Evaluation of Corneal Higher- Order Aberrations in Adults with Different Refractive Status: تقييم الزّوغانات القرنيّة عالية التّرتيب عند البالغين في مختلف الحالات الانكساريّة

Purpose: The aim of this study is to evaluate the root mean square error (RMS) of corneal higher- order aberrations in Syrian adult population in different refractive status (emmetropia, myopia, hyperopia and simple myopic astigmatism). Methods: This cross- sectional study was conducted at Tishreen University Hospital in Latakia, Syrian Arab Republic. A total of 420 patients (840 eyes), ages 18- 40 years, participated in the study. Refraction was measured with an autorefractor keratometer and expressed as a spherical equivalent. Total corneal higher- order aberrations (Coma, Spherical Aberration, Trefoil) were measured using Sirius Corneal Topography at a pupil diameter of 5 mm. Results: RMS of Coma and Spherical aberrations peaked in the hyperopia group (0.18 ± 0.08, 0.11 ± 0.02) respectively. Whereas, Trefoil was higher in the severe myopia and simple myopic astigmatism groups (0.25 ± 0.05, 0.25 ± 0.08) respectively. Conclusions: Among a Syrian population, some types of refractive status were associated with certain types of higher- order aberrations, with a significant increase in trefoil in severe myopia and simple myopic astigmatism.

SERUM LIPID LEVELS IN PATIENTS WITH LICHEN PLANUS: مستويات شحوم الدم عند مرضى الحزاز المسطح

Background: Lichen planus (LP) is a chronic inflammatory disease, involving the skin, mucous membranes, hair, and nails. Cardiovascular risk factors have been assessed with some chronic inflammatory skin diseases such as alopecia and psoriasis. Recently, some studies found that lichen planus (LP) was associated with dyslipidemia. So we did this study to find this association in our patients. Objective: To evaluate lipid levels in patients with L.P and compare it with controls. Materials and Methods: This case- control study included 160 participators (80 with L.P. and 80 controls) admitted to dermatology clinic at Tishreen University Hospital, Lattakia, Syria, from 2020- 2021. Results: Cholesterol, triglyceride and Low- density lipoprotein (LDL) levels in patients were significantly higher than the control group; it was only regarding high- density lipoprotein (HDL) levels that no significant difference was observed between the two groups. Triglyceride levels were significantly higher and HDL levels were lower in patients with diffused disease. There was a recognizable correlation between elevated levels of LDL and cholesterol with disease duration. Conclusion: In this study, a disrupted lipid profile was observed in LP patients, which can be associated with disease severity. This study proposes measuring lipid serum levels prior to commencing the treatment in all known cases of lichen planus, so as to preclude cardiovascular diseases if there is a problem with the lipid profile.

Management of pediatric blunt abdominal trauma: تدبير رضوح البطن الكليلة عند الأطفال

Aim of study: Evaluating a non- operative treatment of pediatric blunt abdominal trauma and avoiding unnecessary surgical intervention in Tishreen University Hospital. Methods: During years (2016- 2020) a retroprospective study was conducted on 62 children who had isolated blunt abdominal trauma or associated with other injuries, most of them were managed by non- operative treatment but some required surgical management. Results: Non- operative management of pediatric blunt abdominal injuries was applied for 59 patients, three patients required a surgical procedure, the spleen was the most organ exposed to injury (40) child, followed by liver (26) child, kidney (4) and (1) pancreatic injury. Non- operative management was successful in most solid organs injuries with grades 1, 2 and 3, but it failed in 5 grade splenic injury. one out of two hollow viscus injuries required surgical intervention. There were no statistical differences between the study groups in age, gender and injury mechanism. Hospital length of stay was significantly longer in patients who underwent a laparotomy (6) days compared to other non- operative patients (3) days, one complication occurred during non- operative management as pseudocyst after pancreatic injury, (4) patient died in the non- operative group due to hemodynamic instability and associated severe cerebral injuries. Conclusion: It is safe to treat most children with blunt abdominal injuries non- operatively if monitoring is adequate with hemodynamic stability.

Study of patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) at Tishreen University Hospital in Lattakia – Syria: دراسة مرضى التنظير الراجع للطرق الصفراوية والبنكرياسية في مستشفى تشرين الجامعي في اللاذقية - سوريا

Objective: The aim of this study is to evaluate the indications, findings, and complications of performing Endoscopic Retrograde Cholangiopancreatography (ERCP). Patients and Methods: A Prospective Observational Descriptive study conducted for the period from January 2020 to January 2021, 167 consecutive ERCP were performed at Tishreen University Hospital in Lattakia-Syria. Results: The median age was 58 years, 59.30% of patients were female. The most common indications for ERCP were common bile duct stones (44.9%) and obstructive jaundice (44.3%). The median number of attempts for cannulation was 2 counts, and 74.3% of the procedures were graded as with difficulty grade 1. The most common abnormal findings were common bile duct dilation (50.3%) and bile duct stones (43.7%). The most therapeutic endoscopic interventions were sphincterotomy (64.7%) and stone extraction balloons (68.9%). The therapeutic success rate was 93.5% with repeated the procedure and complications occurred in (10.8%) of patients. The most frequent complication was mild pancreatitis (6%). Death was reported in five cases (3%), one of them (0.6%) was due to ERCP. Conclusion: ERCP is a potential risk for complications, so physicians should be adept at recognizing and treating any complications as soon as they arise.

Study of endoscopic esophageal variceal ligation cases in Tishreen University Hospital: دراسة لحالات ربط دوالي المري تنظيرياً في مشفى تشرين الجامعي

Objective: The aim of this study is to estimate the effectiveness and complications of performing EVL in cirrhotic patients, and to assess the outcome of rebleeding events after EVL. Patients and Methods: An Observational Descriptive Study conducted for the period from January 2020 to January 2021 at Tishreen University Hospital in Lattakia- Syria, 45 Cirrhotic patients with esophageal varices who underwent 69 EVL sessions whether done as prophylactic or therapeutic followed up for three weeks. Results: The median age was 57 years, 66.70% of patients were male. The most common etiology was cryptogenic cirrhosis (40%), and 44.4% of patients had esophageal varices grade III. The most common indication for performing EVL was primary prophylaxis (46.4%). Initial control of bleeding was achieved in 95.2% of emergency procedures. The mortality rate during follow- up was 2.2%. Chest pain was the most common complication of EVL (31.9%). The incidence of re- bleeding events after EVL was 7.24%, more frequently in emergency procedures. Re- bleeding was significantly associated with alcoholic liver disease, poor liver condition (Child- Paugh C class), emergency procedures, coagulation disorders (low levels of PLT and high levels of INR) and presence of large varices (grade III and IV). Conclusion: EVL is feasible, safe, and effective for the management of esophageal varices in patients with end stage liver disease.

Efficacy of topical 5% fluorouracil (5%- FU) needling in vitiligo: فعالية الحقن الموضعي بالإبر الدقيقة لـ fluorouracil 5% في علاج البهاق

Objective: The aim of this study is to assess the efficacy of topical 5- fluorouracil (5%- FU) with micro needling in treating stable vitiligo. In addition to, assessment the side effects of the treatment. Patients and Methods: A Prospective study (Before& After) conducted for the period one year (April 2019- April2020)at Tishreen University Hospital in Lattakia- Syria, 31 patients with stable vitiligo who received treatment with micro needling and topical 5- fluorouracil (5%- FU) were included in this study. Results : The median age was 36 years, 67.70% of patients were female. Focal type was found in 61.3%, and most common sites of vitiligo involvement were hand and feet (33.7%), followed by trunk (24.8%)and extremities (24.8%). After 6 months of treatment, improvement was excellent in 63.4%, and very good in 23.8%. The lesions of neck and trunk were responded better to treatment than those in other parts of the body. Regarding of side effects, pain, erythema, and itching were reported in 100% followed by ulceration in (16.1%). Conclusion: Topical 5%- fluorouracil (5%- FU) with needling appears to be an effective and safe method in treating stable vitiligo. Except of pain, erythema, and itching after procedure, significant complications not occurred in most patients.

Study of newly diagnosed Gastroenterology tumors and associated risk factors at Tishreen University Hospital in Lattakia – Syria: دراسة لأورام الجهاز الهضمي المشخصة حديثاً في مشفى تشرين الجامعي في اللاذقية - سوريا وعوامل الخطر المرتبطة بها

Objective: The study was conducted in order to determine the epidemiological characteristics of referred patients at Tishreen University Hospital in Lattakia and who have been diagnosed with one of the types of malignant Gastrointestinal tumors and study the distribution of risk factors in these patients. Patients and Methods: An Observational Descriptive study (Cross- Sectional) conducted for the period from January 2020 to January 2021 at Tishreen University Hospital in Lattakia- Syria (in Gastrointerolog Department). The variables analyzed were age, gender, tumor location and risk factors Results: The research sample included 223 patients (127 males and 96 females). Esophageal tumors are relatively rare and most of them are of the squamous cell carcinoma type (72.8%). Stomach tumors are the second most common tumor with a percentage of (23.8%), and adenocarcinoma constituted 89% of the cases. Colon and rectal cancer represented the largest percentage (35%) of gastrointestinal tumors, and half of these tumors were in the rectum. Pancreatic cancer ranked third with 11.2% of cases. Tumors of the small intestine and gallbladder and hepatocellular carcinoma are relatively rare. Our most frequently seen risk factors were smoking in most tumors, positivity for H. pylori in 70% of gastric adenocarcinoma patients, and family history and inflammatory bowel disease in Colon tumor patients. Conclusion: Although the incidence of some gastrointestinal cancers has decreased, these cancers continue to pose major challenges to public health, especially colorectal tumors.

FRACTURE RESISTANCE UNDER CYCLIC LOADING OF LITHIUM DISILICATE VONLAYS VERSUS ROSETTA VONLAYS RESTORING PREMOLARS (IN VITRO STUDY): مقاومة الكسر للقشور السطحية الخزفية المرممة للضواحك تحت تحميل دوري والمصنعة من الليثيوم ديسليكات مقابل القشور السطحية الخزفية المصنعة من الروزيتا: دراسة معملية

The aim of the study was to assess fracture resistance under cyclic loading of Rosetta®SM CAD vs. IPS e.max CAD (control) vonlays restoring maxillary premolars. According to the sample size calculation, a total of 20 samples will be selected and then divided into two equal groups; 10 sample each based on the material type: Group (A): Ten vonlays (n=10) manufactured from IPS e. max CAD blocks (control). Group ( B): Ten vonlays (n=10) manufactured from Rosetta®SM CAD blocks (intervention). A natural tooth presenting an upper first premolar was prepared in accordance with the ceramic onlay restorations preparation guidelines with an occlusal box with half of the bucco-lingual distance and a 2 mm depth from the cusp tip to pulpal floor, gingival seat with 1 mm depth from pulpal floor, occlusal reduction of 2 mm of the functional cusp with extending the preparation at the palatal surface by 2 mm in the cervical direction, occlusal reduction of 1.5 mm of non-functional cusp and 12º divergence angle. The preparation was then extended to the labial surface, with a 0.5 mm chamfer finish line. All line angles were finally rounded, and all margins were finished. For duplication of the natural tooth; the epoxy dies were constructed. Base and catalyst of the epoxy resin material were mixed as instructed by the manufacturer at a rate of 200r/min and then was poured into the silicon mould under vibration to eliminate any air voids, then was allowed to set completely following the manufacturer instructions for 24 hours, this procedure was repeated 20 times for creating 20 epoxy resin dies which replicating the prepared natural tooth. The die was then scanned by optical scanning using Medit i500 oral scanner. Milling of Vonlays was achieved using Sirona MCX5 milling machine using IPS e. max CAD blocks and Rosetta SM CAD blocks: 10 IPS e.max CAD blocks with block size C14 and 10 Rosetta®SM CAD blocks with block size C14 were used. Vonlays were then seated on their corresponding dies and cemented with dual cured self-adhesive resin cement (Variolink, Ivoclar Vivadent). Cementation procedures were performed by keeping each sample under a constant pressure of 5Kg using a custom designed cementation device for standardization the applied load during cementation process. All samples were mechanically aged (cyclic loading) to simulate 6 months of clinical use. Following that, all samples were subjected to fracture resistance testing under a compressive load to the center of their long axis using computer controlled universal testing machine with a load cell of 5 Kilo newton (K N) with a computer software used for data recording (Instron® Bluehill Lite Software). The mean values ± SDs values for e.max group were (502.39 ±102.89 N) with minimum value (338.16 N) and maximum value (721.29 N). The mean values ± SDs values. Rosetta group were (468.76 ± 67.54 N) with minimum value (367.11 N) and maximum value (648.48 N). Failure modes were determined under stereomicroscope and classified into repairable and catastrophic in both groups and showed that 60% of e.max group exhibited repairable failure while 40% of specimens showed catastrophic failure while in Rosetta group, 90% of the specimens exhibited repairable failure. Only 10% displayed catastrophic failure. Then a fractured part within each group was examined under scanning electron microscope (SEM) to reveal and compare their microstructure.

Silver Nanoparticles AgNPs Preparation by Chemical Method to Obtain Optimal Characteristics of The Pharmaceutical Form and Study Their Effect on The Leishmania Parasite in Laboratory: تحضير جسيمات الفضة النانوية AgNPs بالطريقة الكيميائية للحصول على الخصائص المثلى للشكل الصيدلاني المعتمد ودراسة تأثيرها على طفيلي الليشمانيا مختبريا

This study aimed first to prepare silver nanoparticles AgNPs in a chemical reduction, The silver nanoparticles AgNPs properties were characterized using spectroscopy of Vision and UV- Visible (UV- Vis), and atomic force microscopy (AFM) and a ZetaSizer device. This study also aimed to study the results effect of preparing Silver nanoparticles on the Leishmania parasite using an artificial environment. The results of the spectrophotometer of the secondary silver solution with yellow color, showed maximum absorption at a wavelength of 400 mm, while the image of atomic force microscope (AFM) showed the hierarchical morphology shape of the prepared Silver nanoparticles with an average size of (10- 30 nm). Silver secondary particles were estimated with a diameter ranging from (12- 60 nm) and with good dispersion in water by ZetaSizer device. The results illustrated that the number of Promastigotes of the Leishmania parasite decreased after adding the Silver nanoparticles AgNPs in varying proportions, as the concentration of 500 μg/ml had the highest effect after 72 hours from incubation, and the percentage of remaining parasites was 5.2% comparing with the control percentage of 14.99%, while the value of IC50 was 253.075 μg/ml, The value of R2 = 0.8809, slope = 0.0478 after 24 hours from incubation.

Central Corneal Thickness of Syrian Population in Relation to Different Parameters: ثخانة القرنية المركزية لِعيّنة من المواطنين السورييّن وعلاقتها مع المتغيّرات المختلفة

Objectives: The aim of this study is to determine the mean Central Corneal Thickness (CCT) among a normal Syrian population and to correlate between Central Corneal Thickness and age, gender and axial length. Methods: This study was carried out at Tishreen University Hospital in Latakia. A total of 516 eyes from 258 individuals with an age range from 18 to 56 years were studied. Central Corneal Thickness was measured using corneal topography (SIRIUS). Axial length was measured using contact ultrasound A-scan (AVISO). Results: The mean CCT was 546.7±31.2 µm with a range from 456 to 643 µm. CCT was not affected by gender. CCT significantly negatively correlated with age (p=0.001). There was no statistically significant correlation between CCT and axial length (p=0.6). Conclusions: CCT varies according to race. Among a Syrian population, CCT significantly decreased with age.