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Aim of the study: To evaluate morphometric changes in maxillary air sinus (MS) of three different Rapid maxillary expander (RME) {conventional, hybrid and maxillary skeletal expander (MSE)} using cone beam computed tomography (CBCT) Material and Methods: A total sample of sixty CBCT of patients presented with constricted maxilla with an age ranged from 11–18 was distributed in to three groups. Group 1 conventional hyrax, group 2 hybrid hyrax and group 3 maxillary skeletal expander (MSE). The mean age was 14.20Y, 15.13Y, 15.40Y in group 1,2 and 3 respectively CBCT records were taken before and after six month of maxillary expansion; the maxillary sinus was segmented and quantified using Romexis software (version 5.3.4.39USA). Results: Comparison between pre and post values and between left and right was performed by paired t test. the post treatment value was significantly higher than the pre value in the right side, left side and in both sides together. The significance level was set at P ≤ 0.05. One-way analysis of variance (ANOVA) test, followed by Bonferroni post hoc test. Conclusions: RME may have a good effect on maxillary sinus by increasing it is volume (MSV).

Background: The work is done at El-Hussien Hospital in last January. Aim of Study: To compare between the different effect of inspiratory muscle training and resistive diaphragmatic breath-ing on maximum inspiratory pressure and blood gases in patients with interstitial pulmonary fibrosis. Material and Methods: Measuring maximal inspiratory pressure and measuring blood gases. Thirty patients (13 males and 17 females) with interstitial pulmonary fibrosis were selected from El-Hussien Hospital from 2017-2018. Their ages range from 50 to 60 years old. Patients were participated in physical therapy program for eight weeks, patients are assigned into two groups (A-B) equally in number. Group (A): (7 males and 8 females) received inspiratory muscle trainer for deep inspiratory exercise for 8 weeks 3 sessions per week. Group (B): (6 males and 9 females) received resistive diaphragmatic exercise for 8 weeks 3 sessions per week. Results: Result showed that using inspiratory muscle training was more effective and fruitful than diaphragmatic breathing exercise on maximal inspiratory pressure and blood gases in interstitial pulmonary fibrosis as evidenced by sig-nificant increase in measuring maximum inspiratory pressure and blood gases. Conclusion: Inspiratory muscle trainer is more effective than diaphragmatic breathing in increasing maximal inspiratory pressure and blood gases in interstitial pulmonary fibrosis.

Metabolic syndrome (MS) is bundling of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure. Epicardial fat (EPF) plays a role in cardiovascular diseases because of its anatomic and functional proximity to the myocardium and intense metabolic activity. Aim Assess EPF in patients with MS using echocardiography and find its relation to its parameters Methods 200 patients with criteria of MS according to National Cholesterol Education Program's Adult Treatment Panel III were subjected to clinical examination, echocardiography; where EPF (end-systolic thickness of echo free space in front of the free wall of right ventricle) was measured, abdominal ultrasonography for detection of non alcoholic fatty liver disease (NAFLD) and lipid and liver profiles. Fasting blood sugar (FBS), uric acid (UA) and hs-CRP were assessed as well. Patients were classified into two groups, group 1; 176 patients with EPF and group 2,28 patients with no EPF. Results 55% patients in group 1 were females vs 50% in group 2. Patients in group 1 had higher waist circumference (WC) 123 ± 7 vs 107 ± 2, p Conclusion EPF as measured by echocardiography reflects visceral fat and severe MS. Echocardiography is an easy and reliable imaging technique to classify patients with high risk.