Aim: To compare the outcomes of infrapopliteal angioplasty between diabetic and non-diabetic patients with critical limb ischemia.Methods: From September 2014 to April 2015, infrapopliteal angioplasty was performed on 80 patients (43 men; mean age 70.13 years) with critical limb ischemia CLI (Fontaine`s grade III or IV). The number of diabetic patients was 40 (50%). Follow-up included clinical examination for rest pain improvement and ischemic ulcer healing, and duplex-documented target vessel patency or re-stenosis at discharge and at 3 months. Results:The technical success rate was 100% in diabetic and non diabetic groups. The ulcer healing rate was 33/37(89.18%) in diabetic patients vs. 28/30(93.3%) in non diabetic patients and the re-stenosis and re-occlusion rates of treated vessels after 3 months were 10.0% in diabetic vs. 5.0% in non diabetic groups. Conclusion:There were no significant differences between the 2 groups in the technical success rate, but the 3 months clinical success rate and the primary patency rate were better in non diabetic than in diabetic patients with significant differences.Recent hemorrhagic stroke or any other CNS abnormality with increased risk of hemorrhage.
Background: Central obesity is a chronic condition that can contribute to impairments in lung functions. Body position is an important technique that effectively restores and increases lung functions. We aimed to address the possible changes in spirometric parameters in asymptomatic overweight individuals with central obesity with a change in posture from sitting to supine in comparison to normal weight non-obese ones.Methods: Enrolled subjects were healthy Egyptian males, aged between 20-45 years old, asymptomatic and nonsmokers. They underwent spirometry. The following parameters were measured; forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow (FEF)25-75%. They were classified into overweight with central obesity (n=40) and healthy control (n=40) groups based on their body mass index (BMI), weight-hip ratio (WHR), and waist circumference (WC). Spirometric parameters were compared between the 2 groups and in both setting and supine positions.Results: The central obesity group showed significantly lower all spirometric parameters in comparison to the control one. All measured spirometric parameters had a significant reduction with supine position. There were negative correlations between both the WC and WHR and spirometric parameters.Conclusion: In this study of young Egyptian males, individuals with central obesity had reduced spirometric parameters in comparison to healthy ones. Change in position from sitting to supine has significant effects on spirometric parameters in both healthy middle age males with normal weight and those with overweight and central obesity. These results could have important clinical implications.
OBJECTIVE: Tubal abnormalities may stand behind 30-40% of the causes of infertility and evaluation of tubal patency is so crucial in their diagnostic workup. Hysterosalpingography (HSG) is a reliable, simple and cost effective method for evaluation of tubal patency. Our objective is to investigate the analgesic effect of combining oral diclofenac potassium and cervical lidocaine cream in alleviating pain during hysterosalpingography (HSG). DESIGN: Randomized controlled double-blinded trial. MATERIALS AND METHODS: Reproductive-aged infertile women scheduled for HSG were considered for enrollment Eligible women were recruited and randomized (1:1) to diclofenac plus lidocaine or Placebo group (NCT02709590, clinicaltrials.gov). All women received oral 50 mg diclofenac potassium or placebo tablets one hour before HSG, then 3 ml of lidocaine 5% cream or placebo was applied to the anterior cervical lip, followed by 3 ml placed in the cervical canal using a sterile needless syringe. The study outcomes was the participant's self-rated pain perception utilizing a 10-cm Visual Analogue Scale (VAS) during speculum placement, cervical tenaculum placement, injection of the dye, 5 minutes and 30 minutes post-procedure. A 2 cm difference in VAS score between both arms was considered a clinically significant difference. Other endpoints included the number of women who need additional analgesics, and the adverse effects of the study medications. Independent t-test and Chi-square test were used for analysis of the outcomes. RESULTS: One hundred forty women were enrolled and randomized to diclofenac plus lidocaine arm (n¼70) or placebo (n¼70). Both arms were comparable in age, parity, BMI, duration of infertility and the prior mode of delivery. Women in the diclofenac plus lidocaine arm were more likely to report lower VAS scores during injection of the dye, 5 minutes and 30 minutes post procedure (median: 4 vs. 7, p¼0.0001; 2 vs. 4, p¼0.0001; 1 vs. 2.5, p¼ 0.0001, respectively). No significant differences in VAS score after speculum or tenaculum placement. Additionally, fourteen women asked for additional analgesics in the placebo group versus eight women in the study group (p¼0.245). No difference in the rate of adverse effects. CONCLUSIONS: Utility of oral diclofenac potassium one hour before HSG combined with cervical lidocaine 5% cream significantly alleviate the induced pain during and 30 min after the HSG procedure
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