Background and aim Acute coronary syndrome represents one of the most relevant cardiovascular disorders worldwide. We aimed to assess the impact of stress-induced hyperglycemia (SIH) on angiographic findings in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Patients and methods This prospective study was carried out on 200 patients recruited to the study at initial presentation with STEMI who were managed by PPCI and received the standard of care in Al-Azhar University Assiut Cath laboratory. All patients were divided into two equal groups: group 1 ( n =100): patients who developed SIH. Group 2 ( n =100): patients without SIH. Results Poor postprocedural thrombolysis in myocardial infarction flow was significantly higher in SIH patients (40 vs. 15%; P <0.001, odds ratio=3.8, 95% confidence interval: 1.9–7.6). Preprocedural thrombolysis in myocardial infarction flow grade 0 predominated in SIH (95 vs. 60%; P <0.001). SIH correlated with larger thrombus burden (65 vs. 40%; P =0.00068), no-reflow (45 vs. 20%; P =0.00029), and lower left ventricle ejection fraction (43 vs. 45.8%; P <0.001). Conclusions SIH is associated with more severe coronary artery disease, poorer angiographic outcomes, and reduced cardiac function in STEMI patients undergoing PPCI. These findings emphasize the importance of recognizing and addressing SIH in the management of acute coronary syndromes to improve outcomes in this high-risk patient population potentially.

Background and aim Tricuspid valve (TV) repair may be necessary if the valve is incompetent, resulting in leakage, or if it fails to open and close properly. Surgical intervention might be required to correct congenital defects or to address valve damage caused by endocarditis. This study aimed to evaluate the progression of TV dysfunction following mitral valve replacement in patients presenting with mitral valve regurgitation and concomitant mild to moderate TV regurgitation. Patients and methods This prospective research was performed on 50 patients of both sexes, with moderate functional TR secondary to rheumatic mitral valve pathology. The patients were randomized into two groups. The repair group included 25 patients who underwent tricuspid repair with mitral valve replacement, and the nonrepair group included 25 patients, also, but without tricuspid repair with mitral valve replacement. Results Postoperative tricuspid regurgitation murmur and left ventricle ejection fraction (LVEF) were significantly less in the repair group than in the nonrepair group ( P <0.001). TV regurgitation was markedly different at immediately postoperative, 3, 6, and 12 months in repair groups than in nonrepair groups ( P <0.001). Gradient TV was significantly lower immediately postoperative, 3, 6, and 12 months in the repair group than the nonrepair group ( P <0.001). Conclusion Concomitant TV repair during mitral valve regurgitation improved right heart function and reduced tricuspid regurgitation severity, despite a transient reduction in LVEF. The observed LVEF reduction likely reflects methodological variability rather than true hemodynamic compromise, supporting the overall neutrality of this outcome.

Background and aim Cystic ovarian lesions are more prevalent in adolescents due to the initiation of hormonal activity during prepubescence. We aimed to evaluate diagnostic accuracy of ultrasound and tumors markers in diagnosis of complex ovarian cysts in adolescents with histopathological correlation. Patients and methods This prospective cohort investigation has been carried out on 300 adolescent cases diagnosed with ovarian cysts who were attended to the outpatient clinic and emergency room of the obstetrics and gynecology department of Al-Azhar University Hospital (Assiut). The diagnoses of ovarian cysts were made inside or outside the hospital. In cases where the diagnosis was made outside the hospital, we confirmed it inside the hospital. Results Ultrasound was with higher sensitivity and specificity 87% and 84% correspondingly. Tumor markers were with lower sensitivity and specificity 84 and 80%, respectively. Ultrasound detected 92.5% of dermoid cyst, 85% of endometriomas, 87.5% of serous cystadenomas, 66% of mucinous cystadenoma, 100% of juvenile granulosa cell tumor, and 100% of immature teratoma. Conclusion Regarding the results of this study, the ultrasound was with sensitivity and specificity 87 and 84% respectively, and tumor markers were with sensitivity and specificity 84 and 80% respectively. The study concluded that ultrasound was more important in screening for complex ovarian cysts in adolescents and adding cancer indicators is essential for diagnosis or to exclude the ovarian malignancy and combined both increases the sensitivity, specificity, positive and negative predictive value, and accuracy.

Background and aim Pressure-regulated volume-controlled ventilation (PRVC) is a type of dual-control ventilation that offers the benefits of either volume-controlled ventilation and pressure-controlled ventilation. This study aimed to evaluate the efficacy of PRVC and synchronized intermittent mandatory ventilation (SIMV) in the management of patients with chronic obstructive pulmonary disease (COPD) having acute exacerbations necessitating mechanical ventilation. Patients and methods This prospective clinical trial study was carried out on 60 COPD patients, divided into the SIMV group, which included patients ventilated by the SIMV mode, and the PRVC group, which included patients ventilated by the PRVC mode. All patients were subjected to clinical assessment, and laboratory investigations included complete blood count, random blood glucose, liver and kidney function tests, arterial blood gases, plain chest radiograph, ECG, and echocardiography. The outcome was determined. Results The PaCO2, PIP, and RR were lower, and the exhaled MV was higher in the PRVC mode than in SIMV mode 24 h after ventilation. The mortality rate was lower in PRVC than in SIMV mode, with no significant difference. Conclusion PRVC is a recent alternative mode of ventilation in acute exacerbation of COPD patients. It improves some arterial blood gas parameters in mechanically ventilated patients and seems to be better than SIMV ventilation in terms of safety and efficacy.

Background and aim Compared with the general population, patients with type 2 diabetes mellitus (T2DM) have a higher prevalence of cardiovascular disease, heart failure, and mortality. The research aimed to determine the efficacy as a preventative measure of Pioglitazone, Sitagliptin, and Dapagliflozine in the prevention of myocardial infarction caused by isoprenaline in rats with T2DM. Patients and methods This prospective in-vivo experiment involved 50 adult male albino rats obtained from the experimental animal breeding farm in Assiut and Cairo. They were divided into five groups: group (1): negative controls, group (2): positive controls, group (3): diabetic rats treated with Sitagliptin, group (4): diabetic rats treated with Pioglitazone, and group (5): diabetic rats treated with Dapagliflozin. Results The treated groups showed significant improvement in troponin, malondialdehyde (MDA), and Tumour necrosis factor-α (TNF-α) (P<0.05). But Pioglitazone showed superior improvement in troponin, MDA, and TNF-α. The treated groups showed significant improvement in both parameters (R-R and QT interval) (P<0.001, <0.001). Pioglitazone showed more significant improvement in R-R, while Dapagliflozine showed more significant improvement in QT interval. Conclusion Pioglitazone exhibited superior improvement in creatinine, serum urea, MDA, and TNF-α levels in T2DM rats subjected to isoprenaline-induced myocardial infarction, outperforming dapagliflozin and sitagliptin.

Background and aim Endogenous prostaglandins, derived from the uterus, cervix, placenta, and membranes of fetus, are essential for cervical ripening, so we aimed to compare misoprostol and dnoprostone as regarding to cost-effectiveness and safety in the induction of labor. Patients and methods This prospective randomized controlled research has been performed at Al-Azhar University hospitals Assiut and Farshot central hospital from June 2023 to 2024, study populations were done on 200 patients admitted to the obstetrics and gynecology in hospital department at Al-Azhar University hospitals of Assiut and Farshot central hospital. Results The table indicates a statistically insignificant distinction has been observed in Bishop scores before and after induction among the examined groups. There was a very statistically significant variation in the bishop score pre- and postinduction among group A and group B. Our research indicates a statistically insignificant distinction has been observed in the neonatal APGAR scores among the groups examined. Our research indicates a statistically insignificant distinction has been observed among the groups examined about the induction of vaginal labor. Concerning complications, our research indicates a statistically insignificant distinction has been observed among the examined groups. Conclusion The recent investigation illustrated that both dinoprostone and misoprostol were equally safe and efficient in induction of labor. Also, the current study demonstrated that dinoprostone and misoprostol appear to have a similar neonatal and maternal outcome.

Background and aim Hypoparathyroidism after total thyroidectomy is not an uncommon complication; however, not all these complications are due to the removal of the parathyroid gland. It is considered permanent hypoparathyroidism after 6 months. Early diagnosis of permanent hypoparathyroidism by histopathological examination may be beneficial for the outcome and to find the optimum treatment of each type of hypoparathyroidism. This study was done to predict postoperative hypoparathyroidism and clarify the incidence of parathyroidectomy by histopathological examination. Patients and methods A prospective study which included a total of 50 patients undergoing thyroidectomy with benign thyroid disease to determine the incidence of parathyroidectomy by histopathological examination and early diagnosis of hypocalcaemia following thyroid surgery. The study was done in the Surgery Department of Al-Azhar University Hospitals, Assuit. Results Regarding the PTH level, the postoperative level showed a significant postoperative decrease compared to the preoperative level, posttotal thyroidectomy. Histopathological examination of the thyroid gland showed that eight (16%) patients of 50 patients developed hypocalcaemia, and 42 (84%) patients did not develop hypocalcaemia post total thyroidectomy. In our study, five patients were observed with transient hypocalcaemia, and three patients were observed with permanent hypocalcaemia. Permanent hypocalcaemia was observed in the parathyroid gland in 4% and transient hypocalcaemia was observed in the parathyroid gland in 2%in surgical specimens by histopathological examination. Conclusion Histopathological evaluation of the parathyroid gland after total thyroidectomy is important in determining patients suspected of permanent or temporary hypoparathyroidism, changing the management option.

Background and aim The most common disease condition among young females is polycystic ovarian syndrome (PCOS). The woman usually enters the hospital in advance due to a lack of awareness, which is very fatal for their maternity life. We aimed to check awareness among young females for PCOS. Patients and methods The present study was a nonexperimental descriptive research with cross section design conducted in different college of in Sub-Himalaya region. A total of 120 college females of 18–25 year’s age group were selected randomly and interviewed by structured questionnaire (reliability ‘r’=0.90) related to knowledge regarding PCOS. Among 120 young females, all were healthy and no one had diagnosis of PCOS. Data collection tools consist of two parts. Section I consists of 10 items related to bio-demographic variables and Section II consists of 40 standardized multiple choice questions related to assess young women’s knowledge about PCOS. Results The majority of females were of 22–25 year’s age, unmarried, not aware of PCOS, and had not attended any lecture. Their mothers were also educated (36%) and homemakers (56%). Overall, young female had average knowledge (78%) about various concepts related to PCOS. Conclusion Young female always consider menstrual pain and irregularities as part of normal physiological process and never consult to doctors. Very few young females have understanding regarding this disease and warning symptoms of PCOS. Young female educational program must be conducted to educate and sensitized female for early warning sign of PCOS in community.

Background and aim Lateral osteotomy is a key step in septorhinoplasty, performed using either conventional tools or piezosurgery. This study compares the reliability, complication rates, and functional and aesthetic outcomes of both techniques. Patients and methods Forty patients undergoing open septorhinoplasty for nasal deformity and obstruction were randomly assigned to two groups: group A (n=20) received piezosurgery, and group B (n=20) underwent conventional osteotomy. Preoperative assessments included nasal endoscopy, computed tomography imaging, and photographic documentation. Postoperative evaluations of pain, edema, ecchymosis, bleeding, mucosal injury, and patient satisfaction were conducted for up to 6 months. Results Osteotomy time was longer with piezosurgery (7.6±1.2 min vs. 4.2±1.0 min, P<0.001), though total operative times were comparable. On day 1, piezosurgery patients had significantly less edema, ecchymosis, and pain (P<0.001). Mucosal injuries and bleeding were less frequent in this group, though differences were not statistically significant. Patient satisfaction scores were higher in the piezosurgery group (visual analog scale 8.9±0.7 vs. 7.1±1.2, P<0.001). At 6 months, better nasal symmetry, airflow, and minimal scarring were observed in the piezosurgery group. Conclusion Piezosurgery offers a precise and tissue-preserving alternative to conventional lateral osteotomy, with superior early postoperative outcomes and comparable long-term results. It may be considered the preferred method when available, especially in cases requiring delicate bone work. Further large-scale studies are needed to confirm these findings.

Background and aim Trauma-related thoracic injuries, particularly hemothorax and pulmonary contusion, frequently require critical care management. Timely identification of patients needing ICU admission is crucial for optimizing outcomes and resource use. This study aimed to identify clinical and radiological predictors of ICU admission in trauma patients presenting with hemothorax and/or pulmonary contusion. Patients and methods This retrospective cohort study included 200 trauma patients admitted to the Emergency Department of Esenyurt Necmi Kadioğlu State Hospital between January 1, 2023 and December 31, 2024. Demographic data, vital signs, laboratory parameters, imaging findings, and trauma scores were analyzed. Univariate and multivariate logistic regression analyses were used to determine independent predictors of ICU admission. Results Of the 200 patients, 88 (44%) required ICU admission. Hemoglobin levels were significantly lower in ICU-admitted patients and were found to be an independent predictor (P=0.023). The Glasgow Coma Scale showed a near-significant association (P=0.104). Trauma severity scores (ISS, RTS), vital signs, and trauma mechanism (blunt vs. penetrating) were not significantly associated with ICU need. Mortality was higher in the ICU group (17 vs. 6%). Conclusions Hemoglobin level is a significant predictor of ICU admission in trauma patients with hemothorax and/or pulmonary contusion. However, comprehensive clinical evaluation remains essential, as no single variable should determine ICU need. Prospective multicenter studies are recommended to validate these findings and support the development of reliable ICU admission criteria.