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Producing hydrogen efficiently through water electrolysis could greatly reduce fossil fuel consumption. As well as this renewable energy source will also help combat global warming and boost economic investment opportunities. This paper studied some factors affecting the performance of oxy-hydrogen/hydroxy (HHO) gas generator, such as applied voltage (from 10.5 to 13.0 V) and electrolyte solution concentration (from 0.05 to 0.20 M), using a dry fuel cell based on the electrolyzing technique of water. The results revealed that the HHO gas production rate, power consumption, and temperature change of electrolyte solution increased significantly with increasing the tested applied voltage and electrolyte concentration. This study concluded that the optimum conditions for producing HHO gas ranged from 11.5 to 12.0 V for applied voltage and from 0.05 to 0.10 M for KOH concentration according to the lowest specific energy and highest HHO gas generator efficiency. Under the previous optimum conditions, the highest productivity, specific energy, and efficiency of the HHO gas generator were 343.9 cm3 min−1, 3.43 kW h m−3, and 53.79%, respectively, using 12.0 V for applied voltage and 0.10 M for electrolyte solution concentration. These findings provide an unambiguous direction for adjusting the operational factors (applied voltage and electrolyte concentration) for efficient HHO gas production and use in different applications. Furthermore, the required energy to operate the HHO gas generator can be obtained from renewable sources. [ABSTRACT FROM AUTHOR]

Background: Epileptic children can pose an additional risk of poor bone health; this study aimed to evaluate the influence of anti-seizure medications (ASMs) on vitamin D level and sclerostin as a bone turnover biomarker in children with epilepsy. Subject and methods: This case–control comparative study was conducted on 180 children aged from 5–18 years diagnosed with epilepsy according to the definition of the International League Against Epilepsy on ASMs for more than 3 months and were classified into 90 epileptic children on ASM monotherapy and 90 epileptic children on ASM polytherapy, in addition to 90 healthy children age- and sex-matched who served as controls. After obtaining basic data, laboratory investigations were performed, including serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, vitamin D, and serum sclerostin. Results: When we compared epileptic patients to the control group, there was a statistically significant low level of vitamin D, calcium, and phosphorus and a high level of sclerostin among both epileptic groups with mono or polytherapy. Sclerostin has a statistically significant negative correlation with vitamin D, alkaline phosphatase and parathyroid hormone. Additionally, it has a negative correlation with serum phosphorus, but without a significant correlation. On the other hand, sclerostin has a statistically positive correlation with age and serum calcium, but without a significant correlation. Multiple linear regression analyses were conducted to predict the contributing factors of sclerostin. Only duration of treatment and BMI were significant predictors of high levels of sclerostin. In contrast, the other factors failed to show any significant contribution. Conclusion: The present study showed that ASMs modulate the serum levels of sclerostin and vitamin D hence, might be involved in their adverse effects on bone. [ABSTRACT FROM AUTHOR]

Background: Post-burn facial hyperpigmentation is a common consequence of burn injuries, especially in dark skin types, frequently results in severe psychological suffering. Despite the abundance of treatment modalities, most of the outcomes are disappointing and unsatisfactory. We aimed to investigate the therapeutic effect of ablative fractional CO2 laser-assisted delivery of tranexamic acid (TXA) for the treatment of facial post-burn hyperpigmentation. Methods: From January 2021 to January 2023, 30 patients (22 male, 8 female) at a mean age of 26.45 years, skin types (18 type III, 12 type IV), with facial post-burn hyperpigmentation were included in this prospective study. The patients received (4–8) twice-weekly laser sessions with topical TXA. At baseline and 1 month after the final treatment session, clinical evaluation using Investigator's Global Assessment (IGA) six-point scale and biopsy specimens from hyperpigmented areas were stained with Masson fontana (MF) stain and immunostaining procedures for melanin and monoclonal mouse anti-melanoma antigen recognized by T cells-1 (MART-1). The possible adverse effects and patients' satisfaction were recorded. Results: One month after the final treatment session, IGA score was significantly reduced (P < 0.001). Histopathologically, evident reduction of melanin density and significant decrease in the number of MART-1-positive cells (P <.001) were observed. None of our cases experienced serious adverse events, apart from mild and transient degrees of erythema, burning, and edema. After a mean follow-up period of 7.1 months, 26 patients (86.7%) were satisfied with the cosmetic results of the treatment. Conclusions: Laser-assisted delivery of tranexamic acid is safe, well-tolerated, and effective treatment strategy for facial post-burn hyperpigmentation especially in patients with skin of color. Level of evidence: Level IV, therapeutic study [ABSTRACT FROM AUTHOR]

Background: Successful web space reconstruction is the most challenging in the treatment of syndactyly, and the choice of the ideal reconstructive technique is still controversial. The aim of the present study was to evaluate the use of the dorsal metacarpal artery perforator (DMAP) propeller flap for simple syndactyly reconstruction. Methods: From May 2016 to May 2018, 14 consecutive children (8 male, 6 female) at a mean age of 5.3 years (2–7 years) with 16 syndactylous webs were included in this prospective study. They underwent web reconstruction using DMAP propeller flap. All patients had primary simple syndactyly. Simple syndactylies were incomplete in 8, complete in 6, unilateral in 12, and bilateral in 2 cases. Operative time and early post-operative complications were recorded. Objective assessment by 2 senior hand surgeons regarding web creep, the quality of scar, scar contracture, and the passive range of motion of the MCP was done. Parents' satisfaction on esthetic outcome was assessed. Results: Sixteen flaps (mean size, 1.8 × 4.9 cm) were used in 14 patients. Surgery time per web space ranged from 50 to 75 min (mean, 54.9 min). All flaps survived completely except for one developed distal tip partial necrosis and treated conservatively. All donor sites healed uneventfully. One patient had a hypertrophic scar which was treated by silicone gel. Full range of motion, no web creep, no scar contracture, and 78.6% subjective cosmetic satisfaction were noted, at a mean follow-up of 25.1 months (range, 12–42 months). Conclusions: DMAP propeller flap is proved to be a reliable option for simple syndactyly reconstruction. It is easily performed and versatile without the need for skin grafts. Moreover, the final results are functionally and cosmetically good. Level of evidence: Level IV, therapeutic study. [ABSTRACT FROM AUTHOR]

Background: Dysphagia is an important complication of acute stroke. Aspiration pneumonia is the most important acute complication of stroke related dysphagia. Objective: To estimate the frequency and risk factors of pneumonia in acute stroke patients fed by nasogastric tube. Methods: This prospective study was done on 50 consecutive patients with acute stroke who were given tube feeding because of dysphagia. The study was done in Zagazig university hospitals, over one year period (Sept 2012 to Sept 2013). All patients were assessed daily for the presence pneumonia. Results: Pneumonia was diagnosed in 44% of the tube fed patients. As measured by the NIHSS score, patients who acquired pneumonia, were more severely affected than patients without pneumonia. Patients with decreased consciousness and severe facial palsy are at high risk of pneumonia. Conclusions: Decreased consciousness and severe facial palsy are risk factors for development of post-stroke pneumonia. [ABSTRACT FROM AUTHOR]

SSDSDD [ABSTRACT FROM AUTHOR]

Introduction: Intracerebral hemorrhage (ICH) is characterized to be the most lethal form of stroke, with high rates of mortality, not only during the acute phase (39%), but also 3 months later (33.5%) with a significant long-term disability. The National Institutes of Health Stroke Scale (NIHSS) score is a purely clinical scale, is easily administrable, and does not require the use of any additional diagnostic procedure.Objectives: To evaluate if the admission NIHSS score in acute primary ICH patients can be a predictive tool for their short-term outcome.Patient and methods: We included 120 patients diagnosed with spontaneous ICH. All patients were subjected to full history taking, general, and neurological examination with assessment of neurological function on admission using the NIHSS. Laboratory assessment on admission including complete blood count, routine liver and kidney functions, and coagulation profile. Radiological investigations included computerized tomography (CT). The patients were followed, both clinically using the NIHSS score, radiologically with CT brain after 1 week and 4 weeks from the onset to assess the hematoma growth, its complications, and or resolution. Modified Rankin score (mRS) was done after 30 days of onset to assess patient's disability.Results: The 30-day mortality was about one third of the patients. The intracerebral hematoma volume on admission has a significant positive correlation with the NIHSS, and ICH score significantly correlates with the 30-day outcome.Conclusion: Admission NIHSS has an independent predictive value of the 30-day outcome in cases of primary ICH as regards mortality and disability. [ABSTRACT FROM AUTHOR]