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In this paper, we introduce some user-friendly versions of integral-type fixed-point results and give some modifications of the classical Banach contraction principle by constructing a special type of contractive restrictions of integral forms for weak contraction mappings defined on 1 E -complete multiplicative partial cone metric spaces over Banach algebras and formulate some existence and uniqueness results regarding the fixed-point theorems using some integrative conditions. Moreover, we validate the significance our results and exploit them to find the unique solution of a fractional nonlinear differential equation of Caputo type, which complements some previously well-known generalizations found in the literature. [ABSTRACT FROM AUTHOR]

This paper introduces a novel class of generalized α-admissible contraction types of mappings in the framework of ϑ-complete partial satisfactory cone metric spaces and proves the existence and uniqueness of coincidence points for such mappings. In this setting, the topology generated and induced by the partial satisfactory cone metric is associated with semi-interior points rather than interior points of the underlying cone. In addition, some applications of the paper's main coincidence point theorems are given. The results of this paper unify, extend and generalize some previously proved theorems in this generalized setting. [ABSTRACT FROM AUTHOR]

Background: The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post-spinal anesthesia shivering in cesarean section.Methods: Parturient scheduled for elective cesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block. Assessment parameters included; hemodynamics, tympanic membrane temperature, neonatal Apgar score, shivering score, patient satisfaction scores about shivering prophylaxis and adverse effects.Results: Clinically significant shivering was recorded in 55/71 patients (77.5%) in group I, 11/69 (15.9%) in group II and 21/72 (29.2%) in group III (P = 0.000). The intensity of shivering was significantly lower in patients who received granisetron 1 mg compared with granisetron 0.7 mg or saline (P = 0.000). Patients who received prophylactic granisetron 1 mg reported lower mean intraoperative arterial pressure and heart rate values and consumed higher doses of iv ephedrine compared with 0.7 mg granisetron or saline placebo (P < 0.05). Pruritus significantly decreased from (22.5%) in control group to (0%) in granisetron groups (P = 0.000). Nausea was reported in 8 vs 10 and four in group I, II and III, respectively (P < 0.03). Sixteen vs eight and six patients vomited in group I, II, and III, respectively (P < 0.03). Higher patient satisfaction scores were recorded in group II (9.83 ± 0.29, P < 0.03) and III (9.14 ± 1.04, P < 0.04), compared with control group (8.23 ± 1.14).Conclusion: Prophylactic granisetron effectively reduced incidence and severity of perioperative shivering in a dose dependent manner, compared to placebo controls. [ABSTRACT FROM AUTHOR]

Community-based programs may contribute to Latino pediatric obesity prevention; however, attendance remains low. This study aimed to identify factors associated with Latino father/male caregiver attendance in family-based adolescent obesity prevention programs conducted as part of a randomized controlled trial. The study used cross-sectional data from 137 fathers in the program, involving eight weekly sessions to improve their children’s energy balance-related behaviors. Evaluation data were collected at baseline and post-intervention. Fathers in a waitlisted control group attended sessions after post-intervention data collection. Attendance patterns were identified using cluster analysis: consistently high attendance (50% of fathers), declining attendance (19%), and non-attendance (31%) clusters. Multinomial logistic regression was used to examine associations between attendance patterns and variables. Compared to consistently high attendance, fathers in the non-attendance cluster were more likely to have been assigned to the control group (odds ratio [OR] = 7.86, p < 0.001), tended to have lower household income (OR = 2.50, p = 0.098), and attended the program at a site where the program occurred weekdays (OR = 0.35, p = 0.094). Maintaining contact during waiting periods and providing sessions online or during weekends could reduce non-attendance by enhancing convenience for low-income fathers working multiple jobs.

Background: Follicular lymphoma (FL) is one of the most common non-Hodgkin’s lymphomas of B cells, being closely associated with a t(14;18) translocation. Detection of t(14;18), which is present in 70–95% of FL, might aid in FL diagnosis. Objective: To compare the efficacy of routine polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) techniques in detecting t(14;18) in paraffin-embedded tissue samples of FL patients at different stages. Combined with other immunophenotypic biological determinants, detection of t(14;18) might help to determine patients at increased risk according to the FL International Prognostic Index (FLIPI) and therefore facilitate appropriate treatment. Design and Methods: This study was mainly based on a retrospective examination of formalin-fixed, paraffin-embedded lymph nodes. We selected fixed tissue samples of 21 FL patients treated at the National Cancer Institute Center in the period from 2000 to 2001. Results: FISH techniques could detect 14 of 18 FL cases with a sensitivity of 77.8%, while the PCR technique could detect only 11 of 18 FL cases with a sensitivity of 61.1%, resulting in a statistically significant difference between both techniques (p = 0.004). According to the FLIPI index, 9 of the 18 FL patients were categorized into the high-risk group (50%), 5 in the intermediated-risk group (27.8%) and 4 in the low-risk group (22.2%). Conclusion: The sensitivity of FISH is superior to that of PCR in the detection of the t(14;18) translocation in paraffin-embedded tissue samples. There is a statistically significant correlation between both CD10 and FISH with FLIPI. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: Total Hip Arthroplasty (THA) is one of the most frequent major surgical procedures in orthopedics. Aim: To audit the results of THA in Babol, Northern Iran. Materials and Methods: From 2014 to 2015, all patients with indication for THA referred to Shahid Beheshti and Rohani teaching hospitals in Babol were recruited in this prospective study. Patients with severe osteoarthritis of the knee, a psychiatric disorder, history of previous arthroplasty, bilateral osteoarthritis, contraindications to a major surgery, or failure to attend followup were excluded. The Harris Hip Score (HHS) was used to measure physical hip performance, ranging from 0 (poor) to 100 (excellent) points. All patients were followed for six months. Data were collected and analysed using SPSS with t-test analysis. Results: A total of 58 patients were finally assessed, of whom 24 (41.4%) were male and others were female. The mean age was 56.8±16.56 years. The postoperative complications included infection (one case), posterior hip dislocation (two cases) and peroneal nerve paresis (one case). The mean HHS was 49.69±5 before the surgery, but it improved significantly to 88.02±4.04 at sixth months after THA (p

The article presents research examining the anticariogenic effect of the pretreatment of teeth with sodium fluoride prior to stannous fluoride application in children. Researchers are seeking to apply findings of extended protection against tooth decay from the pretreatment of rat molars with concentrated solutions of sodium fluoride to human teeth. Data did not confirm in vitro data indicating the superiority of pretreatment with sodium fluoride.

Background/Aims: Long-term evaluation of cisplatin induced nephrotoxicity and the probable renal protective activities of stem cells are lacking up until now. We evaluated the early and long-term role of human adipose derived mesenchymal stem cells (ADMSCs) in prevention or amelioration of cisplatin induced acute kidney injury (AKI) in Sprague-Dawley rats. For this, we determined the kidney tissue level of oxidative stress markers in conjugation with a renal histopathological scoring system of both acute and chronic renal changes. Methods: This study used eighty Sprague-Dawley (SD) rats weighing 250-300g. They were assigned into four equal groups (each group n=20): (I) Negative control group, rats injected with single dose of 1 ml normal saline. (II) Positive control cisplatin, rats injected with a single dose of 5 mg/kg I.P in 1 ml saline. (III) Cisplatin and culture media group, rats injected with 0.5 ml of culture media single dose into the tail vein and (IV) Cisplatin and ADMSCs group, rats injected with a single dose of 0.5 ml of culture media containing 5 x106ADMSCs into the tail vein one day after cisplatin administration. Each main group was further divided according to the timing of sacrifice into four subgroups (each subgroup n=5). Rats in the subgroup A were sacrificed after 4 days; subgroup B were sacrificed after 7 days; subgroup C were sacrificed after 11 days; and subgroup D were sacrificed after 30 days. Before sacrifice, 24 hrs.-urine was collected using a metabolic cage. Renal function was evaluated through blood urea nitrogen (BUN), serum creatinine and creatinine clearance. Kidney tissue homogenate oxidative stress parameters, Malondialdehyde (MDA), Superoxide dismutase (SOD) and Glutathione (GSH) were determined. In addition, histopathological analysis for active injury, regenerative and chronic changes was performed. Results: ADMSCs were characterized and their capability of differentiation was proved. Cisplatin induced a significant increase in plasma creatinine and tissue MDA and induced a decrease in SOD, GSH and creatinine clearance. ADMSCs attenuated these changes. Cisplatin resulted in prominent histopathological changes in the term of tubular necrosis, atrophy, inflammatory cells infiltration and fibrosis. ADMSCs significantly lowered the injury score at day 4, 7, 11 and 30 with marked regenerative changes starting from day 4 and limited fibrotic score at day 30. Conclusion: ADMSCs have both protective and regenerative abilities with consequent limitation of the development of renal fibrosis after the cisplatin induced acute tubular necrosis, largely through an anti-oxidative activity.

Objective: The treatment of irritable bowel syndrome (IBS) is challenging, calling for therapeutic strategies other than pharmacological treatment. Therefore, this study aimed to investigate the effects of Pilates exercises on IBS symptoms and severity, frequency of complete spontaneous bowel movements, fatigue, anxiety, depression, and body weight in women with IBS., Methods: Sixty women with IBS, aged 20-45, completed this study. They were randomly assigned to two equal groups: a study group (n = 30) and a control group (n = 30). The study group received an 8-week Pilates exercise program (2 sessions per week) in addition to dietary advice, while the control group received dietary advice only. Inclusion criteria were women, IBS diagnosed based on Rome IV Diagnostic criteria, constipation-predominant IBS, and moderate to severe IBS. The outcome measures were the IBS severity scoring system (IBS-SSS), the frequency of complete spontaneous bowel movements, the modified fatigue impact scale (MFIS), hospital anxiety and depression (HADS) scale, and body weight (BW)., Results: The study group showed more significant improvements than the control group in total IBS-SSS score (Cohen d = 0.73, p < 0.001), frequency of complete spontaneous bowel movements (Cohen d = 0.50, p < 0.001), total MFIS score (Cohen d = 0.74, p < 0.001), anxiety (Cohen d = 0.56, p < 0.001), and depression (Cohen d = 0.64, p < 0.001). The study group also showed a significant reduction in body weight compared to baseline (p < 0.05). The control group showed significant improvements in all outcomes, except body weight, compared to baseline (p < 0.05)., Conclusion: Pilates exercises, used in addition to dietary advice, may significantly improve IBS symptoms and severity, frequency of complete spontaneous bowel movements, and alleviate fatigue, anxiety, and depression moderately more than dietary advice alone in women with constipation-predominant IBS. Nevertheless, dietary advice alone may also significantly improve these outcomes in this cohort., Competing Interests: Conflict of interest: The authors declare no conflict of interest., (© 2024 The Authors.)

Background and objective Applying different hygiene tools for implant maintenance alters surface configurations, impacting bacterial adhesion on titanium implant surfaces and potentially leading to peri-implant diseases. This study aimed to assess the alterations in surface topography of titanium implant fixtures after utilizing hygiene instruments such as airflow; erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser; and titanium brush, under scanning electron microscope (SEM) observation. Materials and methods We employed an experimental laboratory study design for this research, involving 20 MegaGen ST titanium implant fixtures (MegaGen Implant Co., Ltd., Seoul, Republic of Korea). These were classified into four groups: untreated/control fixtures (n=5); fixtures treated with airflow using sodium bicarbonate powder (n=5); fixtures treated with an Er, Cr: YSGG laser system at 1.5 W power and a laser pulse of 30 Hz (n=5); and fixtures treated with titanium brush operating between 300 to 1000 rpm (n=5). All fixtures were then rinsed with normal saline, fixed with 2.5% glutaraldehyde, and observed under SEM. Results In the SEM analysis, at 50x magnification, there were no differences between the fixtures. However, at 1000x, 2000x, and especially at 5000x magnification, the control group surfaces appeared to have no obvious change and were quite similar, with clearer surface details. The airflow group exhibited smoother surfaces with less complex and more organized structures. The laser group displayed a more irregular and haphazard structure, revealing a rougher topography. The titanium brush group showed the areas of the implant fixture surfaces appearing smoother and flatter. Conclusions In this SEM study, the titanium brush group yielded the smoothest surfaces and the most favorable overall outcomes, highlighting its efficacy., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ghaffar et al.)

Peri-implant diseases can still develop despite oral hygiene practices being maintained. Consequently, regular debridement must be carried out to ensure the implant is sustained. This review evaluated bacterial colonization on implants following the use of different hygiene instruments. A literature search was conducted in PubMed, ScienceDirect, and Scopus databases for articles published from 2012 to 2022. A total of 19 full-text papers were selected. The number of bacteria colonized was most commonly evaluated with a scanning electron microscope (SEM) or by colony-forming unit (CFU) counts, crystal violet assays, plaque index, probing depth, bleeding on probing, turbidity test, and live-dead assays. Rubber cup polishing with an abrasive paste showed a significantly greater reduction in biofilm formation compared with air abrasion with glycine powder, while the air abrasion treatment was found to be more efficient than piezoelectric, carbon, and stainless steel scalers. Surface treatment with Er, Cr: YSGG laser, and Er: YAG laser resulted in statistically significant superior dental biofilm removal compared with titanium curettes and photodynamic therapy. Air abrasion, plastic curette, titanium curette, and ultrasonic scaler showed no significant differences in bacterial colonization, but air abrasion and plastic curette were safer for zirconia implant decontamination. Furthermore, the titanium brush showed better results in decontaminating the implant surface than the Er: YAG laser. Although no single instrument or method could be considered as offering a gold standard in treating peri-implant diseases, the use of air abrasion with glycine powder, laser therapies, rubber cup polishing with an abrasive paste, and a titanium brush had high levels of cleaning efficacy and acceptance by patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Chen et al.)

Background/objectives Dental amalgam has been a successful restoration for over a century. However, restoration failures due to secondary caries, fractured teeth or restorations, marginal deficiencies, tooth wear, and secondary caries remain significant concerns. Amalgam-bond, known for its ability to bond amalgam to the tooth structure and prevent percolation, forms a strong bond with vital dentin. This study aimed to compare the outcome of marginal fractures in bonded amalgam and conventional amalgam posterior restorations among patients at a tertiary care dental hospital. Materials and methods Sixty consecutive patients aged 25-35 years, meeting the inclusion and exclusion criteria, participated in this study. A thorough history, clinical examination, and standardized periapical radiographs were conducted. Patients were divided randomly into two equal groups, group A and group B. Group A received bonded amalgam restorations, while group B received conventional amalgam restorations. Polishing was performed at a recall visit after seven days, and a follow-up evaluation was done after two months. The final assessment of marginal fractures was recorded after six months. Results After six months, 28 (46.7%) patients showed no marginal fractures, including 11 males and 17 females. On the other hand, 32 (53.3%) patients exhibited marginal fractures, comprising 17 males and 15 females. The clinical success rate of group A was better than group B ( p = 0.001). Conclusion Bonded amalgam demonstrates a high success rate and should be a routine choice for treating carious permanent molars in dental practice., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Iqbal et al.)

Objectives: The study aimed to assess the relationship between the functional single nucleotide polymorphism (SNP) (rs57095329) of miR-146a, the progression of drug-resistant epilepsy (DRE), and the severity of the disease (seizure frequency) in a group of Egyptian children epilepsy patients., Subjects and Methods: 110 Egyptian children were recruited and divided into two groups, the epilepsy patients ( n  = 60) and the healthy control children ( n  = 50). The patient's group was equally subdivided into two subgroups: drug-resistant and drug-responsive epilepsy patients. Genomic DNA samples from all participants were screened for the incidence of the rs57095329 SNP of the miR-146a gene by the Real-Time PCR., Results: There was no statistical significance between epilepsy patients compared to controls    regarding the rs57095329 SNP genotypes and alleles. Contrarily, there was significant difference between the drug-resistant epilepsy and the drug-responsive cases ( P  < 0.05). The genotypes AG ( P  < 0.007, OR: 0.118, 95% CI (0.022-0.636)) and GG ( P  = 0.016, OR: 0.123, 95% CI (0.023-0.769)) were higher among the drug-resistant, while AA was higher among the drug-responsive patients. The alleles A and G were higher among all cases, with a statistically significant difference ( P  = 0.028, OR: 0.441, 95% CI (0.211-0.919)). A significant difference was reported in the dominant model (AA versus AG+GG) ( P  = 0.005, OR: 0.12395% CI (0.025-0.621))., Conclusion: Therefore, miR-146a might be a potential therapeutic target for epilepsy treatment. The study was limited by the low number of young epileptic patients, the refusal of some parents to participate, and the incomplete medical history of some cases in the study, which forced their exclusion. More studies might be necessary to investigate other effective drugs to overcome the resistance issues induced by miR-146a rs57095329 polymorphisms.

Rhinoscleroma is an infectious granulomatous disease. It is important to identify pathognomonic Mikulicz cells on microscopy, as these can be rare and the chronic inflammatory infiltrate can appear otherwise nonspecific on biopsies., Competing Interests: The authors do not have relevant disclosures or conflicts of interest to report., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Background: Hepatitis C virus (HCV) is a worldwide' health problem as Egypt has a very high prevalence (14.7%) that may affect the B-Lymphocytes, and in some cases leading to an expansion of monoclonal B-cell detected by immunoglobulin heavy chain (IgH) gene rearrangement. Therefore, we aimed to assess the occurrence of IgH gene rearrangement in Egyptian chronic HCV patients and studying the effect of oral direct-acting antiviral (DAAs) therapy on regression of the clonality markers., Methods: 78 Egyptian patients with chronic HCV infection were included in this study and polymerase chain reaction (PCR) analysis was used to detect IgH rearrangement based on standardized PCR protocols of the BIOMED-2 international guidelines study., Results: Clonal IgH showed a significant increase of HCV-RNA expression and correlated with increased alanine transaminase (ALT) in all patients, while a significant increase of kappa and lambda free light chain observed only in clonal IgH with lymphoproliferative disorders (LPD) patients. A total of 37.17% (29/78) IgH clonality was detected in all patients (7.69% with LPD and 29.48% without LPD). 37% of these IgH clonality disappeared with HCV eradication after DAAs regimen., Conclusions: we concluded that different DAAs regimen with or without RBV is safe and effective for the treatment of Egyptian patients, but its effect is partially and not completely in the eradication of IgH clonality. Also, using IgH rearrangement in patients with chronic HCV is helpful as indicator in patients at high risk for prediction of LPD.

Objective: Reports of facial palsy occurring after the receipt of COVID-19 vaccines have raised concerns but are rare. The purpose of this study is to systematically assess the association between COVID-19 vaccination and facial palsy., Methods: Our systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and compiled all the reported cases of facial palsy post-COVID-19 vaccination. We discussed the probable pathophysiology behind facial palsy as a consequence of COVID-19 vaccination and measures to be taken for future reference. Furthermore, we conducted a detailed assessment of characteristics, clinical courses, treatment, and recovery of patients with facial palsy after receiving a COVID-19 vaccine., Results: We included 37 studies providing data on 58 individuals in our review. Over half (51.72%) of the patients complained of facial paralysis following the Oxford-AstraZeneca vaccination. Out of 51 cases, most (88.24%) occurred after the 1st dose. The majority (53.45%) of cases had bilateral facial palsy. Intravenous immunoglobin (IVIg), corticosteroids, and plasmapheresis were the first line of treatment with 75.93% of patients partially recovered, including those undergoing treatment or a lack of follow-up till the end while 22.22% had complete symptomatic recovery., Conclusions: Our review shows that Bell's palsy can be a plausible non-serious adverse effect of COVID-19 vaccination. However, the association observed between COVID-19 vaccination and Bell's palsy is less threatening than the COVID-19 infection. Hence, vaccination should be encouraged because facial palsy, if it occurs, has shown favourable outcomes with treatment., Competing Interests: The authors declare that they have no conflicts of interest and no financial interests related to the material of this manuscript., (© 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.)

This study deals with the finite-time synchronization problem of a class of switched complex dynamical networks (CDNs) with distributed coupling delays via sampled-data control. First, the dynamical model is studied with coupling delays in more detail. The sampling system is then converted to a continuous time-delay system using an input delay technique. We obtain some unique and less conservative criteria on exponential stability using the Lyapunov-Krasovskii functional (LKF), which is generated with a Kronecker product, linear matrix inequalities (LMIs), and integral inequality. Furthermore, some sufficient criteria are derived by an average dwell-time method and determine the finite-time boundedness of CDNs with switching signal. The proposed sufficient conditions can be represented in the form of LMIs. Finally, numerical examples are given to show that the suggested strategy is feasible., 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 © 2022 Elsevier Ltd. All rights reserved.)

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children characterized by the overproduction and accumulation of immature lymphoid cells in the bone marrow and peripheral blood. The BMI-1 is an important component of the Polycomb Repressive Complex-1 (PRC1). It is an important molecule for the self-renewal of hematopoietic stem cells (HSCs). The BMI-1 expression is generally high in HSCs and decreases after cell differentiation. The BMI-1 is required for the maintenance of normal and cancer stem cells and has been reported as an oncogene in various tumors. The NANOG is a homeodomain transcription factor responsible for maintaining the stem cell compartment at the blastocyst stage of developing embryos. The NANOG gene has been proven to be transcribed in CD34+ cells and different leukemic cells., Methods: The ribonucleic acid (RNA) was extracted from the peripheral blood mononuclear cells (PBMNCs) of 30 pediatric ALL patients (16 B-ALL and 14 T-ALL) and 14 healthy controls. The Bmi-1 and NANOG expression levels were determined using the quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR)., Results: Compared to normal controls, patients with ALL exhibited upregulated levels of Bmi-1 (p=0.03). Patients who overexpressed Bmi-1 and NANOG displayed a significantly worse survival than low-expressing patients (hazard ratio (HR) 5.74, 95% confidence interval (CI):1.48-22, p=0.012 and HR 3.8, 95% CI:1.009-14.3, p=0.048, respectively)., Conclusions: Taken together, these data suggest that the Bmi-1 and NANOG might serve as a novel survival predictor in ALL patients. Our observation also suggests that the Bmi-1 and NANOG could serve as new therapeutic targets for treatment of pediatric ALL., (Copyright © 2020 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Genetic mutations have been proven to be one of the major criteria in the diagnosis and distinction of different myeloproliferative neoplasm (MPN) subtypes. Therefore, the aim of this study was to determine the molecular profile of Egyptian patients with MPN subtypes and correlate with clinicopathological status., Methods: A series of 200 patients with MPNs (92 polycythemia vera, 68 essential thrombocythemia, and 40 primary myelofibrosis) were included in this study. DNA from each sample was amplified using polymerase chain reaction to detect Janus kinase 2 (JAK2), calreticulin (CALR), and myeloproliferative leukemia virus oncogene (MPL) mutations. Sanger sequencing was used to determine the mutation types., Results: Of the 200 samples, 44% had JAK2V617F and 10% were carrying CALR mutation with type 2 being the most frequent type in this study (55%). No MPL or JAK2 exon 12 mutations were detected. All clinical and hematological data had no differences with other populations except that our CALR-positive patients showed a decrease in the platelet count compared with JAK2V617F-positive patients., Conclusion: Our study on Egyptian patients shows a specific molecular profile of JAK2 mutation, and CALR mutation type 2 was higher than type 1., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Staphylococcus aureus harbouring Panton Valentine Leucocidin gene are emerging and spreading worldwide. PVL gene was first identified by Noel Panton and Francis Valentine in 1932 who explained its ability to lyse leucocytes and its main relationship with skin and soft tissue infections. In Pakistan only limited data is available on the frequency and molecular analysis of PVL gene positive Staph aureus. Therefore, this study was conducted to understand the clinical epidemiology of PVL positive Staph aureus in our setup. Objectives of the study was aimed to determine the frequency of PVL gene in Staph aureus obtained from pus samples from skin and soft tissue infections from various departments; indoor and outdoor of a tertiary care hospital of Lahore., Methods: 384 Staph aureus isolates from skin and soft tissue infections were selected from both indoor and outdoor departments of hospital. After identification by phenotypic methods, they were processed by PCR using luk-F and luk-S primers for the detection of PVL gene., Results: 186 out of 384 Staph aureus isolates were positive for PVL gene. Overall frequency of PVL gene was 49%. Frequency of PVL gene in Staph aureus was 44.9% in males and 53.5% in females. The highest frequency of PVL gene was detected in paediatric age group. A large majority of positive isolates were from pus samples other than swabs and from the general surgery department. They mostly belong to indoor with indoor outdoor ratio of approximately 2:1. Frequencies of PVL gene in MRSA and MSSA were 51% and 44% respectively. Frequency of PVL gene was found to be high in Ciprofloxacin sensitive, Gentamicin sensitive, Erythromycin resistant and Fusidic acid resistant isolates., Conclusion: Almost half of Staph aureus isolates were found PVL positive. They were mostly multidrug resistant came from indoor setup. This situation is very alarming so, there is a need to adopt strict infection control policies in the hospitals to limit the widespread and injudicious use of antibiotics. There is also a need to apply PVL positive Staph aureus treatment to the effected individuals which involve not only antibiotics but also the decolonization of effected individuals and their close contacts.

Background: The prevalence of Hepatitis C virus in Egypt reaches 15%, which is considered the highest in the world. Genotype 4 represents 93 % of Egyptian HCV infections. Non-Hodgkin lymphoma (NHL) is the 5th most common cancer in Egypt. The association between HCV infection and occurrence of B-cell NHL is well known while data are scarce in Eastern countries., Objectives: We aimed to evaluate the prevalence of HCV infection among patients with B-cell NHL and the clinical characteristics of HCV associated B-cell NHL in the Delta region (Mansoura-Egypt)., Methods: Between March 2012 and March 2013, 110 adult patients newly diagnosed with B-cell NHL were enrolled in the current study. This study was carried out at Oncology Center, Mansoura University. Study subjects provided serum for HCV testing., Results: The prevalence of HCV infection among these patients was 61% (67/110 patients). Among them, 80% (32/40 tested patients) presented with viremia. In contrast with the histological distribution previously described in Northern regions, the majority of HCV associated lymphomas were DLBCLs (72%) followed by SLL/CLL (13%), follicular lymphomas (7.5%) and marginal zone lymphomas (7.5%)., Conclusions: B-cell lymphomas are highly associated with HCV infection in Egypt. Further developments are needed to give access to antiviral treatment for these patients., Competing Interests: Competing interests: The authors have declared that no competing interests exist.

Background: The aim of our study was to compare the efficacy of dexmedetomidine, ketamine, and midazolam for sedative premedication administered by nebuliser 30 min before general anaesthesia in preschool children undergoing bone marrow biopsy and aspiration., Methods: Ninety children aged 3-7 yr were randomly allocated into three equal groups to be premedicated with either nebulised ketamine 2 mg kg -1 (Group K), dexmedetomidine 2 μg kg -1 (Group D), or midazolam 0.2 mg kg -1 (Group M). The primary endpoint was a five-point sedation score on arrival in the operating room 30 min after end of study drug administration. Secondary outcomes included: parental separation anxiety scale; medication and mask acceptance scales; haemodynamic variables; recovery time; postoperative face, legs, activity, cry, and consolability scale; emergence agitation scale; and adverse effects., Results: The median (range) sedation score on arrival in the operating room was 3.5 (1-4), 2.0 (2-3) and 2.0 (1-3) in Groups M, D, and K, respectively (P=0.000). Subjects in Group D showed higher medication (P<0.03) and mask acceptance scores (P<0.015) and more satisfactory parental separation anxiety scale (P<0.044). The median (range) recovery time was significantly shorter in Group D [5.5 (4-8) min] compared with Group K [10.0 (5-15) min, P=0.000] and M [8.0 (6-15) min, P=0.000]. The incidence of emergence agitation was lower in Group D (P<0.008)., Conclusions: Preschool children premedicated with nebulised dexmedetomidine had more satisfactory sedation, shorter recovery time, and less postoperative agitation than those who received nebulised ketamine or midazolam., Clinical Trial Registration: NCT02935959., (Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Background: Carnitine deficiency is relatively common in epileptic patients. The risk factors reported include the combination of valproic acid with other antiepileptic drugs (AEDs), young age, multiple neurologic disabilities, non-ambulatory status, and being underweight., Objectives: To study the level of carnitine deficiency and its associated risk factors among a group of children with idiopathic epilepsy treated with different AEDs., Patients and Methods: Fifty children with idiopathic epilepsy and 40 age-matched controls were enrolled. For all, serum carnitine level was measured by enzyme-linked immune sorbent assay (ELISA)., Results: The mean carnitine level was lower in cases compared to controls ( p  = 0.04). Patients receiving monotherapy treatment had a high percentage of carnitine deficiency compared to controls ( p  = 0.04). Patients receiving valproate with other AEDs had a lower level of carnitine compared to controls ( p  = 0.03). The age of the patients, the duration of treatment, and the doses of different AEDs were not risk factors for carnitine deficiency., Conclusions: Carnitine deficiency is common in our population, and the use of valproate with other AEDs is considered the most important risk factor for it in epileptic children., Competing Interests: The study was approved by the Faculty of Medicine Research Ethical Committee of Fayoum University (part of the ENREC). The following Professors are members of the committee: Somaya El Gawhary, Mona Farid Konsoa, Maher El Amir, Ghada El Gallad, Mohamed Mashaheet, Naglaa El Sherbiny, Manal El Hawary, Sawsan Sadek and Mohamed Masoud. The manuscript was approved in the 21st session of the committee on the 10 January, 2016 and its reference number was M133. A written consent was taken from the parents of all children participating after being informed about the objectives of the study. The confidentiality of their information was respected, and their right not to participate in the study was ensured.A consent for publication was obtained from the parents of all the children included in the study. The manuscript does not contain any individual person’s 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.

Sarcoidosis and lymphoma are generally thought of as being two mutually exclusive diseases that need to be considered in the differential diagnosis of patients with hilar/mediastianal lymphadenopathy. However, there are rare patients in whom both of these diseases coexist. These patients constitute a diagnostic challenge because their presentation (ie, clinical symptoms, imaging abnormalities and even pathology) may all be atypical when each individual disease is considered separately. In this report, we describe a patient who presented with such atypical features and was eventually diagnosed as having both sarcoidosis and a B-cell lymphoma with features of splenic marginal zone lymphoma (SMZL) simultaneously. To our knowledge, this is only the second reported case of SMZL and sarcoidosis in the same patient., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Immunotactoid glomerulopathy (ITG) is a rare cause of proteinuria characterized by organized microtubular deposits in the glomerulus. ITG has been associated with underlying lymphoproliferative disorders and any renal impairment may be reversible with treatment of the concomitant hematologic malignancy. This case is the first reported in literature where diffuse large B cell lymphoma developed two years following the initial ITG diagnosis., Case Presentation: A 55-year-old woman with a history of well-controlled diabetes mellitus and thalassemia trait presented with proteinuria (830 mg/day) in 2010. Initially, she was managed with renin-angiotensin-aldosterone-system blockade. In 2012, the proteinuria worsened (4.3 g/day) and a renal biopsy showed immunotactoid glomerulopathy (Fig. 1). Despite extensive work up, no lymphoproliferative disorder was initially found. In January 2014, the patient presented with a soft-palate mass found on biopsy to be diffuse large B-cell lymphoma. She received 6 cycles of R-CHOP, 4 cycles of high dose methotrexate chemotherapy for CNS prophylaxis and 30 Gy of Intensity Modulated Radiation Therapy. Follow-up revealed complete remission of diffuse large B-cell lymphoma and resolution of proteinuria from the ITG., Conclusion: As we recognize that patients with ITG may develop hematopoietic neoplasms, close long-term monitoring is important. Moreover, treatment of the lymphoproliferative disorder can allow for complete remission of ITG.

Background: The paracrine and regenerative activities of mesenchymal stem cells (MSCs) may vary with different stem cell sources. The aim of the present study is to compare the effects of MSCs from different sources on acute kidney injury (AKI) induced by cisplatin and their influence on renal regeneration., Methods: A single intraperitoneal injection of cisplatin (5 mg/kg) was used to induce AKI in 120 Sprague-Dawley rats. Rats were treated with either rat bone marrow stem cells (rBMSCs), human adipose tissue-derived stem cells (hADSCs), or human amniotic fluid-derived stem cells (hAFSCs). 5 × 10(6) MSCs of different sources were administered through rat tail vein in a single dose, 24 hours after cisplatin injection. Within each group, rats were sacrificed at the 4th, 7th, 11th, and 30th day after cisplatin injection. Serum creatinine, BUN, and renal tissue oxidative stress parameters were measured. Renal tissue was scored histopathologically for evidence of injury, regeneration, and chronicity. Immunohistochemistry was also done using Ki67 for renal proliferative activity evaluation., Results: MSCs of the three sources were able to ameliorate cisplatin-induced renal function deterioration and tissue damage. The rat BMSCs-treated group had the lowest serum creatinine by day 30 (0.52 ± 0.06) compared to hADSCs and hAFSCs. All MSC-treated groups had nearly equal antioxidant activity as indicated by the decreased renal tissue malondialdehyde (MDA) and increased reduced glutathione (GSH) level and superoxide dismutase (SOD) activity at different time intervals. Additionally, all MSCs improved injury and regenerative scores. Rat BMSCs had the highest count and earliest proliferative activity in the renal cortex by day 7 as identified by Ki67; while, hAFSCs seem to have the greatest improvement in the regenerative and proliferative activities with a higher count of renal cortex Ki67-positive cells at day 11 and with the least necrotic lesions., Conclusions: Rat BMSCs, hADSCs, and hAFSCs, in early single IV dose, had a renoprotective effect against cisplatin-induced AKI, and were able to reduce oxidative stress markers. Rat BMSCs had the earliest proliferative activity by day 7; however, hAFSCs seemed to have the greatest improvement in the regenerative activities. Human ADSCs were the least effective in the terms of proliferative and regenerative activities.

Background and Objectives: Cisplatin is a nephrotoxic chemotherapeutic agent. So, preventive measures worth to be evaluated. Human amniotic fluid stem cells (hAFSCs) in prevention or amelioration of cisplatin-induced acute kidney injury (AKI) in Sprague-Dawley rates have been tested., Methods: 80 Sprague-Dawley rats (250~300 g) were used and divided into 4 major groups, 20 rats each. Group I: Saline-injected group. Group II: Cisplatin-injected group (5 mg/kg I.P). Group III: Cisplatin-injected and hAFSCs-treated group (5×10⁶ hAFSCs I.V. one day after cisplatin administration). Group IV: Cisplatin-injected and culture media-treated group. Each major group was further divided into 4 equal subgroups according to the timing of sacrifice; 4, 7, 11 and 30 days post-cisplatin injection. Renal function tests were done. Kidney tissue homogenate oxidative stress parameters malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were determined. Histopathological scoring systems for active injury, regenerative and chronic changes were analyzed separately., Results: hAFSCs characterization and differentiation was proved. Cisplatin injection resulted in a significant increase in serum creatinine and MDA and decrease in SOD, GSH and creatinine clearance. These changes were attenuated early by day 4 with the use of hAFSCs. Cisplatin injection induced tubular necrosis, atrophy, inflammatory cells infiltration and fibrosis. The use of hAFSCs was associated with significantly lowered injury score at day 4, 7, 11 and 30 with marked regenerative changes starting from day 4., Conclusion: hAFSCs have both a protective and regenerative activities largely through an antioxidant activity. This activity cut short the acuteness of cisplatin nephrotoxicity.

Background: Therapy for patients with autoimmune hemolytic anemia (AHA) remains a major challenge. Patients with glycophorin A (GPA)-specific immunoglobulin G antibodies can have severe hemolysis, which may occur by mechanisms independent from traditional macrophage-dependent Fcγ receptor (FcγR)-mediated extravascular hemolysis. As intravenous immune globulin (IVIG) is known to display its beneficial effects in FcγR-mediated cytopenias, and IVIG responses in AHA are inconsistent at best, we sought to gain insight into the mechanism of anemia by a GPA complex-specific monoclonal antibody (TER119) in a mouse model of immune hemolytic anemia and evaluate the therapeutic effect of IVIG., Study Design and Methods: The anemic effect of the TER119 antibody was studied in vitro by incubation of mouse RBC with the antibody and in vivo by infusing the antibody into normal mice versus mice genetically deficient for the Fc receptor γ chain (Fcγ), complement C3, mice naturally deficient in complement C5, and splenectomized mice. IVIG efficacy in anemia was determined by treating mice with an intensive IVIG dosing regimen., Results: The TER119-mediated anemia was independent of classical FcγR-, C3-, and C5-dependent mechanisms, but occurred by a mechanism consistent with RBC agglutination. In accordance with agglutination, the presence of the spleen accelerated the anemia observed but anemia could still occur in splenectomized mice. IVIG did not significantly affect the induction of anemia by TER119., Conclusion: The mechanism of anemia induced by AHA-causing antibodies may be an important factor to consider in the response to therapy with IVIG., (© 2013 American Association of Blood Banks.)

Intravascular large B-cell lymphoma is a rare entity that usually presents in late stages with non-specific symptoms. We present a case of an incidentally discovered intravascular large B-cell lymphoma in a 78-year-old man who underwent colectomy for medically refractory pseudomembranous colitis. The malignant lymphocytes were preferentially localized to small colonic submucosal vasculature, without any evidence of an extravascular tumor mass. The gastrointestinal system is an exceeding rare initial diagnostic site for intravascular lymphoma, and presentation with pseudomembranous colitis has not been previously reported. We discuss the current definition of intravascular lymphoma, clinicopathological variants, differential diagnoses, as well as current therapy., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Plasmablastic lymphoma (PBL) is a variant of lymphoma originally described in the oral cavity of patients with advanced HIV. Our patient developed PBL despite well-controlled HIV and a CD4 count greater than 800 cells/µl. A drug interaction with an inhaled corticosteroid and ritonavir likely contributed to the development of this malignancy through increased immune suppression.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal (GI) tract, but are the least common of small intestinal malignant neoplasms. While GI bleeding is the most common clinical presentation of GISTs, intussusception and obstruction are uncommon, as GISTs rarely grow into the lumen. We describe an unusual case of a 50-year-old male who presented with intermittent obscure, overt GI bleeding requiring multiple hospital admissions and blood transfusions. His work-up included abdominal CT imaging, small bowel follow-through, gastroscopies, push enteroscopy, colonoscopies, and anterograde and retrograde double-balloon enteroscopies. Complicating his presentation were colonic angiodysplasias and the development of recurrent venous thromboembolism requiring anticoagulation. Within an hour after an apparently uncomplicated colonoscopy, he developed an acute abdomen secondary to a jejunal intussusception, which led to a laparoscopic small bowel resection and the diagnosis of a jejunal GIST. Given his GIST had no high-risk features, ongoing surveillance with abdominal CT imaging was arranged. This case illustrates the complex presentation and diagnostic difficulty of a jejunal GIST causing obscure, overt GI bleeding and this is the first reported case of a jejunal intussusception following colonoscopy. Due to its submucosal location, multiple endoscopic approaches had failed to diagnose the GIST prior to surgery.

Thrombocytopenia is one of the most frequent hematological manifestations of hepatitis C virus (HCV) infection; which typically worsens with progression of the liver disease and can become a major clinical complication. Several mechanisms have been postulated to explain thrombocytopenia in HCV hepatic patients, including immune mechanisms. The aim of the present work is to investigate the role of immune mechanisms as a causative agent of thrombocytopenia in HCV hepatic patients. The study included 50 hepatic patients with HCV infection (30 with thrombocytopenia and 20 with normal platelets counts). Platelets associated glycoprotein specific antibodies were evaluated by flow cytometry and confirmed by quantitative monoclonal immobilization of platelet antibodies (MAIPA). The frequency of platelet associated immunoglobulin (PAIg) in thrombocytopenic HCV positive hepatic patients by FCM was 86.7, 83.3, 46.7 and 33.3% for total PAIg, PAIgG, PAIgM and PAIgA respectively. MAIPA found platelet specific antibodies in 26/30 (86.7%) of patients. The most likely target antigen for platelets antibodies were glycoprotein (GP) IIb/IIIa (30%), followed by GP IIIa (20.5), GP IIb (13.3%), GPIb (13.3%), then GPIa (10%). The platelets count was inversely correlated to the levels of platelets GP specific antibodies (r=-0.42, p=0.024), and significantly parallel to spleen size (p=0.024). Platelet associated glycoprotein specific antibodies represent a common mechanism inducing thrombocytopenia in patients with chronic HCV infections.

The objective of this work was to provide computer and telecommunications skill training for paraplegics using a telemedicine training center in a curriculum that would support connectivity and offer new skills for career applications in the rehabilitation phase and beyond. This was a hospital-based, cross-sectional study. The study was conducted from October 10, 2005 to May 10, 2006 in the hospitals of Rawalpindi Medical College and the Melody Rehabilitation Center, Rawalpindi, Pakistan. These centers provided care for casualties of the October 2005 earthquake in Pakistan. One hundred and ninety four (194) paraplegics were admitted to Rawalpindi Medical College allied hospitals after injuries in the rural mountains near the epicenter. Surveys assessed the education level of the patients, and a sample of 12 patients was enrolled in computer training classes. Of the 194 patients, 144 were female and 50 were male. The majority, 78% (151) were 16-39 years of age. Although only 60% were literate, the overall literacy rate of Pakistan is just 48.7%. Telephone service at home was available after discharge for 40% of patients. Only 8% of patients had basic computer skills. All patients participated in the survey and sought to take the course. All the enrolled patients demonstrated full competency in the skills taught. The social disruption of disaster plus the new challenge of a neurological deficit in paraplegia did not deter a remarkable number of patients from a rural area from engaging in computer and telemedicine training. This study demonstrated the feasibility of educating rural paraplegics in computer skills for telemedicine. The telemedicine training center was used for this task without special equipment or personnel, thereby increasing the utilization of the facility.

Background: Spinal cord injury (SCI) is a devastating trauma suffered by many of the victims of an earthquake that struck Northern Pakistan on October 8, 2005. It rendered approximately 600 patients paraplegic, which is the highest number ever reported in any disaster. This study was conducted to evaluate the risk of complications., Methods: The cross-sectional retrospective study covering a 2-month period was conducted on 194 patients admitted to the surgical/neurosurgical wards of Rawalpindi Medical College and allied hospitals (Holy Family Hospital, Rawalpindi General Hospital, and District Headquarter Hospital) and Melody Relief and Rehabilitation Center, Islamabad., Results: The male-to-female ratio was approximately 1:3 (n = 50 [26%] and n = 144 [74%], respectively). The majority (78% [n = 151]) were 16 to 39 years of age; 62% (n = 120) had lumbar-level injuries, 25% (n = 48) had thoracic-level injuries, 9% (n = 18) had thoracolumbar-level injuries, and a few had cervical- or sacral-level injuries. Forty-six percent (n = 90) had American Spinal Injury Association type A injuries; 4% (n = 8) were graded B, 11% (n = 21) were graded C, 9% (n = 18) were graded D, and 14% (n = 27) were graded E. Twenty percent (n = 39) developed pressure ulcers, of which 38% (n = 15) had grade 1, 36% (n = 14) had grade 2, 23% (n = 9) had grade 3, and 3% (n = 1) had grade 4. All patients developed urinary tract infections; 15% (n = 30) had bowel complaints; 2% (n = 3) developed deep-vein thrombosis (1 died of pulmonary embolism); and 0.05% (n = 1) developed wound infection., Conclusion: Awareness of potential complications in patients with paraplegia is essential to care planning in the disaster setting. The priorities include skin, bowel, and bladder care and provision of prophylactic heparin. SCI post-disaster care requires comprehensive long-term planning.

Purpose: About one-third of sporadic lung adenocarcinomas demonstrates biallelic inactivation of the LKB1 gene, but the timing of this event is not known., Design: We performed LKB1 immunohistochemistry on 35 primary lung adenocarcinomas and 96 atypical adenomatous hyperplasias (AAH), a form of early glandular neoplasia from which some lung adenocarcinomas arise., Results: In all cases, strong cytoplasmic staining was noted in the non-neoplastic epithelium lining the airways from the bronchi to the terminal bronchioles. There was a marked reduction in LKB1 staining in 9 of 35 (26%) adenocarcinomas and in 10 of 96 (10%) AAHs. When the AAHs were subclassified on the basis of cytoarchitectural atypia, loss of LKB1 expression was more frequent in the high-grade lesions (7 of 33, 21%) than low-grade lesions (3 of 63, 5%; P = 0.021). For the 21 adenocarcinomas where the genetic status was known, immunohistochemistry staining reliably reflected the activational state of the LKB1 gene (95% concordancy)., Conclusions: In AAH, loss of LKB1 expression is strongly associated with severe dysplasia, suggesting that LKB1 inactivation may play a role in the critical transition from premalignant to malignant tumor growth.

Background: Hemangiopericytomas (HPCs) are rare spindle cell tumors, constituting 2.5% of soft tissue neoplasms. Few reports have addressed the fine needle aspiration (FNA) cytology of HPC., Case: We describe the FNA biopsy (FNAB) findings in a 44-year-old patient with a previously resected meningeal hemangiopericytoma. The patient underwent ultrasound-guided FNAB of a 16.0-cm, radiographically heterogeneous density in the liver. The FNA smear showed crowded, ovoid to spindle-shaped cells with poorly defined, scant cytoplasm. The neoplastic cells were positive for CD34 and negative for CD31, factor VIII, glial fibrillary acid protein and cytokeratin AE1/AE3, supporting a diagnosis of HPC and compatible with metastasis from the patient's cerebral tumor., Conclusion: This case documents the role of FNA cytology in confirming HPC.

Introduction: Preliminary studies have shown that high molecular mass kininogen (HK) inhibits cathepsin G-induced platelet activation. However, the potential mechanism underlying this inhibitory effect remains to be elucidated., Materials and Methods: Suspensions of washed and gel-filtered platelets were used in radioligand binding and aggregation studies. The amidolytic activity of cathepsin G was measured using specific chromogenic substrate. Western blot technique was utilised to explore the potential complex formation between cathepsin G and HK. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was used to analyse the cleavage products of HK., Results: At a concentration of 1 microM, HK completely blocked cathepsin G-induced platelet shape change and secretion of ATP. HK inhibited cathepsin G-induced platelet aggregation in a concentration-dependent manner with an IC(50) of 0.48 microM. Moreover, HK was found to inhibit binding of (125)I-cathepsin G to gel-filtered platelets. (125)I-cathepsin G forms a complex with HK. The complex formation did not affect the amidolytic activity of cathepsin G. HK was proteolysed upon interaction with cathepsin G., Conclusion: Our results show that high molecular mass kininogen down-regulates cathepsin G-induced platelet activation by forming a complex with cathepsin G and thus prevents binding of cathepsin G to platelets. These kininogen-cathepsin G interactions may be potential targets for pharmacological intervention.

In 1988 and 1989, seasonal field studies on exposed rabbit carcasses were conducted in Alexandria, Egypt, to describe the decomposition process and arthropod succession patterns. Four decomposition stages were recognized: fresh, bloated, decay, and dry. Carcasses in summer and spring decayed at a much faster rate than those in fall and winter. The bloated stage in summer lasted longer than in spring because of the difference in breeding biology of the primary flies infesting carcasses in these seasons. Dipterous larvae of the family Calliphoridae, and to a lesser extent of the families Sarcophagidae and Muscidae, were responsible for the process of carrion degradation. Carrion-arthropod communities in cooler seasons were distinguished from those in warmer seasons by the presence of certain dipterous (muscids and fanniids) and coleopterous larvae, and by adults of small flies such as sphaerocerids and scatopsids. The presence of adult psychodids, sciarids, and phorids was unique to the winter carrion-arthropod community. Eleven species of carrion-breeding Diptera were found to coexist in the study site. The coexistence of the 2 calliphorids Chrysomya albiceps (Wiedemann) and Lucilia sericata (Meigen) in carrion in fall and spring is a new record for the Palaearctic Region. In spring, 3rd instars of C. albiceps were observed preying on the pupae of their own species. Although the carcasses were of equal size and simultaneously exposed, there was considerable variation in the rate of decay among fall carcasses only, which was attributed to unknown reasons at the beginning of the experiment and to heavy rains later on. This affected oviposition and the feeding period of maggots. Approximately 100 arthropod species were recovered on carcasses throughout the study. Diptera was the predominant group, whereas Coleoptera ranked 2nd. Carcasses in cooler seasons were richer in species than in warmer seasons.