Hosam A Yousef
I'm a Radiologist, currently working at the Department of Diagnostic Radiology, Faculty of Medicine, Assiut University. I do research in different fields of Medical Imaging, especially MRI, CT and duplex Doppler studies. I'm interested in Physics and Computer Science related to my specialty and also in related scientific, financial, socio-economic and healthcare issues.
Supervisors: Shokry M, Elsedfy GO, Bassiouny MM, Anmin M, Abozid H.
Supervisors: Shokry M, Elsedfy GO, Bassiouny MM, Anmin M, Abozid H.
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harm or death of injured individuals. Multi-detector computed tomography (MDCT) became a
mainstay noninvasive diagnostic tool in investigation of firearm injuries as it gives three dimensional
imaging (3-D) and colored images. Objective: This study was designed to through light on the role of
MDCT in medicolagal evaluation of non-fatal firearm injuries in the head which examined in Assiut
University hospital. Subjects and Methods: this study was conducted on 67 cases of non-fatal
firearm injuries in the head including an age group 16-70 years which presented in the trauma unit and
outpatient clinic of neurosurgery department during the period from June 2013 to June 2015. After
forensic examination, the cases were examined blindly by two consultant radiologists using 16-row
multi-detector CT in diagnostic radiology department of Assiut University hospital after giving an
informed consent. The obtained images were post-processed using an advanced diagnostic computer
workstation to obtain multi-planar reformatted and three-dimensional volume-rendered images to
examine soft tissues, skull and intracranial structures. The relevant disclosing MDCT images were
documented, interpreted and data were discussed between participants of the research from
departments of the forensic medicine and diagnostic radiology and compared to results of forensic
examination. Statistical analysis of data was done. Results: Most of injuries occurred in males which
represented 89.45% of total cases and the highest percentage of victims was in the age group 21-30
years which represented 31.3%. MDCT images help in determining details of inlets and exits (in soft
tissue, bone and intracranial structures), recognizing the type of used firearm weapons (weapons firing
shots represented 73.1%), retained projectiles, determination of the distance of firing (79.1 % of total).
In addition it demonstrated retained projectiles which represented 46.3% of total cases and their details
(types, numbers, shapes, sizes, trajectory and deflection inside the skull), intracranial hemorrhage,
edema, skull fractures. It can help in determination of permanent infirmity (which represented 17.9%
of total cases) and in planning for surgical interference. Conclusion: This study demonstrated that
MDCT is an accurate diagnostic tool in the medicolegal investigations of firearm injuries. The MDCT
images are documented forensic evidence which can be stored, electronically sent for medicolegal
consultation and can be shown in the court. In addition, medicolegal experts can trust on MDCT for
determination of permanent infirmities which can help injured persons to obtain compensations and
determine responsibility of physicians about faults in malpractice claims.
markers implicated in resistance of polycystic ovary syndrome (PCOS) patients
to clomiphene citrate.
DESIGN: Cross sectional observational study.
MATERIALS AND METHODS: 90 PCOS patients diagnosed by the Rotterdam
criteria were recruited in a university affiliated fertility clinic . 49 patients
were clomiphene citrate( CC) resistant ( failed to ovulate in response to
CC 150 mg /day for 5 days for 3 successive cycles) and 41 patients were CC
responders. History was taken and body mass index (BMI) was calculated,
Hormonal and metabolic markers including serum luteinizing hormone
(LH,), follicle stimulating hormone( FSH),total testosterone, fasting insulin,
fasting glucose and homeostatic model assessment-insulin resistance
(HOMA-IR) and 25 hydroxy vitamin D were evaluated in both groups. Sonographic
evaluation of ovarian and uterine blood flow and carotid intima-media
thickness (CIMT) were compared between the groups.
RESULTS: The mean age was comparable while the BMI was significantly
higher in the CC resistant group. Total testosterone, serum LH, fasting
serum insulin, and HOMA-RI were significantly higher in the CC resistant
group ( P values were 0.000) ,while serum 25 hydroxy vitamin D was significantly
lower in CC resistant patients (16.25 9.95 ng/ml)than in the CC responders(
31.88 7.24 ng/ml). Relevant sonoraphic vascular markers were
examined. Ovarian artery RI( resistive index),and PI (pulsitility index)
were significantly lower in CC resistant patients,RI (2.30 0.48) compared
to ( 2.00 0.58 ), PI (0.45 0.50) compared to (2.17 0.61). Uterine artery
PI in CC resistant patients were significantly higher(2.30 0.48) compared
to(2.00 0.58)( P values were 0.0001 ) . CIMT as a marker for early atherosclerosis,
was significantly higher in the CC resistant group (P value 0.0001) .
Four patients of the CC resistant group had evidence of atheromatous plaques.
There was no significant difference between both groups in the
following (FSH, fasting glucose, uterine artery RI , and ovarian volume).
CONCLUSION: The resistance of PCOS patients to CC may be affected
by multiple metabolic and vascular factors. Lower levels of vitamin D may
influence the potency of CC in ovulation induction in PCOS patients. The asociation between CC resistance and increased CIMT could be further evaluated
as a prognostic indicator of the cardiovascular risk in women with
PCOS.
Aim of the Work: This is a case study about palatine tonsillar and nasopharyngeal calcifications which require awareness from radiologists, especially in patients with clinical symptoms and signs which may suggest their presence.
Material and Methods: The routine CT studies done for paranasal sinuses or the neck were carefully inspected for presence of tonsillar and/or adenoids calcification. Positive cases with incidentally found calcifications were referred for evaluation by the ear, nose and throat specialists.
Results: Incidental calcifications were found in 31 patients; 30 of them had tonsilloliths and only one patient had calcifi-cation within the adenoids remnants without concomitant palatine tonsillar calcification.
Conclusion: Tonsilloliths are tiny stones lodged in the pharyngeal tonsils, incidentally discovered during CT exam-inations. The awareness of the presence of these calcifications is important for the radiologists to avoid overlooking of these pathological entities which could be of clinical value.
Key Words: Tonsillolith – CT – Adenoids – Halitosis.
Objective: To demonstrate the color duplex Doppler measurements of cavernosal arterial hemodynamic parameters in non-diabetic patients with erectile dysfunction.
Patients and Methods: 100 consecutive non-diabetic men with erectile dysfunction were evaluated clinically and with color duplex Doppler ultrasonography after intracavernosal injection of papaverine to induce erection. Peak systolic and end diastolic velocities as well as the resistive index were measured in the right and left cavernosal arteries.
Results: Patients were classified into 4 groups according to the peak systolic and end diastolic velocities, that help to categorize patients as regard treatment options into patients recommended for medical treatment (having good veno-occlusive mechanism) and others recommended for surgical management (patients with veno-occlusive malfunction).
Conclusion: We conclude that peak systolic & end diastolic velocities of the cavernosal arteries as measured on duplex sonography gives an accurate evaluation of the vascular status in patients with vasculogenic erectile dysfunction, that help in choosing of management options.
Key Words: Erectile dysfunction – Cavernosal arteries – Color Doppler ultrasonography.BSTRACT
harm or death of injured individuals. Multi-detector computed tomography (MDCT) became a
mainstay noninvasive diagnostic tool in investigation of firearm injuries as it gives three dimensional
imaging (3-D) and colored images. Objective: This study was designed to through light on the role of
MDCT in medicolagal evaluation of non-fatal firearm injuries in the head which examined in Assiut
University hospital. Subjects and Methods: this study was conducted on 67 cases of non-fatal
firearm injuries in the head including an age group 16-70 years which presented in the trauma unit and
outpatient clinic of neurosurgery department during the period from June 2013 to June 2015. After
forensic examination, the cases were examined blindly by two consultant radiologists using 16-row
multi-detector CT in diagnostic radiology department of Assiut University hospital after giving an
informed consent. The obtained images were post-processed using an advanced diagnostic computer
workstation to obtain multi-planar reformatted and three-dimensional volume-rendered images to
examine soft tissues, skull and intracranial structures. The relevant disclosing MDCT images were
documented, interpreted and data were discussed between participants of the research from
departments of the forensic medicine and diagnostic radiology and compared to results of forensic
examination. Statistical analysis of data was done. Results: Most of injuries occurred in males which
represented 89.45% of total cases and the highest percentage of victims was in the age group 21-30
years which represented 31.3%. MDCT images help in determining details of inlets and exits (in soft
tissue, bone and intracranial structures), recognizing the type of used firearm weapons (weapons firing
shots represented 73.1%), retained projectiles, determination of the distance of firing (79.1 % of total).
In addition it demonstrated retained projectiles which represented 46.3% of total cases and their details
(types, numbers, shapes, sizes, trajectory and deflection inside the skull), intracranial hemorrhage,
edema, skull fractures. It can help in determination of permanent infirmity (which represented 17.9%
of total cases) and in planning for surgical interference. Conclusion: This study demonstrated that
MDCT is an accurate diagnostic tool in the medicolegal investigations of firearm injuries. The MDCT
images are documented forensic evidence which can be stored, electronically sent for medicolegal
consultation and can be shown in the court. In addition, medicolegal experts can trust on MDCT for
determination of permanent infirmities which can help injured persons to obtain compensations and
determine responsibility of physicians about faults in malpractice claims.
markers implicated in resistance of polycystic ovary syndrome (PCOS) patients
to clomiphene citrate.
DESIGN: Cross sectional observational study.
MATERIALS AND METHODS: 90 PCOS patients diagnosed by the Rotterdam
criteria were recruited in a university affiliated fertility clinic . 49 patients
were clomiphene citrate( CC) resistant ( failed to ovulate in response to
CC 150 mg /day for 5 days for 3 successive cycles) and 41 patients were CC
responders. History was taken and body mass index (BMI) was calculated,
Hormonal and metabolic markers including serum luteinizing hormone
(LH,), follicle stimulating hormone( FSH),total testosterone, fasting insulin,
fasting glucose and homeostatic model assessment-insulin resistance
(HOMA-IR) and 25 hydroxy vitamin D were evaluated in both groups. Sonographic
evaluation of ovarian and uterine blood flow and carotid intima-media
thickness (CIMT) were compared between the groups.
RESULTS: The mean age was comparable while the BMI was significantly
higher in the CC resistant group. Total testosterone, serum LH, fasting
serum insulin, and HOMA-RI were significantly higher in the CC resistant
group ( P values were 0.000) ,while serum 25 hydroxy vitamin D was significantly
lower in CC resistant patients (16.25 9.95 ng/ml)than in the CC responders(
31.88 7.24 ng/ml). Relevant sonoraphic vascular markers were
examined. Ovarian artery RI( resistive index),and PI (pulsitility index)
were significantly lower in CC resistant patients,RI (2.30 0.48) compared
to ( 2.00 0.58 ), PI (0.45 0.50) compared to (2.17 0.61). Uterine artery
PI in CC resistant patients were significantly higher(2.30 0.48) compared
to(2.00 0.58)( P values were 0.0001 ) . CIMT as a marker for early atherosclerosis,
was significantly higher in the CC resistant group (P value 0.0001) .
Four patients of the CC resistant group had evidence of atheromatous plaques.
There was no significant difference between both groups in the
following (FSH, fasting glucose, uterine artery RI , and ovarian volume).
CONCLUSION: The resistance of PCOS patients to CC may be affected
by multiple metabolic and vascular factors. Lower levels of vitamin D may
influence the potency of CC in ovulation induction in PCOS patients. The asociation between CC resistance and increased CIMT could be further evaluated
as a prognostic indicator of the cardiovascular risk in women with
PCOS.
Aim of the Work: This is a case study about palatine tonsillar and nasopharyngeal calcifications which require awareness from radiologists, especially in patients with clinical symptoms and signs which may suggest their presence.
Material and Methods: The routine CT studies done for paranasal sinuses or the neck were carefully inspected for presence of tonsillar and/or adenoids calcification. Positive cases with incidentally found calcifications were referred for evaluation by the ear, nose and throat specialists.
Results: Incidental calcifications were found in 31 patients; 30 of them had tonsilloliths and only one patient had calcifi-cation within the adenoids remnants without concomitant palatine tonsillar calcification.
Conclusion: Tonsilloliths are tiny stones lodged in the pharyngeal tonsils, incidentally discovered during CT exam-inations. The awareness of the presence of these calcifications is important for the radiologists to avoid overlooking of these pathological entities which could be of clinical value.
Key Words: Tonsillolith – CT – Adenoids – Halitosis.
Objective: To demonstrate the color duplex Doppler measurements of cavernosal arterial hemodynamic parameters in non-diabetic patients with erectile dysfunction.
Patients and Methods: 100 consecutive non-diabetic men with erectile dysfunction were evaluated clinically and with color duplex Doppler ultrasonography after intracavernosal injection of papaverine to induce erection. Peak systolic and end diastolic velocities as well as the resistive index were measured in the right and left cavernosal arteries.
Results: Patients were classified into 4 groups according to the peak systolic and end diastolic velocities, that help to categorize patients as regard treatment options into patients recommended for medical treatment (having good veno-occlusive mechanism) and others recommended for surgical management (patients with veno-occlusive malfunction).
Conclusion: We conclude that peak systolic & end diastolic velocities of the cavernosal arteries as measured on duplex sonography gives an accurate evaluation of the vascular status in patients with vasculogenic erectile dysfunction, that help in choosing of management options.
Key Words: Erectile dysfunction – Cavernosal arteries – Color Doppler ultrasonography.BSTRACT