Background: Cicatricial alopecia is a group of disorders that destroy hair follicles which are replaced with fibrosis, causing permanent hair loss. Cicatricial alopecias are subdivided into two groups "primary" and "secondary". For management of 2ry cases, there are different strategies which differ with the location, size and other scarred area characteristics. These strategies include certain surgical procedures such as excision, flap surgery, use of tissue expansion, and hair transplantation that gained popularity as a permanent method for restoring hair loss. In cicatricial alopecia cases, hair transplant is considered challenging because of the degenerative changes and decreased vascularity of these areas that may produce a lower survival rate of donor hair. Aim of Study:This study aimed to evaluate the role of PRP and nanofat injections together with follicular unit extraction technique in restoration of hair in secondary cicatricial alopecia.Material and Methods: This study was conducted on 30 patients with secondary cicatricial alopecia. Patients were divided into 3 groups, 10 patients in each. Group A: Received PRP with hair transplantation, group B: Received nanofat injections with hair transplantation, while in group C (Control group) patients underwent hair transplantation only.Results: Although adding PRP or nanofat injections with hair transplantation procedure provides an excellent improvement in the texture and quality of the scarred tissues compared to other cases underwent without, there were no significant differences in the clinical outcomes of hair restoration including hair growth density.

Background. Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen responsible for burn-wound infection. High incidence, infection severity and increasing resistance characterize P. aeruginosa -induced burn infection. Purpose. To estimate quorum-sensing (QS)-dependent virulence factors of P. aeruginosa isolates from burn wounds and correlate it to the presence of QS genes. Methods. A cross-sectional descriptive study included 50 P . aeruginosa isolates from burn patients in Mansoura University Plastic and Burn Hospital, Egypt. Antibiotic sensitivity tests were done. All isolates were tested for their ability to produce biofilm using a micro-titration assay method. Protease, pyocyanin and rhamnolipid virulence factors were determined using skimmed milk agar, King’s A medium and CTAB agar test, respectively. The identity of QS lasR and rhlR genes was confirmed using PCR. Results. In total, 86 % of isolates had proteolytic activity. Production of pyocyanin pigment was manifested in 66 % of isolates. Altogether, 76 % of isolates were rhamnolipid producers. Biofilm formation was detected in 96 % of isolates. QS lasR and rhlR genes were harboured by nearly all isolates except three isolates were negative for both lasR and rhlR genes and two isolates were positive for lasR gene and negative for rhlR gene. Forty-nine isolates were considered as extremely QS-proficient strains as they produced QS-dependent virulence factors. In contrast, one isolate was a QS deficient strain. Conclusions. QS affects P. aeruginosa virulence-factor production and biofilm in burn wounds. Isolates containing lasR and rhlR seem to be a crucial regulator of virulence factors and biofilm formation in P. aeruginosa whereas the lasR gene positively regulates biofilm formation, proteolytic activity, pyocyanin production and rhamnolipid biosurfactant synthesis. The QS regulatory RhlR gene affects protease and rhamnolipid production positively.

Background: Permanent fillers were previously used to fix wrinkles associated with aging as they were considered a reasonable choice for facial rejuvenation. However, the subsequent removal of permanent fillers is of great concern to surgeons before performing a facelift surgery. Many studies have evaluated the outcomes of facelift surgery; however, we sought to evaluate the outcomes of facelift surgery which required removal of fillers beforehand. Methods: This retrospective cohort study evaluated the outcomes of 50 patients with regard to patient satisfaction and postoperative complications of facelift surgery with removal of permanent filler under local anesthesia. A short scar rhytidectomy with superficial muscular aponeurotic system plication was performed. Preoperative and postoperative photographs were analyzed by two independent surgeons to report asymmetry scores ranging from one to three (one none, two slight, and three obvious asymmetries). Patient satisfaction scores were also recorded. Results:The preoperative presentations of the permanent filler were asymmetry (82%) and disfiguring facial edema (26%). Removing fillers under local anesthesia is generally tolerable, with 56% of patients tolerating rhytidectomy. The degree of the participants' satisfaction after follow-up was satisfactory; two-thirds of patients (62%) were satisfied. There was a significant difference between surgeons' preoperative and postoperative assessment of asymmetry scores (P < 0.05). Conclusions: Permanent filler removal with concomitant face-neck lift surgery has satisfactory outcomes. The procedure length was primarily determined by the patient's skin characteristics and the severity of the local condition.

Background: Recurrence of the symptoms of median nerve entrapment over the wrist remains a challenging problem and in most cases it is secondary to recurrent adhesions around the median nerve, vascularized tissue coverage is one of the most successful treatments to relieve pain and prevent recurrence.Material and Methods: Fifteen patients were involved in this study with recurrent or persistent carpal tunnel syndrome to study benefit of vascularized wrapping of median nerve by tubed adipofascial radial artery perforator flap.Results: Marked improvement had been observed in nerve conduction studies, visual analogue scale and grip strength with no recurrence for one year postoperatively.Conclusion: Radial artery perforator adipofascial flap have the advantage of good volume and vascularity providing protection and vascular supply to the severed median nerve.

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