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Background: Stroke in young patients results in disproportionately high societal cost given the productive life-years lost. Little is known about stroke in young Egyptian patients. We aimed to analyze clinicodemographic characteristics, functional outcome, and socioeconomic impact of ischemic stroke among young Egyptian adults., Methods: This is a prospective, observational cohort study of consecutively recruited patients with acute ischemic stroke (AIS), 18-50 years, between September 2022 and September 2023 at a tertiary stroke center in the south of Egypt. We recorded baseline demographic and cardiovascular risk factors, stroke severity, stroke subtype according to the TOAST classification, intravenous thrombolysis, employment, and ambulation status pre- and post-stroke, post-stroke complications, and 90-day functional outcome measured by the modified Rankin Scale (mRS)., Results: Our cohort comprised 210 patients, 38.0 (±7.8) years, 89 (42%) females. Mean NIHSS score was 11.2 (±4.8); in-hospital case fatality was 9% (19 patients). Dyslipidemia (n = 105, 50%), smoking (n = 105, 50%), and hypertension (n = 67, 32%) were the most prevalent cardiovascular risk factors. At 90 days, 58 (29%) patients had a 90-day mRS 0-1 and 53 (26%) met criteria for depression diagnosis. Sixty-nine of the 116 employed individuals (59%) remained out of work after 90 days of stroke, 61 of whom were single earners in their household. 36/60 (60%) thrombolysis-eligible patients received it; an additional 98 otherwise thrombolysis-eligible patients presented >4.5 h from symptom onset. Patients receiving IV thrombolysis were significantly more likely to have resumed full-time work at 90 days (32% vs. 11%, p = 0.006) but with no significant difference in 90-day mRS., Conclusions: Young adult AIS patients in Egypt experience high rates of post-stroke depression and face challenges in their ability to work and provide for their families. Since most patients have treatable cardiovascular risk factors and only about two-thirds of eligible patients receive thrombolysis, reinforcing primary prevention, education about early stroke signs, and benefits of acute can improve outcomes and have significant potential societal benefit., (© 2024 S. Karger AG, Basel.)

Objectives: To compare the outcomes of bipolar Transurethral Enucleation Resection of the Prostate (TUERP) and simple retropubic prostatectomy in patients with prostate volumes larger than 80 cc., Patients and Methods: A prospective randomized study included all patients amenable to surgeries for benign prostate hyperplasia (BPH) with prostate size over 80 cc at a tertiary care hospital between January 2020 to February 2022. Bipolar TUERP and Retropubic open prostatectomy techniques were compared regarding patients' demographics, intraoperative parameters, outcomes, and peri-operative complications., Results: Ninety patients were included in our study and randomly assigned to bipolar TUERP (Group 1 = 45 patients) and retropubic open prostatectomy (Group 2 = 45 patients). The TUERP group demonstrated significantly lower operative time (77 ± 11 minutes vs. 99 ± 14 minutes, p < 0.001), hemoglobin drop (median = 1.1 vs. 2.5, p < 0.001), and resected tissue weight (71 ± 6.6 cc vs. 84.5 ± 10.6 cc, p < 0.001). Postoperatively, the TUERP group demonstrated significantly lower catheter time (median = 2 vs. 7 days, p < 0.001) and less hospital stay. IPSS, Qmax, and patient satisfaction were better in the TUERP group within six months of surgery. We reported 90-day complications after TUERP in 13.3% of patients compared to 17.8% after retropubic prostatectomy, with a statistically insignificant difference. Urethral stricture predominated after TUERP, while blood transfusion dominated in retropubic prostatectomy., Conclusions: The present study found that TUERP had equivalent efficacy and safety to open retropubic prostatectomy for patients with BPH and prostate volumes > 80 ml.

Semen cryopreservation is very important in animal agriculture to maximize the number of daughters of genetically superior males and to distribute the cryopreserved semen of good males all over the world. However, the freezing process generates some damage to sperm that reduce their fertilizing ability after thawing. Moreover, egg yolk, which is the most common animal-origin cryoprotectant used in semen dilution, is considered a source of biosecurity risk. In the current study, we aimed to compare the replacement of egg yolk in the extender by gum arabic (5%) along with supplementation with antioxidant cysteine or ascorbic acid on semen quality and freezability in Noemi rams in vitro. Semen from six rams were collected with an artificial vagina two times per week. Semen evaluation parameters such as color, volume, pH, general motility, percentage motility, concentration and cell viability ratio were assessed. Spermatozoa motility and concentration were estimated with the computer-assisted semen analysis system. The semen samples were frozen using a Tris extender containing either 15% egg yolk or 5% gum arabic. For antioxidant-supplemented extenders, cysteine or ascorbic acid was dissolved at concentrations of 0.10, 0.50 or 1.0 mM in egg yolk or gum arabic extender. The semen from each ejaculate of each ram were resuspended with a specific extender with glycerol (5%); the final volume after dilution was 1 mL semen to 4 mL extender. The samples were then cooled to 4 °C for 120 min, loaded into 0.5 mL straws and frozen in liquid nitrogen for 7 days. Supplementation of gum arabic or egg yolk extenders for ram semen with antioxidants such as cysteine or ascorbic acid has beneficial effects on semen quality after cold storage or cryopreservation. However, supplementation of a 5% gum arabic extender with cysteine at 0.5 or 1 mM concentration or ascorbic acid at 0.5 mM concentration improved the quality of spermatozoa postcryopreservation. It could be concluded that gum arabic is a good alternative for egg yolk in Noemi ram semen extenders. Antioxidants are necessary to support the addition of gum arabic to the extender to help the ram spermatozoa to survive freezing-thawing and oxidative stresses.

Objective: The present study was conducted to investigate the potential effects of dietary supplemented propolis in two growing rabbit breeds on growth performance, immune response, blood parameters, carcass characteristics, and cecal microflora composition., Methods: A total of 90 growing rabbits aged 6 weeks from two breeds (V-line and Jabali) were randomly allocated to 3 dietary propolis experimental treatments. The experimental treatments consisted of a 2×3 factorial arrangement with two rabbit breeds and three levels of dietary propolis supplementation (0, 250 mg/kg, and 500 mg/kg). Each sub-treatment has 15 rabbits. The experimental period lasted six weeks., Results: There were no significant differences in growth performance and carcass characteristics due to propolis administration. Propolis supplementation at a high level significantly increased (linear; p<0.05) cellular-mediated immunity compared with the unsupplemented group. Furthermore, the rabbits receiving propolis exhibited a significant increase (linear and quadratic; p<0.03) in IgM immunoglobulins compared to the control. The current study provides further evidence that the dietary inclusion of propolis can significantly reduce pathogenic bacterial colonization in growing rabbits. The total count of microflora, E. coli, and Salmonella spp. was significantly lower (linear; p<0.01) in supplemented rabbit groups compared to the control group according to the microbiological analysis of cecal digesta. Based on breed effect, the results indicated that Jabali rabbits (local) performed better than V-line rabbits (foreign) in the majority of the studied traits., Conclusion: Dietary propolis is promising for further investigation into improving intestinal health and enhancing immunity in growing rabbits.

Abstract: Concepts surrounding the mechanisms of thrombocytopenia in ITP have shifted from the traditional view of autoantibody mediated platelet destruction to more complex mechanisms in which impaired platelet production, T-cell-mediated effects, and disturbed cytokine profiles play a role. Interleukin 27 (IL-27) plays pleiotropic roles in immunomodulation and autoimmune diseases.We aimed to determine the level of IL-27 in patients with ITP and its relationship to patient and disease characteristics as well as disease chronicity and response to treatment.Sixty childrens with primary immune thrombocytopenia were consequetively enrolled in this study as well as 20 age and sex matched healthy controls.ITP patients had significantly higher levels of IL-27 than controls (770.6 and 373.8 pg/ml, respectively). Patients with acute ITP had the highest levels of IL-27 among patient groups, while patients in remission had the lowest IL-27 levels (860.1and 622.9 pg/ml, respectively). Patients who received IVIG and combined steroids plus IVIG had significantly higher IL-27 levels than others. Patients who received Eltrombopag had significantly lower IL-27 levels than others.IL-27 seems to play a role in pathogenesis of childhood ITP. IL-27 can be used as a predictor for disease occurrence as well as responsiveness to treatment., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: College students are among the most vulnerable groups to problems associated with high-risk drinking consequences such as illness, injury, sexual abuse, and death. Promising mobile health (mHealth) approaches, such as smartphone (SP) apps, can be used in interventions to address or prevent excessive drinking. Method : The aim of the investigation was to examine the efficacy of a theoretically based mHealth SP app for alcohol intervention in two independent samples ( N   =   379): Mandated participants (Study 1) and voluntary participants (Study 2). Study 1 included a controlled trial with Mandated participants randomized into either an in-person Brief Motivational Interviewing BMI ( n   =   70) or BMI + SP app intervention ( n   =   71). Study 2 included Voluntary participants who participated in either a Control group ( n   =   157) or the BMI + SP app intervention ( n   =   81). Participants in both studies completed baseline and 6-week assessments. Results : In Study 1, peak Blood Alcohol Concentration (BAC) of participants in the in-person BMI group had increased slightly at six weeks, while it had decreased for the app-based BMI + SP group. Study 2 participants using the BMI + SP app reported significant reductions in drinking and consequences; there were no changes in the (AO) Control group. Conclusions: The BMI + SP app was effective with both Mandated and Voluntary participants. Future testing with the BMI + SP app is needed to assess whether reach, adoptability, portability, and sustainability are greater with the mHealth smartphone app for alcohol intervention than in-person approaches.

The influence of subcutaneous injections of silver nanoparticles (AgNPs) on rabbit performance, hematological and biochemical parameters of blood, antioxidant status, and the residues of silver in meat and blood in two breeds (New Zealand White (NZW) and Jabali) of rabbits growing under high ambient temperature was evaluated. A total of 90 six-week-old rabbits (45 NZW and 45 Jabali) were randomly distributed into three equal treatment groups (control, 0.5 mg, and 1.0 mg AgNPs/kg body weight). The treated rabbits were injected twice a week for four consecutive weeks. The results revealed that AgNPs administration had no significant effect on average daily gain (ADG), feed intake, and feed conversion ratio (FCR). The NZW breed surpassed the Jabali breed in growth performance traits, carcass weight, dressing percentage, and cuts of mid parts and hind cuts. Administration of AgNPs had a significant effect on hematocrit (HCT) and platelet (PLT) values. Rabbits injected with AgNPs at a dose of 0.5 mg showed a lower plasma concentration of total cholesterol and triglycerides than that of control rabbits. The NZW breed had significantly low platelet, total cholesterol, and triglyceride values. Rabbits injected with 0.5 mg/kg BW had the lowest total antioxidant capacity and highest malondialdehyde (MDA) and glutathione peroxidase. The Ag residues were higher in blood than those in meat in treated rabbits. The local breed (Jabali) had significantly lower residues than the imported one (NZW) either in meat or in blood. However, the amount of accumulated silver in blood plasma and meat increased with increasing dose.

Heavy alcohol use is a serious health issue in the United States with consequences such as illness, injury, and death. College students are among the most vulnerable to problems associated with risky drinking. This demographic is known as the Net Generation because members have grown up with digital technologies such as smartphones and apps. Thus, mobile health (mHealth) applications, successful in the delivery of health information and interventions to tech-savvy individuals, are a promising means of reaching them. To that end, we developed a smartphone application (SmarTrek) that targets college students and aims to reduce risky alcohol use. SmarTrek features are easy to use and have interactive components including text messages that incorporate motivational interviewing and ecological momentary interventions. We conducted iterative theater testing, field testing, and focus groups to evaluate the acceptability of SmarTrek with college students. We identified salient issues that might arise from SmarTrek use and modified the app based on feedback from participants. Participants were assigned to 2 groups (Group 1 [n = 4] and Group 2 [n = 6]). At baseline, participants completed 2 standardized surveys. Following their field testing, each group of participants was then invited to a focus group session of the app in which they provided feedback. The majority of participants (90%) agreed that SmarTrek was easy to use and that the information provided was useful and had a positive effect on decreasing their drinking. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Iron overload causes most of the mortality and morbidity associated with thalassemia. Excess iron deposits primarily in the liver, but once a threshold level is reached, iron loading may occur in other tissues such as the heart. Magnetic resonance imaging is a well established technique to noninvasively quantify myocardial and liver iron content. More than 300 disease-causing mutations have been identified. We aimed to determine the impact of genotype on liver iron content in patients with beta thalassemia. Cross sectional study was carried on 73 patients with beta thalassemia. MRI liver and heart was performed to determine hepatic and myocardial iron overload. Genotyping was determined by DNA sequencing technique. The mean liver iron content was 17.4 mg/g dw and mean cardiac T2* was 25.5 ms in our patients. Patients with β 0 β 0 were associated with significantly higher liver and myocardial iron content compared to those with β 0 β + and β + β + genotypes. There was a clear association between genotype and both hepatic and myocardial iron overload. Patients with β 0 β 0 had significantly higher liver and heart iron content compared to those with β 0 β + and β + β + genotypes. Liver iron content was strongly correlated to serum ferritin levels and myocardial iron overload., Competing Interests: The authors declare that they have no conflict of interest.The present study was conducted in accordance with the ethical standards of Helsinki Declaration of 1964, as revised in 2000, and was approved by ethics committee of faculty of medicine, Zagazig University. Informed written consent and/or assent were obtained from all study participants and/or their care givers.

In beta thalassemia, the degree of globin chain imbalance is determined by the nature of the mutation of the β-gene. β° refers to the complete absence of production of β-globin on the affected allele. β + refers to alleles with some residual production of β-globin. The homozygous state results in severe anemia that necessitates regular blood transfusion. On the other hand, frequent blood transfusion can lead to iron overload resulting in progressive dysfunction of the heart, Liver as well as multiple endocrinopathies. We studied the impact of genotype on the development of disease complications in patients with β thalassemia. A Cross sectional study was carried on 73 patients with beta thalassemia. Genotyping was determined by DNA sequencing technique. Routine investigations as well as MRI liver and heart were performed to assess iron overload. We found that β + β + was the most common genotype in our patients followed by β°β° and β°β + . Mean Liver iron content (LIC) was significantly higher in β°β° compared to β°β + and β + β + genotypes and mean cardiac T2* was significantly lower in β°β° compared to β°β + and β + β + genotypes. Hepatic complications, hepatitis C, cardiac complications and some endocrinopathies were significantly higher in patients with β°β° genotype compared to other genotypes which explain the role of the underlying genetic defect in thalassemia patients in development of disease complications.

Background: Acute hydrocephalus can cause neurological deterioration after aneurysmal subarachnoid hemorrhage (aSAH). Predicting which patient would require shunting is challenging., Methods: This prospective study was conducted upon twenty patients who suffered acute hydrocephalus due to subarachnoid hemorrhage of ruptured aneurysms. Surgical or non-surgical management of hydrocephalus was conducted. Glasgow Coma scale (GCS) was assessed, and hydrocephalus was graded by bicaudate index. Fisher grade was determined from CT scan. Aneurysm site was determined by conventional or CT angiography. Either surgical clipping or endovascular coiling of aneurysms was performed., Results: Initially, 3 (15%) patients had emergency CSF diversion on admission due to poor GCS on arrival. Initially, the remaining 17 patients were managed conservatively. Five patients did not require any intervention. Twelve patients had external ventricular drainage placement, 4 were weaned, and 8 failed weaning. High bicaudate index (> 0.2) correlated with shunting. Aneurysm site correlated well with shunting (ACoA or PCoA)., Conclusions: Patients with fair GCS can be managed conservatively. Any deterioration warrants shifting to CSF diversion. Higher bicaudate index will usually need CSF diversion. The value of Fisher carries no significant value. Aneurysm location (ACoA or PCoA) correlates with an increased incidence of ventriculoperitoneal shunt placement., Competing Interests: This observational study was approved by the ethics committee of the Department of Neurosurgery, Kasr Alainy Faculty of Medicine, Cairo University. All participants provided informed consent to participate in the study.Consent to publish has been obtained from the participants to report individual patient data.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Precision medicine allows a dramatic expansion of biological data, while there is still an urgent need to understand and insight the exact meaning of those data to human health and disease. This has led to an increasing wealth of data unanalyzed. The concept of precision medicine is about the customization of healthcare, with decisions and practices tailored to an individual patient based on their intrinsic biology in addition to clinical "signs and symptoms". Construction of a standardized model for the integration of data from various platforms is the central mission of the 'New Disease Management Model'. The model is helpful for the development of new taxonomy of diseases and subtypes, to personalize therapy based on patient genetic profiles. A rapid progression of precision therapy has been made recently. Clinical trials have shown the therapeutic efficacy of discovered and developed therapeutic agents has improved. However, next-generation drugs would be designed for disease subtypes with more specificity, efficacy and lower toxicity.

Background: Malnutrition is a common cause of morbidity and mortality in children with congenital heart disease (CHD). This study aimed to identify prevalence and predictors of malnutrition in Egyptian children with symptomatic CHD., Methods: This case-control study included 100 children with symptomatic CHD (76 acyanotic and 24 cyanotic) and 100 healthy children matched for age and sex as a control group. Clinical Evaluation and Laboratory Assessment of Nutritional Status were documented. Anthropometric measurements were recorded and Z scores for weight for age (WAZ), weight for height (WHZ), and height for age (HAZ) have been calculated. Malnutrition was defined as weight, height, and weight/height Z score ≤-2., Results: The overall prevalence of malnutrition was 84.0% in patients with CHD and 20% in controls. Severe malnutrition was diagnosed in 71.4% of cases. All anthropometric measurements and levels of biochemical markers of nutritional state were significantly lower in the patients group compared to controls. In patients with acyanotic CHD, stunting was proportionately higher (57.89%) than in cyanotic CHD, while wasting was predominant (45.83%) in the latter. Malnutrition correlated significantly with low hemoglobin level, low arterial oxygen saturation, heart failure, pulmonary hypertension, and poor dietary history., Conclusion: Malnutrition is a very common problem in children with symptomatic CHD and predicted by the presence of low hemoglobin level, low arterial oxygen saturation, heart failure, poor dietary history, and pulmonary hypertension.