Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy?

Mosaad Mohamed,Khozamy Ali,Barakat Ahmed Samir,Emran Ihab,Elmeligy Yasser,Abulhamd Alaa 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5

Study Design: randomized, prospective, and level I clinical study.Purpose: To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH).Overview of Literature: RDH is a common complication following a primary discectomy. The optimal surgical procedure for RDH is still debated.Methods: Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications.Results: Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays.Conclusions: Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made caseby- case basis, considering many factors related to the patient and surgical facilities.

Numerical and Experimental Behavior of Two-Story Confined Masonry Structure Subjected to Cyclic Loads

Mosaad El-Diasity,Sayed Salah,Mohamed O.R. El-Hariri,Amr A. Gamal,Tarik S. El-Salakawy 한국콘크리트학회 2024 International Journal of Concrete Structures and M Vol.18 No.1

This research presents the numerical and experimental results of lateral cyclic loading applied on a two-story confined masonry structure utilizing local materials and standards. Two half-scale confined masonry structures were constructed using clay masonry units, confining columns, tie beams, and reinforced concrete slabs. The assemblies were tested up to failure using a displacement controlled loading methodology under vertical self-weight and lateral reversed cyclic loading. The walls of the assemblies have varying perforations (solid / windows / doors) to examine the influence of perforation on in-plane and out-of-plane performance. A strengthened assembly with an exterior layer of ferrocement has been used and this suggested upgrading approach enhanced the lateral resistance of the confined assembly by about (61–95%) while improving ductility and total energy absorbed by 27%. The maximum lateral drift at failure have been decreased to (23–31%), however the corresponding load for the first visible fracture have been raised by (150–175%). Furthermore, total failure has been delayed for the strengthened walls (all sides, particularly the perforated sides). Comparing distorted forms, fracture patterns, and capacity curves of finite element models included in this research yielded excellent agreement.

Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer

Hany Mohamed Elgohary,Hadaya Mosaad Eladl,Ashraf Hassan Soliman,Elsadat Saad Soliman 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.6

Objective To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC). Methods Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks. Results ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05). Conclusion The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.

Enhancing the Opacity of the Modified Natural Thickening Agent with Different Metal Oxides for Covering Dark Dyed Fabrics

Fedaa Saad,Mohamed M. Mosaad,Hanan A. Othman,Amina L. Mohamed,Ahmed G. Hassabo 한국섬유공학회 2022 Fibers and polymers Vol.23 No.9

Most natural thickeners do not have a full coverage degree when printing on dark dyed fabrics (brown/navy/black). Therefore, some materials are added to improve their coverage. It is common practice that printing is done on dyed orundyed fabrics. The dyed fabrics are of different shades, so the printing process faces a problem, as most of the naturalthickeners do not have full coverage, especially those extracted from aloe vera and flax seeds when printing on fabrics dyedwith dark colors. Therefore, in this study the effect of adding zinc oxide and titanium oxide to the printing paste was studied. The result confirmed that, adding metal salts to printing paste using aloe vera gel or flaxseeds gum as thickener increases thewhiteness index of these pastes as well as the printed fabric. In addition, using light dye in these printing paste provides goodcovering of dark color with good appearance of the new light color used. Furthermore, the mechanical and physicalcharacteristics of printed textiles with various thickeners and metal oxide (14 %) have been evaluated and provide improvingboth tensile strength and elongation at break and had no effect on the angle of crease recovery of printed textiles across allprinting paste formulations.

Effect of Aqua Therapy Exercises on Postmastectomy Lymphedema: A Prospective Randomized Controlled Trial

Ali Khadra Mohamed,El Gammal Eid Rizk,Eladl Hadaya Mosaad 대한재활의학회 2021 Annals of Rehabilitation Medicine Vol.45 No.2

Objective To investigate the effect of aqua therapy resistance exercise on arm volume, pain, and shoulder range of movements in post-mastectomy lymphedema. Methods This was a single-blind randomized controlled trial. Fifty eligible breast cancer survivors (median, 10 years after surgery) with lymphedema (median, 21% inter-limb difference) were assigned randomly to group A (n=25) or control group B (n=25). The study group underwent 60 minutes of aqua therapy exercise comprising of warm-up for 10 minutes, 40 minutes of strengthening exercises, and 10 minutes of cooling down, three times a week for 8 weeks. The control group underwent 60 minutes of land-based exercise three times a week for 8 weeks. Arm volume calculated by measuring the arm circumference, shoulder flexion, and abduction range of motion (ROM), and pain using a visual analog scale (VAS) were assessed at baseline and after 8 weeks of treatment. Results There was a statistically significant difference in limb volume, shoulder flexion and abduction ROM, and VAS scores in favor of the study group (p<0.001) after 8 weeks of intervention. The mean±standard deviation for limb volume, shoulder flexion, abduction, and pain score were 2,108.71±200.97 mL, 169.68°±4.54°, 150.44°±3.92°, and 3.16±1.1 in the study group and 2,256.41±186.94 mL, 147.36°±5.32°, 131.32°±4.38°, and 5.68±0.94 in the control group, respectively. Conclusion Adding aqua therapy resistance exercise to routine physical therapy might be more effective in decreasing the limb volume and pain intensity and improving ROM of the shoulder in postmastectomy lymphedema.

Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection

Mostafa Shalaby,Waleed Thabet,Oreste Buonomo,Nicola Di Lorenzo,Mosaad Morshed,Giuseppe Petrella,Mohamed Farid,Pierpaolo Sileri 대한대장항문학회 2018 Annals of Coloproctolgy Vol.34 No.6

Purpose: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). Methods: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL. Results: Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was 66.91 ± 11.15 years, and the median body mass index was 24 kg/m2 (range, 20–35 kg/m2). The median tumor distance from the anal verge was 8 cm (range, 4–12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation. Conclusion: These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.