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BACKGROUND Radial head replacement is the main line of treating complex unstable elbow injuries. Based on polarity, radial head prostheses are either monopolar or bipolar. The difference between both designs in patients' clinical outcomes and postoperative complications is not yet clear. So, a systematic review and meta-analysis was conducted to evaluate the efficacy and safety of monopolar versus bipolar implants.background MATERIALS AND METHODS: PubMed, EMBASE, Cochrane and Scopus were searched to identify studies comparing monopolar and bipolar implants. Data on clinical outcomes, postoperative complications, revision, and removal rates were extracted. RESULTS Nine studies met our inclusion criteria, with a total of 591 patients (365 monopolar, 226 bipolar). Both prostheses achieved similar ranges of motion, Mayo Elbow Performance Score, Disabilities of the Arm, Shoulder, and Hand score, and Visual Analogue Scale for pain. Incidence of postoperative complications was also similar between both designs. Revision and removal rates were 24%, 8% and 29%, 14% for monopolar and bipolar implants, respectively, but no statistically significant difference could be detected.results CONCLUSIONS: No significant difference was found between monopolar and bipolar radial head prostheses in terms of efficacy and safety. Therefore, high-quality randomized controlled trials are required to determine the superiority of one design over the other. CONCLUSION

Background: Ascites in cirrhosis has a poor prognosis, with mortality rates of around 40% at one year and 50% at two years. It is also associated with other complications, such as spontaneous bacterial peritonitis (SBP), which can lead to hepatorenal syndrome (HRS) in 30% of patients. Diagnostic paracentesis is the gold standard for diagnosing SBP. Serum biomarkers such as procalcitonin (PCT) have recently received a lot of attention for the early detection of SBP. Objective: To determine the usefulness of measuring serum procalcitonin levels in patients with liver cirrhosis and ascites for the diagnosis of spontaneous bacterial peritonitis. Patients and methods: A cross-sectional case-control study that was conducted on ninety (90) patients diagnosed with liver cirrhosis. They were divided into three groups: Group (A) included 30 cirrhotic patients with ascites diagnosed as spontaneous bacterial peritonitis, Group (B) included 30 cirrhotic patients with ascites but without spontaneous bacterial peritonitis, and Group (C) included 30 cirrhotic patients without ascites as a control group. Results: Serum procalcitonin levels in SBP patients were significantly higher than in sterile ascites and cirrhotic patients without ascites with a P value of 0.001. It had a better cutoff value of 0.315 ng/ml, sensitivity of 87% and specificity of 97% than serum CRP that had a cutoff value of 16 mg/L, sensitivity of 76% and specificity of 90% in cirrhotic patients for predicting ascitic fluid infection. Conclusion: In cirrhotic patients, serum procalcitonin levels appear to provide a satisfactory diagnostic accuracy in the diagnosis of spontaneous bacterial peritonitis, with a suggested cut-off value of 0.315 ng/ml. Further studies are needed to determine the widespread use of serum PCT as a predictor of SBP clinically.

Background: Familial Mediterranean fever (FMF) is an auto inflammatory genetic disease resulted from the mutation of pyrin, which contributes to the formation of inflamma some complex. Therefore, activation of cytokines is one of the hallmarks of FMF pathogenesis. This study aimed to investigate the role of miRNAs as regulatory biomarkers for inflammation in patients with FMF. Methods: 50 FMF patients and 25 healthy subjects were included in this study. Q RT-PCR was used to determine plasma expressions of miR-181a and miR-125a, while IFN-γ and IL-17 were estimated using ELISA technique. Results: Our results indicated that, the expression of miR-181a was significantly decreased (p = 0.006) while miR-125a expression was insignificantly reduced (p = 0.101) also IL-17 levels were significantly higher(p = 0.003) and plasma IFN-γ levels were insignificantly increased (p = 0.322) in FMF patients than control group. Correlation analysis revealed a positive correlation between miR-181a expression and lymphocyte percentages (p = 0.048),while a significant negative association was observed between miR-125a and C-reactive protein (CRP) (p = 0.005) in FMF patients. However, there were no associations between miR-125a and miR-181a with IFN-γ and IL-17 in FMF patients. Conclusion: miR-181a and miR-125a could be used as regulatory biomarkers for inflammation in FMF patients.

Objectives To evaluate anchorage control using miniscrews vs an Essix appliance in treatment of Class II malocclusion by distalization using the Carrière Motion Appliance (CMA). Materials and Methods Twenty-four postpubertal female patients with Class II, division 1 malocclusion were randomly distributed into two equal groups. CMA was bonded in both groups, and one group was treated with miniscrews as anchorage (12 patients, mean age = 18.0 years) while the other group was treated with an Essix appliance as anchorage (12 patients, mean age = 17.8 years). For each patient, two cone-beam computed tomographic scans were obtained: one preoperatively and another after completion of distalization. Results In the Essix appliance group, there was a statistically significant anterior movement (2.2 ± 1.43 mm) as well as proclination of the lower incisor (5.3° ± 4.0°), compared to a nonsignificant anterior movement (0.06 ± 1.45 mm) and proclination (0.86° ± 2.22°) in the miniscrew group. The amount of maxillary molar distalization was higher in the miniscrew group (2.57 ± 1.52 mm) than in the Essix appliance group (1.53 ± 1.11 mm); however, the difference was not statistically significant. Conclusions Miniscrews led to a decrease in the amount of anchorage loss in the mandibular incisors, both in terms of anterior movement and proclination.

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease worldwide. Itposes a serious health risk. Liver cirrhosis of is also linked to a variety of cardiovascular abnormalities.Nowadays, direct-acting antivirals (DAAs) for hepatitis C have the potential to reducethis disease burden, but their potential long-term cardiac effects are unknown. The aim of thiswork was to see how direct-acting antivirals affect the cardiac functions of naive Egyptianswith chronic hepatitis C.The 90 treatment-naive adult patients with chronic hepatitis C were divided into two groups(cirrhotic and non-cirrhotic). Only two patients within the non-cirrhotic group and a patientamong cirrhotic patients showed nonspecific ST segment changes which remained unchangedafter treatments. Two non-cirrhotic patients and four cirrhotic patients showed T wave inversion,which remained static post treatment, but without significant difference in corrected QTinterval before & after treatment between groups.

Background: Patients with AF and concomitant potential cardiac sources of embolism increase the risk of recurrent embolism despite anticoagulation. Objectives: The aim of this study was to study different cardiac sources of embolism in stroke patients with AF and was to study if the presence of concomitant cardiac sources of embolism in AF stroke patients has impact on stroke severity, recurrence, response to treatment & outcome. Patients and methods: The study was a prospective clinical study that was conducted on 60 patients admitted to the Intensive Care Unit (ICU), Menoufia University Hospitals.The patients were divided into 2 groups: Group I: Patients with concomitant cardiac sources of embolism. Group II: Patients without concomitant cardiac sources of embolism. Results: There was significant difference found between the two groups regarding recurrence (P=0.045). We found that Elders, diabetics, patients with dyslipidemia, patients with CVD, severe National Institutes of Health Stroke Scale (NIHSS) score patients and big infarction size were significantly associated with poor stroke outcome. Conclusion: In conclusion, we found that most of the recurrent ischemic strokes were associated with elders, diabetics, patients with dyslipidemia, patients with CVD, severe NIHSS score patients and big infarction size.

Background The description of childhood absence epilepsy (CAE) a benign self-limited generalized epilepsy has become a matter of debate. The objectives of this work were to evaluate the existence of psychiatric and cognitive impairments among patients with typical CAE and to correlate their possible relation to seizure frequency, duration of epilepsy, IISL, and valproate therapy. Methods The study was conducted on 19 typical CAE patients receiving valproate therapy, 11 newly diagnosed CAE patients not receiving AEDs, and 30 healthy control subjects (HCS). Participants were subjected to medical history taking, EEG monitoring, child behavior checklist (CBCL), Stanford Binet Intelligence Scale 5th edition, and computerized psychometric tests that assess cognitive domains and executive functions. Results The study revealed a high rate of cognitive and psychiatric dysfunctions in CAE patients. 53.3% of patients had psychiatric problems versus 16.6% in HCS. Attention deficit hyperactive disorder (ADHD) (26.6%), anxiety (16.6%), and depression (6.6%) were the most common psychiatric disorders in the patient group. Withdrawn/depressed symptoms, thought problems, social problems, and attention problems in CAE patients were significantly increased compared to HCS. At the same time, CAE patients perform worse in cognitive scales than HCS with comparable intelligent quotient (IQ) scores. Conclusion Cognitive and psychiatric impairments in typical CAE patients appear multifactorial in origin with epilepsy-related factors including the duration of epilepsy and interictal spike load (IISL).

Retinal images show an essential role in Ophthalmology to diagnosis wide set of diseases. In this direction, using retinal images in computerized techniques increases the ability of diagnosis in fast time effectively. However, some eye diseases and capturing conditions produce low-quality retinal images, which reduces the diagnosis ability for machines and humans. To solve that, several works have been proposed to enhance retinal images. But they show a lot of negative observations, especially with color images of retina. In this paper, a novel enhancement algorithm for color retinal images is proposed. It consists of three stages; firstly, the appearance of visual details is increased by enhancing the contrast of structural details of retinal image using details enhanced and Bilateral filters. Then, a novel uneven illumination correction method is proposed to solve the uneven illumination problem adaptively. Finally, the advantages of both previous stages are combined using HSV color model to produce the final enhanced retinal images. DRIVE and STARE benchmark datasets are used to conduct experiments. The results were compared with histogram Equalized (HE), Contrast Stretching (CS), the adaptive histogram equalization (CLAHE) and Zhou’s method retinal enhancement methods. In conclusion, the results show that the proposed method shows high performance compared with the corresponding enhancement methods.

The aim of this article was to study the role of S100A12 and resolvin D1-related genes and serum levels in the diagnosis and detection of subclinical inflammation in children with familial Mediterranean fever (FMF) during the quiescent stage of the disease. Seventy-eight children with FMF during the silent state and 60 healthy control were studied. Serum S100A12 and resolvin D1 were quantitatively measured using enzyme-linked immunosorbent assay. In addition, the levels of C-reactive protein, erythrocyte sedimentation rate, and hemoglobin were determined. The clinical severity was evaluated. The link between the Mediterranean fever (MEFV) gene and the genes related to the two studied biomarkers was also assessed. Correlation between S100A12 and resolvin D1 and the clinical severity was assessed. The mean serum levels of S100A12 and resolvin D1 were 847.4 and 793.3, respectively, which were highly significantly increased (p = 0.001) compared with the controls (324.3 and 235.1, respectively). The receiver operating characteristic curve test showed that S100A12 had a sensitivity of 97.4% and specificity of 80% with cutoff value of 529.5, while resolvin D1 showed a sensitivity of 100% and specificity of 50% with cutoff value of 231.2. A correlation was detected between the clinical severity and S100A12 and resolvin D1. This study delineated that S100A12 and resolvin D1 are sensitive biomarkers to detect the degree of inflammation in children with FMF during the silent period. Consequently, we recommend adjusting the colchicine dose to ameliorate the disease's symptoms and to improve the quality of life in these patients.

Introduction: patients with maxillary deficiency can exhibit reduced pharyngeal airway dimensions which can negatively affect the breathing efficiency of such cases. Objective: the purpose of this study was to measure the changes in pharyngeal airway dimensions induced by maxillary protraction using facemask in a group of growing skeletal class III patients. Materials and methods: 20 growing patients with ages ranging between 8-11 years and CVMI stages 1& 2 were included in the study. Patients were diagnosed of skeletal class III malocclusion due to maxillary deficiency. All patients received facemask therapy as a treatment. CBCT scans were taken before the beginning of the treatment and by the end. The nasopharyngeal, oropharyngeal airway volumes and the minimum constricted area were measured using Dolphin software on CBCT scans. Results: All the measured airway dimensions increased significantly after facemask therapy. Conclusion: maxillary protraction induced by facemask treatment in young children was able to effect significant changes in the measured airway dimensions.

Background: Diabetic macular edema is one of the most common causes of vision loss in patients with diabetes. Fluorescein Angiography (FA) provides valuable additional information compared to clinical examination or fundus photography but it has many contraindications. It requires venipuncture and intravenous injection of a dye that has a moderate risk of nausea and a rare but well documented risk of anaphylaxis and death. Optical Coherence Tomography Angiography (OCTA) is a non-invasive modality that generates three-dimensional, depth encoded images of blood flow within the eye by using motion contrast. It offers an alternative angiographic technique without the drawbacks of FA. Areas of capillary loss obscured by fluorescein leakage on FA were more clearly defined on OCTA. Aim of Study: To describe the Optical Coherence Tomog-raphy Angiography (OCTA) findings in diabetic patients with macular edema. Patients and Methods: A cross sectional study was carried out on 46 eyes of 30 diabetic patients with macular edema diagnosed by Optical Coherence Tomography (OCT). The findings of the OCT and OCTA were correlated. The presence of microaneurysms and neovascularization was studied in OCTA. Macular perfusion was quantified using OCTA images by 3 parameters: Foveal Avascular Zone (FAZ) area and Vascular Area Density (VAD) at 2 levels; Superficial Capillary Plexus (SCP) and Deep Capillary Plexus (DCP) and Vascular Density Map (VDM). Results: There is a statistically significant difference between the number of microaneurysms in the DCP and SCP (more in the DCP). A significant negative correlation between the duration of hypertension and the vascular area density of superficial capillary plexus. There is a significant difference between eyes with normal and eyes with abnormal inner retinal integrity [Disorganization of the Retinal Inner Layers (DRIL)] as regards the FAZ of superficial and deep capillary plexuses (larger in eyes with DRIL), the vascular area density of superficial capillary plexuses (less in eyes with DRIL) and the vascular density map center 3mm (more in eyes with DRIL). Although one of the strengths of the OCTA is its ability to assess vasculatures and structures of DCP separately from SCP, this is limited by projection artifacts from the superficial structures onto deeper layers. Conclusion: Correlation between OCT and OCTA images is mandatory to explain the OCT and OCTA findings. The presence of microvascular abnormalities, hemorrhages, cotton wool spots and hard exudates gives fallacies in OCTA images interpretation. The significant correlation between the presence of DRIL by OCT and diabetic macular ischemia by OCTA allows for OCT to be sufficient when FFA cannot be done and OCTA is unavailable.

Tuberculosis (TB) is caused by a bacterial infection that affects a number of human organs, primarily the lungs, but also the liver, spleen, and spine, causing key symptoms of fever, fatigue, and persistent cough, and if not treated properly, can be fatal. Every year, 10 million individuals become ill with active TB resulting with a mortality approximating 1.5 million. Current treatment guidelines recommend oral administration of a combination of first-line anti-TB drugs for at least 6 months. While efficacious under optimum conditions, ‘Directly Observed Therapy Short-course’ (DOTS) is not without problems. The long treatment time and poor pharmacokinetics, alongside drug side effects lead to poor patient compliance and has accelerated the emergence of multi-drug resistant (MDR) organisms. All this, combined with the limited number of newly discovered TB drugs to treat MDR-TB and shorten standard therapy time, has highlighted the need for new targeted drug delivery systems. In this respect, there has been recent focus on micro- and nano-particle technologies to prepare organic or/and metal particles loaded with TB drugs to enhance their efficacy by targeted delivery via the inhaled route. In this review, we provide a brief overview of the current epidemiology of TB, and risk factors for progression of latent stage tuberculosis (LTBI) to the active TB. We identify current TB treatment regimens, newly discovered TB drugs, and identify studies that have used micro- or nano-particles technologies to design a reliable inhalation drug delivery system to treat TB more effectively.

The current investigation entails the application of an electrocoagulation treatment process to the kitchens’ wastewaters discharged from five of the most popular restaurants in New Damietta city – Egypt. The electrocoagulation process was carried out using aluminum electrodes at variable electrolysis times. The specifications of the applied system were; pH 7.03, temperature 25oc, distance between the two used electrodes 20 mm, the applied current 1 ampere, voltage 20 volt, current density 40 mA/cm2, plate shape of the electrode, and dimensions of 100 mm x 50 mm x 0.095 mm, with a surface area of 25 cm2 for each electrode. The system was investigated to treat the food processing effluents of the restaurants prior to their discharge to the public sanitary network, in order to comply with the Egyptian Environmental Regulation (Decree 44/2000) of the wastewaters discharged to the public sewer system. Total operating cost including the energy and electrode consumption, and theoretical amount of hydrogen gas produced were calculated. The results revealed good removal efficiency percentages, especially for the removal of organic matters. The COD removal efficiency for the restaurants 1, 2, 3, 4 and 5 were 84.6, 74.5, 89.15, 68.5, and 92.79%, respectively. At the same time, oil & grease was almost fully removed from the wastewater of the restaurants 1 and 2, while restaurants 3, 4, and 5 had a very good removal efficiency percentage of 92.42, 94.5, and 87.76%, respectively.

In the present study, we assessed seasonal variation in the accumulation potential of wild mint (Mentha longifolia) to heavy metals as well as the chemical composition and antioxidant activity of t...

Cinnamon, clove and thyme essential oils (EOS) were used to manufacture of Kishk product for owns preservation effect and biological & nutritive values. EOS-kishk was prepared by adding various concentrations of essential oils (100 and 200 mg/kg) to traditional kishk mixtures. Results showed that cinnamon, clove and thyme essential oils were having 11, 32 and 18 identified compounds by using GC-MS, respectively. EOS-kishk samples contained (20.44-24.74%) protein, (5.13-5.80%) ash and (4.64 to 6.57%) moisture. The titratable acidity (TA % as lactic acid) and pH in the kishk samples ranged from 1.72 to 2.12% and 4.92-5.12, respectively. The water holding capacity (WHC) of the EOS-kishk samples varied from 464.10 to 498.48 g/kg, which was significantly higher than those of the control sample. EOS-Kishk samples had the highest antioxidant activity values (40.69%) at 200 mg/kg thyme oil compared with the control ones (31.54%). Mineral amounts of EOS-kishk had a slight change among all treatments. Microbiologically, the total viable bacterial count in most samples was slightly decreased as well as Lactobacilli, Streptococci and spore forming bacteria counts when compared with control. Whilst, there were notably decrease on coliform bacteria as well as yeast and mold counts in the EOS-kishk samples when compared with control. Overall, EOS-kishk has highly nutritional and biological value.

Author(s): Portuguese, Andrew J.; Abdulla, Khaled H.; Vornovitsky, Michael; DeAngelis, John | Abstract: Introduction: Ventricular septal rupture (VSR) is a rare complication of ST-elevation myocardial infarction (STEMI), typically discovered post-revascularization.Case report: We present the first case of VSR detected on point-of-care ultrasound (POCUS) in the emergency department immediately prior to emergent angiography, with management positively affected by this discovery. The VSR was quickly confirmed via right heart catheterization. Subsequently, hemodynamic stability was achieved using an intra-aortic balloon pump. A delayed surgical VSR repair, with concomitant coronary artery bypass grafting, was implemented for definitive management.Conclusion: This case highlights the utility of POCUS in a STEMI patient with a suspected mechanical complication.

Background Cognitive impairment is a common finding epileptic children. Studies have linked nocturnal epileptic discharges to delayed cognitive abilities in children. Objective The study aims to evaluate the effect of nocturnal epileptic seizures on cognitive functions in children with idiopathic epilepsy. Patients and methods The study was conducted on 70 children with idiopathic generalized or benign focal epilepsy. Based on seizures semiology, they were classified into cases either with nocturnal epileptic seizures (NES) (n = 40) or with diurnal epileptic seizures (DES) (n = 30). Patients receiving antiepileptic drugs (AEDs) that affect cognitive function, patients with intelligence quotient (IQ) below 70, and those having other neurological or psychiatric disorders' were excluded. All patients were subjected to neurological examination, brain magnetic resonance imaging (MRI), and electroencephalography. Cognition was assessed using Wechsler Intelligence scale for children (WISC) to measure IQ, Wisconsin card sorting test (WCST) (computerized version), Trail Making Test, and Digit spans test. Results There was no significant difference between both groups regarding age, sex, age of epilepsy onset, or seizure frequency. There was a significant difference in almost all cognitive variables including digit forward, digit backward, processing speed, verbal IQ, WCST perseverative responses, WCST failure to maintain set, Trail Making Test A (error), Trail Making Test B (Time), and Trail Making Test B (error). There was no significant difference regarding the associated sleep disturbances between the studied groups. Conclusion Children with idiopathic epilepsy suffering from predominant nocturnal seizure have overt and subtle cognitive functions impairments compared to children with predominant diurnal seizure.

Background Cerebral palsy (CP) is a non-progressive motor disability that mostly results from perinatal complications. It demands extensive and multidisciplinary care, which poses a burden for patients and their families and a challenge to health systems. We aimed to evaluate the effect of stem cells transplantation on gross motor functioning of CP patients. Patients and Methods: It is a prospective study conducted on 20 children diagnosed with cerebral palsy with severe motor disability (GMFC 5) further classified into two groups according to age. The study was carried out from January 2018 to January 2020. Follow up of the patients was done before injection of stem cells and 3, 6, 9 and 12 months after injection of stem cells using Gross motor function classification scale (GMFC). Results: The study revealed that GMFC scores in pre-injection and 3,6,9and 12 months evaluations were not statistically significant when compared among the two groups while significant improvement was found in gross motor scale from pre-injection to final injection score in each group. Median GMFC changed from 5 to 2 among all cases. Conclusion: Gross motor function in children with CP remarkably improved after stem cell transplantation.

Background Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity. Objectives The aim of this study is to compare the efficacy and safety of intravaginal misoprostol alone versus intra cervical Foley catheter combined with vaginal misoprostol in induction of labor at term pregnancy. Methods This study was conducted at Obstetrics & Gynecology Department; Ain Shams University, Maternity Hospital in the period between May 2017 to October 2017. The total number of patients studied was 120 patients, divided into two groups; the first group (A) included 60 patients who received vaginal misoprostol, the second group (B) included 60 patients who received vaginal misoprostol combined with trans cervical Foley catheter. Results The current study found that the combined group has a better chance for NVD 88.3% versus 78.3% in misoprostol alone group, a lesser probability to CS 11.7% in combined group versus 21.7% in misoprostol alone group and a shorter induction delivery interval within 12 hours after induction (81.6% in combined group versus 59.5% in misoprostol group). Regarding the effect of both methods on fetal safety, we found that non reassuring FHR was more common in combined group 8.3% than misoprostol alone group 1.7% but it’s statistically non-significant. There was statistically significant increase in tachysystole in combined group 28.3% versus 13.3% in misoprostol alone group. However, dystocia was more common in misoprostol group 15% than combined group 3.3% that is also statistically significant. Conclusion Both methods can be used in induction of labor at term pregnancy without forgetting the precautions and close observation to the mother and the fetus. Combined method results in a shorter induction-to delivery time, but misoprostol alone was safer for the mother and the fetus.

Prader–Willi syndrome (PWS) is the commonest genetic cause of obesity. Oxidative stress and chronic low-grade inflammation play a crucial role in the pathogenesis of obesity. Alterations of vitamin D (25-OHD) levels are commonly encountered with obesity. The aim of this study was to analyze serum chemerin, oxidized low-density lipoprotein (ox-LDL), and 25-OHD values in pediatric PWS patients in comparison with obese healthy children and nonobese control groups, highlighting possible correlations with body mass index (BMI) and obesity. Twenty-six PWS Egyptian patients and 26 obese healthy individuals referred to the outpatient clinic of the Clinical Genetics Department, National Research Centre, Cairo, Egypt, and 20 control patients with matching age and sex were enrolled in the study. Patients were clinically diagnosed and confirmed by routine cytogenetic and fluorescence in-situ hybridization analysis. Anthropometric measurements were performed, and BMI was calculated by weight/height2 (kg/m2), and BMI z score was also determined. Serum chemerin, ox-LDL, and vitamin D were determined by enzyme-linked immunosorbent assay. Chemerin levels, which reflected chronic inflammation, were significantly elevated as compared with obese and nonobese controls (p ≤ 0.0001). Concerning oxidative damage, children with PWS showed higher Ox-LDL levels compared with obese and nonobese controls (p

Introduction: Digital models showed promising results for orthodontic diagnosis and treatment planning. Digital models can be obtained from alginate impressions as well as direct intra-oral scanners. Studies assessing the accuracy of digital models have shown digital models to be valid, clinically acceptable, and more quickly obtainable. With the advent of new scanners with better scanning technology researches are necessary to evaluate their accuracy and reliability. Aim of Study: To evaluate the diagnostic accuracy of 3D digital models obtained through intraoral and extraoral scanning modalities to the reference gold standard plaster model. Material & Methods: Twenty-four adult male and female subjects were randomly selected for this study. The intraoral scanners evaluated in this study were Sirona (CEREC Omnicam) and 3 shape (TRIOS 3), while the laboratory scanners used were Sirona (inEos X5), and 3 shape (D850). Intra-oral scanning of the subjects and extra-oral scanning of their alginate impressions, plaster models of the alginate impression, rubber base impression, and plaster model of their rubber base impression were done. Linear dental measurements included intermolar width, interpremolar width, intercanine width, mesiodistal width of the 1st permanent molar, 1st premolar, canine and central incisor and arch width. All data were collected, tabulated and subjected to statistical analysis. Results: Small differences between the plaster and digital models were observed. Intra-observer reliability analysis for 14 out of the 16 measurements showed that all variables exhibited good to excellent reliability. Conclusions: There was no difference between the digitization using the intraoral scanner or the laboratory scanner. The most accurate digitization technique was the 3 Shape laboratory scanner of the cast of the alginate impression. The inEos X5 showed the highest error of digitization of the alginate and rubber base impressions.

The objective of this study is to assess the influence of particulates generated by traffic on air quality of the urban area in Damietta City, Egypt. In this study, particulate concentrations had demonstrated in the atmosphere of seven locations in the city, through year 2018 and comparing with the data of year 2009. The chemical characteristics of particulate components (SO42-, NH4+, NO3-, NO2- and Cl-) had also investigated for the sampling locations. It indicated that about 100 % of the measured samples exceeded Egyptian ambient air quality standard (90 mg/m3/year). The air quality index (AQI) of traffic and residential areas in Damietta City with respect to suspended particulate matter (SPM) shows a significant improvement of air quality during the period of 2018, compared with the concentrations during the period of 2009, which indicated extreme air pollution at that period. Whereas the main compounds in SPM in the city follow the order: (NH4)2SO4> NH4NO3. These results clarify that the reaction between NOx, SO2 and ammonia gases might be emitted from auto-exhaust.

Alzheimer's disease (AD) is a complex neurodegenerative disorder with multiple dysfunctional pathways. Therefore, a sophisticated treatment strategy that simultaneously targets multiple brain cell types and disease pathways could be advantageous for effective intervention. To elucidate an effective treatment, we developed an in vitro high-throughput screening (HTS) assay to evaluate candidate drugs for their ability to enhance the integrity of the blood-brain barrier (BBB) and improve clearance of amyloid-β (Aβ) using a cell-based BBB model. Results from HTS identified etodolac and α-tocopherol as promising drugs for further investigation. Both drugs were tested separately and in combination for the purpose of targeting multiple pathways including neuroinflammation and oxidative stress. In vitro studies assessed the effects of etodolac and α-tocopherol individually and collectively for BBB integrity and Aβ transport, synaptic markers and Aβ production in APP-transfected neuronal cells, as well as effects on inflammation and oxidative stress in astrocytes. Transgenic 5XFAD mice were used to translate in vitro results of etodolac and α-tocopherol independently and with concurrent administration. Compared to either drug alone, the combination significantly enhanced the BBB function, decreased total Aβ load correlated with increased expression of major transport proteins, promoted APP processing towards the neuroprotective and non-amyloidogenic pathway, induced synaptic markers expression, and significantly reduced neuroinflammation and oxidative stress both in vitro and in vivo. Collective findings demonstrated the combination produced mixed interaction showing additive, less than additive or synergistic effects on the evaluated markers. In conclusion, this study highlights the significance of combination therapy to simultaneously target multiple disease pathways, and suggest the repurposing and combination of etodolac and α-tocopherol as a novel therapeutic strategy against AD.

The objective of this study is to assess the influence of particulates generated by traffic on air quality of the urban area in Damietta City, Egypt. In this study, particulate concentrations had demonstrated in the atmosphere of seven locations in the city, through year 2018 and comparing with the data of year 2009. The chemical characteristics of particulate components (SO42-, NH4+, NO3-, NO2- and Cl-) had also investigated for the sampling locations. It indicated that about 100 % of the measured samples exceeded Egyptian ambient air quality standard (90 g/m3/year). The air quality index (AQI) of traffic and residential areas in Damietta City with respect to suspended particulate matter (SPM) shows a significant improvement of air quality during the period of 2018, compared with the concentrations during the period of 2009, which indicated extreme air pollution at that period.Whereas, the main compounds in SPM in the city follow the order: (NH4)2SO4> NH4NO3. These results clarify that the reaction between NOx, SO2 and ammonia gases might be emitted from auto-exhaust.

Background Assessment of apoptosis by flow cytometry assay and expression of apoptosis-related genes by quantitative Real-Time PCR has been suggested for predicting the patient response to therapeutic regimes of Familial Mediterranean Fever (FMF), as well as patient's survival. Therefore, the main objective of this study was to investigate the association of ROS generation on changes in apoptosis levels and expression of apoptosis related genes (Bcl2, Bax and Caspase-2) in FMF patients to get general profiling of this disease to use the most appropriate therapeutic strategy. Material and methods The study includes 40 Egyptian patients who were diagnosed with FMF according to Tel-Hashomer criteria. Blood samples of healthy controls were collected from 40 volunteers. Mutational analysis has been performed to confirm the inheritance of FMF. The collected samples of FMF patients and healthy controls were used to investigate the apoptosis rate, mRNA of apoptosis related genes (Bcl2, Bax and Caspase-2), reactive oxygen species (ROS) and DNA damage. Results We found significant increase in apoptosis rates and elevated expression levels of apoptosis related genes in FMF patients. Moreover, the mean values of intracellular ROS generation and DNA damage in blood cells of FMF patients were significantly higher than in the control cohorts. Conclusion The ROS production could be involved in oxidative modification of cellular DNA, modulation of apoptotic gene expression, and promoting cell death in FMF patients.

Electrocoagulation technology is being increasingly used to treat various types of wastewater over the last several years. This study aimed to investigate the industrial wastewater treatment of a fruit juice factory as an example of food processing industries in New Damietta City, Egypt, by using electrocoagulation technology. This is to solve an environmental problem, represented in the high organic load of these effluents. The electrocoagulation treatment processes were examined by using two electrodes of aluminum (Al) and two electrodes of stainless-steel (SS) and also by using Al as an anode and SS as a cathode. In addition, treatment by alum coagulation was investigated. Results showed that electrocoagulation was more effective than alum coagulation. The use of two combined electrodes of Al as an anode and SS as a cathode resulted in an 83.78% COD removal efficiency, while the use of the alum coagulant yielded 57.57%. Furthermore, total operating cost was calculated, and the amount of hydrogen gas as a subsequent energy alternative was theoretically determined in order to solve the process' power problem.

Background Vertigo and dizziness are very common complaints that may be related to epilepsy. The purpose of this study was to assess vestibulo-spinal and linear vestibulo-ocular function in epileptic patients in the inter ictal period. The current observational study was carried out in audio-vestibular unit Menoufia University. Subjects in the current study were divided into two groups: The control group included 30 normal individuals not complaining from any dizzy symptoms and the epileptic cases group included 30 epileptic patients. All subjects in the study were submitted to cervical and ocular vestibular evoked myogenic potential. Results There was no significant difference between the control and epileptic group regarding the age and sex distribution. Sixty-seven percent of epileptic cases had dizzy symptoms. There was statistically significant difference in the latency and amplitude of c and o VEMP between the control and the epileptic group, 39/60 ears (65%) in the study group had cVEMP abnormalities, 32/60 ears (53%) had oVEMP abnormalities. Abnormal c and o VEMP were reported in 28/60 ears (46.7%). There was statistically significant relationship between VEMP abnormalities and duration of seizures, frequency of epileptic attacks, and type of therapy. Conclusion Vestibular abnormalities were frequently reported in epileptic patients in the current study which may be related to the severity and control of epilepsy.

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated glutamine efficacy in preventing and alleviating radiation-induced oral mucositis (OM) among patients with head and neck (H&N) cancer. We screened five databases from inception till February 4, 2021 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 11 RCTs, comprising 922 patients (458 and 464 patients were assigned to glutamine and control group, respectively). The incidence and onset of radiation-induced OM of any grade did not substantially differ between both groups. However, glutamine substantially reduced the severity of radiation-induced OM, as reflected by the reduced incidence of severe OM and reduced mean maximal OM grade score. Additionally, glutamine significantly decreased the rates of analgesic opioid use, nasogastric tube feeding, and therapy interruptions. Oral glutamine supplementation demonstrated various therapeutic benefits in preventing and ameliorating radiation-induced OM among patients with H&N cancer.

Study Design: Systematic review and meta-analysis. Objectives: Arthrodesis has been a valid treatment option for spinal diseases, including spondylolisthesis and lumbar spinal stenosis. Posterolateral and posterior lumbar interbody fusion are amongst the most used fusion techniques. Previous reports comparing both methods have been contradictory. Thus, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to establish substantial evidence on which fusion method would achieve better outcomes. Methods: Major databases including PubMed, Embase, Web of Science and CENTRAL were searched to identify studies comparing outcomes of interest between posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF). We extracted data on clinical outcome, complication rate, revision rate, fusion rate, operation time, and blood loss. We calculated the mean differences (MDs) for continuous data with 95% confidence intervals (CIs) for each outcome and the odds ratio with 95% confidence intervals (CIs) for binary outcomes. P < 0.05 was considered significant. Results: We retrieved 8 studies meeting our inclusion criteria, with a total of 616 patients (308 PLF, 308 PLIF). The results of our analysis revealed that patients who underwent PLIF had significantly higher fusion rates. No statistically significant difference was identified in terms of clinical outcomes, complication rates, revision rates, operation time or blood loss. Conclusions: This systematic review and meta-analysis provide a comparison between PLF and PLIF based on RCTs. Although PLIF had higher fusion rates, both fusion methods achieve similar clinical outcomes with equal complication rate, revision rate, operation time and blood loss at 1-year minimum follow-up.

The burden of breast cancer is imposing a huge global problem. Drug discovery research and novel approaches to treat breast cancer have been carried out extensively over the last decades. Although immune checkpoint inhibitors are showing promising preclinical and clinical results in treating breast cancer, they are facing multiple limitations. From an immunological perspective, a recent report highlighted breast cancer as an “inflamed tumor” with an immunosuppressive microenvironment. Consequently, researchers have been focusing on identifying novel immunological targets that can tune up the tumor immune microenvironment. In this context, several novel non-classical immune targets have been targeted to determine their ability to uncouple immunoregulatory pathways at play in the tumor microenvironment. This article will highlight strategies designed to increase the immunogenicity of the breast tumor microenvironment. It also addresses the latest studies on targets which can enhance immune responses to breast cancer and discusses examples of preclinical and clinical trial landscapes that utilize these targets.

Objective: The aim is to compare between the clinical effectiveness of nasoalveolar molding (NAM) versus the computer-aided design NAM (CAD/NAM) in patients with bilateral clefts. Design: The trial is a randomized comparative trial with 1:1 allocation ratio. Participants: Thirty infants with bilateral complete cleft lip and palate were recruited. Interventions: Patients were randomized between NAM and CAD/NAM groups. The treatment steps described by Grayson were followed for the NAM group. In the CAD/NAM group, digitized maxillary models were made to create series of modified virtual models which were used to fabricate the molding plates using 3-dimensional printing technology. The nasal stents were then added to the plates following Grayson method. The study lasted for 4 months. Main Outcomes: The primary outcome was to evaluate the changes in the intersegment cleft gap. Secondary outcomes included the analysis of the maxillary arch in transverse, anteroposterior, and vertical dimensions as well as the premaxillary deviation and rotation. Chair side time was assessed for both methods. Results: Both modalities decreased the intersegment cleft gap. The CAD/NAM plates caused more reduction in the total arch length by 1.99 mm (−3.79 to 0.19, P = .03) as compared to the NAM treatment. No differences were found between groups in the transverse and vertical maxillary arch changes. Conclusions: Both interventions were effective in narrowing the cleft gap. Similar maxillary changes were found in both groups. The CAD/NAM modality required less chair side time compared to the NAM treatment.