A b s t r a c t Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group. The rats were followed clinically for eight months and neurological examination detected no weakness or paralysis in the operated

Background: Bad wound healing increases the burden to the patient and health care services. So any technology that improves the healing process has the potential to save billions in annual health care costs and preserves the patient quality of life. Silver nanoparticles (AgNps) have become of interest in biomedical applications, because of their antibacterial, antifungal, antiviral and anti-inflammatory activity.Aim: was to investigate the role of AgNps on the healing process of skin wounds in adult male albino rats.Material & Methods: 72 male albino rats were subjected to excisional skin wounds 1.5 cm in diameter on their mid-backs. Then rats were divided into 4 groups 18 rats each; Group I(control): skin wounds were left to heal naturally. Group II: treated with methylcellulose hydrogel, Group III: treated with silver sulphadiazine (dermazine cream) and Group IV: treated with AgNps in methylcellulose hydrogel. For each group 6 rats were sacrificed on 3rd, 7th and 14th day post-wounding. Skin specimens from all groups were processed for paraffin blocks. Sections were stained with Hx& E & Mallory's trichrome and immune-stained with vascular endothelial growth factor (VEGF). Using image analysis software, the number of macrophages, newly formed blood vessels & fibroblasts as well as area % of collagen fibers deposition were assessed and statistically analyzed. Results:In AgNps treated group re-epithelialization started on day 3 post-wounding and complete epithelialization and regeneration of the dermis was observed on day 14. The granulation tissue filling the wound area contained macrophages, newly formed blood vessels, fibroblasts and collagen fibers. The number of macrophages was statistically highest with significant difference in AgNps treated group (group IV) on day 3 post-wounding then was the lowest on days 7 and 14 compared with other groups. Neovascularization started on day 3 in all groups but was prominent on group as proved by results of VEGF immune staining. The newly formed blood vessels declined on day 14 in AgNps treated group and remained high in silver sulphadiazine group and showed maximum density in control group. The number of fibroblasts in group IV was maximum on day 7 postwounding & decreased to minimum on day 14. The percent of collagen fibers deposition was statistically maximum in AgNps treated group with significant difference across all periods of the study Human Anatomy and

Background The ultimate goal for wound healing is a speedy recovery with minimal scarring. Different approaches have been used for achieving this goal such as antimicrobials and cell growth promoting agents. Recently, silver nanoparticles (AgNps) have become of interest in biomedical applications, because of their antibacterial, antifungal, antiviral and anti-inflammatory activity. Aim was to investigate the role of AgNps on the healing process of excisional skin wounds in adult male albino rats. Material & Methods 72 male albino rats weighing 200 g were obtained from research center, Ain Shams Faculty of Medicine and subjected to excisional skin wounds 1.5 cm in diameter on their mid-backs. Then rats were divided into 4 groups 18 rats each; control (group I) skin wounds were left to heal naturally. Other wounds were topically treated once daily with methylcellulose hydrogel (group II), silver sulphadiazine (group III), and AgNps in methylcellulose hydrogel (group IV). For each group 6 rats were sacrificed on each of the following days post-wounding; 3rd, 7th and 14th. Skin specimens from all groups were fixed in 10% neutral formalin & processed for paraffin sections which were stained with Hx & E, Mallory’s Trichrome and vascular endothelial growth factor (VEGF). Using image analysis software, number of (macrophages, newly formed blood vessels & fibroblasts) and area % of collagen fibers deposition were assessed and statistically analyzed. Results Control and methylcellulose hydrogel groups revealed almost similar results. Re-epithelialization started on day 3 post-wounding only in AgNps treated group and on day 7 in all other groups. Epithelialization was complete on day 14 only in AgNps treated group and the dermis was mostly regenerated with the appearance of skin appendages. Components of the granulation tissue varied considerably among the studied groups and across the three time points. In Hx & E stained sections the number of macrophages was highest in AgNps treated group on day 3 post-wounding then was the lowest on days 7 and 14 compared with other groups as confirmed by image analysis. Neovascularization started on day 3 in all groups but was prominent on AgNps treated group which showed high density on day 7 as proved statistically and by results of VEGF immune staining. The number of the newly formed blood vessels declined on day 14 in AgNps treated group and remained high in silver sulphadiazine group and showed maximum density in control groups. Statistical analysis proved that the number of fibroblasts in AgNps group was maximum on day 7 & decreased to minimum on day 14 compared with all other groups. In Mallory’s trichrome stained sections the area percent of collagen fibers deposition in the granulation tissue was maximum in AgNps treated group across all periods of the study compared to other studied groups. Conclusion AgNps showed advantage of rapid healing of excisional skin wounds in rats compared with traditional methods of treatment. It might be the treatment of choice particularly for high risk patients.

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Introduction: Laparoscopic Sleeve Gastrectomy (LSG) has become the most commonly performed bariatric procedure. LSG is known for its safety and effectiveness, shorter operative time, feasibility, and easiness of revision and conversion to a malabsorptive surgery. Surgeons are tailoring different techniques to avoid complications from arising. Twisting of the sleeved gastric tube is one of the causes of sleeve obstruction and persistent nausea and vomiting. This study aims to compare between the postoperative complications in sleeve gastrectomy with and without posterior fixation. Patients and methods:In this prospective comparative cohort study 643 patients were included; divided into two groups according to the surgical technique. Group 1 included 364 LSG operations without fixation and Group 2 included 279 LSG with sleeve fixation. The operations were performed at Ain Shams University Hospitals between June 2017 and June 2021. Fixation of the sleeve was performed by two or three absorbable stitches to the prepancreatic fascia and root of the mesocolon. Incidence of postoperative complications were compared in each group.Results: There were no statistically significant differences in baseline characteristics between the two groups included in the study. Group 2 showed highly significant increase in operative time (p<0.001) the overall incidence of complications was significantly less in the fixation group (p <0.0001). Incidence of vomiting, bleeding, GERD and re-operation was significantly lower in group 2 (p<0.05).Seven patients from group 1 were diagnosed with gastric twist as post operative complication with one patient suffering from leakage compared to three patients in group 2. There were no mortalities in both groups. Conclusion:Adding posterior fixation to LSG ensures decreases incidence of complications. Many randomized controlled trials are needed to draw a solid outcome.