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Introduction: Dementia is one of the most important public health problems due to the increased prevalence among elderly all over the world. It is a syndrome caused by a number of progressive illnesses that affect memory, thinking, behavior and the ability to perform everyday activities. The aim of this study was to estimate the prevalence of Dementia and to identify its predictors in Sharkia Governorate.Population and method one sector from 5 sectors in Zagazig city at Sharkia governorate was chosen randomly. The study began in December 2017 to April 2018. During this period 1820 individuals were interviewed by the research team who visited the field 2–4 days a week. The study was conducted in three phases: (1) screening, (2) clinical diagnosis and (3) laboratory diagnostic phases.Result 1820 elder individuals were included in the study, 108 of them were positive by screening test. Most of them were females, more than 80 years old . 43.5% of neurodegenerative dementia were of moderate degree. it was found that the most significant predictors of neurodegenerative dementia were age ≥80 years (O.R=18.7, p < 0.05), Single or widow or divorced(O.R=1.98, p < 0.05), illiterate (O.R=6.7, p < 0.05),low social class(O.R=8.8,p < 0.05),smoking(O.R=3.03, p < 0.05),irregular mental and social activities (O.R=2.2,1.3 respectively, p < 0.05),hypertension and diabetes(O.R=4.7, p < 0.05), Hyperlipidemia (O.R=2.5, p < 0.05), Occupations or Environmental exposures(O.R=10.3, p < 0.05), Living alone(O.R=2.07, p < 0.05) and Family history of dementia(O.R=7.7, p < 0.05).

Background: Atrial-fibrillation is the most prevalent cardiac arrhythmia and a significant public health issue. Recently,radiofrequency current ablation and cryoballoon ablation are frequently used for rhythm control in symptomatic paroxysmal AF patients who are resistant to anti-arrhythmic drugs or even as a firstline rhythm control strategy. Several studies have demonstrated an increase in heart rate and a decrease in heart rate variability after radiofrequency catheter ablation of atrial fibrillation due to vagal denervation. Aim of the work: to Assess the incidence and the value of postAF ablation cardiac autonomic dysfunction after Pulmonary vein isolation using radiofrequency and cryoballoon ablation techniques. Patients and Methods: This study enrolled 40 patients who underwent paroxysmal AF ablation at Ain Shams University hospitals. Patients were randomized into 2 groups, Radiofrequency ablation guided by 3D mapping (RF group; n=20) and Cryoballoon ablation using 2nd generation balloons (CB group; n=20). Valid 24-hour Holter for heart rate variability analysis was done for each patient pre ablation, after 1 month, after 3 months and after 12 months. Statistical comparison between both groups regarding HRV changes and clinical outcome was done. Results: The efficacy data in the form of freedom from AF at one year using radiofrequency technique was slightly higher than cryoballoon technique (75% Vs 65% respectively). However, this difference wasn’t statistically significant (P-value 0.490). During the 3-point follow up of HRV parameters (month-1, month-3 and month-12), changes in time domain and frequency domain parameters persisted for 12 months after both techniques, being more pronounced in RF group than CB group. The change in HRV parameters was in favour of vagal withdrawal and sympathetic dominance (there was a Significant decrease in SDNN, rMSSD and triangular index, on the other hand there was a significant increase in LF/HF).Conclusion: Cardiac autonomic dysfunction _assessed by Changes in time domain and frequency domain heart rate variability parameters_ persisted for 12 months after both techniques, being more pronounced in radiofrequency group than cryoballoon group.

Background: Cervicogenic Headache (CGH) represents a major health problem, aggravating Quality of Life (QOL) and work productivity. The Suboccipital Muscles (SOM) have been identified as playing a role in cervical pain, and are therefore a target for rehabilitation.Aim of the Study: To asses the effect of CGH on myoe-lectrical activities of suboccipital muscles, functional activities and ROM of neck.Subjects and Methods: Thirty patients with CGH of both genders participated in this study. They were recruited from the out patient clinic of Kasr El-Ainy and thirty normal subjects, their ages ranged from 18-55 years old. They were randomly assigned into 2 experimental groups: Group A (18- 35 years)-group B (36-55 years) & 2 control groups: Group C (18-35 years)-group D (36-55 years). Myoelectrical activities was measured by Natus nicolet vikingquest to analyze the motor unit potentials by quantitative measures & neck range of motion was measured by Cervical Range of Motion (CROM) device and functional activities of the neck was measured by Neck Disability Index (NDI).Results: There was non significance increase in myoelec-trical activities of the suboccipital muscles in cervicogenic patients than normal subjects with (p-value=0.147). And there was statistical significant decrease in all ROM values and functional activities in cervicogenic patients than normal subjects in cervicogenic patients than normal subjects with (p-value

Background: Extracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.Aim of Study: To provide the physical therapist with an objective guideline about the success rate of shock wave in the treatment of musculoskeletal conditions.Methods: Systematic review and meta-analysis. Sources of data: PubMed, PEDro, Cochrane and science direct were searched from January 2007 till September 2017 for studies of any design investigating the effectiveness of ESWT in GTPS, PT, and AT. Citation tracking was performed using PubMed and Google Scholar. Animal and non-English lan-guage studies were excluded. A quality assessment was per-formed by 2 independent reviewers, and effect size calculations were computed when sufficient data were provided.Results: The meta-analysis of the selected studies revealed significant effects of the shockwave on the ligament, tendon, muscle and joint disorders.Conclusion: Shockwave either focused or radial has a significant effect in treatment of musculoskeletal disorders.

Background: Endometrial polyps are a main cause of Abnormal Uterine Bleeding (AUB) in premenopausal & postmenopausal women and suggested by screening transvaginal ultrasound. Objectives: The aim of the current study was to determine the effectiveness and acceptability of outpatient hysteroscopic endometrial polypectomy by vaginoscopic approach, and if the technique confers any advantage in term of patient discomfort and reduction in procedure time over the traditional technique. Patients & Methods: This study is prospective randomized clinical trial, it was carried in Endoscopy Unit in the Department of Obstetrics and Gynecology at Zagazig University Hospitals, in period from May 2018 to April 2019. Results: there was a statistical significant difference between traditional and vaginoscopic groups in procedure time where traditional technique needs more time than vaginoscopic one (7.8 VS 6.1 minutes), and all cases had (100.0%) success rate of polypectomy in both groups without complication. but histopathology results discovered one case (2.5%) of all study groups adenocarcinoma and the patient sent to oncology unit for further evaluation and appropriate management. Conclusions: Office vaginoscopic polypectomy for small polyp is feasible and safe minimally invasive procedure.

Background: labor induction between 41 and 42 weeks of gestation reduce the adverse perinatal risks. Aim of work: to determine the effect of intravenous dexamethazone administration on preparing the cervix and duration of labor induction in term pregnancy. Patients and Methods: this randomized Case control study on 52 women who were primparous, with a gestational age (40- 42)weeks and had Bishop Score 4 or less, who were admitted to obstetrics and gynecology department, zagazig university hospital during period from (April 2018 – April 2019) for the termination of their pregnancy. 6 hours before induction, experimental group (26 participants) was given 8mg intravenous dexamethasone while control group (26 participants) was given 2 ml saline intravenously. Six hours after the injection, the Bishop Score of participant was measured, and labor induction done by using oxytocin. Interval between induction initiation and starting of the active labor phase, duration of first and second stage of labor and the neonatal outcome of two groups were compared. Results: Bishop Score statistically differ between the studied groups after 6 hours of dexamethasone injection (5.88±1.18, vs. 5.19±0.85 respectively). The interval between induction initiation and beginning of active labor phase was shorter in the dexamethasone group compared to control group (90±26.3 minutes vs. 112.88±48.87 minutes). Dexamethasone group has shorter duration of first stage and second stage of labor than control group. Conclusions: The administration of dexamethasone can play a role in cervical ripening and progress of labor.

Objective: To compare the degree of difficulty and outcome measures of hysteroscopic myomectomy of submucous fibroid according to 2 classification systems. Methods: This prospective study conducted in the Cytogenetic & Endoscopy unit, Zagazig University Hospitals during the period from July 2009 to July 2012, included 100 patients candidates for hysteroscopic resection of submucous fibroids. All fibroids were diagnosed and assessed by saline infusion sonohysterography and diagnostic hysteroscopy. Presurgical classification was performed according to the two classification systems; the European Society of Endoscopic Surgery (ESES)–considering only the penetration of the fibroid into the myometrium – and STEPW considering size, topography, extension, penetration and wall affected. Primary outcome measure was incomplete resection of the fibroid. Secondary outcome measures were operating time (in minutes), the fluid deficit (in milliliters) and any intraoperative complications. Sensitivity, specificity and kappa measure of agreement were calculated for each classification at their best cut off. P value less than 0.05 is considered significant. Results: Myomectomy was considered incomplete in 8 out of 104 fibroids (7.7%) According to ESES, 2 belonged to type 0 and 6 belonged to type 1.Risk ratio and 95% confidence interval (CI) was 0.56 (0.07-3.3) and the difference was not significant (p=0.7); whereas according to the STEPW classification, the incomplete myomectomies were one in group I (1/8, 12.5%) and seven in group II (7/8, 87.5%). The risk ratio (95% CI) was 0.02 (0.0-0.18) and the difference was significant (p= 0.000). Considering the area under the ROC curve, the dichotomized STEPW scores performed better than the dichotomized ESES scores (P

Digital video broadcasting, DVB has become the synonym of digital television as well as data broadcasting. The DVB Project was launched on the 10th of September, 1993. DVB systems distribute data using a variety of approaches. These approaches include: satellite, cable and terrestrial television. These three sub-standards are basically differ in the specifications of the physical representation, modulation, transmission as well as reception of the signal. DVB-T is the consortium standard for broadcast transmission of digital terrestrial television. The key motivation behind this standard was the desire in several European countries to offer high definition television (HDTV) services as efficiently and effectively as possible.DVB-T2 is considered to be the modified version of DVB-T.DVB-T2 leads to performance improvement by introducing state-of-the art communication techniques where it achieves 30% better capacity compared with DVB-T. In some cases, the data rate will be up to 50% higher under comparable conditions. In this paper we demonstrate the architecture of the DVB-T2 system, as well as a MATLAB design and simulation of the DVB-T2 transmitter. The transmitter model is then tested for different data rates. The model provides an overall evaluation of the DVB-T2 transmitter parameters and can be used for educational and testing purposes.