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Background Hemiplegic cerebral palsy (CP) enormously affects the quadriceps and hamstring muscles. It causes weakness in the affected lower-extremity muscles in addition to muscle imbalance and inadequate power production, especially in the ankle plantar-flexor and knee extensor muscles. It also causes anomalous delayed myoelectrical action of the medial hamstring. A whole-body vibration (WBV) exercise can diminish muscle spasticity and improve walking speed, muscle strength, and gross motor function without causing unfavorable impacts in adults suffering from CP. Thus, the aim of this study is to investigate the impacts of WBV training associated with conventional physical therapy on the quadriceps and hamstring muscle strength, endurance, and power in children with hemiparetic CP. Results The post-intervention values of the quadriceps and hamstring muscle force, endurance, and power were significantly higher than the pre-intervention values for both groups (p = 0.001). The post-intervention values of the study group were significantly higher than the control group (quadriceps force, p = 0.015; hamstring force, p = 0.030; endurance, p = 0.025; power, p = 0.014). Conclusion The 8 weeks of WBV training that was added to traditional physical therapy was more successful in improving the quadriceps and hamstring muscle strength, endurance, and power in children with hemiparetic CP when compared to traditional physical therapy alone.

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Background: Pulmonary embolism (PE) is associated with short-and long-term adverse events including mortality. Prompt diagnosis, risk stratification and treatment can improve the outcome. The objective of the present study is to determine the predictors of early death within 30 days in the course of acute pulmonary embolism (APE). Patients and methods: One hundred patients with APE were recruited from both inpatients department and ICUs at Cardiothoracic Minia University Hospital .All patients subjected to detailed history, general and local chest examination. Laboratory investigation included CBC, Hs-CRP, troponin and D-dimer. CT pulmonary angiogram (CTPA) with calculation of pulmonary artery obstructive index (PAOI) using Qandali Score and measurement of right ventricle to left ventricle (RV/LV) ratio, Echo with measurement of pulmonary artery systolic pressure (PASP) were done for all patients. Patients were monitored for 30 days from the onset of symptoms to assess the mortality. Results: Patients classified according to outcome into survivors, 80 (80%) patients and 20 (20%) non-survivors patients. Po2 and Sao2 were significantly higher in survivors (P values 0.0001 and 0.05, respectively). Pulmonary Embolism Severity Index (PESI) was significantly higher in the non-survivor group (P value 0.001). PAOI and RV/LV ratio were higher in non survivors with (P value 0.001 and 0.001, respectively). Also central location of emboli was higher in non survivors representing. PASP was higher in non survivors (P value 0.001). Conclusion: The non-survivor group showed decrease Po2 and Sao2, higher PESI, PAOI, RV/LV ratio, and dilated RV compared with the survivor group. Thus these parameters could be predictors for poor patient outcome.

Background: Pulmonary Embolism (PE) is a major cause of morbidity and death in patients worldwide. PE is a common and potentially fatal disease that is caused by a perfusion defect due to an embolus blocking blood flow in the lungs. Aim: Aim of this study is to assess predictive value of chest ultrasound in diagnosis of pulmonary embolism using computed tomography pulmonary angiography (CTPA) as a gold standard. Material and Method: In this study seventy three patients of suspected pulmonary embolism were attend to the emergence unit of chest, cardiology departments at Minia Cardiothoracic University Hospital in the period between June 2018 to October 2019. The patients were included according to inclusion criteria listed later. The patients were evaluated clinically and assess risk factors and probability scores (modified wells criteria). Then, Thoracic Ultrasonography (TUS) was done. Multi-slice computed tomography (MSCT) was the reference gold standard method in this study. MSCT scans were interpreted by a radiologist who was unaware of the TUS results. Predictive value of chest ultrasound in diagnosis of pulmonary embolism was evaluated by measuring sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) of thoracic ultrasonography. Results: In this study, sensitivity, specificity, PPV, NPV, and accuracy of chest ultrasound (CUS) for PE diagnosis were 81.25%, 95%, 98.3%, 77.3% and 87% respectively. Conclusion: TUS is a bedside, safe, easily available, noninvasive method for early diagnosis of PE in emergency department and in situations where CTPE couldn't be used.