Keloids and hypertrophic scars could impair the psychological, physical, and cosmetic aspects of the patient's quality of life. Unfortunately, there is no curative treatment available till now. This study aimed to evaluate the efficacy and safety of intralesional vs topical botulinum toxin A combined with Fractional CO 2 laser in the treatment of hypertrophic scars and keloids. Twenty patients with Keloids and hypertrophic scars were enrolled in the study. Each scar was divided into two halves, one subjected to intralesional injection of botulinum toxin type A once a month for 4 months and the other was subjected to four sessions of CO 2 laser therapy at 1 month interval followed by topical application of botulinum toxin A. Significant improvement was noted in Vancouver Scar Scale in hypertrophic scars in laser group than intralesional botulinum toxin A. In keloid cases, the improvement was significantly higher with intralesional botulinum toxin A. Clinical improvement showed significant negative correlation with scar duration and size. Botulinum toxin A is a promising treatment for hypertrophic scars and keloids. The use of fractional CO 2 laser as a mode of delivery enhanced the efficacy of botox in hypertrophic scars.
Background: Background: Ebstein's anomaly is an uncommon clinical syndrome accounting for approximately 0.5% of congenital heart disease (CHD) patients. It is defined as a congenital displacement of the posterior and septal leaflets of the tricuspid valve towards the right ventricular apex which results in atrialization of a part of the right ventricle. Aim and objectives: Review the pathological spectrum of Ebstein´s Anomaly in adults, illustrate by MR the morphologic aspects of EA. Discuss MR Findings of right ventricular overload including right ventricular dimension, paradoxical ventricular septal motion. Emphasize the role of MR in the assessment of ventricular and valvular function. Demonstrate the use of delayed contrast-enhanced MR to rule out segments of myocardial dysplasia, Subjects and Methods: The present study involved twenty patients who were previously diagnosed for assessment and treatment of Ebstein's anomaly. The clinical records and surgical details of all identified patients were examined, and Participants were selected from the outpatients in National Heart Institute, Giza, Egypt. Results: results of the study revealed that Ebstein`s anomaly severely affecting tricuspid regurge since 75% of patients (15 of 20) were affected while only one patient (5%) suffered of mild regurge and four patients (20%) suffered of moderate regurge, Conclusion: The diagnosis of Ebstein'sanomaly is usually based on echo findings; however, cardiac magnetic resonance imaging(CMR) can add useful information enabling a detailed visualization of cardiac abnormality, as well as a method of accurate physiological evaluation. CMR, in conjunction with echocardiography, offers a comprehensive non-invasive evaluation either for surgical management or ongoing follow-up of these patients.
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