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Objective: The objective of the study was to investigate the consequences of using CArm Cone-Beam computed Tomography (CBCT) on super-selective catheterization of Hepatic Artery (HA) branches during chemoembolization of hepatocellular carcinoma. Methods: Two groups of patients were created according to the dates of their treatment sessions. Group A and Group B included patients who had their treatment sessions in 2004 - 2005 and 2008 - 2010, respectively. The sessions performed in 2006 and 2007 were excluded to allow for the adoption and incorporation of CBCT imaging into clinical practice. All chemoembolized HA branches were categorized according to selection order (0-1, 2, or ≥3). Other procedure variables were documented. Results: A total of 58 and 183 sessions were included in Groups A and B, respectively, for 144 patients. C-arm CBCT was used in 2 (3%) sessions and 142 (78%) sessions in groups A and B, respectively. The average number of vessels treated was significantly higher in group B (1.8) compared to group A (1.3) (P < .0001). A shift to an increased selection order in group B (0-1, 44 [24%]; 2, 85 [46%]; ≥3, 54 [30%]) was more significant (P = .0004) than that in group A (0-1, 32 [55%]; 2, 18 [31%]; ≥3, 8 [14%]). The average duration of the procedure was significantly longer in group B (P = .0002). Conclusions: Using C-arm CBCT during chemoembolization has a positive impact on increasing the number and order of HA selected and chemoembolized. This comes at the expense of an increase in the duration of the procedure.

Diabetic Retinopathy (DR) has been considered one of the leading causes of blindness or vision loss in the long run. Retinal microvasculature formed due to diabetes mellitus may lead to this sickness case. Therefore, early identification of abnormalities in retinal images will help not only in curing but also in preventing or delaying vision loss. The main objective of this research is to detect and classify the DR stages as non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) via multifractal geometry, as well as automating the classification process by enforcing multistage artificial neural network. Two hundred and seventy eyes have been used for normal, diabetic without DR, non-proliferative diabetic retinopathy (Mild to Moderate), and PDR. The macula superficial capillary plexus of the subjects’ images had been imaged using the swept-source optical coherence tomography angiography (SS-OCTA). The proposed classification technique based on a multistage artificial neural network has achieved accuracy with 98.1%. It provides a detecting method for the early diabetic retinopathy stages before the precipitate treatment.

This study conducted to examine the clinical bovine mastitis to isolate and identify the bacteria causing the disease and to determine the sensitivity pattern of isolates to commonly using antibiotic in Eldamazine locality, Blue Nile State. A total of 45 dairy cows clinically infected by different types of mastitis. Mastitis milk samples were collected from the animals and transported to microbiology laboratory for bacteriological examination. The samples were cultured in blood agar, MacConkey agar and purified in nutrient agar. Gram stain was used for morphological characteristics. Biochemical tests were done to all isolates. Sensitivity test was applied to gentamycin, ampicillin, vancomycin, ciprofloxacin, tetracycline and erythromycin. There were 3 types of mastitis were detected and these were acute mastitis with high prevalence (62.2%) followed by chronic mastitis (35.6%) and gangrenous mastitis (2.2%). The isolates were Staphylococcus spp (73.36%), Streptococcus spp (4.4%), Bacillus spp (8.9%) Pseudomonas spp, and Escherichia spp (8.9%). Also, the results revealed that high prevalence of Staphylococcus epidermidis (8.9%), followed by Staphylococcus hyicus (6.7%), Streptococcus agalactia (4.4%), and Pseudomonas aeruginosa (4.4%). Most effective antibiotics to isolated bacteria were ciprofloxacin, gentamycin, tetracycline, vancomycin and ofloxacin, while resistant to ampicillin and erythromycin. The species Pseudomonas aeruginosa were resistant to all antibiotics used. In conclusion, mastitis is associated with huge economic loss to farmers in the study area, and most effective control is prevention by using good management practices.

Background Ductal stenting is the preferred method of securing adequate pulmonary blood flow in patients with duct-dependent pulmonary circulation. The main limitation in most centers is the difficult vertical tubular or convoluted ducts that represent real challenges to interventional pediatric cardiologists. We present our experience in patent ductus arteriosus (PDA) stenting with some technical tips to overcome difficulties, especially in stenting tortuous or long tubular ducts. This study was conducted on all patients with cyanotic congenital heart disease who underwent PDA stenting between January 2011 and December 2018. Results We attempted to stent the PDA in 43 patients, with a success rate of 93% (40 patients) and only one procedural mortality. There was also one stent migration that needed to be treated with urgent surgery. Three-fourths of the patients had difficult ductal morphology and origin. One stent was used to cover the PDA in 27 patients (62.8%), two stents were used in 13 (30.2%), and three stents were used in 2 patients (4.6%). In-stent stenosis rate was 12.5% (5 patients) and the development of progressive left pulmonary artery stenosis was seen in two patients (5%). Pulmonary artery growth was adequate in all patients. Conclusions PDA stenting is an effective method of palliation for patients with duct-dependent pulmonary circulation. It has low morbidity and mortality rates. Stenting difficult ducts have become more feasible with evolving materials and techniques.

Ahmed Omar Kaseb,1 S Cheenu Kappadath,2 Sunyoung S Lee,1 Kanwal Pratap Raghav,1 Yehia I Mohamed,1 Lianchun Xiao,3 Jeffrey S Morris,4 Chimela Ohaji,1 Rony Avritscher,5 Bruno C Odisio,5 Joshua Kuban,5 Mohamed E Abdelsalam,5 Beth Chasen,6 Khaled M Elsayes,7 Mohamed Elbanan,7 Robert A Wolff,1 James C Yao,1 Armeen Mahvash2 1Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 4Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 5Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 6Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 7Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USACorrespondence: Ahmed Omar Kaseb Email akaseb@mdanderson.orgPurpose: The most common cause of death in advanced/metastatic hepatocellular carcinoma (HCC) is liver failure due to tumor progression. While retrospective studies and meta-analyses of systemic therapy combined with liver-directed therapy have been performed, prospective studies of safety/efficacy of antiangiogenesis followed by intra-arterial therapies are lacking. We tested our hypothesis that sorafenib followed by yttrium 90 glass microspheres (90Y GMs) is safe and that survival outcomes may improve by controlling hepatic tumors.Methods: We enrolled 38 Child–Pugh A patients with advanced/metastatic HCC. In sum, 34 received sorafenib, followed after 4 weeks by 90Y GMs. Analysis of safety and survival outcomes was performed to assess adverse events, median progression-free survival, and overall survival.Results: A total of 34 patients were evaluable: 14 (41.2%) with chronic hepatitis, nine (26.5%) with vascular invasion, and eleven (32.4%) with extrahepatic diseases. Safety analysis revealed that the combination therapy was well tolerated. Grade III–IV adverse events comprised fatigue (n=3), diarrhea (n=2), nausea (n=1), vomiting (n=2), hypertension (n=4), thrombocytopenia (n=1), hyperbilirubinemia (n=1), proteinuria (n=1), hyponatremia (n=1), and elevated alanine or aspartate aminotransferase (n=5). Median progression-free and overall survival were 10.4 months (95% CI 5.8– 14.4) and 13.2 months (95% CI 7.9– 18.9), respectively. Twelve patients (35.3%) achieved partial responses and 16 (47.0%) stable disease. Median duration of sorafenib was 20 (3– 90) weeks, and average dose was 622 (466– 800) mg daily. Dosimetry showed similar mean doses between planned and delivered calculations to normal liver and tumor:normal liver uptake ratio, with no significant correlation with adverse events at 3 and 6 months post-90Y treatment.Conclusion: This is the first prospective study to evaluate sorafenib followed by 90Y in patients with advanced HCC. The study validated our hypothesis of safety with encouraging efficacy signals of the sequencing treatment, and provides proof of concept for future combination modalities for patients with advanced or metastatic HCC.Clinical Trial Registration Number: NCT01900002.Keywords: HCC, sorafenib, yttrium 90, BCLC, hepatocellular carcinoma

Cardiac catheterization can affect clinical outcomes in patients on extracorporeal membrane oxygenation (ECMO) after congenital heart surgery; however, its effect in this group of patients remains unclear. This study aimed to evaluate the safety and outcome of cardiac catheterization in patients undergoing ECMO after congenital cardiac surgery and determine predictors that influence successful weaning. This retrospective cohort study included pediatric patients who underwent cardiac catheterization while on ECMO after congenital heart surgery in two cardiac centers between November 2012 and February 2020. Predictors of successful weaning from ECMO were studied using univariate and multivariate logistic regression analyses. Of 123 patients on ECMO support after congenital cardiac surgery, 60 patients underwent 60 cardiac catheterizations (31 diagnostic and 29 interventional). Thirty-four (56.7%) and 22 patients (36.7%) underwent successful decannulation from ECMO support and survived after hospital discharge, respectively. Patients who underwent earlier catheterization (within 24 h of ECMO initiation) had more successful weaning from ECMO and survival compared to others. Patients who underwent an interventional procedure (interventional catheterization or redo cardiac surgery after cardiac catheterization) had better survival than those who underwent only diagnostic catheterization (P = 0.038). Shorter durations of ECMO was the most important predictor of successful weaning from ECMO. Early cardiac catheterization greatly impacts successful weaning from ECMO and survival. Patients with correctable lesions amenable either by catheterization or redo surgery are more likely to survive. Shorter durations of ECMO could have a significant influence on successful weaning from ECMO and survival.

Introduction For maximum utility of molecular characterization by next-generation sequencing (NGS) and better understanding of tumor microenvironment with immune correlates analysis, biopsy specimens must yield adequate tumor tissue, and sequential biopsy specimens should sample a consistent site. We developed a web-based lesion selection tool (LST) that enables management and tracking of the biopsy specimen collections. Methods Of 145 patients, the LST was used for 88 patients; the other 57 served as controls. We evaluated consistency of the lesion biopsied in longitudinal collections, number of cores obtained, and cores with adequate tumor cellularity for NGS. The Fisher exact test and Wilcoxon rank sum test were used to identify differences between the groups. Results The analysis included 30 of 88 (34%) patients in the LST group and 52 of 57 (91%) in the control group. The LST workflow ensured 100% consistency in the lesions biopsied compared with 75% in the control group in longitudinal collections and increased the proportion of patients in whom at least five cores were collected per biopsy. Conclusions The novel LST platform facilitates coordination, performance, and management of longitudinal biopsy specimens. Use of the LST enables sampling of the designated lesion consistently, which is likely to accurately inform us the effect of the treatment on tumor microenvironment and evolution of resistant pathways. Such studies are important translational component of any clinical trials and research as they guide the development of next line of therapy, which has significant effect on clinical utility. However, validation of this approach in a larger study is warranted.

Diabetic Retinopathy (DR) is a complication of diabetes that affects the eyes. It is caused by blood vessel damage of the light-sensitive tissue at the back of the retina. Neovascularization are emerged and the small blood vessels are blocked. The prevention or delaying vision loss can be obtained by DR early detection. The retinal microvascular network as a biological system has its own multifractal features as generalized dimensions, lacunarity and singularity spectrum. In this study, a novel approach for DR early detection based on the multifractal geometry has been proposed in some details. Analyzing the macular optical coherence tomography angiography (OCTA) images for diagnosing early non-proliferative diabetic retinopathy (NPDR). Using a supervised machine learning method as a Support Vector Machine (SVM) algorithm to automate the diagnosis process and improving the resultant accuracy. The classification technique had achieved 98.5 % accuracy. This approach also can classify easily other diabetic retinopathy stages or other retinal diseases, which affect the vessels or neovascularization distribution.

Background: Childhood rheumatologic disorders are multisystem diseases characterized by inflammation, damage, and/or pain of the joints, and connective tissues. Aim: This study aimed to detect the presence of insulin resistance (IR) in pediatric patients with systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) which can lead to the development of diabetes mellitus. Subjects and Methods: This case-control study was performed on 60 SLE, 60 RA patients, and 60 healthy subjects as a control group. All subjects were subjected to detailed history taking, physical examination, and laboratory investigations including determination of fasting blood glucose (FBG), total cholesterol, triglyceride (TG), HDL, LDL, and fasting insulin. Homeostatic model assessment of insulin resistance (HOMA IR) was calculated. Results: There was no significant difference in the age, and FBG in the three studied groups but there was a significant difference as regard platelets counts, hemoglobin, ESR, CRP, TG, HDL, fasting insulin levels, and HOMA IR. There is no significant difference between the SLE, and RA in disease duration, ESR, CRP, HDL, LDL, triglyceride, cholesterol, fasting blood glucose, fasting insulin levels, and HOMA IR. There were significant positive correlations between HOMA IR with patients’ BMI, ESR, CRP, TG, FBG, and fasting insulin levels in both SLE and RA groups. Conclusions: SLE, and RA patients had a higher insulin resistance than age-matched healthy controls which can lead to the development of type 2 diabetes mellitus. HOMA IR had positive correlations with BMI, TG, FBG, and fasting insulin levels in both SLE and RA groups.

PURPOSE 99m Tc-MAA-SPECT/CT may be used in 90 Y-glass microsphere radioembolization treatment planning to assess perfused liver volumes and absorbed dose distributions. The partition model (PM) offers a more detailed planning dosimetry option beyond the single-compartment model more traditionally used in 90 Y radioembolization. As 90 Y radioembolization treatments shift toward activities and doses that aim to achieve tumor control, accurate and reliable treatment planning dosimetry for both tumors and normal liver (NL) becomes more critical. In this work, we explore the accuracy and precision of 90 Y dosimetry predictions from pretherapy 99m Tc-MAA and PM. METHODS Both PM and voxel dosimetry models were used to calculate tumor and NL mean doses using both planning 99m Tc-MAA and verification 90 Y-SPECT/CT in this retrospective analysis of hepatocellular carcinoma cases treated with glass microspheres (NCT01900002, n = 32). Linear regression models were developed at first access, and then later correct, the estimates by (a) 99m Tc-MAA for 90 Y voxel dosimetry and (b) 99m Tc-MAA PM for voxel dosimetry, separately for both tumors and NL. Bland-Altman analysis was then used to evaluate the accuracy and precision of the regression model predictions with the mean bias and 95% prediction intervals (PI, ±1.96σ). Two categories of cases were stratified (catheter matched vs catheter unmatched) by establishing the level of 99m Tc-MAA and 90 Y catheter position alignment. Only catheter-matched cases were included in the 99m Tc-MAA vs 90 Y voxel dosimetry comparison, while all cases were used to compare dosimetry models (PM vs voxel). RESULTS Half (16/32) of cases were deemed catheter matched. 99m Tc-MAA could reliably predict NL doses in catheter-matched cases after application of the linear model, with mean bias (PI) of -1% (±31%). PM was equivalent to voxel dosimetry for NL doses with mean bias (PI) of 0% (±1%). Even among catheter-matched cases, 99m Tc-MAA planning for 90 Y tumor voxel doses was poor, overestimating dose by an average of nearly 40%. Upon application of the linear model, 99m Tc-MAA predictions for 90 Y tumor voxel dose were only minimally biased (-4%) but possessed very large PI (±104%). PM predictions for tumor voxel dose using the linear model also showed small bias (-6%) but maintained similarly high PI of ±90%. Cases with tumors representing a large majority (>80%) of the total tumor volume demonstrated the best scenarios for 99m Tc-MAA and PM tumor dose predictions, with mean biases (PI) of -3% (±53%) and -4% (±21%), respectively. CONCLUSION The unconditional use of 99m Tc-MAA to predict 90 Y dosimetry across all cases is not recommended due to: (a) demonstrated the risk of unmatched catheter positions between procedures, and (b) large bias and uncertainty in 99m Tc-MAA predictions in cases with matched catheter locations. However, NL voxel dose predictions with 99m Tc-MAA are clinically viable and either PM or voxel dosimetry can be used to produce equivalent predictions. Both 99m Tc-MAA and PM can provide tumor dose predictions with potential clinical utility, but only in catheter-matched cases and with tumors comprising a clear majority (>80%) of the total tumor volume. These findings stratify the predictive fidelity of 99m Tc-MAA- and PM-based treatment planning for 90 Y dosimetry in improving treatment outcomes.

In this study, samples of farmed thin-lipped mullets, Mugil capito from Lake Manzala and wild-caught grey mullet Mugil cephalus from Alexandria were found to be infected with heterophyid encysted metacercariae (EMC), and the overall prevalence rates were 80 and 100%, respectively. The number of metacercarial infection in tail tissue was significantly higher than that recovered from trunk and head among M. capito and M. cephalus. M. capito were simultaneously infected with two morphologically different EMC that ascribed to Heterophyes and Pygidiopsis species, while M. cephalus were infected with EMC of Heterophyes species. The experimental infection of domestic pigeons (Columba livia domestica) with the recovered encysted metacercariae confirmed the successful development of two types of Heterophyid flukes: identified as Heterophyes heterophyes and Pygidiopsis genata in the small intestine of pigeons. The histopathological examination revealed that Heterophyes cyst was small, elliptical with thick wall and predominating between cardiac muscle fibres and in the lumen of atrioventricular region of the heart. Pygidiopsis species cyst appeared larger in size, rounded with thin cyst wall and prominent internal structure. Pygidiopsis species were few in the abdominal fat and prominently encysted in the internal visceral organs including wall of the stomach, kidneys and muscular tissue away. They were also deeply encysted in testes and ovaries. Interestingly, the adult flukes were demonstrated in the intestinal lumen of the experimentally infected pigeons but with minor histopathological alterations. Our findings suggest that the heterophyids EMCs in mullets have genera-specific morphological characters and may induce histopathological changes in surrounding host-associated tissues.

Purpose To assess the overall survival (OS) and progression-free survival (PFS) of unresectable hepatocellular carcinoma (HCC) patients undergoing yttrium-90 glass-microsphere transarterial radioembolization (TARE) with and without concurrent sorafenib. Methods OS and PFS were analyzed in 55 patients with an intrahepatic tumor (IHT) ≤50% without advanced or aggressive disease features (ADFs), which was referred to presence of infiltrative/ill-defined HCC, macrovascular invasion, or extrahepatic disease treated with only TARE (TARE_alone) and in 74 patients with IHT ≤50% with ADFs or IHT >50% treated with TARE and sorafenib (TARE_sorafenib). Prognostic factors for OS and PFS were identified using univariate and multivariate analyses. Results Median OS and PFS of TARE_alone patients were 21.6 (95% CI 6.1-37.1) and 9.1(95% CI 5.2-13.0) months, respectively, and for TARE_sorafenib patients 12.4 (95% CI 9.1-15.6) and 5.1 (95% CI 2.6-7.5) months, respectively. Better OS was associated with serum AFP

In this study, three farmed Gilthead seabream exhibited tumor-like mass above the left pectoral fin. The mass measured 9 mm in length, 8 mm in width. Morphometrically, the mass was fleshy, raised, circumscribed, and rosy colored with grayish-white center. The affected fish showed poor growth with 280 g average body weight after 30 months rearing period. Internally, moribund fish exhibited pale kidney/liver, mottled spleen with remarkable visceral adhesions. The presumptive bacteriological and conventional biochemical assays revealed that fish were clinically infected with Photobacterium damselae subspecies piscicida. The histopathological picture of the tumor-like mass concurred with the standard cellular criteria of fibropapilloma. In brief, the epidermal papilloma was denoted by the remarkable hyperplasia of epidermis together with eosinophilic intracytoplasmic inclusion bodies and prominent mitosis in the hyperplastic cells. Ultimately, the proliferated dermal fibroblasts appeared whirling and elongated with spindle nuclei. Such pathological alterations have confirmed a typical form of dermal fibroma upon positively reacted with Masson’s trichrome stain. In the spleen, characteristic granulomatous reactions were observed especially in the area of melanomacrophage centers where the granuloma showed different developmental stages. The occurrence of skin tumors in farmed marine fish is an alarm for the critical impacts of the erratic usage of pesticides on marine aquaculture presenting a staggering prototype for the growing aquatic environmental pollution.

Diabetic retinopathy (DR) is one of the leading causes of vision loss. It causes neovascularization with blocking the regular small blood vessels. Early detection helps the ophthalmologist in patient treatment and prevents or delays vision loss. In this work, multifractal analysis has been used in some details to automate the diagnosis of diabetic without diabetic retinopathy and non-proliferative DR. Concerning using number of multifractal geometrical methods, as a necessary second step the enforcement of the sophisticated artificial neural network has been consultant in order to improve the accuracy of the obtained results. Patients and methods: Thirty normal cases’ eyes, 30 diabetic without DR patients’ eyes and 30 non-proliferative diabetic retinopathy (mild to moderate) eyes are exposed to optical coherence tomography angiography (OCTA) to get image superficial layer of macula for all cases. These images were approved in Ophthalmology Center in Mansoura University, Egypt, and medically were diagnosed by the ophthalmologists. We extract the most changeable features that associated to the morphological retinal vascular network alternations. The seven extracted features are related to the multifractal analysis results, which describe the vascular network architecture and gaps distribution. A supervised Artificial Neural Network (ANN) is used to classify the images into three categories: normal, diabetic without diabetic retinopathy and non-proliferative DR. Results: The human retinal blood vascular network architecture is found to be a fractal system. Multifractal geometry describes the irregularity and gaps distribution in the retina. We extracted seven features from the studied images. The features were the generalized dimensions D0, D1, D2, α at the maximum f(α) singularity spectrum, the spectrum width, the spectrum symmetrical shift point and lacunarity. The ANN obtains a single value decision with classification accuracy 97.78%, with minimum sensitivity 96.67%. Conclusion: Early stages of DR could be noninvasively detected using high-resolution OCTA images that were analysed by multifractal geometry parameterization and implemented by the sophisticated artificial neural network with classification accuracy 96.67%. This approach could promote risk stratification for the decision of early diagnosis of diabetic retinopathy.

Background: The knowledge on pericardial disease has increased but the European Society of Cardiology in the last guidelines 2015 stated a section of perspective and unmet needs referring to the surgical management as one of these needs. Here, we present an institutional experience to contribute with other studies in explanation of questionable aspects about their surgical management. Methods: Among 127 cases (93 adults and 34 children) that were diagnosed as pericardial syndrome, we retrospectively analyzed 45 cases (40 adults and 5 children) operated for pericardial syndrome from May 2012 to June 2019. Echocardiogram was the main preoperative diagnostic tool. Surgical approach was selected according to each diagnosis. Postoperative clinical assessment, recurrence and mortality rate were the main determinants of outcome. Results: Regarding pericardial effusions, the mean preoperative medical treatment period was 17.7 ± 21.9 days and pericardial window through thoracotomy was the common approach (54.5%). In constrictive pericarditis, infection was the main etiology (40%), mean preoperative medical treatment period was 16 ± 8.8 days and complete pericardiectomy was the surgical procedure for most cases. Trans-sternal drainage was the standard approach for cardiac tamponade. No postoperative same admission recurrences were reported and 11 (24.4%) mortalities were recorded, 7 (15.5%) cases of them were diagnosed as malignant effusions. Conclusion: Decision making and surgical approach affect the outcome of surgery for pericardial syndromes. Children are more responsive to medical treatment than adults are. Primary etiology and patient’s condition are still the leading determinants of morbidity and mortality.

Mycoplasma is associated with fatal diseases in human, animals, and fish. Mycoplasma of aquatic origin has not been thoroughly studied. The current study has shed the light on isolation and characterization of unique piscine Mycoplasma isolates retrieved from diverse geographical locations across the Egyptian state. Mycoplasma spp. was isolated using specific culture media. Mycoplasma was identified using the morphochemical tests and then confirmed molecularly by PCR of the 16S rRNA gene. The results indicated that the incidence of Mycoplasma from Cyprinus carpio, Oreochromis niloticus, Aulopiformes synodontida, and Clarias gariepinus were 33.33%, 16.36%, 8.108%, and 6.45%, respectively, while Mugil cephalus were negative for Mycoplasma isolation. Mycoplasma was detected only from gills and swim bladder of affected fish. Biochemically, the isolated Mycoplasmas were grouped into two clusters. Mycoplasma cluster 1 (35 isolates) and Mycolplasma cluster 2 (7 isolates). Mycoplasma cluster 1 was positive for tetrazolium reduction while Mycoplasma cluster 2 was negative. The phylogenetic tree of partial sequences of 16S rRNA showed that both clusters were grouped in one branch and separated from other Mycoplasma spp., suggesting that both clusters are belonging to one species. Interestingly, all fish Mycoplasma isolates were PCR negative for both Mycoplasma mobile and Mycoplasma monodon using specific species primers. This result confirmed that these two clusters belonged to unspecified Mycoplasma species, for which the temporary names Mycoplasma cluster 1 and Mycoplasma cluster 2 were designated. Pathogenicity trials of both Mycoplasmas clusters revealed that all inoculated Nile tilapias were susceptible to the unspecified Mycoplasmas.

Background: Burnout remains a significant concern in nursing, affecting both nurses and patients. The stressful nature of nursing profession can lead to job dissatisfaction and burnout. Aim: This study is aimed to measure staff nurses' burnout, job satisfaction and their relation to patient satisfaction in Port Said hospitals. Design: A descriptive correlational research design was conducted in this study. Sample: The subjects of this study consisted of two groups: First group : nurses, they were (310) nurses from the selected hospitals. Second group: patients, they were (116) patients from the selected hospitals. Tools: Data were collected using a questionnaire sheet containing three tools, first tool Maslach burnout inventory, second tool job satisfaction scale, and finally patient satisfaction questionnaire sheet. Results: The study results revealed that more than half of total nurses (59.52%) were burned out in both studied hospitals, nearly half of total nurses (43.49%) were dissatisfied with job in both studied hospitals. Conclusion: There was a statistically significant negative correlation between total burnout, total job satisfaction, and patients' satisfaction levels at both of the studied hospitals. Recommendations: The study recommended to provide measures to reduce the workload on nurses and appropriate interventions should be conducted including their salary and improving work condition.

Background Prediction of ovarian reserve has long been the golden key of reproductive endocrinology. Various endocrine [follicle stimulating hormone (FSH), inhibin B, estradiol (E2) etc.], and ultrasound tests [ovarian volume, antral follicle counts (AFC)] have been suggested to improve prediction of oocyte yield and pregnancy outcome following assisted reproductive technologies (ART).Purpose to investigate whether serum anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), or antral follicle count (AFC) carry a predictive role for clinical pregnancy in intracytoplasmic sperm injection (ICSI) patients. Methods Serum AMH, FSH and AFC of 100 women under 40 years of age were investigated in this study. Pregnant and non-pregnant women were compared.Results 33 (33%) chemical pregnancies were observed in 100 women. Clinical pregnancy was found in 21 women (63.6%) of chemical pregnancy. Conclusion we concluded that Serum AMH was proved to be the most effective predictor in this study. Serum FSH wasn’t significant for both poor& high response groups. AFC was very helpful& cheap method for prediction.

OBJECTIVE. The purpose of this article is to investigate the oncologic effectiveness and survival outcomes of percutaneous image-guided thermal ablation for clinical T1a renal cell carcinoma (RCC) ...

Background: Cardiac catheterization performed for patients supported by extracorporeal membrane oxygenation (ECMO) after congenital heart surgery may affect their clinical outcome, yet its effect in this group of patients is not adequately studied. The objective of this study was the evaluation of the impact of cardiac catheterization on successful weaning from ECMO support and survival after congenital heart surgery and determining predictors that influence successful weaning. Methods : This is a retrospective cohort study conducted on paediatric patients underwent cardiac catheterization while on ECMO support after congenital heart surgery in two cardiac centres from November 2012 till February 2020. Predictors of successful weaning from ECMO support were studied using univariable and multivariable logistic regression analysis. Results: Out of 141 patients received ECMO support after congenital cardiac surgery,60 patients underwent 60 cardiac catheterizations (31 diagnostic and 29 interventional). The median age was 6.5 months (range 4 days -20 years), median weight was 5 kg (range 2-53 kg). Thirty-four patients (56.7%) underwent successful decannulation from ECMO support and 22patients (36.3%) survived to hospital discharge. Predictors of successful weaning from ECMO support and survival were shorter duration on ECMO support, absence of bleeding tendency, early cardiac catheterization, and biventricular physiology. Conclusion: Cardiac catheterization is feasible with acceptable risks for patients receiving ECMO after congenital heart surgery. The shorter duration on ECMO support may have a significant influence on successful weaning from ECMO and survival after congenital heart surgery. Early cardiac catheterization could also influence the successful weaning from ECMO.

Migraines are associated with multiple comorbidities like depression, anxiety, poor sleep quality, and subjective cognitive impairment (SCI). This study aimed to evaluate the association of SCI with depression, anxiety, and modalities of sleep in those who have transformed migraines (TM). The study was conducted on 120 participants with TM and 41 control group participants. The subjective cognitive decline questionnaire classified the participants as SCI and non-SCI. The Headache Impact Test-6, Migraine Disability Assessment, Montreal Cognitive Assessment, Mini-Mental State Examination, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Full Polysomnography, and Beck’s Anxiety and the Depression Inventories were used and analyzed between patients with SCI and non-SCI. Patients with TM who had SCI represented 34% with severe headache effects, disability, pain severity, increased depression, and increased anxiety. They showed shorter sleep duration during weekdays, lower sleep quality, less sleep time, lower efficiency, and less REM sleep along with greater sleep latency, periodic limb movements, a higher arousal index, snore index, and percent of NREM3. There was a positive correlation between certain polysomnography parameters like percent NREM3, sleep period, sleep index, sleep latency, sleep arousal index, and periodic limb movements, and an inverse correlation with the percent of REM sleep, total sleep time, and sleep efficiency. Subjective cognitive complaints are common in patients with transformed migraine affecting about 34% of cases. TM patients with SCI had more sleep and psychological disturbances. Clinicaltrials.gov is NCT04413110.

Aim To evaluate systolic and diastolic cardiac function in children who had cardiomyopathy induced by ectopic atrial tachycardia (EAT). Methods Twenty-two pediatric patients who had cardiomyopathy induced by EAT and 25 age-matched controls were recruited in this case-control study. The patients were examined after rhythm control and normalization of their left ventricular systolic function. Different echocardiographic modalities including tissue Doppler imaging and two-dimension speckle tracking echocardiography were utilized to assess the ventricular and atrial function. Results The patients' median age was 51 months (interquartile range: 28.5-84 months). The median time interval required for normalization of left ventricular ejection fraction (EF) among patients was 1.5 months (interquartile range: 1.5-2.12 months). Compared to controls, patients had a significantly higher median left ventricular myocardial performance index (MPI) at the interventricular septum (0.44 vs. 0.38, p = .001) and left ventricular lateral wall (0.46 vs. 0.32, p = .0001). The median right ventricular MPI of the patients' group was significantly higher when compared to the control group (0.34 vs. 0.26, p = .0001). The median right atrial (RA) reservoir function in patients was significantly reduced compared to controls (30% vs. 36.63%, p = .007). Conclusions Shortly after rhythm normalization and restoration of left ventricular EF, using tissue Doppler imaging and two-dimension speckle tracking echocardiography, children who had cardiomyopathy induced by EAT continue to have left ventricular diastolic dysfunction, right ventricular dysfunction, and reduced RA reservoir function.

Background: We reported our experience in managing patients with single ventricle (SV) physiology and increased pulmonary blood flow (PBF), aiming to assess if it is feasible to proceed with primary Bidirectional Glenn (BDG) without a prior operation to limit PBF. Materials and methods: This is a retrospective study with 51 consecutive patients who underwent BDG operation as a primary operation or a second stage prior to the definitive Fontan operation at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia between 2010 and 2018. Patients were categorized into two groups based on their PBF prior to the operation: Patients who had SV physiology and increased PBF (seven patients) vs. patients with SV physiology and restricted PBF (44 patients). Results: The median age for the increased PBF group was 9.9 months [interquartile range (IQR): 2-16.9 months], and the median age for the restricted PBF group was 15.3 months (IQR: 6.7-42.6 months). Although the length of hospital stay was longer in patients with increased PBF (P = 0.039), we couldn't find a statistically significant difference in early mortality, duration of mechanical ventilation, length of pleural drainage, and length of intensive care unit (ICU) stay between the groups. Conclusion: In our experience, we found that primary BDG could be done safely for patients having SV physiology and increased PBF with acceptable short-term outcomes. It might further reduce the morbidity and mortality for those patients by avoiding the risk of initial pulmonary artery banding or aortopulmonary shunts.

Nocturnal enuresis is one of the side effects of valproic acid treatment, and generally underdiagnosed by clinicians. Studies reported that a variable incidence of valproic acid–induced nocturnal enuresis is 2.2% to 24% with unclear explanations of the reasons behind valproic acid–induced nocturnal enuresis. A retrospective study was carried out on 260 children (aged 5-12 years) diagnosed with idiopathic epilepsy, treated with valproic acid to evaluate the nocturnal enuresis secondary to valproic acid, and to discuss the characteristics of their sleep architecture. Nocturnal enuresis was reported in 28 (10.7%) patients after a mean exposure time to valproate of 18.78±8.4 days. Nocturnal enuresis was significantly associated with younger age and serum level of valproate ( P = .05). The polysomnographic study suggested that the underlying mechanism may be related to impaired sleep efficiency, frequent arousals, prolonged sleep latency, snoring, or increased sleep depth which may impair a child’s ability to awaken to the sense of bladder fullness or contractions.Clinical trial registration: ClinicalTrials.gov identifiers: NCT04191863

Background Cardiac catheterization after congenital heart surgery may play an important role in the diagnosis and management of patients with a complicated or unusual post-operative course. The main objective of this study was to evaluate the safety, efficacy, and outcome of cardiac catheterization performed in the early post-operative period following congenital heart surgery. All patients who underwent cardiac catheterization after congenital heart surgery during the same admission of cardiac surgery from November 2015 to May 2018 were included in the study. Results Thirty procedures were performed for 27 patients (20 interventional and 10 diagnostic). The median age of the patients was 15 months (15 days to 20 years), median weight was 8.2 kg (3.4 to 53 kg), and median time from surgery was 3 days (0–32 days). Eleven procedures were performed for 11 patients on extracorporeal membrane oxygenation (ECMO) support. The main indications for catheterization included the inability to wean from ECMO (10 procedures) and cyanosis (10 procedures). Interventional procedures included angioplasty using stents (10 procedures, success rate of 90%), angioplasty using only balloons (2 procedures, success rate of 50%), and occlusion for residual shunts (8 procedures, success rate of 100%). No mortality was recorded during any procedure. Vasoactive–inotropic score had significantly decreased 48 h after catheterization when compared to pre-catheterization scores (p = 0.0001). Moreover, 72% of patients connected to ECMO support were successfully weaned from ECMO after catheterization. Procedural complications were recorded in 3 interventional procedures. Survival to hospital discharge was 55.5% and overall survival was 52%. Patients on ECMO support had a higher mortality than other patients. Conclusion Cardiac catheterization can be performed safely in the early post-operative period, and it could improve the outcome of the patient (depending on the complexity of the cardiac lesions involved).

The purpose of this study is to assess the risk factors, biomarkers of stroke, mechanism, and outcomes of cerebral infarction among cancerous diseases.156 patients presented by acute ischemic stroke were divided into two groups: the first group included 78 ischemic stroke patients associated with different types of cancer and the second group (control group) included 78 ischemic stroke patients not associated with cancer. Both groups were compared regarding the risk factors, previous thrombotic activity, subtypes, biomarkers of stroke, and outcomes.Cancer patients presented by acute ischemic stroke were accompanied by a significantly less incidence of diabetes mellitus, hypertension, dyslipidemia, and coronary heart disease, and atrial fibrillation than non-cancer patients (P 0.001). While, levels of biomarkers of inflammation like erythrocyte sedimentation rate and C-reactive protein, and stroke biomarkers like fibrinogen, and D-dimer, all together were highly elevated in cancerous disease group of patients (P 0.01). The prevalence of deep vein thrombosis, pulmonary embolism, and myocardial infarction was significantly higher in patients with cancer than in control patients without cancer (P = 0.008, P 0.01 and P 0.01 respectively). The most common stroke etiologies were atherosclerosis of large arteries and stroke of undetermined cause in a cancerous group of patients. Cancer patients were accompanied by significant higher mortality rate (P = 0.005), and more disability as determined by mRS (P 0.005) CONCLUSIONS: Pathophysiology and mechanism of ischemic stroke in cancerous disease patients were due to different risk factors, biomarkers of stroke, and subtypes in comparison with non- cancerous cases.

Upon the demand of a private fish farmer, this study was applied to assess the influence of electro-fishing adopted by some Egyptian fish farmers on the fish welfare and quality. Therefore, a total of 60 Nile tilapia (Oreochromis niloticus) were sampled; from which 30 were stunned by electrofishing and the remainders by conventional fishing. Biochemical analysis (oxidative stress and energy status), meat quality based on total bacterial count (TBC) and pathological alterations were assessed. Biochemical analysis in both liver and muscle tissue showed that electro-stunned fish exhibited low oxidative stress and high energy status. Meat of electro-stunned fish showed an acceptable limit of TBC (Max. limit 107) while the histopathological examination revealed various tissue reactions. These were in the form of congestion in branchial, hepatoportal, brain and splenic blood vessels with edema in brain and pericardium. In addition, there was mild inflammatory reaction together with the presence of eosinophilic granular cells and perivascular melanophores aggregation in both branchial and muscular tissue. As a consequence of this work, we recommend the use of electrofishing method in Egypt after modifying the current tool by reducing applied voltage. Further studies and more optimization are needed to cover both fish farmers and animal welfare issues, and take in consideration the human safety precautions.

BACKGROUND: CD10 was initially recognised as a cell–surface antigen expressed by acute lymphoblastic leukaemias, and hence it’s early designation as Common Acute Lymphoblastic Leukemia Antigen (CALLA). Also, it has been proven to be reactive in various non-lymphoid cells and tissue and different types of neoplasms. AIM: To evaluate the immunohistochemical expression of CD10 in malignant thyroid neoplasms and different benign lesions and to assess whether CD10 can be used as a malignancy marker in thyroid pathology or not. MATERIAL AND METHODS: A total of 83 archived, formalin fixed, paraffin embedded tissue blocks of 83 cases of malignant thyroid neoplasms and different benign lesions. The samples were immunohistochemically analysed for CD10 expression. A p-value of less than 0.05 was considered statistically significant. RESULTS: CD10 was expressed in 91% of the studied malignant thyroid neoplasms and 58% of benign thyroid lesions. It was expressed in 26 of 28 (92.9%) conventional papillary carcinomas, ten of 10 (100%) follicular variants of papillary carcinoma, seven of nine (77.8%) minimally invasive follicular carcinomas, two of three (66.7%) widely invasive follicular carcinomas, and seven of 7 (100%) undifferentiated carcinomas, seven of 11 (66.7%) adenomatous nodules and eight of 15 (53.3%) follicular adenomas. No statistically significant correlations were detected between CD10 expression and patients’ age, sex, lymph node metastasis, tumour stage and capsular invasion. CONCLUSION: CD10 shows strong sensitivity (91.2%) and moderate specificity (42.3%) in the diagnosis of malignancy overall and shows strong sensitivity (86.4%) and moderate specificity (42.3%) in the diagnosis of malignancy in the follicular-patterned lesions. So, CD10 might be useful in differentiating malignant from benign thyroid lesions (good positive test) and in the diagnosis of follicular variant of papillary carcinoma.

Introduction: More than one third of travelers to developing countries report health problems when traveling. The Egyptian Ministry of Health reports the occurrence of 400 cases of malarial infection yearly among Egyptian travelers. This article aimed to assess the knowledge, attitude, and practice (KAP) of Egyptian travelers towards infectious diseases, vaccination, and malaria chemoprophylaxis. Methods: A survey was conducted at Cairo International Airport and included 1500 travelers. The questionnaire inquired about the travelers’ knowledge about infectious diseases at their destinations and their KAP regarding vaccination, malaria, and its prophylaxis. Results: Most travelers (68%) had poor knowledge, specifically; 90.2%, 85.6%, 88.5% did not know the endemic diseases at their destinations, the modes of disease transmission, or the protective measures against disease, respectively. Knowledge about malaria prevalence, symptoms, modes of transmission, and prevention was good in only 18%, 29.8%, 6.7%, and 21.4% of travelers, respectively. Poor practice of malaria prophylactic measures was found in 66.3% of travelers. Although 91.3% did not receive any vaccination, the general attitude towards vaccination was good. The total travel health knowledge, practice, general attitude toward vaccination, and the perceived benefits of malarial prophylaxis scores were significantly correlated with older age and high socioeconomic level. Most of the studied travelers (90.4%) did not carry or use malaria chemoprophylaxis. Ignorance was the main barrier to receiving vaccines (65.3%) and to adherence to malaria chemoprophylaxis (88.3%). Conclusion: Egyptian travelers have poor travel health knowledge and practices. Their knowledge and practice scores improve with older age, urban residence, and higher educational levels. They have a good attitude towards vaccination, and ignorance was the main barrier to sound practices.

Background: This study was designed to measure the prevalence of chronic gingivitis among 16- year-old public high school students in Khartoum State.Methods: A total of 385 high school students of 16 years of age, from public schools in different geographical locations representing different socioeconomic classes in Khartoum were randomly selected and examined. The variables of the present study had been collected by one examiner using a direct interview questionnaire and all the present teeth were examined at four sites (Mesiobuccal, distobuccal, mesiolingual, distolingual) for the presence of plaque, using the Plaque Index (Loe and Sillness) and Gingival Index (Sillness and Loe).Results: Prevalence of gingivitis was 96.9%, of which 68.6% were of mild form (majority), 27.5% of moderate condition and only 0.8% was of severe grade. The most common form of gingivitis was the generalized form that accounted for 94.5%. The relationship between oral hygiene and degree of gingivitis was assessed after collecting data on study area, gender, socio-economic status, tooth brushing tool used, frequency of brushing per day, direction of tooth-brushing and regularity of dental visits. The adjusted relationship was still significant at the 99% confidence level (p-value 0.000), with a correlation coefficient of 0.704.Conclusions: The study showed significantly higher prevalence of chronic gingivitis among 16-year-old public high school students in Khartoum State. The degree of gingivitis showed statistical significance when correlated with oral hygiene status, socioeconomic status, frequency and horizontal direction of tooth brushing, while it showed insignificance when correlated with gender. Med Phoenix. Vol. 3, Issue. 1, 2018, Page : 1-5

OBJECTIVES Vitamin D deficiency is rarely considered or treated in critically ill patients. Deficiency of 25-hydroxy vitamin D [25(OH)D] prior to hospital admission might be a significant predictor of short- and long-term all cause patient mortality in a critically ill patient. The aim of this work is to investigate the prevalence of vitamin D deficiency in hospitalized patients and its relation to the length of stay and outcome of hospitalization. METHODS Prospective cohort study performed on 80 patients admitted with acute deterioration of their chronic illness. Four groups of diseases were included, namely, chronic liver diseases (CLD), chronic obstructive pulmonary diseases (COPD), cerebrovascular stroke (CVS), and heart failure (HF). The patients were followed up until their discharge, or transfer, or death. Patients were sampled for their vitamin D level on admission and were divided according to their vitamin D status into sufficient, insufficient, and deficient. Statistical methods and analysis of the present study were conducted using the SPSS V17 program. RESULTS Vitamin D level had a significant inverse correlation with length of hospital stay (r = -0.648) (p < 0.001). In vitamin D-deficient and -insufficient groups, there was a significant difference between survivors and nonsurvivors as regards vitamin D levels and an inverse correlation between vitamin D level and outcome of hospital admission. CONCLUSIONS Vitamin D deficiency and insufficiency are significantly associated with a longer hospital stay and a poor outcome of hospital admission in comparison to control.

Aim: This cross-sectional study was conducted from April to July 2012 in Khartoum state, Sudan, to determine the seroprevalence of brucellosis in goats and to investigate potential risk factors associated with this disease. Materials and Methods: A total of 307 serum samples were collected from both sexes of goats in four different localities and were subjected to testing for brucellosis using rose bengal plate test (RBPT), serum agglutination test (SAT), and competitive enzyme-linked immunosorbent assay (cELISA). Results: The overall seroprevalence was 11.4% (n=35) with a 95% confidence interval (CI) ranging from 7.80 to 15.0. Out of these 35 RBPT-positive samples, the positivity of 18 and 17 were confirmed by SAT and cELISA, respectively. A significant statistical variation was observed between brucellosis seroprevalences in goats purchased from local animal markets and goats that were raised at the farm. Conversely, such significant variations were not observed among the categories of other risk factors with seroprevalences ranging from 3.0% (95% CI between 0.40 and 7.20) to 16.3% (95% CI between 10.4 and 22.3). Location (χ2=9.33, df=3, p=0.02), breed (χ2=3.52, df=1, p=0.05), herd size (χ2=6.59, df=2, p=0.03), and herd expansion (χ2=5.39, df=1, p=0.02) were associated with RBPT-positive status for brucella in the two-tailed Chi-square test. In addition, Sharq an-Nil locality and goats raised at the farm had increased odds of being RBPT positive. Conclusion: Brucellosis was detected in goats in all surveyed localities. An effort should be made to educate goat owners/herders about brucellosis as well as about the importance of vaccination.

Introduction: Travel health practice and research in Egypt lag behind both needs and demands. This study was done in two parts to assess travel health knowledge, attitude, and practice (KAP) among Egyptian travelers. Methods: This survey was conducted at the departure halls of Cairo International Airport and included 1500 travelers to Africa (excluding North Africa), Southeast Asia, and Latin America. An interview questionnaire was used to measure the KAP of travelers inquiring about different aspects of pre-travel health. Subjective evaluations of travel health services and suggestions for improvement were also solicited. Results: Travelers in this study were mainly males (89.3%), less than 40 years of age (82%), living in urban residences (89.1%), married (65.9%), university educated (83.3%), traveling for work (69.1%) with destinations of Africa (61.3%), Asia (28.4%), and Latin America (10.3%). They had poor travel-associated risk perception, and only 13.4% had risk management plan. Less than half (42.4%) sought information about their destination, and 11.9% sought health information; their source of information was mainly the internet (98.7%). The majority had poor scores on various travel-related practices, including seeking pre-travel health services (87.9%), receiving pre-travel vaccines (91.3%), and using malaria chemoprophylaxis (90.6%). The travel health services were rated good by 0.5% of travelers and bad, very bad, or undetermined by 11.4%, 61.3%, and 26.9% respectively. Conclusion: Egyptian travelers, although mostly educated, had poor travel health perceptions and practices and are unsatisfied with the travel health services in Egypt.

The aim of this study is to differentiate recurrent/residual gliomas from postradiation changes using arterial spin labeling (ASL) perfusion and diffusion tensor imaging (DTI)-derived metrics. Prospective study was conducted upon 42 patients with high-grade gliomas after radiotherapy only or prior to other therapies that underwent routine MR imaging, ASL, and DTI. The tumor blood flow (TBF), fractional anisotropy (FA), and mean diffusivity (MD) of the enhanced lesion and related edema were calculated. The lesion was categorized as recurrence/residual or postradiation changes. There was significant differences between residual/recurrent gliomas and postradiation changes of TBF (P = 0.001), FA (P = 0.001 and 0.04), and MD (P = 0.001) of enhanced lesion and related edema respectively. The area under the curve (AUC) of TBF of enhanced lesion and related edema used to differentiate residual/recurrent gliomas from postradiation changes were 0.95 and 0.93 and of MD were 0.95 and 0.81 and of FA were 0.81 and 0.695, respectively. Combined ASL and DTI metrics of the enhanced lesion revealed AUC of 0.98, accuracy of 95%, sensitivity of 93.8%, specificity of 95.8%, positive predictive value (PPV) of 93.8%, and negative predictive value (NPV) of 95.8%. Combined metrics of ASL and DTI of related edema revealed AUC of 0.97, accuracy of 92.5%, sensitivity of 93.8%, specificity of 91.7%, PPV of 88.2%, and NPV of 95.7. Combined ASL and DTI metrics of enhanced lesion and related edema are valuable noninvasive tools in differentiating residual/recurrent gliomas from postradiation changes.

Radioembolization has gained wide acceptance as a safe and efficient treatment for unresectable liver-dominant metastatic colorectal cancer. In this comprehensive article, we focus on clinical outcomes and dosimetry models in the era of personalized medicine.

Objective: This cross-sectional study was conducted from July to November 2015 to estimate the prevalence of anti-toxopalsma antibodies in sheep and goats in El-Gadarif state. Material and methods: A total of 400 serum samples comprising of 200 sheep and 200 goats were collected and tested by Toxo-latex agglutination test and indirect enzyme linked immunosorbent assay (iELISA). Results: The overall sero-prevalence was 52.0% (n=208/400) using Toxo-latex agglutination test and 45.7%(n=42/92) and 27.2%(n=25/92) using iELISA in sheep and goats, respectively. Furthermore, the sero-prevalences among the two investigated species and the two age groups were statistically similar but were different between localities, breeds and sexes. In the univariate analysis, species (P=0.028) and locality (P=0.001) were associated with Toxo-latex agglutination test positive status. Additionally, species (sheep) and locality (Al-Fao, Al-Hawatah, and West El-Gadarif) had increased odds of being Toxo-latex agglutination test positive in the multivariate analysis. Conclusion: It can be concluded that the prevalence of anti-toxopalsma antibodies is relatively high and there was no between-species variation in sero-positivity. These findings warrant further investigations to estimate the burden of the disease and the likelihood of zoonotic transmission. http://doi.org/10.5455/javar.2017.d205 XML PubReader

In its most recent guidelines for management of small renal tumors, the American Urological Association identified percutaneous thermal ablation as an alternative therapy for tumors smaller than 3 cm in selected patients. Ablative therapies can be thermal (heat-based or cold-based) or nonthermal (irreversible electroporation).The technologies most widely used in clinical practice for ablation of renal tumors are radiofrequency ablation and cryoablation. Microwave, irreversible electroporation, laser, and high-intensity focused ultrasound technologies are in various stages of experimental or early clinical application for treating renal tumors. In this chapter, we briefly discuss specific ablation devices that are commonly used to treat renal cell carcinoma. Our main focus is a review of indications, contraindications, technique, complications, follow-up care, and outcomes of percutaneous ablation of renal cell carcinoma.

Background Diabetic retinopathy (DR) refers to the ocular effect of diabetes. It is one of the retinal vascular diseases that can cause loss of vision. DR leads to alterations in vascular networks, including angiogenesis and capillary regression. Objective The objective of this research is to provide an effective robust and accurate automatic methodology for the early detection of DR subjects. The methodology depends on two steps: 1) Blood vessel reconstruction, enhancement, and re-continuity using written custom programs, and 2) An Artificial Neural Network (ANN) as an automatic classifier between the diabetic without diabetic retinopathy (DR) and the Mild to Moderate Non-Proliferative Diabetic Retinopathy (NPDR) subjects. Methods This approach depends on extracting the seven features, which are the most changeable features according to the morphological retinal vascular network changes. These features are the mean of the intercapillary areas as regions of interest for the largest 10 and 20 selected regions, either including or excluding the Foveal Avascular Zone (FAZ) region, FAZ perimeter, circularity index, and vascular density. The OCTA images were obtained and approved by the Ophthalmology Center in Mansoura University-Egypt. Results One hundred images were processed, distributed as follows: 40 eyes were normal, 30 eyes were diabetic without DR, and 30 eyes were NPDR subjects. The total system accuracy reached 97%. The performance parameters of the classification system for normal versus diabetic were 97.5% for sensitivity, 96.67% for specificity, and 95.2% for precision. While, the measures for a diabetic without DR versus non-proliferative DR (mild to moderate) were 96.67% for sensitivity, 96.67% for specificity, and 96.67% for precision. The maximum misclassification error was 3.33%. Conclusion The proposed methodology is capable of accurate classification of the diabetic without DR and Non-proliferative diabetic retinopathy subjects. This methodology depends on using written custom programs and a plugin for MATLAB and Fiji based Image-J software with a supervised artificial neural network. This technique achieves high accuracy, resolution, specificity, and precision with only a short time needed for diagnosis.

Tilmicosin (Til), an effective macrolide antibiotic, is widely used against respiratory diseases in livestock; however, its treatment is associated with cardiac tissue impairments. In this study, the ethanolic extract of Moringa oleifera (MO) leaves was investigated at two doses (400 and 800 mg/kg body weight [bw], orally) to determine its role in counteracting the effects of Til treatment (75 mg/kg bw) on the cardiac tissue in rats, exploring the oxidative stress-mediated damage and apoptosis. A high dose of MO ethanolic extract elicits considerable changes in the body weight, reduces the mortality rate, neutralizes the impaired cardiac injury markers, improves antioxidant endpoints (total antioxidant capacity, superoxide dismutase, catalase activity, and reduced glutathione level). Also it attenuates the oxidative stress indices (total reactive oxygen species, 8-hydroxy-2-deoxyguanosine, lipid peroxides [malondialdehyde], and protein carbonyl levels) that are associated with Til injection. The co-administration of MO ethanolic extract with Til considerably modulates the expression of apoptosis pathway-encoding genes (Bcl-2, caspase-3, Bax, p53, apoptosis-inducing factor, and Apaf-1), particularly in the high-dose group. Our results support that the concurrent administration of MO ethanolic extract with Til at a dose of 800 mg/kg bw increases the protective activity of the antioxidant system and delays or slows the pathological development of cardiotoxicity mediated by Til injection.

The aim of this review was to review the basic background, technique, and clinical applications of arterial spin labeling in brain tumors. Arterial spin labeling is used for differentiation of brain tumors from nonneoplastic lesions such as infarction and infection. It has a role in the grading of gliomas and in the differentiation of gliomas from lymphomas and metastasis. It is used for detection of the best biopsy site and prediction of treatment response. Arterial spin labeling is used for the assessment of extra-axial tumors and pediatric tumors. Last, it has a role in the differentiation of tumor recurrence from postradiation changes and in monitoring patients after therapy.