 0.05).

Conclusion: The home bleaching processes had a significant effect on the discoloration of the conventional dental restoration; however, the application of single shade composite resin improved the tooth composite color-match after home bleaching.

مُعيقات الإرضاع الوالدي الحصري لدى الأمّهات خلال الشهور الستّة الأولى من عمر الرضيع

2024-02-09T15:03:14+00:00

مُقَدِّمة

يُوصَف الإرضاع الوالدي بأنّه هديّة من الأم لطفلها، فهو يوفّر أفضلَ بدايةٍ ممكنة في الحياة؛ حيث يقدّم فوائد صحّية وغذائية وعاطفية لكلٍّ من الأطفال والأمّهات، كما يوفّر مصدراً غذائيّاً كاملاً، مُناسِباً وآمِناً للرضّع، ويعزّز بقاءَ الطفل ورفاهَه، بالإضافة إلى ذلك يوفّر حليب الثدي المُغذّيات والمعادنَ الكافية، يعزّز مناعة حديثيّ الولادة، يحسّن النموّ المعرفي والنفسي، ويحمي الطفل من الإصابة بالأمراض، كما أنّ الأمّهات اللواتي يُرضِعنَ إرضاعاً والديّاً ويستمرَّينَ فيه حتى مدّة شهر واحد فقط لديهنّ خطرَ أقل للإصابة بالنزيف المُميت بعد الولادة، وخطر الإصابة بسرطانيّ الثدي والمبيض وفقر الدم، وتكون لديهنّ نوعية حياة أفضل من اللواتي لا يفعَلن، لِذا، توصي منظّمة الصحّة العالميّة أن يتمّ إرضاع الطفل إرضاعاً والديّاً حصرياً خلال الشهور الستّة الأولى من حياته.

تحتاج الأمّهات إلى الدعم لبدء الإرضاع الوالدي واستمراره، ويجب على المتخصّصين في الرّعاية الصحّية من ضمنهم الممرّضون معالجة العوامل النفسية والاجتماعية القابلة للتعديل لمنع الإيقاف المُبكر للإرضاع الوالدي، ويمكن أن يؤدّي تحسين الوصول للاستشارة المُثلى إلى إطالة مدّة الإرضاع الوالدي الحصري وتعزيزه، فكلّما كان تلقّي الرّضيع لحليب الثدي أطول وأكثر حصريّةً خلال الشهور الستّة الأولى من عمره زادت الفوائد الصحّية المُتاحة له.

هدف البحث:

هدفَ هذا البحث إلى تحديد مُعيقات الإرضاع الوالدي الحصري لدى الأمّهات خلال الشهور الستّة الأولى من عمر الرضيع.

مواد وطرائِق البحث:

تصميم البحث: اتّبَعَ هذا البحث المنهجَ الوصفي.

مكان البحث: أُجريَ هذا البحث في المراكز الصحّية التالية: مركز الشهيد عدنان عابدين، مركز الشهيد حسن زوان، ومركز الشهيد نوّار يوسف التابعة لمديريّة الصحّة باللاذقيّة.

زمن البحث: تمّ جمع البيانات من أفراد العيّنة في الفترة الزمنيّة الواقعة بين 1\8\2022 و 31\8\2023

عيّنة البحث: تمَّ اختيار عيّنة مؤلّفة من 003 أُمّ، حيث تمَّ أخذ 100 أُمّ من كلّ مركز صحّي وذلك بطريقة العيّنة المُتاحة ممّن تتوفّر فيهنّ الشروط التالية:

لم تمضِ 6 شهور على ولادتهنّ ولا يُرضعن إرضاعاً والديّاً حصريّاً.
قادرات على التواصل اللفظي.
راغِبات بالمُشاركة في الدراسة.

أداة البحث: تمّ جمع بيانات هذه الدراسة باستخدام أداة وحيدة تحوي الأجزاء الثلاثة التّالية:

الجزء الأول: المعلومات الديموغرافية والاجتماعية للأمّهات الّذي تمّ تطويرُه من قِبَل الباحثة، ويتضمّن: (العمر، المستوى التعليمي، المستوى الاقتصادي، العمل، ترتيب الطفل الحالي، طريقة الولادة،…)

الجزء الثاني: مُمارَسات الأمّهات المتعلّقة بتغذية أطفالهنّ، تمّ تطويرها من قِبَل الباحثة بعد مراجعة الأدبيّات ذات الصلة بموضوع البحث.

الجزء الثالث: استبيان مُعيقات الإرضاع الوالدي الحصري لدى الأمّهات، وهو استبيان تمّ تطويره من قِبَل (Thomas J. 2016)، الذي يتألّف من 21 بنداً ومن هذه المُعيقات (عدم إنتاج/ كفاية حليب الثدي، التعب والإجهاد، عدم توفّر الوقت الكافي، العمل، مشاكل في حلمتيّ الثدي، ضعف إطباق شفتَيّ الرضيع،...)، قامَت الباحثة بترجمته إلى اللُّغة العربية وتألَّفَ من 35 بنداً بعد إجراء بعض التعديلات عليه بما يتلاءَم مع موضوع البحث، وإضافة بنود جديدة مثل (استخدام اللهّاية، الحمل، التدخين،...)، وتمّت الإجابة على كلّ منها بـ(نعم 0 أو لا1 ). ⁽⁴⁷⁾

طرائق البحث:

تمّ طلب الموافَقات اللازمة من إدارة جامعة تشرين والمراكز الصحّية المذكورة سابقاً.
قامت الباحثة بتطوير الجزأين الأوّل (المعلومات الديموغرافية والاجتماعية للأمّهات)، والثاني (مُمارَسات الأمّهات المتعلّقة بتغذية أطفالهنّ) من أداة البحث.
تمّت ترجمة الجزء الثالث من الاستبيان (مُعيقات الإرضاع الوالدي الحصري لدى الأمّهات) من قِبَل الباحثة وإجراء التعديلات اللازمة بعد مُراجعة الأدبيّات ذات الصلة بموضوع البحث.
تمّ التأكّد من وضوح أداة البحث ومُلاءَمة أسئلتِها لموضوع البحث، وذلك بعرضِها على لجنة من الخُبَراء في كلّية التمريض.
تمّ الحصول على الموافَقات الشفهيّة من أفراد العيّنة بعد شرح الهدف من الدراسة وضمان سرّيّة المعلومات لهم.
قامَت الباحثة بمُقابلة أفراد العيّنة كلّ على حِدة وطرحِ أسئلة الاستبيان عليهم لجمع البيانات، واستغرَقَ مَلء الاستبيان 10-51 دقيقة.
تمّ إجراء دراسة دليليّة استرشادية Pilot Study)) على 10٪ من مُجتَمع الدراسة (30 أُمّ) واستبعادُهم من البحث، والتأكد من موثوقيّة وثبات أداة البحث باستخدام مُعامل ألفا كرونباخ، وتبيّن أنّها قابلة للتطبيق وكانت درجة الثبات 79.
تمّ تحليل البيانات وفقَ برنامج SPSS الإصدار 25، وعرض النتائج ضمن جداول وأشكال بيانيّة.

النتائج الرئيسة للدراسة:

أظهرَت دراستُنا الحاليّة وجودَ مُعيقاتٍ للإرضاع الوالدي الحصري متعلّقة بالرّضيع، وكان المُعيق الأبرز رفض الرضيع للثدي وحدوث الفطام الذاتي لدى (10.34٪) من الأمّهات وذلك نتيجةً لعدم وجود حليب في الثدي، ثمّ انفصال الرضيع عن أمّه لأسباب مرَضيّة لديه أوّلها وجوده في الحاضنة لدى (9.7٪) من الأمّهات، تلاه بكاؤه المستمر حتى بعد إرضاعِه من الثدي لدى (9٪) من الأمّهات، ثمّ عدم زيادة وزنه لدى (7.3٪) من الأمّهات، يليه اعتياد الرضيع الحليب الصناعي لدى (6٪) من الأمّهات، والحمل التوءَمي لدى (4.33٪) منهنّ.

وجَدَت أيضاً مُعيقاتٍ للإرضاع الوالدي الحصري متعلّقة بالأم، وكان المُعيق الأبرز عدم إنتاج/ كفاية حليب الثدي نتيجةً لأسباب عضويّة أو مجهولة السبب لدى (15٪) من الأمّهات، تلاه وجود اضطرابات نفسيّة لدى الأم مثل (اكتئاب ما بعد الولادة) أدّت لعدم إنتاج / كفاية حليب الثدي لدى (13.3٪) من الأمّهات، ثم وجود مشاكل في حلمتيّ الثدي (ألم، تشقّقات، غؤور، نزّ دموي) لدى (9.3٪) من الأمّهات، يليه ابتعاد الأم عن رضيعِها لأسباب مرَضيّة لديها عند (7.7٪) من الأمّهات، ثمّ التعب والإجهاد لدى (5٪) منهنّ.

كانت هناك مُعيقاتٌ إضافيّة للإرضاع الوالدي الحصري متعلّقة بالأم كان نصفها اعتقاد الأم أنّ حليبها خفيف القوام لا يُشبِع الرّضيع والبقيّة توزّعت بين حدوث سوابق ولادة مبكرة لدى (14.28٪)، وجود قثطرة قلبيّة وانسمام حملي لدى الأم، قلّة نومها، نقص تناولها للطعام، ظهور طفح جلدي لديها، وعدم محاولتها الإرضاع الوالدي بعد اعتياد الرضيع الحليب الصناعي، ولكلّ منها حالة واحدة بلغت نسبتها (7.14٪).

وُجِدَت فروق ذات دلالة إحصائيّة مهمّة جدّاً في نمط الإرضاع الحالي وفقَ متغيّر بدء إرضاع الوليد بعد الولادة، حيث بلَغَت نسبة من اعتمَدنَ نمط الإرضاع الوالدي مع الصناعي وكنّ قد بدأنَه بعد الولادة (39.2٪) مقابل (10٪)، وقيمة الدلالة الإحصائية (P=0.000).

وُجِدَت فروق ذات دلالة إحصائيّة مهمّة في نمط الإرضاع الحالي وفقَ متغيّر المهنة لصالح المرأة العاملة التي استمرّت بالإرضاع الوالدي مع الصناعي بنسبة (42.3٪) مقابل (28.8٪) لربّة المنزل، حيث قيمة الدلالة الاحصائيّة (P=0.016).

تبيّنَ في دراستنا وجود فروق ذات دلالة إحصائية مهمّة في نمط الإرضاع الحالي وفقَ متغيّر تلقّي الدّعم من الزوج أو العائلة لصالح من تلقّت الدعم، حيث قيمة الدلالة الإحصائيّة (P=0.029).

لم تُوجد فروق ذات دلالة إحصائيّة في نمط الإرضاع الحالي وفقَ مُتَغيِّرات العمر، المستوى التعليمي، المستوى الاقتصادي، الحالة الاجتماعية و مكان السكن، حيث قيمة الدلالة الإحصائيّة (P>0.05).

تَبيّنَ في دراستنا عدم وجود فروق ذات دلالة إحصائيّة في نمط الإرضاع الحالي وفقَ ترتيب الطفل الحالي، طريقة الولادة، وبقاء الطفل مع الأم في نفس الغرفة بعد الولادة، حيث قيمة الدلالة الإحصائيّة (P>0.05).

لم توجَد فروق ذات دلالة إحصائيّة في نمط الإرضاع الحالي وفقَ مُتَغيِّرات النيّة للإرضاع الوالدي، تلقّي الإرضاع الوالدي في سنّ الرضاعة، تلقي تثقيف حول الإرضاع الوالدي، وتحضير الثدي للإرضاع قُبَيل الولادة؛ حيث مستوى الدلالة الإحصائيّة أكبر من (0.05) لجميع هذه المُتَغيِّرات.

أهمّ التّوصيات:

التعرّف باكراً على الأمّهات المُعَرَّضات للإيقاف المُبكر للإرضاع الوالدي من أجل تقديم الدّعم والتثقيف اللازِمَين لهنّ.
تمكين الممرّضين ومُقَدّمي الرّعاية الصحّية والمَعنيّين بصحّة الأم والطفل من أداء دورهم بنشر ثقافةٍ تعزّز وتدعم استمرار الإرضاع الوالدي الحصري لاسيّما في الشهور الستّة الأولى من عمر الرضيع.
تقديم التثقيف الصحّي للسيّدات عموماً، والحوامل والمُرضِعات خصوصاً حول فوائد حليب الثدي، وكيفيّة التحضير لعملية الإرضاع الوالدي، وتعليمهنّ الطريقة الصحيحة للإرضاع الوالدي، وتوزيع بروشورات توضيحيّة حول ذلك.
التأكيد على أهمّية محاولة إرضاع الرّضيع من الثدي في الساعة الأولى من ولادته والّتي تُسمّى الساعة الذهبية من أجل الحفاظ على إدرار حليب الثدي واستمراره فيما بعد.
المُطالَبة بإحداث سياسات تُراعي أمومة المرأة العامِلة، وتسمح لها بتقديم كلّ العناية اللازمة لأطفالِها الرضّع بعدَ كلّ ولادة.
إجراء هذه الدراسة على عيّنةٍ أكبر من الأمّهات، وعلى مُجتمعات مختلفة، وإجراء المزيد من الدراسات حول أسباب إيقاف الأمّهات للإرضاع الوالدي قبل الشهور الستّة الأولى من عمر الرّضيع، وطرق التغلّب على تلك الأسباب.

الكلمة المفتاحية:

الإرضاع الوالدي الحصري

Efficacy of intermittent versus continuous phototherapy in the treatment of unconjugated hyperbilirubinemia in newborns

2024-02-27T09:01:15+00:00

Background: Jaundice in newborns is a common disease and an important reason for hospitalization and medical intervention. Phototherapy is the first and most widely used in medical treatment of jaundice. Current studies refer to use intermittent rather than continuous phototherapy to reduce the side effects of phototherapy.

Objectives: To study the effectiveness of intermittent phototherapy versus continuous in the treatment of unconjugated hyperbilirubinemia in newborns.

Methods: An analytical observational study involved 63 neonates at Tishreen University Hospital Latakia during the period from August 2022 to September 2023. The patients were divided into two groups: group A received intermittent phototherapy (2 hours on/ 1 hours off) and group B received continuous phototherapy for 12 hours. Total serum bilirubin values were measured at hospitalization and after 6 and 12 hours of phototherapy

Results:The mean of total serum bilirubin at admission was 16.6±1.33 mg/dl for the intermittent group A and 16.8±1.34 mg/dl for the continuous group B. The TSB mean after 6 and 12 hours for the intermittent group A was 15.7±0.4 mg/dl, 13.7±1.33 mg/dl and 15.5±0.7 mg/dl, 13.5±1.22 mg/dl for the continuous group B, respectively. There was no any significant difference between the two groups regarding TSB (P-value˃5%).

Conclusion: Intermittent phototherapy is as effectives as continuous one in the treatment of unconjugated hyperbilirubinemia in newborns.

Evaluation of functionl outcome of surgical mangement in femoral neck fractures with cannulated screws in adult

2024-02-10T11:42:02+00:00

Introduction: Injuries to the lower extremity, especially the femoral neck, are common injuries that can carry a large percentage of functional disability and thus constitute huge unexpected economic burdens.
Age 18-50 years
There are several methods of treatment:
Canulated screws
DHS plate , arthro plasty .
Research objective: Improving the results of treating intracapsular femoral neck fractures in young people using surgical treatment with cannulated screws by studying the functional results of this method
. Materials and methods: The research includes patients with femoral neck fractures who underwent surgical treatment at Tishreen University Hospital during the years 2021-2022 and who met the inclusion criteria in the research.
The ages of the research sample patients ranged from 18 to 50 years, with an average of 34.2 years .
Results: In this study, analyzed 39 cases of intracapsular femoral neck fractures in adults who were surgically treated with closed reduction and replacement with three cannulated screws. We found that the most common cause of intracapsular femoral neck fractures in adults is traffic accidents, and these fractures are common in patients aged between 31 and . 40 years, and the average age of patients in our current study was 34.2 years. These fractures were more common in males than in females in this age group, as in our current study, males: females, the ratio was 2.5: 1, and the proportion of fractures of the altered type was much higher than without. The variable rate was 71.8%: 28.2%, and the majority were type 3 according to the Garden classification for intracapsular femoral neck fractures
The functional results of the studied patients according to modified Harris hip scoring improved clearly with continued follow-up, and a significant increase was observed in the percentage of patients with results ((excellent - good)), reaching 94.87 after one year of follow-up
Conclusion: We recommend treating intracapsular femoral neck fractures in the age group 18-50 years based on good response, fixation with three cannulated screws, and performing surgery as early as possible
,Adherence to medical advice during the treatment period, especially preventing complete resting 3 months before surgery.

Study Of Early Thrombosis Factors Of Ateriovenous Fistula For Hemodialysis

2024-02-21T12:16:08+00:00

Background: Chronic renal failure is a public health problem worldwide with a significant morbidity and mortality rate that is increasing. Among the treatment options available for end-stage chronic renal failure, hemodialysis is the most widely used.

To perform the dialysis, a temporary or permanent vascular access must be created, and the autogenous arteriovenous fistula is considered the most appropriate method, as it is a long-term access that allows effective and safe dialysis with a low infection rate and low medical care costs.

Early thrombosis is defined as thrombosis that occurs within a month of the procedure and is diagnosed clinically (absence of thrill or pulsation by palpation or bruit by auscultation) and by ultrasound.

Objective: The research aims to study the risk factors that predict early thrombosis of an autogenous arteriovenous fistula prepared for hemodialysis, thus reducing the incidence of failure and thrombosis.

Methods: An Analytic Observational Study (Prospective) was conducted, in which 80 patients with ESRD who underwent new arteriovenous fistulas for hemodialysis, during the period extending between the years 2022-2023, where the following variables were studied: Age, gender, location of the fistula, diameter of the feeding artery, diameter of the vein, administration of anticoagulants, surgeon’s opinion, anastomosis technique.

Patients were followed for one month after surgery and the outcome of the procedure was evaluated in terms of fistula maturation or thrombosis.

Results: Early thrombosis occurred in 17 patients (21.2%).

The thrombosis rate was higher in older ages (mean age 61.23±9.3), and was higher in females than males by 58.8%.

No statistically significant differences were observed regarding the location of the arteriovenous fistula, except that 64.7% of cases of early thrombosis were in distal sites. The rate of early thrombosis cases was 76.5% with a venous diameter of less than 2 mm, and 52.9% with a feeding artery diameter of less than 2 mm.

We did not find statistically significant differences between taking anticoagulants and the occurrence of early thrombosis of arteriovenous fistula.

It was noted that 64.7% of cases of early thrombosis were with arteriotomy less than 6 mm, and there was no statistical significance with regard to the anastomosis technique using two sutures (P value = 0.5)

prognostic factors in severe head trauma patients

2024-02-15T08:29:25+00:00

Results: A total of 200 patients, 40 females (20%) and 160 (80%) males participated in the study, average age was 42 ±23 and average Glascow scale was 6±2, 123 (61.5%) patients deceased during the study. We studied the factors to discharge patients or to cause death. Sex and age do not factor, patients with higher Glascow scale had and patients with higher oxygen pressure were more likely to survive. Pupillary unresponsiveness and hypertension also affect the incidence of death post head trauma. We studied prognostic factors among discharged patients; we found that a good prognostic factor is associated with lower age, pupillary responsiveness and a normal partial pressure of oxygen.A good prognostic factor is not associated with cisterna effacement. Findings of CT-scan except for epidural hemorrhage, previous surgeries, sex and blood pressure are not associated with a prognostic factor.

Evaluation of the relationship between mandibular root apices and mandibular canal in a selected Coastal Syrian population (Retrospective Radiographic study by CBCT)

2024-01-25T04:21:32+00:00

Aim of the study: This radiographic study aimed to evaluate the distances from the root apexes of (first and second mandibular premolars, the mesial and the distal roots of the first and the second mandibular molars) from the upper cortical borders of the mandibular canal in a selected coastal Syrian population, and to study the relation between these measurements and individual factors (sex and age) in both sides by cone beam computed tomography.

Materials and Methods: This retrospective radiographic study included 150 CBCT scans from 150 individuals, the age raged between 18 and 75 years old, the age was categorized into 3 subgroups: Young ages (18-35) , Middle ages (36-55) , Advanced ages (56-75), Cs 3D imaging software was used to evaluate the scans, Data was analyzed by IBM SPSS Statistics 25.

Results: This study showed that the mean of the distances from the root apexes of first and the second mandibular premolars, the mesial and the distal of the first and second mandibular molars from the upper cortical borders of the mandibular canal in the right side: ( 1.99±0.702 , 2.47±0.714 , 4.06±0.571 , 4.56±0.570 , 3.56±0.569 , 5.15±0.832 ) , and in the left side ( 2.09±0.703 , 2.57±0.714 , 3.86±0.571 , 4.46±0.569 , 3.46±0.565 , 5.06±0.827 ) respectively, and the females showed smaller means than males for all these distances which was statistically significant (P-value<0.05) , and the young ages showed smaller means than the other age subgroups for all these distances which was statistically significant (P-value<0.05).

Conclusions: by the limitations of this study, we could conclude that the apex of distal root of the second mandibular molar is the nearest to the upper border of the mandibular canal, whereas the apex of the first mandibular premolar was the furthest. And both the sex and the age have an effect on all these distances which was statistically significant.

Functional results of surgical treatment with elastic nails for closed displaced forearm diaphyseal fractures in children (8-15 years)

2024-01-11T06:59:45+00:00

Objective of the study: To study the functional results in treating this type of common fracture using elastic nails with the aim of achieving healing, restoring function, and reducing complications.

Materials and methods:

The study was conducted on 20 children who were admitted to Tishreen University Hospital during the years 2022-2023 and who underwent surgical treatment using flexible Intramedullary nails after clinical and radiological evaluation. Patients were followed up clinically and radiographically at postoperative intervals and clinical and radiological re-evaluation.

Results: The study sample included 20 patients, with a predominance of males, 15 children versus 5 females, and the ages ranged between 8-15 years. The reason was exposure to sports injuries and car accidents. Patients were followed clinically and radiographically after surgery. The study reached good and important results in restoring forearm function and healing fractures.

Conclusion: This study concluded the importance of using flexible Intramedullary nails in treating this type of fracture and obtaining positive results while reducing complications.

Functional results of treating closed displaced femoral shaft fractures using elastic nails in children (6-12 years old).

2024-02-05T20:20:41+00:00

Objective of the study: To study the functional results of surgical treatment of femoral shaft fractures in children, which achieves healing quickly and with fewer complications.

Materials and methods:

The study included 25 children who visited Tishreen University Hospital between the years 2021-2022 and who underwent surgical treatment using flexible intramedullary nails. The patients were followed up clinically and radiologically after surgery during specific periods until complete healing.

Results:

The study was conducted on 25 patients. Most of them were males, 18 (72%), and the number of females was 7 (28%). Most of the injuries in children were caused by falls, 20 (80%), and the rest of the injuries were the result of a traffic accident, 5 (20%). The patients were followed up Clinically and radiologically after surgery, the study reached significant functional and radiological results regarding healing of fractures.

Conclusion:

The study concluded that it is of great importance to use intramedullary rods in the treatment of hip fractures because of the positive results it achieves and reduces complications.

Evaluate The Effect of Immediate Finishing and Polishing of Composite Resin on its Color Stability

2023-12-04T11:49:59+00:00

Aim: the aim of this study was to evaluate the effect of immediate finishing and polishing of the tetric N ceram composite resin on its color stability.

Materials and Methods: The research sample included 40 blocks of tetric N ceram composite, which were divided into two groups according to the time in which the finishing and polishing procedures were carried out. The first group was finished immediately after curing, and the second group was finished after 24 hours. After that, the samples were immersed in the coffee solution and then placed in the incubator for a 48 hours at 37°C and 100% humidity.

After removing them from the incubator, the samples were washed for a minute with saline, then dried with tissues, and the color was recorded using Easz shade device. The L, a, and b values were recorded after staining, and the appropriate statistical tests were conducted.

Results: There was no statistically significant difference in the coloration of the composite whether it was finished and polished immediately after curing or after 24 hours.

Conclusion: Within the limitations of this study, it can be concluded that Tetric N ceram restorations can be finished immediately because immediate finishing does not affect their coloration.

Evaluation of the results of treatment of hallux valgus using the closed wedge osteotomy technique and fixation with Kirchner wires.

2024-01-05T16:53:18+00:00

Objective : to evaluate the functional results of the treatment of hallux valgus patients using the technique of closed wedge osteotomy and fixation with Kirchner wires, to study the extent to which this technique can be applied as a more common and easy means of Appeal.

Materials and methods : this study included 28 feet in 25 patients from Al-Assad and Tishreen University Hospitals in Latakia between 2006 and 2018. All patients underwent surgical treatment with closed wedge osteotomy and fixation with Kirchner wires after appropriate clinical and radiological evaluation. Removal of the splint after 4-6 weeks and rehabilitation was recommended for all patients after surgery and patients were followed up at maximum intervals 12 months of treatment.

Results: the study sample consisted of 28 feet in 25 female patients and there were no males in the study, the average age of the patients was 41 years ( ranging from 20 to 62), the follow – up period extended over 12 months, and the family story was present in 80% of the patients.

The clinical evaluation after surgery resulted in 72% satisfaction (18 patients) with the results while 28% (7 patients) were not satisfied, the results were excellent and good at 72% of patients (18 patients), acceptable results at 16% ( 4 patients ) and poor results at 12% (3 patients (.

The complications varied between delayed union (24%), malunion 4%, relapse 4%, infection around the entrance to the wires 4%, SODIC's syndrome 4%, metatarsophalangeal joint apoplexy 56%, but only two patients complained of symptoms.

Conclusion: this study showed the positive results of the treatment of hallux valgus cases using the closed wedge osteotomy technique and fixation with Kirchner wires, the importance of this surgical technique in managing these cases, and its positive impact on rehabilitation.

Health-related quality of life among elderly individuals with chronic obstructive pulmonary disease

2024-01-01T19:39:26+00:00

Chronic obstructive pulmonary disease (COPD) is a common condition that affects the health of older adults. Elderly individuals with COPD experience symptoms such as shortness of breath, increased mucus production, and persistent coughing, which negatively impact their quality of life. Therefore, comprehensive support should be provided to improve the quality of life and general well-being of these patients. The aim of this study was to assess the health-related quality of life among elderly individuals with COPD. The study included a convenience sample of 100 male and female patients, and data were collected at Tishreen University Hospital in Latakia. The results revealed that the majority of patients had poor quality of life in terms of disease-related symptoms, with more than two-thirds of the sample experiencing a poor quality of life due to the impact of the disease. The study recommended the implementation of specialized rehabilitation and training programs for elderly individuals with COPD, including respiratory exercises, self-care techniques for symptom management, and patient education on preventing symptom exacerbation.

Key words: Quality life, Chronic obstructive pulmonary disease (COPD).

Evaluation of the effectiveness of the biomic LiSi connect spray in the securing bond between zirconia and resine cement

2024-01-29T12:59:08+00:00

Introduction: There is a constant effort to treat the surface of zirconia in many different ways to improve its bond with the resin cement, as it is a crystalline ceramic, as grinding with aluminum oxide granules is still the gold standard. A new material was introduced, which is (Biomic LiSi connect spray) containing a glass ceramic to be applied over the surface of zirconia to improve its bond With resin cement and to reduce cases of debonding in fixed prosthodontics

Aim of the study: To evaluate the effectiveness of (Biomic LiSi connect spray) in treating the surface of zirconia to increase its bond with resin cement compared to the traditional method of sandblasting with aluminum oxide granules.

Materials and methods: The research sample consisted of 20 zirconia discs, which were turned using CAD/CAM technology. The sample was divided equally into two groups according to the surface treatment of the zirconia: 10 discs were placed in the sandblasting group with aluminum oxide granules, 10 discs were placed in the Biomic LiSi connect sprayer, they were cemented to the buccal surfaces of healthy upper premolars prepared with a specific area and thickness using dual-cured resin cement. They were kept in water for 24 hours at a temperature of 37 degrees, then shear bond strength tests were conducted using a universal test machine, and the results were recorded.

Results: The results of the T student test for independent samples at the 95% confidence level showed that there were statistically significant differences in the average values of the amount of resistance to shear forces in megapascals between the two groups in favor of the Biomic LiSi connect spray group.

Conclusions: Within the limits of this study, we conclude: Biomic LiSi connect spray contributed to improving and increasing the bond of the zirconia surface with the resin cement more effectively than the traditional method using sandblasting with aluminum oxide granules.

Evaluation the results of the treatment of displaced intra-articular distal radius fractures in adults by Kirchner wires

2024-01-30T22:54:06+00:00

Objective of the study: to evaluate the functional and healing results of displaced intra articular distal radius fractures in adults by studying the advantages and disadvantages of surgical treatment using Kirchner wires "K-wires".

Materials and methods : this study included 34 patients from the reviewers of Tishreen University Hospital in Lattakia between 2021-2022. All patients in the study underwent fixation of the displaced intra articular distal radius fractures using K-wires after appropriate clinical and Radiological evaluation . Rehabilitation was recommended for all patients after surgery and patients were followed up at maximum intervals 12 months of treatment.

Results: the study sample consisted of 34 patients with a predominance of females by more than 64%. The majority of patients participating in the study were in the age group between 51-65 years, in half of the cases .The majority of cases were right-sided injury, with no bilateral cases were recorded . With the control of fractures of type c1, while no case of type c3 was recorded in the research sample.

When studying the range of wrist movement and estimating the mean values, little determination was found in patients with K-wires , and the same applies to grip strength due to delays in physical therapy and the length of stay of the splint .

A small percentage of the occurrence of the following disorders was observed: infection, secondary mutation, and Sudeck dystrophy , while no cases of non-healing were recorded in the study sample .

Conclusion: this study showed the positive results of the treatment of fractures of the displaced intra articular distal radius fractures using K-wires , and the importance of this surgical technique in the management of these cases.

Separation and Determination of charged drugs in aqueous and biological media using capillary zone electrophoresis coupled to different detectors

2024-01-28T08:50:52+00:00

In order to determine the pharmacokinetics and pharmacodynamics profiles of drugs after administration by varying routes, capillary electrophoresis coupled to different detectors, as a simple alternative analytical method, was developed to separate and determine both the anticholinergic (Glycopyrronium Bromide; the cationic substance) and the modified gamma cyclodextrin (Sugammadex; the anionic substance) in water and in human biological media; urine and plasma. All the results showed that there is an excellent linear relationship between the peak areas and the corresponding concentrations, and that is confirmed by the value of the correlation coefficient (R²> 0.99). The detection for glycopyrronium bromide was in micrograms per milliliter sensitivity limit (using ultraviolet detector) after a short time of injection. The samples were easily pre-treated; urine samples were diluted with water and plasma ones were treated with acetonitrile. The method showed good reproducibility with RSD < 0.28% for migration time and < 0.92% for peak area at different media. Since sugammadex is a non-active ultraviolet substance, there is no possibility to be directly detected using an analytical instrument coupled to ultraviolet detector. In this study, it was determined easily and rapidly using contactless conductivity detector in water and human urine samples.

The effect of a proposed training program with weights on the level of digital achievement in the shot put using the sliding method

2024-01-28T11:08:40+00:00

The aim of the research is to identify the effect of training with weights on the level of achievement in shot put in a gliding way. The researcher used the experimental method, and the research sample consisted of (20) male students from the Faculty of Physical Education - Tishreen University in the third year, with an average of two groups, an experimental group (10) Students and a control group (10) students, giving them three attempts for each of them and analyzing the results of the best attempt. The training program was designed, which lasted for (8) weeks, and consisted of (16) educational units at a rate of two units per week, after which the tribal tests were implemented. Then the training program was applied, after that, the post-tests were conducted in the same way as the pre-tests.

Then the data was analyzed using the arithmetic mean, standard deviation, skewness coefficient, Pearson simple correlation coefficient, and T-Test.

The results of the study concluded that the training program used led to an improvement in the level of achievement in shot put in a gliding way

The researcher recommended the use of training with weights in developing the level of achievement in shot put, and conducting similar studies for various athletics activities.

Women take leadership positions in sports management From the point of view of students of the Faculty of Physical Education at Tishreen University

2023-12-04T14:32:46+00:00

The participation of women in sports activity is a manifestation of civilized progress in all societies, and the entry of women into some leadership positions in sports constituted an important achievement, and standing on the students’ acceptance of the idea of female leadership in the sports field contributes in one way and another to the development of sports awareness programs and the development of strategies aimed at building Preparing female leaders to invest their energies and talents in which they are distinguished, and this study aimed to identify the viewpoint of students of the Faculty of Physical Education on women’s assumption of sports leadership positions, and to identify the differences in the students’ viewpoint according to the variables (gender - school year), the researcher used the approach Descriptive survey method on a sample of (100) male and female students who were chosen randomly, distributed over the academic years, where the number of first-year students was (26), the number of second-year students was (26), the number of third-year students was (22) and the number of students of the second year The fourth is (26), and the number of males was (46), while the number of females was (54), with a percentage of (19.08%) of the research community, through a questionnaire designed by the researcher, and the study concluded that the viewpoint of the students of the Faculty of Physical Education in taking Women have positive sports leadership positions, and their point of view differs according to the variable of sex and in favor of females, and their point of view differs according to the variable of the school year and in favor of the fourth year students.

Key words :

Sports administration - Leadership - Women - Students of the Faculty of Physical Education.

The effect of a therapeutic program based on strengthening exercises centered on the lower back muscles on the severity of pain and quality of life among young subjects

2024-02-06T03:26:51+00:00

The research aimed to examine the effect of a therapeutic training program and its impact on the severity of pain and quality of life among young peoples, in addition to identifying the correlation between the intensity of pain and quality of life among these subjects. The study used Brief Pain Inventory Short Form questionnaire, as using the short version of the BPI allows us to identify painful areas in the research sample and the effect of pain on activities of daily life in addition to its intensity while answering the questionnaire and in the previous week. The question of pain relief through medications also allows us to exclude the participant who takes medications to relieve perceived pain so that it does not affect the measurements in the experiment. The study also applied a therapeutic program of strengthen exercises concentrated on lower back for a period of 8 weeks, at a rate of 3 hours of training per week. The duration of the training session is (45 minutes) divided into (4) parts (warm-up - stretching exercises - strength exercises - calm-down exercises). The subjects includes 10 young adults aged between 21-25 years. The results of the study led to the fact that strengthen exercises concentrated on the lower back muscles contributed significantly to a decrease in the intensity of pain and increase the quality of life. The statistical results also demonstrated that there was a negative correlation between pain scores and the level of quality of life.

The effect of applying negative pressure technique on the degree of healing of diabetic foot ulcers

2023-12-04T15:08:01+00:00

Introduction: Diabetes is considered the most common metabolic disorder around the world, and diabetic foot ulcers are one of the most important health complications associated with chronic diabetes and are the main cause of non-traumatic leg amputation. The current study aimed to evaluate the effect of applying negative pressure technology on the degree of healing of diabetic foot ulcers among patients with type 2 diabetes at Tishreen University Hospital in Lattakia .Methods According to the experimental method, the study was applied to a random sample that included 30 patients of both sexes in the vascular surgery department. They were divided into two experimental groups (15 patients) who underwent dressing changes for foot ulcers using the negative pressure technique, and control groups (15 patients) who underwent dressing changes according to the routine method approved in the hospital. The degree of healing of ulcers and the degree of ulceration were evaluated using the Risevic scale and the ulcer score scale during days (1, 5, 10, 15, 20) after the start of dressing application. Results: The results showed that there were very significant statistical differences in the degree of healing of diabetic foot ulcers in patients in the experimental group during repeated assessments compared to patients in the control group (U = 44, P = 0.004), and there were significant statistical differences in the total ulcer degree)X²،10.09= p(0.018= compared to patients in the control group. Conclusions: The negative pressure technique has a role in improving the healing of diabetic foot ulcers. Therefore, the study recommends the necessity of adopting it as a routine dressing method for diabetic foot ulcer patients and conducting more research on it in order to improve the healing of patients and reduce the need for lower limb amputation.

Reconstruction of the alveolar bone deficiency in the mandible by expansion screws

2023-12-27T11:31:37+00:00

Objectives:

The goal of this study was to evaluate the results of using the expansion screws for treatment of atrophic and deficient mandible bone.

Material and Methods:

A total of 6 patients (5 men and 1 woman; Age 20-36 years) who came with

atrophy of alveolar bone were treated using expansion screws by horizontal distraction osteogenesis. The used device consisted of 2 parts: one was an orthodontic expander and the other was a screw-ring. The expansion screws were set on the transport bone which was osteotomized from adjacent bone and fixed to the segment using microscrews. The bone gain was gauged using radiographs (cbct). The overage of

follow- up was 4 months.

Results:

The average of the horizontal bone gain after 4 months of the distraction osteogenesis was 7.55 mm (5.5-10). The average of the vertical bone gain after 4 months of the distraction osteogenesis was 6.91 mm (3.5-9).

Conclusion:

Under the limitations of this study it can be concluded that the distraction osteogenesis using expansion screws leads to reconstruction of the alveolar bone deficiency in the mandible.

The Role of Platelet-Rich Plasma Injections in the Treatment of Ovarian Insufficiency

2023-12-30T06:43:53+00:00

The research aimed to evaluate the effectiveness of platelet-rich plasma injections in treating ovarian insufficiency in terms of FSH values, and to study the effect of age on the improvement of FSH values for patients before and after the injection.

(13) female patients of reproductive age were admitted to the women's clinic at Tishreen University Hospital, who were suffering from infertility due to ovarian insufficiency. The necessary general and hormonal analyzes were performed, ultrasound imaging of the uterus and appendages was performed to diagnose ovarian insufficiency, and a semen analysis of the husband was performed (provided that it was normal). The patient was prepared for laparoscopy in order to inject platelet-rich plasma after the end of the menstrual cycle in the first phase of the cycle (10) ml of platelet-rich plasma was prepared from the blood of the concerned patient.

The results of the research showed that platelet-rich plasma injections are a promising treatment for ovarian insufficiency, as this treatment can help improve fertility and women’s general health. This is indicated by the fact that (69.23%) of the female patients in the sample experienced an improvement in ovulation after the injection procedure. The significance of FSH values after injection indicates its return to normal values compared to its values before injection, which indicate that it has risen above normal limits.

The role of Insulin Resistance in Polycystic Ovarian Syndrome

2023-12-19T10:47:04+00:00

Polycystic ovarian syndrome (PCOS) is one of the readily recognised endocrine gland illnesses in women, with an incidence range from 2.2% to 26%. Patients experiencing PCOS experience issues involving irregular menstrual periods, hirsutism, acne, being overweigh,. Long-term, low-grade inflammation has emerged as a crucial factor leading to PCOS. A rise in glucose levels may stimulate oxidative stress and a troubling reaction from mononuclear cells (MNC) of females with PCOS, which normally do not rely on fat. The findings of this specific lesson indicated that individuals with the conventional PCOS phenotype had obesity and higher insulin levels and insulin resistance, neglecting the absence of BMI differences from other phenotypes. These data show that insulin resistance is the most significant pathophysiological trait in people with PCOS.

Assessment of sleep Quality among cancer patients undergoing chemotherapy

2024-01-17T11:44:10+00:00

The current descriptive study aimed to evaluate the sleep quality of cancer patients undergoing chemotherapy. The study included 60 patients at the Chemotherapy and Radiotherapy Treatment Center at Tishreen University Hospital in Lattakia. They were selected using convenience sampling, and data was collected using the Pittsburgh Sleep Quality Index. The study found that the majority of cancer patients undergoing chemotherapy had somewhat poor sleep quality. They took between half an hour to an hour to fall asleep after getting into bed, and their sleep duration ranged from five to six hours. Their sleep efficiency was between 75-84%, indicating a significant sleep disturbance. They needed sleep medication once or twice a week, and they experienced mild disruption in daily activities over the past month. More than three-quarters of them had poor sleep quality. There were no significant differences in sleep quality attributed to their demographic characteristics. The study recommended the necessity of scheduling patients’ need for sleep within the treatment plan, designing programs to improve their sleep, and conducting a similar study on a larger sample.

The Prognostic Value Of Apelin On Cardiac Outcomes In Patients With Chronic Kidney Disease And The Relationship With Genetic Polymorphism Of Apelin

2024-01-11T06:52:47+00:00

Introduction: Cardiovascular disease is a common complication of chronic renal failure, especially in its end stages. It is also the main cause of death in patients with chronic renal disease, as it is responsible for 50% of all deaths. Recently, the role of apelin, which is an endogenous peptide coded by the APLN gene and serves in the pathophysiology of cardiac failure, has been defined. Apelin also appeared to be in lower levels in CKD patients. Thus the purpose of this study is to examine the prognostic role of apelin as an early marker of CVD in the context of CKD and studying the genetic polymorphism of apelin.

Methods: The sample was taken from the Department of Nephrology of Tishreen University's Hospital, consisting of 70 subjects suffering from CKD specifically stage 2-4. They were divided based on their glomerular filtration rate (GFR), in addition to that 15 other nephrologically and cardiovascualrly healthy subjects were added as a control group. The control group is homogenous in terms of age and sex with the test subjects. The sample's subjects were monitored for 18 months starting on the 25th of July 2021 and ending on the 12th of December 2022. Their cardiovascular status was observed consistently by the hospital's cardiologists in addition to their kidney and overall status through a weekly patient examination.

Results: As anticipated, the average GFR of the observation subjects was lower than those of the control group. Which was 42.06 ml/min/1.73 m^2 compared to 122.4 and this difference carried a big statistical significance being of p<0.0001. Also we found that the average apelin was lower in CKD patients than in the control group, being 378.86 compared to 663.93, carrying statistical signicance of p<0.0001. Additionally, the average systolic and diastolic blood pressures were higher in CKD patients than the control group. All members of the control group were from the TT genetic type while 95% of the chronic renal disease patients having the TT genetic type and this difference was not statistically important; The cardiovascular complications were more present in CKD patients than in the control group, having 39% prevalence in comparison to the latter. This difference is also statistically significant p=0.017. Myocardial infarction and left ventricular hypertrophy were the most commonly occurring complications amongst CKD patients.

Conclusion: We found that only apelin had a statistically significant importance in the incidence of CVD in CKD patients. As apelin levels were negatively correlated with the known CVD risk factors and positively correlated with eGFR. These findings solidify the role of apelin as a prognostic marker for the progression of CVDs in CKD patients.

The Effect of Syrian Climate Coast On The Stability of Aspirin

2024-03-28T09:49:22+00:00

Aspirin is a commonly used medicine. It is used routinely in older people to prevent heart attacks.

This is due to its anti-platelet effect. However, it is known to show an allergy problem and its destruction under the influence of moisture which will turn it into salicylic acid which causes stomach irritations and maybe ulcer, This calls for studying the stability of aspirin tablets.

The aim of this study is to determine the effect of the coastal climate on the stability of aspirin, tablets made by three national companies and available in the local market, from both the physical side ( hardness and fragility), and chemical side ( content level).

The study was conducted on the tablets in their commercial format in the market, and within the medicine portfolio under different storage conditions (either on the shelf or via a speeding study).

Constitutional methods in regard to the hardness and fragility of the tablets were adopted! Whereas, TLC and Spectrophotometer methods were adopted to calibrate the content of aspirin. The causes that lead to the damage of aspirin were also addressed.

The low concentration of aspirin was observed for legally constitutionally permitted percentages after 180, 30 and 90 days for the tablets manufactured by company A , Company B and company C, respectively, as for the marketed product.

Whereas, the concentration in aspirin decreased in the tablets which were placed in the portfolio after 3 days in regard to the tablets made by company A , 2 days for the other two companies (B, C).

As for storing the tablets under the conditions 75% RH, 40 ° C and 75% RH, 25 ° C, the concentration was decreased in the tablets of all three companies ( A, B, C) after 15 days.

There were left in the blister, but those which were kept in the clipboard, the concentration dropped in one day

Upon studying the stability in both conditions 60% RH, 40 ° C and 60% RH, 25 ° C, the results were comparable to those results from the storage on the shelf, whether, in the blister or in the clipboard.

Studying the hardness and fragility of the aspirin tablets, it became clear that the hardness has been decreased while the hardness of the studied condition has been increased.

This decreased of the tablets was larger in regard to the tablets placed in the portfolio, while the fragility has increased significantly in the extreme storage conditions in the clipboard.

Comparative Study Of The Shear Strength Between Resin Cement And Y-TZP Zirconia treated With aluminum oxide granules and carbide burs

2024-02-21T11:57:50+00:00

Statement of problem:The use of zirconia in dentistry dates back to the early 1990s.Yttria-stabilized tetragonal polycrystal zirconia (Y-TZP) is one of the most common types of zirconia used in fixed prostheses, due to its high mechanical properties. This ceramic is crystalline and cannot be etched chemically, as glass-ceramics do. As a result, mechanical etching was used more heavily to ensure appropriate surface roughness, increase microscopic depressions, and allow the resin cement to hydrate and flow, so that this bond will be stronger and these prostheses will be more stable, especially when the abutments are short or over-prepared. By either sandplasting with aluminum oxide granules or roughening with burs, this can be accomplished.

Aim of the study: The purpose of this study was to compare the shear strength between resin cement and zirconia treated with mechanical etching with aluminum oxide granules and carbide burs, in order to evaluate the best bond strength between them.

Materials and methods: CAD/CAM was used to mill 20 zirconia discs for the research sample. The sample was divided into two groups based on the zirconia surface treatment: the sandblasting group with aluminum oxide granules included 10 discs. The etching (roughening) group with tungsten carbide burs included 10 discs. They were cemented to the buccal surfaces of healthy upper premolars prepared with a specific area and thickness, using Adhesive Resin Cement. At 37°, they were kept in water for 24 hours. A universal mechanical test machine was used to conduct the shear strength test, and the results were recorded.

Results: According to T student test of independent samples at a 95% confidence level, there were no statistically significant differences between the two groups (the sandblasting group with aluminum oxide granules - the roughing group with carbide burs) in the average values of shear strength.

Conclusions: Based on the findings of this study, we conclude: The carbide burs used in treating zirconia surfaces provided a shear strength, as did sandblasting with aluminum oxide granules, and both methods provided a comparable bond strength with resin cement.