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Fe 3 O 4 nanoparticles were embedded within a glauconite‑calcium alginate (G/CA) matrix to create magnetic hybrid spheres (MNPs-G/CA), with the aim of purifying water from methylene blue (MB) at temperatures of 25, 40, and 50 °C. MNPs-G/CA adsorbent was characterized using numerous techniques, including elemental mapping, zeta potential, FTIR, FESEM, XRD, EDX, and TEM. The greatest amount of the removed MB was achieved under definite conditions of solution pH 8.0, MNPs-G/CA mass (25 mg), interaction time (2 h), and 200 mg/L of MB concentration. The MB uptake process kinetic followed a pseudo-second-order equation (R 2  > 0.99) at all tested temperatures. The equilibrium data were fitted to a statistical physics multilayer model in conjunction with the Langmuir and Freundlich equations. The steric n parameter reveals that MNPs-G/CA adsorbent possesses a mixed adsorption orientation (i.e., ranging from 0.69 to 0.93) across various temperatures. The amount of MNPs-G/CA active positions (the N M parameter) was progressively increased from 245 mg/g to 419 mg/g. The measured adsorption capacities (Q sat ) ranged from 466.49 to 664.37 mg/g, and the removal of MB molecules was consistent with an endothermic interaction. The interface between the MNPs-G/CA-MB was principally dictated by electrostatic attractions, as evidenced by the values of adsorption energies (∆E), which varied from 16.75 to 21.52 kJ/mol. The regenerated MNPs-G/CA offered over 80 % of its adsorption strength after the fourth adsorption-desorption cycle. This study contributes to our understanding of the physicochemical parameters controlling the MB adsorption mechanism on multifunctional hybrid adsorbents, like the interface between glauconite, alginate, and MNPs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: It has recently been reported that the use of platelet-rich fibrin (PRF) as an extralayer over the urethroplasty has been related to a considerable reduction in fistula rates. Due to the lack of evidence supporting the usage of PRF in urethrocutaneous fistula (UCF) repair, we conducted this study to evaluate the efficacy of PRF in patients with UCF., Materials and Methods: We conducted a randomized controlled study on patients with distal fistula after hypospadias repair. Patients were randomized into two groups, one with local dartos coverage and the other with PRF coverage layer., Results: In the present study, we included 37 patients; 20 patients underwent local dartos coverage, and 17 patients underwent PRF. The mean age was 22.45 ± 4545 ± 4515 ± ±15.35 (range 11-56) months for the study group and 20.6 ± 66 ± 614 ± ±14.5 (range 6-45) months for the control group. The incidence of recurrent UCF was 11.8% in the treatment group (two patients), whereas the incidence was 30% (six patients) in the control group ( P = 0.246)., Conclusion: UCF surgery may benefit from the use of PRF as a supportive tissue that promotes wound healing, angiogenesis, and tissue restoration. We believe that the use of PRF as a new approach for UCF repair should be investigated further through clinical studies., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)

Naringenin, a natural dihydrochalcone flavonoid, exhibits diverse pharmacological properties. This study investigates the hypolipidemic effects of Nar-NPs on obese mice. The characteristics of Nar-NPs, including morphology, particle size, zeta potential, UV-vis, and FT-IR spectra, were examined. The anti-obesity properties of Nar-NPs were evaluated in obese rats, considering LD 50 , 1/20 LD 50 , and 1/50 LD 50 for treatment preparation. Results indicated that synthesized Nar-NPs were uniform, spherical, and well-dispersed, with a size of 130.06 ± 1.98 nm and with a zeta potential of -25.6 ± 0.8 mV. Nar-NPs exhibited enhancement in the cumulative release of naringenin (56.87 ± 2.45 %) as compared to pure naringenin suspension 87.83 ± 1.84 % in 24 h of the study. The LD 50 of Nar-NPs was determined as 412.5 mg/kg.b.w. HFD induced elevated glycemic, oxidative stress, and inflammatory biomarkers while reducing HDL-C, GSH, and superoxide dismutase (SOD) levels. Administration of Nar-NPs significantly mitigated body weight, glucose, insulin, leptin, TC, TG, SREBP1c, pAMPK, PPAR-α, as well as vanin-1, MCP-1, and iNOS mRNA gene expression. Histological investigations supported the biochemical and PCR findings. In a nutshell, the study suggests that the Nar-NPs could serve as a promising and viable pharmacological strategy for the treatment of obesity-related disorders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

H 2 O 2 -modified graphite schist (GS) and sodium alginate (SA) interface was loaded by Fe 3 O 4 nanoparticles (MNPs) to prepare a magnetic biosorbent that was employed in removing Mn(VII) from solutions. The prepared GS/SA/MNPs adsorbent was investigated using a variety of techniques, including elemental mapping, TEM, XPS, FTIR, FESEM, EDX, XRD, XPS, and zeta potential. An experimental study supported by statistical physics calculations was carried out to obtain a new outline of the Mn(VII) uptake mechanism. The classical Freundlich and the statistical physical double-layer models adequately described the Mn(VII) uptake process at pH 3.0 and a temperature of 25-55 °C. The removed number of Mn ions (such as Mn +7 and Mn +2 ) per GS/SA/MNPs active site ranged from 0.70 to 0.84, indicating a mixed adsorption orientation driven by surface complexation and attraction forces mechanisms. The adsorption energies (∆E) calculated by the double-layer model ranged from 18.79 to 24.94 kJ/mol, suggesting that the interaction between Mn(VII) and GS/SA/MNPs was controlled by physical forces. Increasing the adsorption capacity at saturation (Q sat ) from 333.14 to 369.52 mg/g with temperature proposed an endothermic capture process. Thermodynamic functions clarified the viability and spontaneity of Mn(VII) uptake on the GS/SA/MNPs adsorbent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Candida auris is an emerging multidrug-resistant fungal pathogen that represents a current serious threat to healthcare settings., Objective: The objective was to determine the prevalence of C. auris in a Riyadh hospital since its initial detection in late 2019., Methods: Using an adapted risk assessment tool, we reviewed the charts and medical files of all suspected and confirmed cases of C. auris infections reported at King Khalid University Hospital, Riyadh, between November 2019 and December 2022. Anonymized data were retrieved in a pre-established datasheet and analyzed to determine the epidemiological characteristics of C. auris infections in our facility. We analyzed prevalence by age, gender, risk factors, and according to sampling source., Results: Of the 53 confirmed C. auris -positive cases during the study period, 33 (62%) were males. Their ages ranged between 15 and 98, with most positive cases occurring in those aged 50 and above. Only one of the confirmed cases was hospital-acquired. All patients had at least one risk factor, and urine samples yielded the greatest number of positive cases, while admission to healthcare facilities constituted the highest risk in our study., Conclusion: Establishing a local prevalence pattern could serve as a baseline/benchmark to compare with regional and international benchmarks.

Background: Mandibular angle is the most common site for fractures, accounting for 23-42% of all cases of mandibular fractures. A customized fixation system is designed directly for a specific patient, which reduces the time spent bending and fixing the plate during the operation. This study was designed to assess the effect of CAD/CAM customized V pattern plate versus standard miniplates fixation in mandibular angle fracture., Materials and Methods: This prospective randomized clinical trial included 26 patients suffering from mandibular angle fracture. Patients were selected from Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University and Ahmed Maher Teaching Hospital. Study group (13) needed open reduction and internal fixation by using CAD/CAM V plate with surgical guide, while control group (13) needed open reduction and internal fixation by using standard superior-inferior miniplate fixation. The patients were then followed up for one year postoperatively., Results: It showed that there was a statistical difference between the study group and the control group regarding postoperative pain, occlusion, and maximal interincisal opening ( p value < 0.05%). There was no statistical difference ( p value > 0.05%) in the postoperative panoramic radiograph that was taken within the postoperative 1st week in both groups, while the increase in mean bone density was statistically significant ( p value < 0.05%) from 6 months to one year postoperatively., Conclusion: CAD/CAM customized V pattern plate is a suitable plate design because it offers sufficient stability for normal bone healing, the creation of an ideal occlusion, an early return to function, and adequate postoperative radiographic outcomes., Trial Registration: It was registered at ClinicalTrials.gov. Registration number: NCT03761524. Registration date: 03.12.2018., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2023.)

Background: The miracle herb Nigella sativa (N. sativa) is a member of the Ranunculaceae family that possesses many properties, such as antioxidant, anticancer, analgesic, antibacterial, and anti-inflammatory. Thymoquinone (TQ) is the primary ingredient that makes up N. sativa, which is responsible for its many properties. So, our research focused on the biological role of TQ and its anticancer activities., Methods: A wide range of TQ concentrations (50µg/µl, 25µg/ µl, and 12.5µg µl) was prepared and evaluated for their potential regulatory role in cell lines of hepatocellular carcinoma (HepG2 cell line) compared with normal hepatocytes cells, untreated and DMSO-treated cells., Results: The more significant level of LDH obtained after TQ treatment compared to untreated cells provides evidence of the cytotoxic effects of TQ on HepG2 cells. Notably, the normal hepatocyte cells subjected to the same concentrations of TQ showed neglected influence in cell viability rate, indicating the selective regulatory role of TQ in cancer cell proliferation. Interestingly, as a critical mediator of malignancy transformation, the nuclear factor-kappa B expression level (NF-κB) significantly decreased in a time and dose-dependent manner of TQ treatment. Furthermore, we investigated whether TQ regulates the expression of deleted liver cancer 1 (DLC1) and Caspase 3 (Casp3). Notably, the treatment with TQ showed increased expression levels of DLC1 and Casp3 upon treatment. TQ extract sufficiently mediated the secretion of the released pro-inflammatory cytokines from treated cells. This regulation of released cytokines by TQ may affect the activation of NF-κB in treated cells., Conclusion: These results indicate that TQ mediates the activation of Casp3, DLC1, and NF-κB, providing a new function of TQ in treating hepatocellular carcinoma (HCC).

Objective: Hypotension is the most frequent side effect of intrathecal anaesthesia, with an incidence of more than 80%. Following neuraxial anaesthesia, perioperative shivering is a serious complication affecting 40-60% of patients undergoing surgery. This study aimed to determine the effectiveness of low-dose ketamine on blood pressure in patients undergoing cesarean delivery after spinal anaesthesia., Methods: We included 126 female patients undergoing cesarean deliveries, American Society of Anesthesiologists (ASA)-(II and III), and aged 21-40 selected from the outpatient clinics of the anaesthesia department. Patients were randomized to two groups; Group K (63 patients), who received 0.3 mg kg -1 of ketamine IV diluted to 10 mL, followed by an infusion of 0.1 mg kg -1 h -1 . Group C (Controlled) (63 patients) received 10 mL of normal saline, followed by an infusion of 0.1 mL kg -1 h -1 , which started before spinal anaesthesia., Results: Compared with the saline group, the average heart rate, blood pressure, and level of sedation were significantly higher in the ketamine group ( P < 0.05). The ketamine group reported a significantly lower incidence of shivering ( P < 0.01). The ketamine groups exhibited significantly less mild or severe hypotension ( P < 0.05). There was no significant difference between the two groups in terms of nystagmus, diplopia, hallucinations, or neonatal outcomes ( P > 0.05)., Conclusion: Ketamine decreases the incidence of hypotension and shivering in patients undergoing spinal anaesthesia during cesarean delivery. In addition, it resulted in improved sedation for the mother and prolonged postoperative analgesia without neonatal illness.

Depressive disorders affect individual's thoughts, feelings, and social interactions. Enhancing emotional competencies of depressed individuals may alleviate their suffering. Purpose : This study aimed to compare depression severity and emotional intelligence before and after emotional intelligence training in patients with depressive disorders. Methods : A nonrandomized trial (one-group pretest-posttest) research design was applied to 69 patients purposively recruited. The patients' sociodemographic and clinical data were collected. The Beck Depression Inventory-II and Trait Emotional Intelligence Questionnaire-Short Form were completed before and immediately after an 8-weeks of focused weekly group training. Results : A significant improvement in the scores of well-being, self-control, emotionality, and sociability; total emotional intelligence scores; and total depression scores was perceived after training ( Z  = 5.601, 4.398, 5.686, and 3.516; 4.943; and 2.387, respectively). Implications for Nursing Practice : As emotional intelligence can be learned; it may be a target for interventions when dealing with patients with depressive disorders by strengthening their emotional intelligence.

Objective: Post-orthopaedic operative pain is a serious concern that often requires the administration of analgesics; however, the optimal time of analgesic administration is still inconclusive. Perioperative analgesia is administrating pre-emptive analgesia before and during the surgery followed by postoperative analgesia to decrease the procedure associated nociceptive response. We aim to assess perioperative meloxicam versus postoperative meloxicam for pain control after orthopaedic operations., Methods: A systematic review and meta-analysis involving randomized controlled trials from PubMed, Embase, Scopus, WOS, and Cochrane until 28th May 2022. We pooled dichotomous outcomes using risk ratio (RR) presented with a 95% confidence interval (CI) and continuous outcomes using mean difference (MD) with 95% CI. We registered our protocol in PROSPERO with ID: CRD42022336046., Results: We included five RCTs with 964 patients. All the included trials showed high risk of performance and detection biases because of lack of blinding. Pooled analysis favored perioperative meloxicam in reducing pain score after six hours (MD: -0.42 with 95% CI [-0.63, -0.21], p  = .0001), 12 h (MD: -0.54 with 95% CI [-0.69, -0.39], p  = .00001), and 24 h (MD: -0.23 with 95% CI [-0.36, -0.10]. Pooled analysis favored perioperative meloxicam in improving patient global assessment scale after 12 h (MD: -0.66 with 95% CI [-0.86, -0.46], p  = .00001), 24 h (MD: -0.30 with 95% CI [-0.49, -0.11, p  = .002), and 48 h (MD: -0.17 with 95% CI [-0.33, -0.01], p  = .04). Pooled analysis favored perioperative meloxicam in reducing patient-controlled analgesia (MD: -4.25 with 95% CI [-5.96, -2.54], p  = .00001)., Conclusion: Short-term pain management after orthopaedic procedures is better accomplished with perioperative meloxicam than postoperative meloxicam. Before recommending perioperative meloxicam for pain control following orthopaedic surgeries, further multicentre trials are still warranted to examine the impact of perioperative meloxicam in different orthopaedic procedures.

Purpose: To compare the changes in quality of life in edentulous patients with single implants supporting mandibular overdentures with two different attachment types before implant placement and after 6 and 24 months., Materials and Methods: Eighty edentulous patients were recruited, and all patients completed the validated Oral Health Impact Profile (OHIP)-EDENT-19 questionnaire before implant surgery. A single implant was placed in the midline of the edentulous mandibles. All implants were allowed to heal for 3 months. After the healing period, randomization into one of two groups was accomplished using sealed envelopes: group A (ball attachment) and group B (locator attachment). The same questionnaire was completed 6 and 24 months postplacement. Mann-Whitney U test for independent samples was used to compare the two groups, while Freidman test was used for comparison within each group. Two-sided P values less than .05 were considered statistically significant., Results: There was an improvement in all domains of the OHIP-EDENT-19 scores at the 6- and 24-month follow-ups for both groups. The social disability domain showed a statistically significant improvement for group A at 6 and 24 months postplacement (P = .004, .005). Within group A, there was a statistically significant improvement within all seven domains (P = .001); while in group B, four domains (functional limitation, physical pain, psychosocial discomfort, and physical disability) and the total score (P = .001) showed a statistically significant improvement., Conclusion: Both attachments improved the patients' quality of life at 24 months postplacement. The ball attachment demonstrated a significant improvement regarding the social effects of the prostheses.

Aim: To identify the predictors of in-hospital mortality in patients with coronavirus disease of 2019 (COVID-19) and acute renal impairment (ARI) or chronic kidney disease (CKD), and to evaluate the performance and inter-reader concordance of chest CT total severity scores (TSSs). Methods: This retrospective single-center study was conducted on symptomatic COVID-19 patients with renal impairment (either acute or chronic) and a serum creatinine of >2 mg/dL at the time of admission. The patients’ demographic characteristics, clinical data, and laboratory data were extracted from the clinical computerized medical records. All chest CT images obtained at the time of hospital admission were analyzed. Two radiologists independently assessed the pulmonary abnormalities and scored the severity using CT chest total severity score (TSS). Univariate logistic regression analysis was used to determine factors associated with in-hospital mortality. A receiver operating characteristic (ROC) curve analysis was performed for the TSS in order to identify the cut-off point that predicts mortality. Bland−Altman plots were used to evaluate agreement between the two radiologists assessing TSS. Results: A total of 100 patients were included, with a mean age of 60 years, 54 were males, 53 had ARI, and 47 had CKD. In terms of in-hospital mortality, 60 patients were classified in the non-survivor group and 40 were classified in the survivor group. The mortality rate was higher for those with ARI compared to those with CKD (p = 0.033). The univariate regression analysis showed an increasing odds of in-hospital mortality associated with higher respiratory rate (OR 1.149, 95% CI 1.057−1.248, p = 0.001), total bilirubin (OR 2.532, 95% CI 1.099−5.836, p = 0.029), lactate dehydrogenase (LDH) (OR 1.001, 95% CI 1.000−1.003, p = 0.018), CRP (OR 1.010, 95% CI 1.002−1.017, p = 0.012), invasive mechanical ventilation (MV) (OR 7.667, 95% CI 2.118−27.755, p = 0.002), a predominant pattern of pulmonary consolidation (OR 21.714, 95% CI 4.799−98.261, p < 0.001), and high TSS (OR 2.082, 95% CI 1.579−2.745, p < 0.001). The optimum cut-off value of TSS used to predict in-hospital mortality was 8.5 with a sensitivity of 86.7% and a specificity of 87.5%. There was excellent interobserver agreement (ICC > 0.9) between the two independent radiologists in their quantitative assessment of pulmonary changes using TSS. Conclusions: In-hospital mortality is high in COVID-19 patients with ARI/CKD, especially for those with ARI. High serum bilirubin, a predominant pattern of pulmonary consolidation, and TSS are the most significant predictors of mortality in these patients. Patients with a higher TSS may require more intensive hospital care. TSS is a reliable and helpful auxiliary tool for risk stratification among COVID-19 patients with ARI/CKD.

Background: Mycobacterium bovis notoriously causes detrimental infections in bovines and humans. In this study, 1500 buffaloes and 2200 cattle were tested by single intradermal comparative cervical tuberculin test and compared with the detection rates of M. bovis isolation, real-time and simplex PCR, and flow Cytometry., Results: The tuberculin test is the reference test in Egypt, the positive rate was 54/3700 (1.5%) composed of 18/1500 (1.2%) buffaloes and 36/2200 (1.6%) cattle which were mandatorily slaughtered under the Egyptian legislation, after postmortem examination the non-visible-lesion proportion was 39/54 (72.2%) which surpassed the visible-lesion rate 15/54 (27.8%) with (p < 0.0001). The samples from each case were pooled into one sample representing the case, and the isolation rate of M. bovis was 25/54 (46.3%). Real-time PCR using atpE was positive for mycobacteria on the genus level in 18/18 (100%) and 5/5 (100%) of tissue samples and isolates, respectively; simplex PCR detected M. bovis in 44/54 (81.5%) and 25/25 (100%) of tissue samples and isolates, respectively. Flow Cytometry evaluation of the CD4 + , CD8 + , WC1 + δγ, and CD2 + cell phenotypes showed increased counts in the tuberculin-positive cases compared with negative cases (p < 0.0001), and these phenotypes in the tuberculin-positive cases increased after antigen stimulation than in the negative cases (p < 0.0001). Detection rates of PCR techniques and flow Cytometry exceeded that of bacterial isolation (p < 0.0001) and exhibited a strong correlation., Conclusions: The skin test suffers from interference from non-tuberculous mycobacteria able to cause false-positive reactions in cattle and other species. Real-time PCR using atpE, conventional PCR targeting RDs, and flow Cytometry are rapid and accurate methods that correlate with the isolation and can be promising for detection and confirmation of infected live and slaughtered cases., (© 2022. The Author(s).)

Objectives: Death with graft function is one of the most catastrophic events after kidney transplant. Various pre and posttransplant risk factors have been linked to death with graft function. Characterization of this event is crucial to set successful preventive measures. Here, we reported on death with graft function among living donor kidney transplant recipients seen at the Urology and Nephrology Centre at Mansoura University (Mansoura, Egypt) throughout a period of >4 decades., Materials and Methods: This single-center study included 2953 patients who received living donor kidney transplant between March 1976 and December 2018. Patient data were retrospectively analyzed. Patients who had death with graft function were compared with other patients with regard to pre- and posttransplant data. Causes of death with graft function were also studied., Results: Among our patients (1654 male [56%] and 1299 female [44%] patients), death with graft function was reported in 9.9% of patients and responsible for 58.3% of deaths and 24.6% of graft losses. Male sex, pretransplant dialysis and blood transfusion, pre- and posttransplant diabetes and hypertension, high HLA mismatches, antithymocyte globulin induction, steroid and cyclosporine use, steroid dose, acute rejection episodes, and posttransplant infections and malignancy were significantly higher among the death with graft function group. However, multivariate analyses showed that only pretransplant diabetes, steroid dose, and posttransplant infections were risk factors for death with graft function. The most common causes of death with graft function were cardiovascular disease, infections, and malignancy., Conclusions: Death with graft function remains a significant hindrance to competent kidney transplant outcomes. We found that the most common contributors to this major event were cardiovascular disease, infections, and malignancy. More attention is needed to modify risk factors of cardiovascular disease, to update implementation policies for posttransplant vaccinations, and to conduct increased malignancy surveillance, as well to adopt less aggressive immunosuppression regimens.

Background: The aim of this study was to assess the safety and efficacy of chronic subdural hematoma (CSDH) evacuation by two burr-hole craniostomies under local versus general anesthesia (GA) in elderly patients over 70 years., Methods: This retrospective study included 45 patients with CSDH aged over 70 years old treated from March 2018 to April 2020. The cases were subdivided into Group A ( n = 22) that underwent evacuation under local anesthesia and Group B ( n = 23) that was treated under GA. Patients' demographics and history of comorbidities were recorded. Variables including pre- and post-operative neurological status and Markwalder's score, complication rate, operative time, and length of hospital stay were evaluated., Results: The mean and standard deviation of patients' age of groups (A) and (B) were 74.3 ± 2.5 and 73.2 ± 1.7 years, respectively. Postoperative Glasgow Coma Scale of group (A) was statistically higher than Group B at postoperative day 1 ( P = 0.01). Operative time was statistically shorter in Group A than B ( P < 0.0001). The length of hospital stay was found to be longer in group (B) than (A) ( P = 0.0001). The complication rate was found to be higher in group (B) than (A) ( P = 0.044)., Conclusion: Evacuation of CSDH under local anesthesia in elderly patients over 70 years is effective, safe, and economic with less complication rate than the traditional technique with GA., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Surgical Neurology International.)

Background: Biomphalaria alexandrina snails, as transitional hosts of schistosomiasis, plays an essential part in the spread of the illness. Control of these snails by the substance molluscicides antagonistically influences the oceanic climate, causing poisonous and cancer-causing consequences for non-target life forms., Objective: Looking for new naturally safe substances that can treat schistosomiasis disease with minimal side effects on the environment and plants, fish wealth and do not affect vital human functions., Methods: Fifty fungal species were used to evaluate their activity against Biomphalaria alexandrina. Study the effect of the fungal extract on vital functions of Biomphalaria alexandrina and fish wealth. Purification of active substances and identification of their chemical structures., Results: Cladosporium nigrellum and Penicillium aurantiogresium metabolites were effective against B. alexandrina snails, and the effects of promising fungal extracts sublethal concentrations (IC 10 & IC 25 ) on the levels of steroid sex hormones, liver enzymes, total protein, lipids, albumin and glucose were determined. Chemical analyses of this filtrate separated a compound effective against snails; it was identified. Protein electrophoresis showed that fungal filtrate affects the protein pattern of snails' haemolymph. Little or no mortality of Daphnia pulex individuals was observed after their exposure to sublethal concentrations of each treatment., Conclusion: Certain compounds from fungal cultures could be safely used for biological control of Biomphalaria alexandrina snails., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Acne vulgaris is one of the most common chronic inflammatory skin disorder affecting millions of people worldwide. Vitamin D deficiency has a role in various inflammatory skin diseases as acne. This study aimed to investigate the serum level of 25 hydroxy vitamin D in acne patients and to assess the efficacy and safety of active vitamin D in management of acne. This study was conducted on 100 patients with acne and 100 healthy controls, then the 100 acne patients were randomized to either the study group that received 0.25ug alfacalcidol daily or the placebo group that received oral placebo during the 3 months study period. Serum levels of 25-hydroxy-vitamin D were significantly lower in acne patients than in healthy control and were inversely correlated to the severity of acne. After alfacalcidol administration, the study group showed significant higher level of 25(OH) D levels ( p  < .05) compared to placebo group. In addition, median serum level of IL6 and TNFα significantly decreased ( p  < .05) in the study group in comparison to placebo group and as compared to their baseline results. Acne patients are more commonly to have vitamin D deficiency as compared to healthy people and hence, alfacalcidol might have a beneficial role in the acne management with no reported side effects.

Background: The Shiga toxin-producing Escherichia coli (STEC) represented a great risk to public health. In this study, 60 STEC strains recovered from broiler and duck fecal samples, cow's milk, cattle beef, human urine, and ear discharge were screened for 12 virulence genes, phenotypic and genotypic antimicrobial resistance, and multiple-locus variable-number tandem-repeat analysis (MLVA)., Results: The majority of strains harbored Shiga toxin 1 (stx 1 ) and stx 1d , stx 2 and stx 2e , and ehxA genes, while a minority harbored stx 2c subtype and eaeA. We identified 10 stx gene combinations; most of strains 31/60 (51.7%) exhibited four copies of stx genes, namely the stx 1 , stx 1d , stx 2 , and stx 2e , and the strains exhibited a high range of multiple antimicrobial resistance indices. The resistance genes blaCTX-M-1 and blaTEM were detected. For the oxytetracycline resistance genes, most of strains contained tetA, tetB, tetE, and tetG while the tetC was present at low frequency. MLVA genotyping resolved 26 unique genotypes; genotype 21 was highly prevalent. The six highly discriminatory loci DI = 0.9138 are suitable for the preliminary genotyping of STEC from animals and humans., Conclusions: The STEC isolated from animals are virulent, resistant to antimicrobials, and genetically diverse, thus demands greater attention for the potential risk to human., (© 2021. The Author(s).)

Objectives: To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up., Materials and Methods: Eighty completely edentulous patients were seeking to improve retention of their lower complete denture by installing a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. After a 3-month healing period, all patients were randomized using sealed envelopes into ball attachment and CM-LOC attachment. The Periotest readings (PTV) was recorded using the Periotest M device and was recorded every 3 months for the first year and then annually in the second year. The scope of this clinical trial focused only on results of the ball attachment. The Mann-Whitney U test was used for comparison between study groups for independent samples. Two-sided p values less than 0.05 was considered statistically significant., Results: There was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Initially, at the day of pickup (baseline) and 3-month follow-up, the mean PTV reading for the NS was greater than that of the S group (-4.471 ± 1.489, -4.391 ± 1.4727 ( p =0.913)), while the S group has shown a greater improvement in PTV than the NS group after 6-month follow-up and continued throughout the 24-month follow-up (-5.730 ± 1.7804, -50855 ± 1.2581 ( p =1))., Conclusion: Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. The submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group although this improvement was not statistically significant., Competing Interests: Ahmed Salah and Karim Foda, DDS, Ms, are working as lecturers in the Prosthodontic Department, Faculty of Dentistry, Cairo University. Mohamed Farouk, DDS, Ms, is an associate professor in the Prosthodontics Department, Faculty of Dentistry, Cairo University. Marwa Abdel Aal, DDS Ms, is a lecturer in the Prosthodontics Department, Faculty of Dentistry, Cairo University. Amr Ahmed Naguib, DDS, Ms, is a lecturer in the Prosthodontics Department, Faculty of Dentistry, Cairo University. Nouran A. Nabi, DDS, Ms, is an associate professor in the Prosthodontics Department, Faculty of Dentistry, Cairo University., (Copyright © 2021 Ahmed Salah et al.)

Objective: The aim of this randomized clinical trial was to compare the masticatory ability subjectively between ball and Cendres+Métaux Locator (CM-LOC) attachment for a single implant retained mandibular overdenture throughout a 24-month follow-up period., Materials and Methods: Eighty completely edentulous patients were recruited. All patients received new complete dentures, and masticatory ability was recorded using a questionnaire (baseline record). All patients received a single implant in the midline of the completely edentulous mandible. After 3-month healing period, patients were randomized using sealed envelopes into two groups: ball or CM-LOC attachment. The same masticatory ability questionnaire was used to record masticatory ability for both groups after 2 weeks of pickup and 3-, 6-, 9-, 12-, and 24-month follow-up. Comparison between the study groups was done using Mann-Whitney U test for independent samples. Two-sided P values less than 0.05 were considered statistically significant., Results: The mean masticatory scores improved for both attachments, with no statistically significant difference between them throughout the 24-month follow-up. The CM-LOC attachment group showed a greater improvement change in masticatory ability after 6- and 12-month follow-up (-12.47 ± 12.006, -11.46 ± 14.625; P =0.826), while the ball attachment group showed a slight improvement after the 24-month follow-up (-11.72 ± 12.368, -10.88 ± 11.963; P =0.778)., Conclusion: Single implant retained mandibular overdenture improved masticatory ability subjectively with no significant difference between both attachments used although the ball attachment showed better masticatory ability scores after 24-month follow-up., Competing Interests: All authors declare that they have no conflicts of interest., (Copyright © 2021 Marwa Abdel AaL et al.)

Breast cancer is one of the most common causes of death in women worldwide and has harmful influence on their psychological state during therapy. Multikinase inhibitors have become effective drugs for treating a variety of cancer diseases such as breast cancer. A purified short peptide (H-P) was isolated from the natural honey and tested for its potential regulatory role in breast cancer cells compared with the effectiveness of the anticancer drug, Sorafenib (SOR), using MCF-7, EFM-19, and MCF-10A cell lines. Furthermore, we investigated the direct connection between Raf-1 activation and cellular autophagy as potential targets of SOR and H-P extract using RNA interference. Interestingly, the treatment with H-P showed competitive regulation of phosphorylated Raf-1, MEK1/2, and matched autophagy-related LC3B without any detectable toxic effects in the non-tumorigenic epithelial cells. Unlike SOR, the regulation of Raf-1 protein and autophagic machinery by the novel H-P extract showed neglected levels of the released proinflammatory cytokine. This regulation of cytokine secretion by H-P resulted in decreasing the expression level of the transcription factor nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) in treated cells. Moreover, the transfection of MCF-7 cells with small interference RNA (siRNA) antagonist Raf-1 expression markedly reduced the expression of LC3B, while it increased the expression of NF-kB1 and NF-kB2, indicating the potential cross-link between Raf-1, autophagy, and NF-kB effector. Collectively, these findings suggest that H-P-mediated Raf-1, MEK1/2, LC3B, and NF-kB provide a novel and efficacious multikinase inhibitor for treating breast cancer without detectable cytotoxic effects., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 El-Fadl, Hagag, El-Shafei, Khayri, El-Gedawy, Maksoud, Mohamed, Mohamed, El Halfawy, Khoder, Elawdan, Elshal, Salah and Khalil.)

Dendritic cells (DCs) are efficient antigen-presenting cells (APCs) and potent activators of naïve T cells. Therefore, they act as a connective ring between innate and adaptive immunity. DC subsets are heterogeneous in their ontogeny and functions. They have proven to potentially take up and process tumor-associated antigens (TAAs). In this regard, researchers have developed strategies such as genetically engineered or TAA-pulsed DC vaccines; these manipulated DCs have shown significant outcomes in clinical and preclinical models. Here, we review DC classification and address how DCs are skewed into an immunosuppressive phenotype in cancer patients. Additionally, we present the advancements in DCs as a platform for cancer immunotherapy, emphasizing the technologies used for in vivo targeting of endogenous DCs, ex vivo generated vaccines from peripheral blood monocytes, and induced pluripotent stem cell-derived DCs (iPSC-DCs) to boost antitumoral immunity., Competing Interests: HW and NQ were employed by the company Hangzhou Biaomo Biosciences Co., Ltd., Hangzhou, China and Asia Stem Cell Therapies Co., Limited, Shanghai, China. MJ was employed by the company Hangzhou Biaomo Biosciences Co., Ltd., Hangzhou, China. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Salah, Wang, Li, Ji, Ou, Qi and Wu.)

Electrophoretic display (EPD) is a type of flexible display which has attracted wide attention. In this work, blue nanosized crystals of cobalt aluminum oxide (CoAl 2 O 4 ) were precipitated on silica nanoparticles, and then the nanocomposites were coated with an ionic liquid polymer (PIL) to give blue electrophoretic particles. The blue nanocomposites (SCAs) formed possess an excellent spherical structure, and the average diameter is about 188 nm. The porous silica matrix presents a relative light density, and the blue CoAl 2 O 4 pigment offers excellent color. The outside ionic liquid polymer supplies the PIL/SCAs with a light density of 1.7915 g cm -3 , excellent hydrophobicity and dispersion stability in the electrophoretic liquid. The fabricated single-particle EPD prototypes show a response time of 165 ms in the EPD cell with a 0.2 mm thickness, which is much faster than the commercial EPDs, and this is probably because of the unique composite structure., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Pasteurella multocida is a Gram-negative bacterium that causes drastic infections in cattle and humans. In this study, 55 isolates were recovered from 115 nasal swabs from apparently healthy and diseased cattle and humans in Minufiya and Qalyubia, Egypt. These isolates were confirmed by kmt1 existence, and molecular classification of the capsular types showed that types B, D, and E represented 23/55 (41.8%), 21/55 (38.1%), and 11/55 (20.0%), respectively. The isolates were screened for five virulence genes with hgbA , hgbB , and ptfA detected in 28/55 (50.9%), 30/55 (54.5%), and 25/55 (45.5%), respectively. We detected 17 capsular and virulence gene combinations with a discriminatory power (DI) of 0.9286; the most prevalent profiles were dcbF type D and dcbF type D, hgbA , hgbB , and ptfA , which represented 8/55 (14.5%) each. These strains exhibited high ranges of multiple antimicrobial resistance indices; the lowest resistances were against chloramphenicol, ciprofloxacin, amoxicillin/clavulanic acid, and levofloxacin. The macrolide-lincosamide-streptogramin B methylase gene erm (Q), with erm (42) encoding MLS B monomethyltransferase, mph (E) encoding a macrolide efflux pump, and msr (E) encoding macrolide-inactivating phosphotransferase were present. The class 1 and 2 integrons and extended-spectrum β-lactamase genes intl1 , intl2 , bla CTX-M , bla CTX-M-1 , and bla TEM were detected. It is obvious to state that co-occurrence of resistance genes resulted in multiple drug-resistant phenotypes. The identified isolates were virulent, genetically diverse, and resistant to antimicrobials, highlighting the potential risk to livestock and humans.

Background: Cerebral venous sinus thrombosis (CVST) is not a common type of stroke (5%) but still hazardous to be misdiagnosed or mistreated. Aggressive medical treatment is usually failed to hinder increase intracranial tension. Therefore, decompressive craniectomy (DC) is the final measure to mitigate the deleterious effect of supratentorial herniation. The purpose of the study is to illustrate our experience with the surgical treatment of CVST and reviewing the previous works of literature., Methods: Forty-two patients were admitted to Kasr Al-Ainy University Hospital from June 2019 to March 2020. The admission was either to the neurology department or intensive care unit or neurosurgery department. Every patient who was diagnosed with CVST received an emergency neurosurgery consultation. Seven patients were operated on with DC according to the criteria mentioned above. Therapeutic heparin was given in addition to intracranial pressure lowering measures., Results: The mean and standard deviation of the age was (25.14 ± 10.1) years. There were five females (71.45%) in our series. The mean and standard deviation of clinical manifestations are (8.5 ± 7.77) weeks with range (3- 14 weeks). Most of the cases were presented by a decreased level of consciousness (6/7) and anisocoria (6/7), followed by fits (3/7). Four cases out of seven had the previous history of oral contraceptive administration., Conclusion: DC provides an urgent last arm for intractable increased intracranial tension. Patients with CVST need urgent consultation for neurosurgical intervention., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Surgical Neurology International.)

Objective: Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons., Methods: Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Variables of the study included patients' demographics, mechanism of injury, incidence of cerebrospinal fluid (CSF) leakage, types of associated injuries, imaging findings and operative techniques., Results: Three-hundred eighty two patients were eligible to be screened in our study and represented the sample size under investigations in the following sections, 206 (53.9%) of patients were treated conservatively while 176 patients (46.1%) were identified as having an indication for surgical intervention. Eighty-four percent of patients were males. The mean age was 36.2±9.4 years (14-86 years). Depressed skull fracture was commonly associated injury (17.61%). Leakage of CSF was found in 32.95% of patients., Conclusion: Frontal sinus fracture is not an easy scenario. It harbors many proportions and deliver many varieties in which, deep understanding of anatomy, naso-frontal outflow tract status, CSF leakage and neurological injury are of important points in decision. Our institutional algorithm provide rapid, accessible and applicable treatment protocol for resident and young neurosurgeons which minimizes consultations of other specialties., Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest., (Copyright © 2021 Korean Neurotraumatology Society.)

Background: Vitamin D is a regulatory factor for immunity and skin barrier functions. It is hypothesized to be linked to atopic dermatitis (AD) which is characterized by interaction between epidermal barrier dysfunction and dysregulation of skin immune functions., Methods: One hundred AD patients and one hundred and one normal controls were collected from outpatient clinic based on their clinical condition, both had measurement of 25-hydroxyvitamin D [25(OH)D]. We assessed the relationship between 25(OH)D deficiency and AD prevalence using adjusted Poisson regression model., Results: Serum 25(OH)D levels were significantly lower in cases than controls (mean 35.1 versus 22.6 ng/mL, p  < .001). The unadjusted prevalence ratios (PRs) (95% CI) for AD for comparing participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.11 (1.91, 5.06) and 4.77 (2.99, 7.60), respectively. The association did not materially change after adjusting for potential confounders. In the fully adjusted analysis stratified by gender, PRs for AD for comparing male participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.38 (1.21, 9.40) and 5.20 (1.91, 14.13), respectively, whereas in the female participants were 1.32 (0.96, 1.83) and 1.49 (1.04, 2.14), respectively ( p -interaction <.001)., Conclusion: In this case-control study in children, we found a statistically significant dose-response association between vitamin D deficiency and AD. We also observed a statistically significant effect modification of this association by gender. Further research is recommended to study this association longitudinally, and to examine whether treating vitamin D deficiency may potentially improve AD. Key points Question: Can atopic dermatitis be associated with vitamin D deficiency? Finding: Serum 25(OH)D levels were significantly lower in cases with AD than in controls. Prevalence ratios for comparing male participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.38 (1.21, 9.40) and 5.20 (1.91, 14.13), respectively, whereas in the female participants were 1.32 (0.96, 1.83) and 1.49 (1.04, 2.14), respectively ( p -interaction <.001). Meaning: vitamin D deficiency is associated with AD in children, effect modification of this association by gender was also observed.

Macrophages (Mϕs) play an essential role in maintaining body homeostasis. They perform dual functions produced by different subtypes. Mϕs not only fight against pathogens and foreign bodies such as bacteria or cancer cells but also participate in healing and repairing damaged tissue since they maintain both proinflammatory and anti-inflammatory effects sequentially. Tumors possess the ability to polarize Mϕs from proinflammatory M1 subtype to anti-inflammatory M2-like Mϕs called tumor-associated macrophages, which, in turn, help the tumors to acquire cancer hallmarks. Consequently, this polarization allows tumors to grow and spread. In this light, Mϕs have been a subject of intense study, and researchers have developed protocols to derive different Mϕs subtypes either as a new state-of-the-art therapeutic approach or to understand the cross-talk between cancer and Mϕs. In this review, we present the use of primary Mϕs in adoptive immunotherapy for cancer, illustrate the reciprocating interplay between cancer and Mϕs, and the resulting structural and functional change on both cell types. Furthermore, we summarize the recent cutting-edge approaches of using Mϕs in cancer immunotherapy.

Hepatitis C virus (HCV) infection is a major health problem all over the world including Egypt. Chronic HCV infection is usually accompanied by decrease of libido and erectile dysfunction. This study aimed to evaluate the efficacy of new oral direct acting antiviral (DAA) therapy on sexual function of male patients with HCV. This study was conducted on 200 male participants divided into two groups, first group included 100 male patients with HCV and the second group included 100 healthy age matched males as a control. Patients received DAA for three months and virological free status was confirmed by polymerase chain reaction. All participants were subjected to full history taking, general examination and local genital examination, assessment of sexual function by a validated Arabic version of the international index of erectile function-5. Laboratory investigations included liver functions serum testosterone, free testosterone, sex hormone-binding globulin and bioavailable testosterone. Results of this study showed that patients with HCV suffer from sexual dysfunction than controls that significantly improved after DAA therapy, and this is accompanied by increasing of bioavailable testosterone. It could be concluded that beside its effectiveness in treatment of HCV infection, DAA therapy can improve sexual function in male patients with HCV., (© 2020 Wiley-VCH GmbH.)

Background: Pneumonia is the foremost cause of child death worldwide. M-ficolin is encoded by the FCN1 gene and represents a novel link between innate and adaptive immunity., Objectives: To investigate the FCN1 -144 C/A (rs10117466) polymorphism as a potential marker for pneumonia severity and adverse outcome namely complications or mortality in the under-five Egyptian children., Methods: This was a prospective multicenter study that included 620 children hospitalized with World Health Organization-defined severe pneumonia and 620 matched healthy control children. Polymorphism rs10117466 of the FCN1 gene promoter was analyzed by PCR-SSP, while serum M-ficolin levels were assessed by ELISA., Results: The FCN1 A/A genotype and A allele at the -144 position were more frequently observed in patients compared to the control children (43.4% vs 27.6%; odds ratio [OR]: 1.62; [95% confidence interval {CI}: 1.18-2.2]; for the A/A genotype) and (60.8% vs 52.5%; OR: 1.4; [95% CI: 1.19-1.65]; for the A allele); P < .01. The FCN1 -144 A/A homozygous patients had significantly higher serum M-ficolin concentrations (mean: 1844 ± 396 ng/mL) compared with those carrying the C/C or C/A genotype (mean: 857 ± 278 and 1073 ± 323 ng/mL, respectively; P = .002). FCN1 -144 A/A genotype was an independent risk factor for adverse outcomes in children with severe pneumonia (adjusted OR = 4.85, [95% CI: 2.96-10.25]; P = .01)., Conclusion: The FCN1 A/A genotype at the -144 position was associated with high M-ficolin serum levels and possibly contributes to enhanced inflammatory response resulting in the adverse outcome of pneumonia in the under-five Egyptian children., (© 2020 Wiley Periodicals, Inc.)

Objective: To study the prevalence of anxiety and its correlation with the academic performance among medical students.., Methods: The analytical cross-sectional study was conducted over six months from March 2018 to August 2018, at the male and female campuses of the College of Medicine, Majmaah University, Majmaah, Saudi Arabia, and comprised medical students of either gender. Data on anxiety was collected using a selfreporting questionnaire that included the Beck Anxiety Inventory. Academic performance was taken as a measurable record from the cumulative grade point average. Data was analysed using SPSS 24., Results: Of the 247 subjects, 170(68.8%) were males. Anxiety was found in 97(39.3%) of the students. The level of anxiety was significantly higher among females compared to males (p=0.001), among those in the final year (p=0.002), and in those with low academic grades (p=0.016)., Conclusions: Anxiety was found to be common among medical students and it was associated with female gender, low grades and advanced year of studies.

Pseudomonas aeruginosa is an evolving pathogen which can cause serious infections especially to immunocompromised patients. Its high resistance profile to antibiotics results in difficulty, and sometimes impossibility, in treating afflicted patients. Developing an effective vaccine against P. aeruginosa is an important approach to tackle this problem. A similar problematic situation exists for Acinetobacter baumannii. Several vaccine candidates have been investigated up till now but still there is no approved vaccine in the market. One important antigen of P. aeruginosa is the outer membrane protein F (OprF) which functions as a porin with relevant important roles in virulence. Previous studies focused mainly on the C-terminal peptidoglycan binding domain of OprF as a vaccine candidate. In the current study, we have investigated the N-terminal porin domain of OprF as a potential vaccine candidate against P. aeruginosa. Histidine-tagged recombinant N-terminal OprF (amino acid range 25-200; OprF 25-200 ) was overexpressed in Escherichia coli and purified using metal affinity chromatography. Swiss albino mice were immunized with OprF 25-200 adjuvanted with Bacillus Calmette-Guérin (BCG) and alum and the immune response was evaluated. Immunized mice developed antigen-specific IgG1 and IgG2a and were protected against challenge by both P. aeruginosa and a clinical isolate of A. baumannii expressing OprF. Serum from OprF 25-200 -immunized mice showed cross-reactivity with both pathogens using western blotting and whole cell enzyme-linked immunosorbent assay (ELISA). To our knowledge, this is the first report to demonstrate that the N-terminal domain of OprF is sufficiently immunogenic to protect against the two pathogens., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2020 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Mastitis caused by multi- or pan-drug resistant bacteria is a growing health concern. A total of 110 milk samples were collected: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus dysgalactiae, Enterococcus faecalis, and Escherichia coli were present in 54/110 (49.09%), 37/110 (33.63%), 25/110 (22.72%), 7/110 (6.36%), and 50/110 (45.45%) samples, respectively. A total of 20 methicillin-resistant S. aureus (MRSA) isolates, 19 Streptococcus sp. isolates, and 15 E. coli isolates were selected, and 100% were positive for (coagulase and hemolysins), streptokinase, and hemolytic activity, respectively. A number of 11 E. coli isolates were serotyped, and the serotypes were: O26, O55, O111, O119, O124, O125, O127, and O158. The antimicrobial resistance index ranges for MRSA, Streptococcus sp., and E. coli were 0.49-0.83, 0.39-0.83, and 0.56-1, respectively. The most effective antimicrobials on Gram-positive isolates were cephradine, ciprofloxacin, doxycycline, norfloxacin, and vancomycin, while doxycycline and norfloxacin were effective on E. coli serotypes. All of the selected isolates exhibited slime layer production. The efflux pumps of the 12 MRSA, 12 Streptococcus sp., and 11 E. coli isolates exhibited activity with ethidium bromide concentrations of 1, 1.5, and 0.5 µg/ml, respectively. There was a simultaneous antimicrobial activity of the efflux pump inhibitor chlorpromazine with amoxicillin/clavulanic acid, erythromycin, and oxacillin, to which the isolates were resistant. The 12 MRSA isolates harboured the methicillin resistance genes mec(A,A1, and A2), mecA1, and mecC at frequencies of 9/12 (75%), 9/12 (75%), and 8/12 (66.7%), respectively, and the penicillin resistance gene BlaZ was present at a frequency of 5/12 (41.7%). The distributions of erm(A), erm(B), erm(C), erm(F), erm(G), and erm(Q) were 8/12 (66.7%), 5/12 (41.7%), 12/12 (100%), 2/12 (16.7%), 0/12 (0.0%), and 8/12 (66.7%), respectively. The 12 Streptococcus sp. isolates harboured mec(A, A1, and A2), mecA1, mecC, and blaZ at rates of 4/12 (33.33%), 4/12 (33.33%), 5/12 (41.7%), and 4/12 (33.33%), respectively. The frequencies of erm(A) and erm(F) were 4/12 (33.33%), and 9/12 (75%), respectively. The 11 E. coli isolates harboured the extended-spectrum β-lactamases integrase1, integrase2, blaCTX-M, blaCTX-M-1, and blaTEM at frequencies of 10/11 (90.90%), 11/11 (100%), 9/11 (81.81%), 6/11 (54.54%), and 10/11 (90.90%), respectively. Moreover, the frequencies of erm(A), erm(B), erm(C), erm(F), erm(G), and erm(Q) were 7/11 (63.63%), 4/11 (36.36%), 4/11 (36.36%), 5/11 (45.45%), 10/11 (90.90%), and 10/11 (90.90%), respectively. Our results demonstrated the high antimicrobial resistance of the investigated isolates and confirmed the existence of multiple mechanisms underlying multidrug resistance.

Objectives: To evaluate Doppler ultrasound and platelet indices for the prediction of preeclampsia (PE). Design: Prospective observational study. Methods: The study included 270 normal pregnancy primigravida <20 years at 20-24-week gestation. Doppler ultrasound was done to detect uterine artery diastolic notch and to measure the pulsation index (PI) and the resistance index (RI). The platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (Plcr) was measured by automated blood picture. Outcome: Validity of combined tests in prediction of PE. Results: Patients who developed PE had significant higher percentage of diastolic notch, higher mean PI, RI, and significant increase of MPV and PDW than normotensive women ( p  < .001). Patients with abnormal Doppler and abnormal platelet indices had significant higher incidence of severe PE ( p  < .001). Conclusion: Abnormal platelet indices combined with abnormal Doppler is a predictor of severity rather than the rate of development of PE.

Introduction: Cancer is one of the most difficult challenges faced by humanity due to its many associated issues, such as inability to prevent diseases, treatment safety, and high mortality rate. In cancer, a variety of cellular signaling is activated to ensure malignancy transformation, angiogenesis and metastasis. The most efficient signaling pathway in cancer is mitogen-activated protein kinase (MAPK), which controls malignancy and regulates apoptosis. Methods: Four different flavonoid glycosides have been isolated from Pulicaria jaubertii using the phytochemical characterization of hydro-methanol extract. The purified glycosides (PJs) were investigated for their potential repression of cancer development using human lung epithelial cells and hepatocellular carcinoma (HCC) and compared with Sorafenib (SOR), the standard systemic drug for HCC. In PJ-treated cells, the expression profile of K-Ras, B-Raf, and P53 were detected using qRT-PCR, flow cytometry, confocal microscopy and western blot. Steady-state mRNA and levels of transforming growth factor-beta (TGF-β) and interleukin 8 (IL-8) were monitored in the fluids media at different time points following treatment. Results: Our results showed that the qurictine glycosides (PJ-1 and PJ-9) selectively inhibited the mutant K-Ras/B-Raf proteins expression and interaction in both cancer cells; while SOR showed obvious depletion of total Raf-1 protein in cancer cells and normal cells as well. Interestingly, the combination of PJ-1 or PJ-9 with SOR exhibited restoring cell viability of normal cells via controlling Raf-1 and P53 genes expression. Further, these identified PJ agents significantly adjusted the levels of TGF-β and IL-8 in cancer treated cells accompanied by restoring the activation of P53 expression. These findings were confirmed by docking analysis of PJs ligand and the crystal structure of K-Ras, B-Raf, and ERK transcription factor. Conclusion: The current data provide novel and natural multi-kinase inhibitors with competitive regulation of the mutant proteins; K-Ras and B-Raf and sustained MAPK signaling without any detectable toxic effect in normal cells., (Copyright © 2019 Abd El Maksoud, Taher, Gaara, Abdelrazik, Keshk, Elawdan, Morsy, Salah and Khalil.)

Background: Several epidemiological studies have suggested that the risk of depression is increased in patients with asthma, but the impact of asthma during pregnancy on postpartum depression remains unknown., Objective: To assess the association between maternal asthma and postpartum depression in a population-based cohort study retrieved from administrative databases., Methods: A cohort of 35,520 pregnancies in women with asthma during pregnancy and 197,057 pregnancies in women without asthma who delivered between 1998 and 2009 was extracted from the Quebec Asthma and Pregnancy Database. They were followed from the day of delivery up to 1 year postpartum. A generalized estimating equation model was used to estimate the adjusted odds ratios of postpartum depression with 95% CIs in women with asthma during pregnancy versus women without asthma., Results: Postpartum depression within 1 year after delivery occurred in 6.1% of women with asthma versus 2.9% of women without asthma. After adjusting for several potential confounders, including depression/postpartum depression up to 10 years before pregnancy, we found that women with asthma were 58% more likely to experience postpartum depression within 1 year after delivery than women without asthma during pregnancy (adjusted odds ratio, 1.58; 95% CI, 1.50-1.67)., Conclusions: Our findings suggest that women with asthma are more likely to suffer from postpartum depression. A close monitoring of signs of depression for pregnant women with asthma is indicated, allowing prompt and efficient interventions if needed., (Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Competing interests: None declared.

A system of N two-level atoms, Tavis-Cummings Dicke (TC-Dicke) model, interacting with a one-mode electromagnetic radiation field in the presence of the Stark shifts is studied, which is expected to predict new phenomena that are not explored in the original TC-Dicke model. We obtained the potential energy surface of the system using a trial state the direct product of coherent states in each subspace. In the frame of mean-field approaches, the variational energy is evaluated as the expectation value of the Hamiltonian for this state. The order of the quantum phase transitions is determined explicitly and numerically. We estimate the ground-state energy and the macroscopic excitations in the superradiant phase. Moreover, we investigated the critical properties of the TC-Dicke model in the classical spin limit and coherent state. We observed that in the thermodynamic limit, the energy surface takes a simple form a direct description of the phase transition. Moreover, it is found that when the microwave amplitude changes the new phase transition occurs with the Stark shift. The analytical solutions and numerical results, which appear in this paper are agreement with our paper which published recently in Int. J. Mod. Phys. B when we studied the same model using a different coherent state.

Background: Pasteurella multocida continues to pose a danger to prone farm and wild animals all over the world. Chemotherapeutic treatments are progressively losing their effectiveness, last for long time, and cost a lot of money, as well as being toxic to human consumers. Therefore, clearing the way for immunization as a big-wheel alternative against the economic grain. Yet, the vaccines available in the market do not confer the necessary protection against the pathogen. The integration of the well adjuvanted killed vaccine with the attenuated vaccines proved to offer an effective protection to the host animals. However, the bare use of the killed bacterin to provide protection from the possible harm of the live attenuated vaccine was doubtful., Methods: In the present study, propolis extracts were used to ameliorate the immunogenicity of the Pasteurella bacterin. The cellular and humoral activities were assessed for the different bacterin formulations., Results: Propolis extracts adjuvants proved to broaden and extend the IgG potency, as well as to induce a unique mucosal protection against the bacterium. Simultaneously it offered an anti-inflammatory effect that increased the tolerability to the bacterin. While the cellular activity was relatively reduced with propolis extracts., Conclusion: These results confirm the effectiveness of the formulation of the bacterin with propolis to offer a potent homologous primary protection to the animals against the long-life use of the attenuated Pasteurella vaccines.

Objective: The aim of this study was to determine whether adding mobilization of the outer cavernous sinus membrane as a part of the approach, in large spheno-clinoidal meningiomas without cavernous sinus extension, would reduce bleeding and increase the extent of resection., Methods:: This prospective randomized controlled trial was held between February 2016 and April 2017 at Cairo University Hospitals. The study recruited 94 patients with spheno-clinoidal meningiomas without cavernous sinus involvement. Patients were randomly assigned (by a computer based randomization system) into two groups; the treatment group, in which the patients received mobilization of the outer layer of the lateral wall of the cavernous sinus, prior to opening of the dura; and, the control group, in which the patients were operated by a direct opening of the dura without cavernous sinus dissection. The primary outcome of this study was the difference in the amount of blood lost during surgery between both groups of patients. The secondary outcome variables were the estimated blood loss (EBL) calculated according to Mercurelli's formula, the extent of tumor resection and the amount of blood transfused., Results:: The amount of blood loss and estimated blood loss (EBL) were significantly less in the "with mobilization group" with the P value being 0.00 and 0.013, respectively. Additionally, the amount of residual tumor was compared between both the groups and it showed that the group of patients who have received mobilization of the outer cavernous sinus membrane had a higher rate of radical resection as expressed by a lower volume of residual tumor (P value 0.005)., Conclusion:: In large spheno-clinoidal meningiomas without cavernous sinus involvement, routine mobilization of the outer cavernous sinus membrane reduces bleeding. This helps in a better visualization of cranial nerves in a relatively avascular field as it enables the performance of neurovascular dissection in an earlier phase of surgery. It also enables a more radical resection., Competing Interests: There are no conflicts of interest

In this paper, we used the Hyper-Pure Germanium (HPGe) detector to measure 30 samples which are collected from north of Nile Delta near Rosetta beach in Egypt. The activity of primordial radionuclides, such as 238 U, 235 U, 232 Th, and 40 K was estimated. Concentrations ranged between 36.5-177.4, 50-397.5 and 56.1-168.9 Bq.kg -1 for 238 U, 232 Th and 40 K respectively. Activity concentration of 235 U and the variation in uranium isotopic ratio 235 U/ 238 U was calculated. External hazard indices (H ex ) (or radium equivalent activity Ra eq ), activity concentration indices (I), alpha index (I α ), absorbed outdoor gamma dose rate (D out ), effective outdoor gamma dose rate (E out ) and Excess Lifetime Cancer Risk (ELCR) due to different samples are estimated. External hazard indices (H ex ) are ranged between 0.32-2.04, radium equivalent activity (Ra eq ) are ranged between 118.67-753.91, the activity concentration indices (I) are 0.42-2.61, and alpha index (I α ) are 0.18-0.89. External hazard indices (H ex ) in some samples more than unity then it exceeds the upper limit of exposure. Also, the radium equivalent activities (Ra eq ) are higher than the exemption limits (370 Bq.kg -1 ).

Background: The aim of the study is to measure plasma vitamin D levels in a group of Egyptian children with familial Mediterranean fever (FMF) compared to healthy children., Methods: The study enrolled 52 children with FMF and 40 apparently healthy controls. Serum vitamin D level was measured by enzyme-linked immunosorbent assay., Results: The mean serum vitamin D level was significantly lower in children with FMF than control group (12.3±3.4 and 21.2±3.5ng/mL, respectively, p<0.001). Vitamin D level was significantly lower in female patients than males (11.3±2.9, 13.2±3.6, respectively p=0.04). No statistically significant relations were detected between vitamin D level and different clinical, laboratory and genetic variables., Conclusion: Vitamin D levels were lower in Egyptian FMF children than healthy controls. There is a speculation that vitamin D deficiency in FMF patients may be related to inflammation. Further studies with larger number of patients before and after Vitamin D, therapy may be needed. Supplementation with high doses of vitamin D seems appropriate for children with FMF., (Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.)

Introduction: Fc gamma receptor (FcγR) IIa is considered the most widely distributed of the three classes of Fc receptors, and it expresses an allelic polymorphism. This type of polymorphism may modify the immune response and may be an important factor for some diseases. The aim of the study reported herein was to evaluate the association between the FcγRIIa polymorphism and susceptibility to both end-stage renal disease (ESRD) and acute kidney graft rejection (AR) in children who have undergone renal transplantation., Material and Methods: The study evaluated 70 children who had undergone transplantation and 60 healthy subjects. AR was observed in 25 children., Results: FcγRIIa genotypes and alleles were significantly different between transplantation patients and the control group. The assessment for FcγR of the groups in which AR was present showed that there was only a risk of having an acute rejection in homozygous genotype RR., Conclusions: FcγRIIa RR genotype and allele frequency was increased in paediatric renal transplant recipients. The present findings showed that FcγRIIa genotype may be related to ESRD disease susceptibility, and FcγRIIa polymorphisms seemed to affect AR., Competing Interests: The authors declare no conflict of interest.

Background: An essential milestone in pediatric transplantation is to find noninvasive biomarkers to monitor acute rejection (AR). In this retrospective (Case-control) study, we examined the role of Fas -670A/G and Fas Ligand (FasL) -843C/T gene polymorphisms in allograft nephropathy in pediatric renal transplant recipients., Methods: In 47 pediatric kidney transplant recipients and 20 healthy controls, Fas -670A/G and FasL -843C/T gene polymorphisms as well as serum soluble Fas Ligand level (sFasL) were measured., Results: Serum sFasL levels were significantly higher in transplant recipients children than that in controls (548.25±298.64pg/ml vs 143.17±44.55pg/ml, p=0.0001). There was no significant difference between patients with AR and those without AR in regards to serum sFasL levels (567.70±279.87pg/ml vs 507.85±342.80pg/ml, p=0.56). Fas -670A/G genotypes or alleles were not significantly different between controls and transplant recipients and among transplant recipients with and without AR. (P>0.05 for all). FasL -843C/T genotypes were not different between transplant recipients and controls and among transplant recipients with and without AR (P>0.05 for all). However, Frequency of C allele in transplant patients was significantly higher than that in the control group (44.68% vs 25%, P=0.03). FasL -843C/T alleles were significantly different between patients with and without AR (P=0.03). The percentages of C allele were higher in children with AR (58.82% vs 36.67%). We found that serum FasL and serum creatinine were variables that were independently associated with AR., Conclusion: This study suggests that FasL gene polymorphisms in peripheral blood might be accurate in detecting cellular AR., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background and Objectives . SAA is an acute-phase reactant detected during an FMF attack or other inflammatory conditions. High SAA levels may increase the risk of amyloidosis. The aim of the study is to measure the serum amyloid A (SAA) level in a group of Egyptian children with familial Mediterranean fever (FMF) and study its various correlates, if any. Methods . The study enrolled seventy-one children with FMF. Results . SAA level was high in 78.9% of the studied patients with a mean of 81.62 ± 31.6 mg/L, and CRP was positive in 31% of patients. There was no significant releation between SAA level and any demographic or clinical manifestation. High SAA was more frequent in V726A allele (16.9%) followed by M694V allele (12.3%). Elevated SAA levels were more frequent in patients on low colchicine doses. Forty-five percent (45%) of patients have low adherence to colchicine therapy. Interpretation and Conclusion . High SAA levels were detected two weeks after last FMF attack in a large percentage of Egyptian FMF children. This indicates that subclinical inflammation continues during attack-free periods, and SAA could be used as a marker of it., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.

Ambulant flexible cystoscopy is the standard procedure in the urological practice for follow-up of Ta-T1 urothelial carcinoma (UC) due to its ability to survey the bladder for a variety of indications. It is the principal means of diagnosis and surveillance of bladder tumors. The follow-up of patients treated for Ta-T1 UC is of great importance because of the high incidence of recurrence and progression of the disease, whereby patients with Ta-T1 UC undergo cystoscopy every three months. The aim of this study to evaluate the procedure of ambulant flexible cystoscopy in proper diagnostic follow-up of Ta-T1 UC, patient's acceptance in regard to pain tolerance, non-hospital stay and expenses. Twenty one patients (18 male and 3 female) were diagnosed before as Ta-T1 UC by rigid cystoscopy and transuretheral resection of bladder (TURB) lesion scheduled for follow up by flexible cystoscopy under local anesthesia using 20 ml 2% lidocain gel on an ambulatory bases. Comparison was done using a cohort of 32 patients who underwent the procedure of follow-up of Ta-T1 cystoscopy and TURB using rigid cystoscopy and resectoscope. Seventeen patients 80.9% (16 male and 2 female) proved to be bladder free from recurrent lesion, 4 patients {19.1 %} (3 males and one female) which revealed recurrent lesions in spite of that the urinary bladder was free in pelvic ultrasonography. Cold cup biopsy from the lesions sent for histopathological examination which revealed recurrence of the tumor in 3 patients (two patients with Ta and one patient T1. TURB was done to have complete resection in 4 patients, the histopathological examination revealed ulcerating mucosa and free lamina propria in 3 specimens, and T2 in the fourth specimen. Comparison between the 2 groups revealed more patient's acceptance for the flexible cystoscopy group as regard pain tolerance, non-hospital stay and expenses. Ambulatory flexible cystoscopy with 20 ml of 2% lidocaine gel anesthesia is tolerated well by patients, with advantage of no hospital stay in the regular follow up of Ta-T1 tumors, pain perception was accepted by all patient provided delayed cystoscopy after lidocaine-gel instillation.

Background: Blood culture is necessary for appropriate management of clinically severe pneumonia in children under five years of age. However, in limited resource countries it might be unduly costly and waste of valuable time because of the high negative culture rate., Objectives: This study aims to identify clinical and laboratory parameters that potentially predict a positive blood culture in cases of severe pneumonia., Materials and Methods: A hospital based study, enrolled 189 cases satisfying the WHO definition of severe pneumonia. Age, gender, clinical history, physical examination, temperature, complete blood count, C-reactive protein, blood culture and Chest X Ray for all the patients were recorded., Results: Forty one patients had positive blood culture giving a prevalence of 21.7%. All variables were used in a dichotomous manner. White Blood Count (WBC) more than 20 000, very high C-reactive protein (C-RP ≥8mg/L) and Temperature more than 40(o)C, had a positive predictive value of 46.1%, 44.3% and 40.0% respectively for a positive culture as well as a Negative Predictive Value of 91.1%, 91.6% and 91.7% respectively. The WBC more than 20 000 and temperature above 40(o)C had a significant association with a positive blood culture. Their adjusted Odds Ratios were 3.9 (95% CI: 1.4-10.90) and 3.1 (95% CI: 1.2-8.4) respectively. This was not the case for C-RP (Odds Ratio=2.2, 95% CI: 0.7-2.2) or positive Chest X Ray (Odds Ratio=1.5, 95% CI: 0.6-3.6)., Conclusion and Recommendation: Temperature of more than 40(o)C, Very high C-RP and WBC of more than 20 000 are good indicators of a potential positive blood culture. It is therefore recommended that further research be undertaken to refine these predictors as screening tools before resorting to blood culture. It is also recommended that antibiotic treatment may be initiated on the basis of the high temperature and WBC, while waiting for the culture results.

There are very few published reports on the causes of chronic kidney disease (CKD) in Egyptian children. We reviewed the records of 1018 (males 56.7%, age ranged from 1 to 19 years) Egyptian patients suffering from CKD and followed-up at the pediatric nephrology units (outpatient clinics and dialysis units) of 11 universities over a period of two years. The mean of the estimated glomerular filtration rate was 12.5 mL/min/1.73 m 2 . Children with CKD stage I and stage II comprised 4.4% of the studied group, while those with stage III, IV and V comprised 19.7%, 18.3% and 57.6%, respectively. The most common single cause of CKD was obstructive uropathy (21.7%), followed by primary glomerulonephritis (15.3%), reflux/urinary tract infection (14.6%), aplasia/hypoplasia (9.8%) and familial/metabolic diseases (6.8%); unknown causes accounted for 20.6% of the cases. Of the 587 patients who had reached end-stage renal disease, 93.5% was treated with hemodialysis and only 6.5% were treated with peritoneal dialysis.