Biomedical subjects

E Saleh

Publications and source records attributed to E Saleh.

33 records · Page 2Linked to original sources

PubMed1995

Intravenous drug addicts: a high risk group for infection with human immunodeficiency virus, hepatitis viruses, cytomegalo virus and bacterial infections in Alexandria Egypt.

In this work the seroprevalence of HIV, HBV, HCV and CMV were studied among two groups of population; IVDA (intravenous drug addicts) (100) and control group (40). Syphilis and other bacterial infections which may be encountered among IVDA were also investigated. It was found that all serum samples (of both groups) were negative for anti-HIV. Regarding HBV markers, the prevalence of HBc antibodies was significantly higher among IVDA (62%) than the control group (27.5%). Also HBsAg was detected in 16% of IVDA while it was 75% among the control group. Prevalence of anti-HCV was significantly higher among IVDA (63%) than the control group (27.5%). The prevalence of co-infection with HBV and HCV was significantly higher in IVDA (40%) than the control group (15%). Sharing of needles and duration of drug use were positively associated with the presence of both HBV markers and anti-HCV. CMV seroprevalence was high in both groups. Antibodies to Syphilis were found in sera of 3 IVDA and one control using MHA-TP test. Although HIV infection has not yet been sufficiently introduced among IVDA in Alexandria but potentials for its spread among addicts are high as supported by observation that other infections with similar mode of transmission are common among addicts.

Adult↗

PubMed1995

Facial nerve neuromas: diagnosis and management.

Facial nerve neuromas are uncommon tumors that involve the facial nerve. There is no classic presentation of these tumors. This study presents a series of 22 patients with facial neuromas managed from 1977 to 1993. Facial nerve dysfunction was the most common complaint, present in 90.5% of cases. Hearing loss was the second most common complaint and was found in 76.2% of cases. High resolution computed tomography and magnetic resonance imaging with gadolinium proved to be the most accurate methods of preoperative assessment of these tumors and are complementary in selected cases. Different surgical approaches were performed according to tumor location and preoperative hearing level. In all cases long-term follow-up showed no tumor recurrence, and acceptable return of facial function was noted in 80% of cases.

Adolescent↗

PubMed1995

[Incidence of normal hearing in acoustic neuroma].

Unilateral or asymetrical sensorineural hearing loss, tinnitus and instability classically represent the main symptoms for the suspected diagnosis of acoustic neurinoma. In literature there are very few studies which refer about acoustic neurinoma in patients with normal hearing. In this article we report the results of a retrospective analysis of 155 acoustic neurinoma cases with normal hearing managed in our center in the last 7 years. These patients are classified in two groups: 1) with normal hearing at the time of diagnosis and 2) with at least a mild sensorineural hearing loss. Of this 155 cases, 21 (13.5%) had normal pure tone audiogram. An important characteristic of these patients, in comparison with the group with normal hearing, is the younger age. Tinnitus, instability, sudden hearing loss with complete recovery and vertigo are the most common symptoms. The mean pure tone threshold is 14.7 dB, speech audiometry is positive in very few cases, while a large number of cases show false negative. ABR are positive in 90.5% of cases, and demonstrate its high sensitivity for retrococlear pathology. The mean tumor size shows significant differences between the group with normal hearing and this with hearing loss. We believe that the presence of this symptoms in a young patient should necessitate complete neurotologic examination and in the patients with normal hearing a high level of suspicion represents the first step for early diagnosis of small tumors; the next step is the through evaluation of patient with pure tone audiogram, ABR, and imaging studies, preferably MRI with gadolinium, as this permits the diagnosis of small intracanalicular tumor. Thus, in cases of small tumors with good hearing we feel that will be possible to adopt hearing conservation surgical approach like FCM and retrosigmoid approach in more cases.

Audiometry, Pure-Tone↗

PubMed1995

[Meningoencephalic herniation into the middle ear].

Herniation of meningeal and/or encephalic tissue into the middle ear is a pathology which, even if rarely found by the otologist, can be life-threatening for the patient because of eventual infective intracranial complications. Four different etiological types are possible, infective, post-surgical, traumatic and spontaneous. From a pathogenic point of view, all types are characterized by a bony and dural defect localized in the tegmen through which meningeal and encephalic tissue can herniate. Symptomatology is often non-specific so that some cases are diagnosed during surgery. When there is strong suspicion of herniation neuroradiological assessment procedures must be carried out in order to make a correct pre-operative diagnosis, High Resolution Computed Tomography (HRCT) of the temporal bone in particular, can show the exact limits and location of the bone defect, while Magnetic Resonance Imaging (MRI) allows the nature of the tissue in the middle ear to be determined. Surgery is the only appropriate therapy. Different approaches have been described amongst which the transmastoid with or without temporal minicraniotomy and the middle cranial fossa (MCF) are the most frequently reported literature. From June 1982 to March 1994, 27 consecutive cases underwent surgery at the Gruppo Otologico, Piacenza. As a result of the occurrence of postoperative meningitis in one case, a new surgical technique through the MCF was standardized. The main step of this procedure consist in leaving the herniated tissue in situ so as to make a barrier between the middle ear and subdural space. The technique is indicated either in the case of large, multiple or very anteriorly located bony defects or when there is an infection in the middle ear.

Adolescent↗

PubMed1994

The enlarged translabyrinthine approach for removal of large vestibular schwannomas.

This study was carried out to validate the enlarged translabyrinthine approach for the surgical management of large vestibular schwannomas. A retrospective review of the charts of 53 patients with large tumours removed via the enlarged translabyrinthine approach at the Gruppo Otologico, Piacenza, Italy, during the last five years was carried out. The ability to control large tumours and the achievement of total removal with low morbidity and very few complications, demonstrate that tumour size does not influence the use of the enlarged translabyrinthine approach for managing large tumours.

Adult↗

PubMed1994

Surgical anatomy of the extended middle cranial fossa approach.

The extended middle cranial fossa approach includes removal of the petrous bone from its subtemporal surface in order to expose widely the internal auditory canal and the posterior fossa dura around its porus while preserving all the important and closely related anatomical structures. We have dissected 25 temporal bones and five fresh cadavers in order to define the limits of this approach. Measurements were obtained between the different structures to find reliable angles and distances that could guide working in this area. A new method of identification of the internal auditory canal is discussed based on the measurements taken.The results of the present work showed wide variations in the different structures. The arcuate eminence was coincident with the superior semicircular canal in only 48% of bones. Dehiscence of the geniculate ganglion and of the internal carotid artery was noted in 16% and 20% of specimens, respectively. The angles measured between the different structures showed great variations. However, the angle between the internal auditory canal and superior petrosal sinus was constant. Though the extended middle cranial fossa is a versatile approach, it affords a limited access to the cerebellopontine angle. A thorough understanding of the complex and variable anatomy of this area is necessary should this approach be utilized.

Journal Article↗

PubMed1994

Decision making in acoustic neuroma management: the only hearing ear.

Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical practice. Managing this group of patients is a challenge to both patient and surgeon. In this study we report on five cases of acoustic neuroma in an only hearing ear. Our decision for nonsurgical management of those patients with regular follow-up using auditory brainstem responses and magnetic resonance imaging is discussed. Other management options currently available are considered as well.

Journal Article↗

PubMed1994

Revision stapes surgery: a critical evaluation.

Fifty-six revision stapes surgeries performed during the last 9 years were evaluated retrospectively for their preoperative symptoms, intraoperative findings, and postoperative results according to the causes of failure, at the Gruppo Otologico, Piacenza, Italy. The most frequent causes of failure were found to be prosthetic misalignments, a reaction to the surgical trauma in the form of excess fibrous tissue reaction or new bony regrowth at the oval window, and ossicular chain problems. The location of the pathology was found to be an important factor in the outcome. Sixty percent of cases resulted in 0- to 20-dB air-bone gap. The causes of these failures, management, and their prevention during primary surgeries are also discussed.

Adult↗

PubMed1994

Surgical anatomy of the petrous apex as it relates to the enlarged middle cranial fossa approaches.

This work was designed to study the surgical anatomy of the petrous apex as it relates to the enlarged middle cranial fossa approaches, on 25 temporal bones. In this study we suggest dividing the petrous apex into two topographic areas: an anterior triangular and a posterior quadrangular area with respect to the posterior border of the Gasserian ganglion. Anatomic descriptions endorsed by relevant measurements of these areas are provided in this study.

Humans↗

PubMed1994

Surgical management of epitympanic cholesteatoma with intact ossicular chain: the modified Bondy technique.

The results of 37 cases surgically treated with the modified Bondy technique during a 6-year period at the Gruppo Otologico-Piacenza, Italy, are reported. This technique, indicated in epitympanic cholesteatoma with good hearing and intact ossicular chain and pars tensa, provides a one-stage mastoid cavity exteriorization with radical removal of cholesteatoma while preserving the preoperative hearing levels. The technique, indications, results, and comparison with other current techniques are discussed in this article.

Adolescent↗

PubMed1993

Antiviral susceptibility testing of cytomegalovirus: criteria for detecting resistance to antivirals.

Testing cytomegaloviruses for antiviral susceptibility is increasing especially since the reports of 'resistance' to ganciclovir and foscarnet (Erice et al., 1989; Knox et al., 1991). There is however no standardized method for susceptibility testing nor are there criteria for designating an isolate as sensitive or resistant. In a previous paper we utilized a plaque reduction assay and suggested that a resistant strain be defined as one requiring > 12 microM ganciclovir for inhibition of 50% of viral plaques. (Drew et al., 1991) This concentration was chosen because it was at least four-fold greater than the mean concentration required to inhibit pretherapy isolates. In this paper we present the results of testing a large number of isolates prior to and during therapy with either ganciclovir or foscarnet. By analyzing the results of these assays we propose revised criteria for susceptibility of cytomegalovirus </= 5 microM for ganciclovir and <400 microM for foscarnet.

Journal Article↗

PubMed1993

Vascular malformation of the internal auditory canal.

A report of a case with a vascular malformation of the internal auditory canal (IAC) is presented. A review of the literature of this rather rare lesion is also made in an attempt to outline its clinical features, radiological diagnosis and management. The differential diagnosis and distinction between vascular malformations and other internal auditory canal tumours are discussed.

Adult↗

PubMed1991

Comparative study between different schedules for sclerosing oesophageal varices.

There were no significant differences between the one week and the 2 weeks interval groups with regard to total number of sclerotherapy sessions, total volume of the sclerosant used (5% ethanolamine oleate) or rate of complications such as pyrexia, stricture ulcer and/or slough formation. Neither early nor recurrent bleeding occurred in any patient in the two (2) groups. Eradication of varices in the 2-week interval group was achieved significantly earlier (P less than 0.05) than in the one week interval group.

Esophageal and Gastric Varices↗

PubMed1990

Evaluation of gastric carcinoembryonic antigen in endemic schistosomal hepatosplenomegaly.

In endemic hepatosplenomegaly with histopathologically proved atrophic gastritis, the gastric juice carcinoembryonic antigen (CEA) showed significant increase. Comparing this group of patients with histopathologically proved gastric neoplasia the levels were significantly higher in the later group. The level of (CEA) was only increased in 75% of cases with endemic hepatosplenomegaly and atrophic gastritis opposite to 100% of cases with gastric neoplasia. The level of serum (CEA) was also studied in patients and control groups. In patients with endemic hepatosplenomegaly and atrophic gastritis the level was insignificantly higher than the control group and significantly lower than the group with gastric neoplasia.

Adenocarcinoma↗

PubMedDate not supplied

[The extended middle cranial fossa approach: a morphometric analysis].

The extended middle cranial fossa (EMCF) approach calls for removal of the petrous bone from its subtemporal surface in order to well expose the internal auditory canal (IAC) and the posterior fossa dura (PDF) around its meatus, safeguarding, at the same time, all the important, closely related, anatomical structures (the Gasserian ganglion (GG) and its third trigeminal division, the internal carotid artery (ICA), the cochlea, the posterior labyrinth, the superior petrosal sinus (SPS), the inferior petrosal sinus (IPS) and the jugular bulb (JB). The middle meningeal artery, on the other hand, could be divided when necessary. We dissected 25 temporal bones preserved in formaldehyde and those of five cadavers in order to define the limits of this approach. Measurements were taken so as to establish the limits of the approach as well as to determine the most appropriate angles and distances in working in this area. As previously suggested by the Senior Author (MS), we found it safer to start working medially in order to identify the IAC and then to extend the dissection laterally. The most constant angle proved to be that between the IAC and the SPS. The distances and areas found appear to be highly variable and difficult to rely upon. A thorough knowledge of this anatomy is of most importance for the surgeon who intends to use this approach.

Brain↗