Objective: To evaluate and analyze the effect of platelet-rich plasma (PRP) injection on the scar formed after unilateral complete cleft lip scar repair using a modified Millard technique. Hypothesis: An unavoidable cheiloplasty scar is a result of the wound healing process that not only influences patient self-esteem for life but also affects muscle function. Design: Blind, randomized, controlled clinical trial. Patients: From December 2016 to February 2018, 24 patients with unilateral complete cleft lip undergoing primary cheiloplasties were equally assigned to study and control groups. Intervention: All patients were treated by modified Millard cheiloplasty. In the study group, PRP was injected into the muscle and skin layers immediately after wound closure, while the control group patients were treated with no PRP injection. Outcomes Measures: Scar width was assessed after 6 months through the muscle using ultrasonography and at the skin surface via photographs. Results: Scar width showed a significant improvement in the study group. Conclusions: Injection of autologous PRP provides effective improvement of cutaneous and muscular wound healing and decreases scar tissue formation.

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Background Hypoxic ischemic encephalopathy (HIE) is a major cause of mortality and morbidity in neonates. Malondialdehyde (MDH) is a colorless lipid that can be used as a marker for oxidative stress. Cranial ultrasound sensitivity and specificity in detection of neonatal HIE ought to be further investigated. This study aims to detect whether serum (MDH) can be used as an indicator for HIE severity and to assess the role of cranial ultrasound in diagnosis of HIE neurological disorders, correlating ultrasound findings to MDA levels. Results Statistically significant differences were found between the serum MDA levels in patients compared to controls as well as among serum MDA in patients with advancing Sarnat stages (I, II, III) P value < 0.001. Statistically significant levels of serum MDA were found in patients with ischemic US findings compared to those with normal scan; 36.4% of cases with ischemic US findings were diagnosed as Sarnat stage II while 63.6% were diagnosed with stage III with a statistically significant difference (P = 0.016). Conclusion Cranial ultrasound can be used for diagnosis of neonatal hypoxic ischemic insults, with lower sensitivity in mild cases and increased sensitivity in severe cases; and when combined with measuring serum MDA levels, it can be used as a diagnostic marker and as a predictor for severity of HIE.

Background Neuroblastoma is the third most common childhood cancer. It is the most common extra-cranial solid tumor of childhood. It accounts for about 15% of all pediatric cancer fatalities. The International Neuroblastoma Risk Group (INRG) Project proposed a new staging system which is dependent on whether image-defined risk factors (IDRFs) are or are not present, and IDRFs are surgical risk factors, detected on images, that make total tumor excision risky or difficult. The purpose of the study is to assess the validity of using the image-defined risk factors (IDRFs) of abdominal neuroblastoma as predictors of the surgical resectability and complications. Methods We retrospectively studied the clinical, imaging, and surgical data of 43 patients with abdominal neuroblastoma, and then the results were correlated with each. For comparing categorical data, chi-square (χ2) test was performed. P values less than 0.05 were considered as statistically significant. Results At least 1 pre-operative IDRF was present in 33 cases (76.7%), and they were absent in 10 cases (23.3%). There was statistical significant correlation between the pre-operative IDRFs and surgical resectability, and the complete resection rate if no IDRF was found was 80% in this study. Out of the 13 cases with surgical complications, pre-operative IDRFs were present in 12 cases. Conclusion The neuroblastoma IDRFs are useful predictors of the surgical resectability and the risk of surgical complications and should be considered in surgical planning.

Background and Purpose The pathology of juvenile myoclonic epilepsy (JME) is related to thalamocortical dysfunction, and the putamen is closely related to the thalamocortical circuit. The purpose of this study is to evaluate the microstructure of the thalamo-cortico-striatal circuit in JME patients using diffusion tensor imaging (DTI). Materials and Methods This case–control study was conducted on 13 patients with JME (10 females and 3 males with a mean age of 23.38 ± 4.75 years) and 9 age- and sex-matched volunteers as control subjects. All subjects underwent DTI and conventional magnetic resonance imaging. The data were then processed via denoising, registration, and segmentation of the internal capsule and right and left putamen using the FMRIB Software Library (FSL). The FSL was also used to calculate the different anisotropy measures: the fractional anisotropy (FA), mean diffusivity (MD), longitudinal diffusivity (LD), and radial diffusivity (RD). Results The patients with JME had lower FA and higher LD in the thalamocortical tracts and lower MD in the frontal corticospinal tracts than the control subjects (p = 0.014, 0.001, and 0.04, respectively). No other significant differences were detected between the patients with JME and control subjects. The values measured in the right putamen were not significantly different from those measured in the left putamen in either the patients or controls. Conclusion This study demonstrates that microstructural abnormalities occur in the thalamocortical tracts but not the putamen of patients with JME. Nevertheless, microstructural asymmetry was not observed in the patients with JME.