bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobile Money Transfer Charges’ Effects on Adult Learning Entrepreneurial Agents’ Commission in Tanzania: A post-Government Tax Levy Imposition Era
Authors: Kabung'a Mbowe
Published: September 2023

This paper reports the findings of a study that was conducted to determine the effects of charges imposed in Mobile Money Transfer (MMT) on Adult Learning Entrepreneurial Agents (AEA)’s commission after government tax levy introduced in Tanzania. This action research used questionnaires and interviews to collect primary data, which has been complemented by secondary data. It applied purposive sampling to select 350 AEA participants from Dar es Salaam region. Moreover, the study employed a mixed methods research approach to ensure the validity and reliability of the results and improve specific practices. The MMT charges and AEA’s commissions were analysed using Spearman correlation, t-test, and descriptive statistics. The Statistical Package for Social Sciences (SPSS) version 20 facilitated the analysis of quantitative data. Qualitative data (perceptions/feelings on the effects) on the other hand ware subjected to content analysis. The study found that there is a statistically significant negative correlation at (r = -.124, p < .05) between MMT charges imposed by government tax levy and AEA’s commissions. The findings further indicate that 63.7 percent of the respondents noticed a decrease in AEA agents’ commissions after the government imposed a tax levy on MMT charges. The findings also indicated that there is a significant difference between the AEA’s commission before and the post-government tax levy charges imposed on MMT in Tanzania at (t=13.04, df=349, p<.05). Based on the study findings, to improve the AEAs’ practices it is recommended that the stakeholders in MMT need an agent special forum for discussion within the industry. The AEA must also restructure their work practices to integrate unexpected changes in agency activity. Furthermore, the agents need to rethink the concurrent or diversified kinds of business to accommodate the effects of charges introduced in MMT.
The Influence of Entrepreneurial Education on Adult Learners’ Motives for Creativity and Intention: A case of IAE in Tanzania
Authors: Kabung'a Mbowe
Published: September 2023

The study presents the findings on the Influence of entrepreneurial education on adult learners’ motives for creativity and intention in Tanzania. Using a case study research design of the Institute of Adult Education (IAE), the study used a structured questionnaire to collect primary data from 170 respondents selected from 291 IAE adult learners in Tanzania using simple random sampling. Data were subjected to the structural equation model technique facilitated by Analysis of Moment Structures (AMOS 20.0) software to verify the hypothesis relationships. The study found A positive and significant influence of the entrepreneurial education module contents on the motives for creativity ( β = 0.61, Cr = 2.432, p < 0.000), Moreover, the study found a positive and significant influence of adult learners’ motives for creativity on entrepreneurial intention ( β = 0.142, Cr = 3.302, p < 0.001). The findings further show that entrepreneurial education module contents had a positive and significant influence on adult learner’s entrepreneurial intention ( β = 0.172, Cr = 2.831, p < 0.021). Furthermore, the findings indicate that motives for creativity had a positive and significant indirect effect in the relationship between entrepreneurial education and adult learners’ entrepreneurial intention ( β = 0.112, p < 0.001). The findings suggest that the individual’s subjective attitude towards entrepreneurial intention was affected by discrepancy in the module quality contents. Therefore, promoting entrepreneurial intention among adult learners requires module developers to design module content that reflects quality practical-oriented and conveniently adult learners-centred, including the use of regular presentations by successful entrepreneurs to stimulate their motives for creativity.
Comparison between body mass index and percentage of body fat as measured by bioelectrical impedance in Egyptians
Authors: AbdelRahman Dalia R. , Maamoun Hoda , Soliman Amin R.
Published: September 2023

Background

During the past decade, the number of Egyptians showing overweight and obesity as measured in terms of BMI (kg/m2) has been documented through different surveys. This increase in adiposity has been associated with metabolic syndromes in Egyptians and with higher fasting insulin concentrations. The purpose of this study was to assess the relationship between BMI and percentage body fat (PBF) in Egyptians and to determine whether this relationship differs between men and women.

Methods

We conducted a cohort study including 152 healthy participants; body fat composition was calculated using the BMI equation and bioelectrical impedance (BEI).

Results

The predicted PBF values based on BMI values between 15 and 50 for women and 18 and 50 for men were analysed, which showed that the trend of predicted PBF values differs in accordance with BMI:

at BMI at least 30, men tended to have higher PBF compared with women;

at BMI at least 35, women tended to have higher PBF compared with men.

Conclusion

The present study has investigated the relationship between PBF and BMI in Egyptians. The results show a significant difference in PBF on the basis of BMI and sex. There are some potential explanations for this difference, including sedentary lifestyles and possible genetic makeup. Similar observations with regard to the mediation of BMI on PBF according to sex have been reported previously. It is important to emphasize that the PBF values obtained in this study using BMI are estimates determined on the basis of the samples and that significant differences were found only among women.
Dissection of the aorta, a rare combination of coarctation, a bicuspid aortic valve, and hypertension in a young patient
Authors: Aldousari Abdulrahman , Masud Amir , Mahmood Mohsin
Published: September 2023

Aortic dissection is an uncommon but very lethal disease. Majority of cases are found in elderly patients with a history of hypertension. Young patients usually have other risk factors such as vasculitis, Marfan syndrome, unrecognized coarctation of the aorta, and a bicuspid aortic valve. We present a case of a young patient who presented with epigastric pain mimicking peptic ulcer disease that was later on proved to be type B dissection of the aorta. The patient had a unique combination of hypertension, a bicuspid aortic valve, and postductal coarctation.
Hepatic blood flow in late sepsis patients
Authors: El Maqsoud Amany Abd , Zakaria Abir , Shoukry Fayrouz
Published: September 2023

Background

Systemic inflammatory response syndrome (SIRS), sepsis, and severe sepsis influence total hepatic blood flow. However there are conflicting data on the time of its assessment, methodology, study design, and differentiation in terms of whether the condition is an experimental SIRS, sepsis, or a human clinical syndrome.

Objective of the study

The aim of this study was to assess the total hepatic blood flow and the contribution of hepatic arterial blood flow (HABF) and portal venous blood flow using a Doppler vascular ultrasound in SIRS, sepsis, and severe sepsis patients, aiming at a clear prognostic parameter that can predict the patient’s outcome.

Results

There was a clear cutoff point of 16.09 ml/min for HABF, above which the hazard ratio for death was 5.6046, with a 95% confidence interval of 2.0078–15.6451 and a P-value of 0.0011 in late sepsis patients. The predictive potential for this HABF cutoff for patient mortality showed a sensitivity of 80%, specificity of 73.7%, positive predictive value of 70.6%, negative predictive value of 82.4%, 95% confidence interval of 0.612–0.907, and P-value of less than 0.0004. There was a significant positive correlation between the HABF and APACHE II scores (P= 0.023). Cox regression analysis showed that only the APACHE II score and HABF were independent predictors for patients’ outcome.

Conclusion

Duplex ultrasound assessment was a useful bedside method for predicting mortality in late sepsis patients through estimation of HABF, with a reasonable predictive potential at a definite cutoff level.
Role of iNOS and eNOS expression in a group of Egyptian diabetic and nondiabetic nephropathy patients
Authors: Aly Mayssa I. , Abdalla Mohamed N. , El Akad Mohamed H.F. , El-Sheikh Samar A.E.M. , Yousief Elham M.
Published: September 2023

Introduction and aim

Changes in renal nitric oxide (NO) production have been associated with glomerular hyperfiltration, vascular permeability, albuminuria, glomerulosclerosis, and tubulointerstitial fibrosis. This study aimed at detection of the role of both inducible nitric oxide synthases (iNOS) and endothelial nitric oxide synthases (eNOS) expression in diabetic and nondiabetic nephropathy patients.

Methodology

Renal biopsies and clinical data of 30 diabetic patients, 10 nondiabetic patients with renal impairment, and 10 control individuals were assessed for eNOS and iNOS expression.

Results

Both glomerular eNOS and iNOS expression levels were increased in diabetic nephropathy patients and this was associated with peripheral arterial occlusive disease. In nondiabetic patients, increased serum creatinine was found to be associated with increased iNOS and eNOS expression, and, together with the control group, they showed increased iNOS expression in tubular and interstitial cells. An association between cigarette smoking and increased expression of both iNOS and eNOS was detected in diabetic patients.

Conclusion

The presence of iNOS is associated with tubular damage resulting in renal failure. The upregulation of NO in diabetes mellitus type 2 may explain the endothelial dysfunction that is associated with almost all diabetic complications.
Renal artery stenting: early results
Authors: Abdel Mooty Hesham N. , Hefnawy Engie T. , Kareem Heba S.H. , El Kaffas Khaled
Published: September 2023

Background

Atherosclerotic renovascular disease (ARVD) is defined as renal artery stenosis with an occlusion of 60% or more. It is an established cause of resistant hypertension and renal insufficiency. ARVD is evaluated using renal artery duplex ultrasound, which measures the degree of renal artery stenosis and renal resistance index. Treatment with renal artery balloon angioplasty and stents has been shown to improve blood pressure and renal function in some patients.

Aim of the study

This was a prospective study evaluating the early effects of renal artery angioplasty and stenting in patients with ARVD as regards the blood pressure and renal function.

Methods

During March 2009 to September 2011, 37 patients (21 men and 16 women) with ARVD (unilateral or bilateral), resistant hypertension, and renal impairment were selected and divided into two groups: group A (25 patients) comprised patients who underwent renal artery balloon angioplasty and stenting (intervention group) and group B (12 patients) comprised those who were kept on medical treatment as controls and followed up without intervention.

Results

Two weeks after intervention, eight patients (32%) stopped one medication, seven patients (28%) stopped two medications (i.e. one antihypertensive medication only), and five patients (20%) stopped all medications, whereas the blood pressure did not change in five patients (20%). The average mean systolic blood pressure of group A was 140 mmHg and the average serum creatinine level was 2.1. As regards group B, the average mean systolic blood pressure was 170 mmHg for patients who were on three antihypertensive medications, and the average serum creatinine level was 2.4.

Conclusion

The main effect of renal artery revascularization in ARVD is on blood pressure control in patients with resistant hypertension, with minimal influence on the renal function.
25-Hydroxy-vitamin D3 level is a predictor to insulin resistance in patients with hepatitis C virus-induced liver cirrhosis
Authors: Zakaria Abir , Ramadan Nagwa , El-Sayed Naglaa , Zahra Amr
Published: September 2023

Background

There is an established relationship between liver disease and hepatogenous diabetes mellitus, and a growing evidence for the role of vitamin D deficiency in the pathogenesis of type 1 and type 2 diabetes mellitus. However, data on the impact of vitamin D serum level on insulin resistance among liver cirrhosis patients are lacking.

Objectives of the study

The primary objective of the current study was to investigate the relationship between vitamin D status and insulin resistance among hepatitis C virus (HCV)-induced liver cirrhosis patients using a homeostasis model for assessment of insulin resistance (HOMA-IR). The secondary objectives were to assess the association between deterioration of liver function on the one hand and insulin resistance and vitamin D deficiency on the other.

Participants and methods

Fifty patients with biopsy-proved HCV-induced liver cirrhosis were enrolled in this cross-sectional study. Routine clinical, laboratory, and imaging workout was performed to assess the degree of liver decompensation using the model of end-stage liver disease (MELD) score and the Child–Turcotte–Pugh Score (CTPS). Serum level of 25-hydroxy-vitamin D3 [25(OH)D3] was estimated. Fasting plasma glucose and fasting insulin were also measured to calculate HOMA-IR as an indicator of insulin resistance. Patients were subclassified according to serum 25(OH)D3 levels into tertiles, according to the MELD score into three groups, and according to CTPS into Child A, B, and C.

Results

A significant inverse correlation was found between serum 25(OH)D3 level and insulin resistance as assessed by HOMA-IR, whether using one-by-one correlation (r = −0.976, P =0.000) or using 25(OH)D3 tertiles’ correlation (r = −0.830, P =0.000). Linear multiple regression analysis determined low serum 25(OH)D3 level as an independent predictor for increase in HOMA-IR among HCV-induced liver cirrhosis patients. No significant association was identified between low serum 25(OH)D3 level and the severity of liver dysfunction as assessed by the MELD score or CTPS.

Conclusion

The present study showed that low serum 25(OH)D3 level was an independent predictor for insulin resistance among patients with HCV-induced liver cirrhosis.
The link between the fibroblast growth factor-23—klotho—vitamin D3 axis and the renin—angiotensin—aldosterone axis in the development and progression of obesity-related kidney disease
Authors: Nassar Wael F. , Mustafa Mustafa A. , Kamel Uomna , Hafez Mohammad H. , Saad Abdekbaser , Anan Mohammad , Temraz Mahmud , Hendi Yaser , Elokely Amir , Fouad Malaka
Published: September 2023

Introduction and aim of the work

Obesity is established as an important contributor of increased diabetes mellitus, hypertension and cardiovascular disease, all of which can promote chronic kidney disease (CKD). Recently, there is a growing appreciation that even in the absence of these risks, obesity itself significantly increases CKD and accelerates its progression. The aim of this work is to evaluate the link between Renin-Angiotensin-Aldosterone System (RAAS) and FGF23-Klotho-1,25D3 axis and their impact in obese and non-obese CKD patients.

Patients and methods

In a cross sectional randomized multi centers study, two hundred twenty six CKD patients stage III and IV (eGFR20–60 ml/min/m2) have enrolled in this study as follows: group I; 87 non diabetic CKD patients aged 20–40 years with body mass index (BMI) between 20–25 kgm/m2; group II; 130 non diabetic CKD patients aged 20–40 years with (BMI) >30 kgm/m2 and group III; 89 CKD patients aged >60 years. All patient have been tested for plasma leptinlevels, 1,25-dihydrocholicalciferole (1,25D3), plasmaparathormone (PTH) Serum calcium (Ca), serum phosphorus (PO4), and plasma FGF-23 , plasma renin activity (PRA), plasma angiotensinogen receptor 1 & 2 (AT1 & AT2) and plasma aldosterone (ALD) and pulse wave velocity (PWV).

Results

The eGFR was significantly reduced in the obese group II (eGFR = 37.7 ± 13.6) when compared with eGFR of the lean group I (eGFR = 49.3 ± 7.51) were P < 0.001, but not significant when compared with the old age group III (eGFR = 41.0 ± 13.47). The obese group II shows significant increase in the ALD/PRA ratio when compared with the lean group I and old age group III (43.23 ± 14.9) for group II vs 11.29 ± 4.1 for group I, P < 0.001 and 24.91 ± 12.1 for group III, P < 0.05 ). Regarding the FGF23-Klotho-vitD3 axis, its components of the obese group II (FGF23 259.55 ± 138.6 Ru/ml; PTH 77.63 ± X32.4 pg/ml; S.PO 4.74 ± 1.61 mg/dl) were significantly elevated when compared to the lean group I (FGF23 132.81 ± 126.1 Ru/ ml; PTH 59.18 ± 24.7 pg/ml; S.PO4 3.85 ± 0.92 mg/dl); the P values were <0.001, <0.01 and <0.05 respectively , while when compared with the old age group III (FGF23 179.33 ± 237.4 Ru/ml; PTH 70.94 ± 15.26 pg/ml; S.PO4 4.09 ± 0.42 mg/dl), values were of less significance. Plasma insulin levels were significantly high in the obese group II (insulin = 13.73 ± 2.38fg/l) than the lean group I (insulin = 5.59 ± 2.31 fg/l) and P < 0.001 and in group III p. insulin level was 10.7 ± 1.68 (P < 0.05).

Conclusion

Obesity per se is an independent risk factor in the development and progression of chronic kidney disease specially in young age patients.
Right ventricular dysfunction in patients with end-stage renal disease on regular hemodialysis
Authors: Momtaz Mohamed , Fishawy Hussein Al , Aljarhi Ula Mabid , Al-Ansi Rabei Z. , Megid Mohamed A. , Khaled Mahmoud
Published: September 2023

Background

Although there are considerable data on the changes in left ventricular function in hemodialysis (HD) patients, only a few studies on right ventricular (RV) function can be found in the literature. We investigated the changes in RV function in HD patients.

Methods

We examined 74 individuals grouped as follows: healthy controls (n = 24) and HD patients (n = 50). Echocardiography including tissue Doppler imaging (TDI) of the RV was performed in all patients.

Results

HD patients had significantly lower RV systolic indices than control participants in right ventricle fractional area change (normal 35–63%) (37.54 ± 9.86 vs. 43.5± 4.8%, P<0.001), tricuspid plane systolic excursion (normal 1.6–3 cm) (2.09 ± 0.49 vs. 2.61± 0.36 cm, P<0.001), STDIS′ wave (7.99± 1.37 vs. 9.66± 1.86 cm/s, P<0.001), and LTDIS′ wave (peak systolic velocity at lateral tricuspid annulus; normal: 10–19 cm/s) (11.86 ± 2.86 vs.16.04 ±3.60, P<0.001). HD patients had statistically significantly higher systolic pulmonary pressure (normal<35mmHg at rest) compared with those in the control group (32.75 ± 10.11 vs. 25.23± 3.99, P<0.001). There were no statistically significant correlations between systolic pulmonary pressure and RV dimensions or RV function indices.

Conclusion

Subclinical RV dysfunction – as estimated by RV function indices; tricuspid plane systolic excursion, right ventricle fractional area change, and LTDIS′ – is increased among HD patients. A high prevalence of pulmonary hypertension was found among HD patients and this was not associated significantly with RV or left ventricular dysfunction in these patients.
Visfatin and adiponectin as early markers of atherosclerosis in type 2 diabetes mellitus
Authors: Zakaria Ibtissam , Rizk Mary N. , Rakha Maha , Shehaby Amal
Published: September 2023

Introduction

As cardiovascular disease is the leading cause of mortality in type 2 diabetes mellitus, new markers for early detection and risk stratification of diabetic macroangiopathy and microangiopathy are highly desired. Adipocytokines were considered to lead to an increased risk of vascular complications in patients with type 2 diabetes by modulating vascular function and affecting the inflammatory process, thus enhancing atherosclerosis. Two of these were of particular interest, namely, visfatin and adiponectin.

Aim

The aim of this study was to evaluate serum visfatin, serum, and urinary adiponectin as early, sensitive surrogate markers of vascular atherosclerosis. We also correlated the levels of these markers to the degree of carotid intimal medial thickness (reflecting the atherosclerotic burden) in type 2 diabetic patients.

Results

Sixty diabetic patients were subdivided into two groups: group I (30 patients with carotid atherosclerosis as assessed by carotid Doppler) and group II (30 patients without carotid atherosclerosis). Twenty healthy volunteers participated as controls. Serum visfatin as well as serum and urinary adiponectin were assessed in all the study groups. We found significantly higher levels of serum visfatin among diabetics compared with the control group. Visfatin was also significantly higher in group I diabetics with atherosclerosis than those without (P<0.05). Similarly, urinary adiponectin was significantly higher in group I than in group II and in diabetics than in the control group. Serum adiponectin was higher in the control group than both the study groups. Using a regression model, visfatin proved to be the only significant predictor in the model (ß = 0.03, P<0.001). In fact, visfatin alone proved significant, explaining 63% of the variability in carotid intima-media thickness (P<0.001).

Conclusion

Serum visfatin is highly correlated with macrovascular complications in diabetic patients. Serum visfatin may emerge as a valuable and cheaper surrogate marker for the prediction of prevalent macrovascular complications in a type 2 diabetic population. It is a novel and easy-to-obtain method for the clinical assessment of vascular stress and cardiovascular disease risk in type 2 diabetes. Future prospective studies are needed to confirm our results.
Plasma long pentraxin 3 as a marker of endothelial dysfunction in early diabetic nephropathy
Authors: El Meligi Amr A. , Hamid Alaa M. Abdel , Aziz Manal A. , El Haddadd Hemmat E. , Ishak Marian F. , Yousief Elham M.
Published: September 2023

Objective

This study investigated the utility of measuring plasma long pentraxin 3 (PTX3) levels in the early detection of endothelial dysfunction compared with Von Willebrand factor (vWF) activity and flow-dependent arterial dilatation (well-known markers of endothelial dysfunction) in early diabetic nephropathy.

Materials and methods

A total of 50 Egyptian patients with type 2 diabetes and 20 healthy controls were recruited from the Diabetes, Endocrinology and Metabolism center, Faculty of Medicine, Cairo University. The diabetic patients were divided into two equal groups of comparable age and sex: group I consisted of patients with normal urinary albumin excretion and group II consisted of patients with microalbuminuria.

Results

In group II, the plasma PTX3 level was significantly higher (median value 2.3 ng/ml) and the mean flow-mediated dilatation (FMD; 0.433 ±0.059) was significantly lower when compared with the control group (PTX3 1.15 ng/ml, FMD 0.901 ± 0.04; P<00001) and with group I (PTX3 1.2 ng/ml, FMD 0.627± 0.05; P<0.0001). The vWF activity (median value) was significantly higher in the two diabetic groups compared with controls (20.2, 16.3 and 4% in group I, group II, and controls, respectively; P<0.0001), with no significant difference between the two diabetic groups. There was a significant positive correlation between PTX3 levels and vWF activity (P<0.001), diabetes duration, and concentration of fasting blood sugar, HbA1c, cholesterol, and triglyceride and a significant negative correlation between PTX3 levels and FMD (P<0.001) in all diabetic patients. In group II, there was a significant positive correlation between PTX3 levels and vWF activity (r= 0.603, P= 0.001).

Conclusion

PTX3 may represent a useful endothelial dysfunction marker in early diabetes nephropathy.
Endoscopic-assisted laser therapy for extensive rhinoscleroma
Authors: Nassim Nassim Talaat
Published: September 2023

En

Abstract

Background

Scleroma is a granuloma affecting mainly the nose, and may extend to affect the pharynx, the larynx, the lacrimal apparatus, and many soft tissue structures surrounding the nose. In Egypt, as in many other Eastern countries, scleroma is the most common nasal granuloma diagnosed clinically and pathologically. Although it mainly affects the anterior part of the nose, it is not uncommon to find cases with extensive lesions that extend to occupy the entire nasal cavity, and also to the sinuses and the orbit. Active rhinoscleroma is usually treated medically, and surgical intervention is carried out in the fibrotic stage.

Theory

The aim of this study was to determine the role of CO2 laser in the management of extensive active rhinoscleroma.

Materials and methods

This is a prospective study that included 24 patients with extensive rhinoscleroma in the active phase, that is, patients had almost complete nasal obstruction with mouth breathing. Patients were divided into two groups: group A (12 cases), who were managed only with medical treatment, and group B (12 cases), who were managed with CO2 laser debulking, concurrently with medical treatment.

Results

Patients were followed up clinically for nasal blockage and histologically to assess the activity of the disease; group B showed earlier relief of nasal obstruction and needed less medical treatment to reach the inactive stage.

Conclusion

CO2 laser debulking is a good option in treating extensive rhinoscleroma, even in the active stage, as it provides rapid relief of nasal blockage and decreases the time needed for medical treatment, reducing the possible side effects of antibiotics.
Comparing sound field audiometry and free field auditory steady state response in the verification of hearing aid fitting in adults
Authors: Selim Mona H. , Mourad Mostafa E. , El-Shennawy Amira M. , Elfouly Hedayet S.
Published: September 2023

En

Abstract

Objectives

The aim of this work was to establish hearing aid (HA) functional gain measurements using free field (FF) auditory steady-state response (ASSR) and to compare and correlate sound field (SF) versus ASSR functional gain and unaided and aided hearing thresholds in order to assess the reliability of FF ASSR as an objective tool for the verification of HA fitting.

Participants and methods

This study was conducted on 20 HA user adults with a mean age of 57.09±14.79 years. For each patient, the following were administered: history taking, basic audiological evaluation including pure tone audiometry and immittancemetry, unaided and aided SF audiometry thresholds, and unaided and aided FF ASSR thresholds. The results obtained were then compared. In addition, correlation studies between all the obtained results were carried out.

Results

A highly significant difference was found at 500 Hz only between the SF hearing thresholds and the FF ASSR thresholds among the unaided patients at the four test frequencies (500–4000 Hz). Similarly, aided SF and FF ASSR hearing thresholds showed a statistically significant difference only at 500 Hz. The results of correlation coefficient showed that unaided SF and FF ASSR thresholds were positively significantly correlated at 2 and 4 kHz. In addition, aided SF and FF ASSR thresholds were positively significantly correlated at 1 and 2 kHz. Comparison between the functional gain obtained using both SF and FF ASSR tests showed that there was a highly significant difference only at 4000 Hz.

Conclusion

SF audiometry and FF ASSR unaided and aided thresholds showed very similar results and this indicates that ASSR may be a good alternative method for the measurement of hearing level in infants and children, for whom pure tone audiometry is not possible. FF ASSR appears to be a reliable procedure for the verification of HA fitting and can be used to assess functional gain in difficult-to-test populations and children. Future research on the effect of the electroacoustic characteristics of HAs on aided FF ASSR thresholds is recommended.
Tongue base suspension using a repose bone screw system in the treatment of obstructive sleep apnea
Authors: Sabry Ramez , Reda Ramez , Abdelmonem Mohamed Sherif A.
Published: September 2023

En

Abstract

Objectives

The aim of this study was to evaluate the tongue base suspension suture technique using a repose bone screw system with respect to efficiency in relieving obstructive sleep apnea, safety, and postoperative morbidity.

Study design

This was a prospective study carried out on 10 patients with a complaint of moderate or severe obstructive sleep apnea because of retrolingual hypopharyngeal obstruction.

Methods

Demographic data were determined and preoperative investigations (flexible nasopharyngoscopy, polysomnography, and lateral cephalometry) were carried out; in addition, operative technique and postoperative assessment of patients’ complaints and postoperative data of polysomnography and lateral cephalometry were carried out.

Results

Improvement in the main complaints of patients, a significant reduction in the mean apnea hypopnea index in postoperative polysomnography, and an increase in the mean posterior airway space at the level of the tongue base in postoperative lateral cephalometry were recorded.

Conclusion

The tongue base suspension technique using a repose bone screw system is an easy and efficient procedure for the treatment of retrolingual obstruction, with minimal postoperative morbidity.
Audiovestibular manifestations in a radiologically confirmed enlarged vestibular aqueduct in congenital nonsyndromic sensorineural hearing loss in Egypt
Authors: Ghannoum Tarek , El-Minawi Sherif , Hosni Noha , Aly Aml , Nassef Amr
Published: September 2023

En

Abstract

Background

Enlarged vestibular aqueduct (EVA), the most common radiological finding in children with sensorineural hearing loss, is associated with variable auditory and vestibular symptoms.

Aim of the work

The aim of this study was to determine vestibular findings in patients with EVA.

Patients and methods

Twenty patients diagnosed with sensorineural hearing loss and EVA were included in the study group and 20 healthy individuals matched for age and sex were included in the control group. Both groups were subjected to the following: complete history taking, general and neurological examination, full ENT examination, pure tone audiometry, tymanometry, high-resolution computed tomography, vestibular evoked myogenic potentials (VEMP), caloric test, and computerized dynamic posturography.

Results

EVA was bilateral in 14 patients and unilateral in six patients. The VEMP amplitude of wave p13–n23 was higher in ears with EVA and it correlated positively with its size. p13–n23 latencies did not differ significantly from the control group. The caloric test showed an absent response in four patients, unilateral weakness in six patients, and normal results in 10 patients. There was no statistically significant difference in the results of computerized dynamic posturography.

Conclusion

The results showed a larger VEMP amplitude, which is indicative of a third window lesion. Some patients showed abnormalities in the caloric test, which indicates a peripheral vestibular lesion. VEMP, caloric test, and computerized dynamic posturography testing were effective in the evaluation of patients with EVA.
Simultaneous bilateral myringoplasty as a single-stage operation
Authors: El-Ahl Magdy A. S. , Amer Hazem S. , El-Anwar Mohammad W.
Published: September 2023

En

Abstract

Background

Myringoplasty is a common otologic procedure that results in successful closure of the perforation in most cases; however, the theoretical risk of iatrogenic sensorineural hearing loss during surgery has induced a reluctance among otosurgeons to perform bilateral myringoplasty.

Objectives

The aim of this study was to evaluate simultaneous bilateral myringoplasty as a single-stage operation.

Patients and methods

A prospective study was carried out between December 2009 and March 2012 on 30 patients (60 ears) with bilateral tympanic membrane perforations. Bilateral myringoplasty was performed in the same sitting using an underlay technique.

Results

Of the 60 ears operated upon, perforation closure was achieved in 56 (93.3%) ears and 51 (80%) ears gained hearing. No worsening of hearing was observed in any ear.

Conclusion

Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation, with a high success rate.
Comparison of three fitting rationales in adults in an artificial intelligence parallel processing hearing aid
Authors: Shabana Mohamed I. , Dabbous Abeir O. , El-Dessouky Tarek , Koura Rabab A.
Published: September 2023

En

Abstract

Introduction

Hearing rehabilitation using nonlinear hearing aid (HA) fitting formulae provides hearing-impaired individuals with the audibility, comfort, and speech intelligibility for a better life.

Objective

To compare three nonlinear HA fitting formulae in adults in a Channel Free artificial intelligence parallel processing HA.

Materials and methods

The study included 19 adults with bilateral moderate to severe sensorineural hearing loss, monaurally fitted with nonlinear HA. Comparisons were made on the basis of aided speech intelligibility in quiet and in noise, aided sound field thresholds, and functional performance in real life using APHAB, COSI, and GHABP questionnaires.

Results

The three formulae have significantly improved speech discrimination in adults, with no significant difference among the formulae for speech intelligibility in quiet or in noise, with no sex or HA experience differences. The three formulae have significantly improved functional performance in real-life speech communication, with the NAL-NL1-based formula showing the greatest degree of benefit and improvement in listening needs, followed by NAL-NL1 and then DSL [I/O]. However, amplification with the three formulae increased aversiveness to environmental sounds. Participants reported significant benefits using NAL and NAL-NL1-based formulae. Experienced HA users, using the NAL-NL1-based formula, showed significantly less difficulty in listening quality in large spaces and greater capacity to recognize speech within competitive noise and better tolerance to environmental sounds than nonexperienced users. The SPIN test correlated well with real-life speech communication.

Conclusion

The three fitting rationales have equally improved intelligibility, with variable degrees of improvement in real-life speech communication with preferences for NAL-NL1 and the manufacture-specific NAL-NL1-based formula.
Endoscope-assisted surgery: a major adjunct in cholesteatoma surgery
Authors: Badr-El-Dine Mohammed , Shewel Yasser G. , Ibrahim Ahmad A. , Khalifa Mohammed
Published: September 2023

En

Abstract

Objective

The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft.

Materials and methods

A total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure.

Results

The incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear.

Conclusion

Endoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.
Assessment of narrative skills in preschool children
Authors: Safwat Rasha F. , EL-Dessouky Hossam M. , Shohdi Sahar S. , Hussien Ibtihal A.
Published: September 2023

En

Abstract

Background

Narrative skills are a form of discourse that describes real or fictional events. In recent years, the study of communicative competence has extended to examining longer discourse units, including narratives in many languages. Unfortunately, few studies have been carried out to assess narrative skills in Arabic-speaking children.

Objective

The aim of this study was to design an assessment protocol for narrative skills in Arabic-speaking children in order to reach a better understanding of their developmental pattern.

Participants and methods

The study was carried out on 60 Arabic-speaking normal Egyptian children aged between 2 and 6 years. The children were divided into four groups according to their age. An assessment tool was designed to assess their narrative skills on three aspects, namely, story structure, language structure, and narrative productivity.

Results

The results revealed significant differences between the groups in all studied aspects. Narrative skills were found to develop with age. However, the age at which narrative skills are acquired varies from one skill to the other.

Conclusion

Children start to acquire narrative skills at the age of 2 years and these skills become well developed around the age of 6. Some narrative skills are acquired at an earlier age compared with others.
Effect of a prolonged topical glucocorticosteroid on interleukin-5 production and eosinophilic recruitment in the nasal submucosal compartment
Authors: Mostafa Hany S. , Fawzy Tamer O. , Ayad Essam , Soliman Ahmed A.
Published: September 2023

En

Abstract

Aim

Intranasal corticosteroids offer effective treatment for allergic rhinitis. The action of interleukin 5 (IL-5) (Th2-type cytokine) and its response to intranasal steroids has not been thoroughly studied in the deep compartment of the nasal mucosa. The aim of this study was to determine the influence of prolonged topical glucocorticosteroid on the allergic inflammatory responses in the deep compartment of the nasal mucosa in patients with allergic rhinitis.

Materials and methods

Fluticasone furoate spray was used once daily. Biopsies were obtained from 22 patients with perennial allergic rhinitis at different intervals: before treatment with nasal corticosteroids, and after 1, 6, and 12 months. Biopsies were taken from 18 individuals serving as a control group. All biopsies were examined by light microscopy and immunohistochemisty.

Results

The results showed the efficacy of fluticasone in reducing the number of eosinophils in both epithelial and subepithelial layers, which suppresses the allergic manifestations. The maximum reduction occurred after 12 months. This is achieved by reducing the number of eosinophils and IL-5 in both epithelial and subepithelial compartments.

Conclusion

Intranasal corticosteroids effectively reduce both the number of eosinophils and IL-5 expression inside activated eosinophils. They influence both the epithelium and the deep compartment of the nasal mucosa.
Hairy polyp of the nasopharynx, an unusual presentation, a case report and literature review
Authors: Al-Qudehy Zeinab A. , Al-Nufaily Yasser , Yagi Hashim
Published: September 2023

We report a rare tumor of the nasopharynx with an unusual presentation in a 15-year-old female: the teratoid or hairy polyp. Hairy polyps are rare benign congenital tumors that present at birth or shortly after. Usually, they arise from the ectoderm and endoderm. Their presence in older individuals is unusual. Their clinical presentation depends on the site and size. Our patient presented late with nasal obstruction, snoring, and mouth breathing, and the clinical examination indicated a nasopharyngeal mass. The tumor was removed without complications and the histopathology was consistent with hairy polyp. In this short communication, we raised awareness of such a rarity of nasopharyngeal mass that has to be suspected in pediatric age group. A review of this unusual malformation will be included. We believe, after a computerized literature search, that this is the first report of its kind from the Arabian Peninsula.
Hypoglossal nerve conduction studies in patients with obstructive sleep apnea
Authors: Ragab Samy M. , El Din Mohamed H. Bader , Hefny Mohamed A. , El Tabakh Mohamed T.
Published: September 2023

En

Abstract

Aim of the work

To identify the correlation between obstructive sleep apnea (OSA) and motor nerve conduction study of hypoglossal nerve in terms of amplitude and terminal latency.

Patients and methods

The present study included 16 adult OSA patients who presented to the Otolaryngology outpatient clinic of the Suez Canal University Hospital. Exclusion criteria included previous significant facial trauma, head or neck cancer, previous surgery (including tonsillectomy or adenoidectomy), previous radiation therapy to head or neck, known diagnosis of peripheral neuropathy, any implanted device (nerve stimulator, implanted pump, pacemaker, and defibrillator), and known pregnancy. All patients were subjected to an assessment protocol that included thorough assessment of history (age, sex, snoring, nasal obstruction, and excessive daytime sleepiness), clinical examinations [BMI, apnea/hypopnea index (AHI), Friedman tongue position (FTP), and Mallampati grading], and electrophysiological studies of hypoglossal nerve.

Results

87.5% of the patients had moderate to severe AHI (15 to >30). The degree of excessive daytime sleepiness was slight in 18.8% of the patients, mild in 50% of the patients, and moderate in 31.3% of the patients. FTP grades ranged from grade II (FTP II) (37.5%) to grade III (FTP III) (62.5%). Mallampati grading of tonsils also ranged from grade 2 (T2) (43.8%) to grade 3 (T3) (56.2%). Seventy-five percent of the patients had delayed distal latency of hypoglossal nerve. The mean distal latency of the patients was 3.24±123 ms, with the range of 2.5–7.7 ms. All the patients had low motor amplitude of the hypoglossal nerve. There were significant positive correlations between excessive daytime sleepiness and BMI, snoring, FTP, Mallampati grading, and decreased hypoglossal nerve distal latency.

Conclusion

Most patients with OSA had significantly impaired hypoglossal nerve conduction in the form of delayed distal latency and low motor amplitude.
The cool new kid on the block: Lung cryobiopsy
Authors: Esmail A , Dheda K
Published: September 2023

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L’OMS et la CIDIH
Authors: Robinson David
Published: September 2023

En 1988 la revue du Réseau International de la CIDIH a publié cet article de David Robinson dans le Volume 1, numéro 1 intitulé « Vers une CIDIH officielle en 1991 - Bulletin du CQCIDIH ». Il nous fait plaisir de republier l’article de Monsieur Robinson qui avait participé aux consultations organisées par le réseau international pour proposer une révision du 3e niveau de la CIDIH pour parler de la relation entre l’OMS et la CIDIH. Conférence prononcée le 2 juin 1987 lors de la journée précongrès consacrée à la CIDIH.
Déclaration de la Disabled Peoples’ International (DPI) sur la Classification Internationale des Déficiences, Incapacités et Handicaps (CIDIH) de l’Organisation Mondiale de la Santé (OMS), Janvier 1987
Authors: Enns Henry
Published: September 2023

En 1989 la revue du Réseau International de la CIDIH a publié cet article de Henry Enns dans le Volume 2, numéros 2-3 intitulé « Rencontre internationale de Québec 1987 : Textes des participants ». Il nous fait plaisir de republier l’article de Monsieur Enns qui avait participé aux rencontres au nom de la Disabled Peoples’ International (DPI) et avait par la suite rédigé ce texte.
Inteligência emocional e gestão pública brasileira: um estudo bibliométrico
Authors: Figliuolo Vanessa Susan Pinheiro , Roberto José Carlos Alves , Da Cunha Edileuza Lobato , De Lima Orlem Pinheiro , De Araújo Paulo César Diniz , De Oliveira Júnior Nilson José , Maduro Márcia Ribeiro
Published: September 2023

O estudo da inteligência emocional (IE) parece recente devido sua ampla divulgação midiática, todavia data-se o início, a partir dos anos 90. Apesar disso a publicação de artigos científicos com esse tema atrelado a liderança/gestão, principalmente, pública brasileira é inicial. Diante disso o presente trabalho buscou compreender: qual o curso evolutivo das pesquisas científicas e qual cunho metodológico entre os anos de 2021-2023?. Teve como objetivo geral compreender o desenvolvimento de pesquisas científicas envolvendo a inteligência emocional no serviço público brasileiro, especificamente no líder/gestor público. Foi realizada uma revisão bibliométrica a partir de artigos científicos coletados nas bases de dados Google Acadêmico e Scientific Periodicals Electronic Library (SPELL). Os dados aqui apresentados adicionados aos resultados de Ferari e Gedini (2021) perpassam significativamente por 33 anos de estudos sobre inteligência emocional e liderança/gestão pública brasileira e apontam como os estudos ainda estão em um momento inicial e necessitam avançar quanto a estudos de base e, conseguintemente, estudos empíricos.
Clinical Profile and Risk Factors of Exudative Age-related Macular Degeneration: A Hospital Based Case-control Study
Authors: Ravi Aparna , George Simon
Published: September 2023

Introduction: Age-Related Macular Degeneration (ARMD) is one of the leading causes of vision loss in the elderly population. ARMD is characterised by progressive degeneration of the retinal pigment epithelial complex and photoreceptors primarily in the macular region of the retina. The prevalence of ARMD in India ranges from 39.5% to 0.3%, as reported in populationbased studies. Numerous risk factors, both modifiable and nonmodifiable, have been identified for this condition. Aim: To determine the clinical profile and risk factors associated with exudative ARMD. Materials and Methods: This is a case-control study conducted in a tertiary eye care hospital in South Kerala from June 2011 to June 2012. The cases were patients attending the Outpatient Department (OPD) and Retina clinic who were diagnosed with wet ARMD. The corresponding control is the next patient seen after the case who is of the same sex and comparable age. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 17.0. Chi-square test was used to elucidate the association between the presence of ARMD and diet, educational status, occupation, smoking, alcoholism, hypertension, diabetes mellitus, cardiovascular disease, obesity, hyperlipidemia, history of cataract surgery, and cataract. Multivariate logistic regression analysis was used to assess these risk factors for cases and controls. Results: A total of 130 subjects consisting of 65 cases and 65 controls participated in the study. The majority of patients were in the age group of 60-69 years. History of hyperlipidemia (Odds Ratio [OR]: 1.649, Confidence Interval [CI]: 0.524-5.191, p=0.042) was significantly associated with the development of exudative ARMD. Hypertension (OR: 1.398, CI: 0.694-2.815, p=0.051), cardiovascular disease (OR: 1.770, CI: 0.274-5.064, p=0.188), Body Mass Index (BMI) >25 (OR: 0.537, CI: 0.254- 1.133, p=0.075), dietary factors (OR: 1.351, CI: 0.461-3.961, p=0.609), smoking (OR: 1.400, CI: 0.484-4.051, p=0.593), alcoholism (OR: 1.400, CI: 0.484-4.051, p=0.593), history of cataract surgery (OR: 1.160, CI: 0.411-3.279, p=0.456), cataract (OR: 1.618, CI: 0.692-3.782, p=0.149) were not found to be significant. The results may vary in the present scenario due to changes that have occurred over the years, especially in the case of smoking and alcoholism, as the prevalence of which has increased. The majority (88.75%) of study subjects have classic Choroidal Neovascular Membrane (CNVM). Conclusion: ARMD was found to have a significant association with hyperlipidemia. Those with hypertension, cardiovascular disease, cataract, smokers, and alcoholics have a higher risk of developing exudative ARMD. By controlling modifiable risk factors like hyperlipidemia and by avoiding smoking and alcoholism, the authors can prevent this potentially blinding condition to some extent.