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PURPOSE:: The electric activity of the corpora cavernosa (CC) is recorded by needle electrodes introduced into the CC. We investigated the hypothesis that transcutaneous electrocavernosography (ECG) would register electric waves similar to those recorded by the needle ECG but noninvasively.MATERIALS AND METHODS:: The ECG was recorded transcutaneously in 35 healthy volunteers (mean age 37.6 ± 4.8 SD years). Two silver-silver chloride electrodes were applied on the dorsum of the penis over 1 of the CC. A reference electrode was applied to the thigh. Intracavernosal ECG using 2 needle electrodes introduced into the CC was performed in the same subjects. At least two 20 minutes sessions were recorded for each subject.RESULTS:: Slow waves (SWs) were registered transcutaneously. The waves from the 2 electrodes in each individual had the same frequency, amplitude and conduction velocity. They had a regular rhythm and were reproducible. The SWs were followed or superimposed by action potentials which occurred randomly. The transcutaneously recorded SWs were confirmed by the intracavernous route. Both routes had similar ECG recordings.CONCLUSIONS:: The study demonstrated that the transcutaneous ECG recorded electric waves similar to those registered by the intracavernosal route. The transcutaneous ECG is simple, easy, non-invasive, and may be included as an investigative tool in the diagnosis of erectile dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy. Material and methods: In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure. Results: There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively). Conclusions: Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently. [ABSTRACT FROM AUTHOR]

Background: Of all the hernia varieties, groin hernias are the most prevalent. A gap in the endo-abdominal fascia known as an inguinal hernia is large enough to allow the evacuation of intraperitoneal or preperitoneal contents into the groin. Aim of study: To evaluate various hernia sac management strategies either sac transacted or sac reduction regarding feasibility and complications if both hernia repair is done laparoscopically using the Trans Abdominal Pre-Peritoneal (TAPP) surgery. Patients and methods: A randomised controlled clinical trial was conducted for this study at Zagazig University Hospitals' General Surgery Department through the period from Jul 2022 to Jan 2023. This study included 24 adult candidates for indirect inguinal hernia repaired laparoscopically with transabdominal preperitoneal repair of inguinal hernia sac. Potential patients with indirect inguinal hernias that need laparoscopic transabdominal preperitoneal repair were classified into two groups. Group (A): Underwent indirect hernia sac transection and group (B) that underwent complete sac reduction. Results: The post-operative problems did not alter noticeably (scrotal edoema). In terms of post-operative pain, group A had statistically significantly higher mean pain at 12 hr post-operative. In relation to postoperative hospitalisation, there was no statistically significant difference between the study groups. Scrotal edema in group A at follow-up was 24.9%, compared to 8.3% in group B without statistical significance while recurrence was reported in 16.7% of the patients among group A and 8.3% with group B. Conclusion: Full sac reduction and hernia sac transection are both dependable and safe procedures. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study is to evaluate the correlation between the level of serum oestradiol (E2) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome. Material and methods: This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E2 level on the day of hCG administration: Group A - serum E2 < 1000 pg/ml; Group B - serum E2 1000 to < 2000 pg/ml; Group C - serum E2 2000 to < 3000 pg/ml;Group D - serum E2 3000 to < 4000 pg/ml; Group E - serum E2 = 4000 pg/ml. Results: The highest fertilization rate (58.1%) was among women with E2 = 4000 pg/ml, while the lowest (37%) was in women with E2 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E2 > 4000 pg/ml, while the lowest (5.3%) was in women with E2 < 1000 pg/ml. In the current study the median serum E2 level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E2 at hCG administration was = 3682.3 pg/ml. Conclusions: this study suggests that the optimal range of E2 level for achieving a successful pregnancy is > 4000 pg/ml. [ABSTRACT FROM AUTHOR]

This study hypothesized that resveratrol, a silencing information regulator 1 (SIRT1) activator, would counteract the inflammatory signaling associated with radiotherapy-induced premature ovarian failure (POF). Immature female Sprague–Dawley rats were subjected to a single dose of γ-radiation to induce POF and treated with resveratrol (25 mg/kg) once daily for two weeks before and three days post irradiation. Resveratrol preserves the entire ovarian follicle pool manifested by increasing serum anti-Müllerian hormone (AMH) levels. Radiation triggered inflammatory process in the ovary through enhanced NF-κB and poly(ADP-ribose) polymerase (PARP)-1 expression which convinced the expression of inflammatory markers including IL-6, IL-8, and visfatin mRNA levels, as well as inducible nitric oxide synthase and cyclooxygenase-2 protein expression with a concomitant reduction in IL-10 mRNA levels. Resveratrol significantly counteracted the effect of radiation and upregulated the gene expression of peroxisome proliferator-activated receptor γ (PPAR-γ) and SIRT1. Resveratrol-activated SIRT1 expression was associated with inhibition of PARP-1 and NF-κB expression-mediated inflammatory cytokines. Our findings suggest that resveratrol restored ovarian function through increasing AMH levels, and diminishing ovarian inflammation, predominantly via upregulation of PPAR-γ and SIRT1 expression leading to inhibition of NF-κB provoked inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Backgrounds and Aims. The benefit of lateral pelvic lymph node dissection (LPLD) for rectal cancer remains controversial. The aim of this study was to assess the incidence of local recurrence between patients who underwent total mesorectal excision (TME) with and without LPLD in rectal cancer. Patients and Methods. The study was conducted on 92 patients presenting with extraperitoneal rectal cancer (T3 and T4) in the colorectal department at our hospital. Patients were divided into two groups: Group A was subjected to total mesorectal excision (TME) after neoadjuvant chemoradiation and Group B was subjected to TME with LPLD with autonomic nerve preservation. Patients were followed up for the incidence of local recurrence, distant recurrence, and urinary and sexual dysfunctions. Results. Incidence of local recurrence was slightly higher in Group A (8.7%) than in Group B (4.3%) but was not statistically significant. There was no statistical significance between both groups regarding distant metastasis (8.7% in Group A and 13% in Group B). Urinary and sexual dysfunctions were higher in Group B (26.1%) compared to those in Group A (21.7%) but were not statistically significant. The incidence of lateral pelvic lymph node metastasis was 30.4%. Also, intraoperative blood loss was higher and operative time was longer in Group B which was statistically significant (P value

Background: Incisional hernia is one of the most common types of the ventral hernia. It nearly complicates 4-18% of abdominal operations within 5 years follow up. In women with pendulous abdomen, a combined hernio-abdominoplasty anticipated to improve the cosmoses as well as life quality. As it is expected to reinforce the muscular bending, improve intertrigo, stead lumbar spine and decrease the postoperative drawbacks. Objective: The aim of this study is to enhance the result of incisional hernia repair and to compare the outcome of combined hernio-abdominoplasty and hernioplasty of incisional hernia in obese female with lax redundant abdomen. Patients and Methods: The present study was carried out at Zagazig University Hospitals, in the period between March 2021 and June 2022, on 80 multiparous women admitted for incisional hernia repair. Patients were divided randomly into two equal groups, the first group (A) included 40 patients corrected by hernioplasty alone, while the second group (B) corrected by concomitant hernioplasty and abdominoplasty. Results: Both time of operation and hospital stay were significantly more in the group (B). However, recurrence, infection, intertrigo, abdominal deformity and need for refashioning, were significantly complicate the patients of group (A). Although, hematoma and seroma were more common in group (B) yet, without significant difference, and the quality of life was highly improved in this group. Conclusion: A combined hernio-abdominoplasty of incisional hernia in female with pendulous abdomen, significantly improves the esthetic results and the quality of life, and can also decrease the postoperative complications. [ABSTRACT FROM AUTHOR]

Abstract Background New onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. Cluster seizures (CS) or status epilepticus (SE) can be the first manifestation of epilepsy or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome. This study aims to determine the etiology of CS and SE in NOS among adult Egyptians. One hundred twenty adult Egyptian patients presented with NOS were enrolled in a hospital-based cross-sectional observational study within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination including mini mental status examination, laboratory, neuroimaging, and electroencephalogram. Results Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (> 55 years) were prevalent (60%). Of the patients, 25% presented by CS, while 11% presented by SE. Post-stroke epilepsy (41%) was the predominant etiology of NOS. Cerebrovascular diseases (CVDs) were the prevalent etiology of SE in NOS (35%). NOS presented by CS were more prevalent among patients with brain tumors (29%) in comparison to CVDs (25%). Conclusion CS represented 25% of NOS in adult Egyptian patients. SE is prevalent among 11% of NOS. Despite CVDs being the most prevalent etiology of NOS in adult population (41%) including those presented with SE (35%), brain tumors are the most prevalent etiology of new onset CS (29%).

Abstract Background New-onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. A first-ever seizure can be the first manifestation of epilepsy. Or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome that deserves special attention and treatment. This study aims to identify the etiology of NOS among different age and sex groups of adult Egyptian patients. A hundred and twenty adult Egyptian patients (> 18 years) presented with acute NOS were enrolled in a hospital-based cross-sectional observational study from the emergency room and neurology outpatient clinics of our hospitals within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination, laboratory, neuroimaging, and electroencephalogram investigations. Results Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (age group > 55 years) were the most prevalent cohort (60%). Cerebrovascular diseases (CVDs) were the most common identified etiology of NOS (44.17%), followed by idiopathic epilepsy syndrome (18.33%), symptomatic mainly “metabolic” (11%), brain tumors (9.17%), post-traumatic epilepsy (6.67 %), encephalitis (5.83%), and cryptogenic (5%). Idiopathic epilepsy syndrome was the most common etiology (55.56%) of new-onset seizures among the young adult age group ( 55 years). Also, CVDs were the most common etiology among males (43.4%) as well as females (45.4%). However, male predominance was the highest among post-traumatic seizures (87.5%). And female predominance was the highest among brain tumors identified etiology of NOS (54.5%). Conclusion NOS among adults are prevalent in elder males. CVDs are the most commonly identified etiology of adult NOS across males and females. Idiopathic epilepsy syndromes are the predominant etiology among younger adults.

Highlights: [•] Sodium selenite stimulates in vivo folliculogenesis and ovarian follicles proliferation. [•] Sodium selenite elicited anti-oxidant and anti-apoptotic effects against radiation-induced ovarian damage. [Copyright &y& Elsevier]

AIM: To detect the quantitative expression levels of the pro-inflammatory interleukin-8 (IL8), antimicrobial peptides human beta defense-2 (HBD2), and human beta defense-3 (HBD3) genes in bacterial conjunctivitis. METHODS: The human conjunctival epithelial cells were obtained using the impression cytology technique from healthy controls and patients. The genes expression levels were determined utilizing a reverse transcription quantitative polymerase chain reaction (RT-qPCR). The contribution of causative agent type, the number of isolates and severity of clinical features, in the increase of genes expression was also determined. RESULTS: The RT-qPCR showed that IL8, HBD2, and HBD3 expression increased in bacterial conjunctivitis as compared to healthy control (P

Abstract Background Atherosclerotic intracranial arterial stenosis (ICAS) is one of the most common causes of stroke worldwide and is associated with a high risk of recurrent stroke. Patients with a recent transient ischemic attack (TIA) or stroke and severe stenosis (70 to 99% of the diameter of a major intracranial artery) are at particularly high risk for recurrent stroke in the territory of the stenotic artery (approximately 23% at 1 year) despite medical treatment. Therefore, alternative therapies are urgently needed for these patients. Objective To determine the efficacy and safety of angioplasty with stenting in medically refractory ICAS and to compare its effectiveness with optimal medical treatment. Subjects and methods Fifty patients with symptomatic ICAS despite medical treatment (i.e, recurrent stroke or TIA) were enrolled and equally randomized in a prospective study where twenty-five patients underwent angioplasty with stenting and twenty-five patients received optimal medical treatment. Clinical assessment with NIHSS and mRS were done at 0, 3, and 6 months, and transracial Doppler (TCD) assessment of ICAS was done at 0 and 3 months after treatment. Results The interventional group had a better clinical outcome with mean NIHSS scores (5.2 ± 4.2, 4.43 ± 4.28 and 3.9 ± 4.7) at baseline, 3 and 6 months, respectively, in comparison to the medical group with mean NIHSS (4.5 ± 4.2, 11.42 ± 6.3, and 8.5 ± 5.1) and better functional outcome with mean mRS scores (1.3 ± 0.96, 1.2 ± 1.13, and 1.0 ± 1.13) at baseline, 3 and 6 months, respectively, in comparison to the medical group (0.84 ± 0.75, 2.28 ± 1.2, and 2 ± 1.24). TCD assessment of ICAS showed a marked reduction of the percentage of stenosis on 3 months of follow-up among the interventional groups (only 5.6% had > 70% stenosis) in comparison to the medical group (85.7% had > 70% stenosis). Recurrent ischemic events on 6 months of follow-up were 16% among interventional groups in comparison to 84% among medical groups. The mortality rate was 8% among interventional groups due to subarachnoid hemorrhages (SAH) related to procedure in comparison to 28% among medical groups secondary to ischemic events. The intraoperative success rate was 96% with the failure of stent deployment in 1 patient due to the tortuous anatomy of vessels. Early post interventional complication rate, i.e, SAH was 8%. Late post interventional restenosis and occlusion rates were 8% on 3 months of follow-up. Conclusion Endovascular stenting of medically refractory ICAS is more efficacious and effective with better clinical and functional outcomes than optimal medical treatment; however, its safety is still debatable. Trial registration Done at ClinicalTrials.gov . Trial ID (NCT Number) NCT04393025 .

Background and Aims: Ipsilateral shoulder pain (ISP) post-thoracotomy impairs the recovery in early postoperative period, the aetiology of which is unclear. We studied to find out the incidence and risk factors associated with ISP., Methods: We did a prospective observational study, wherein 296 patients scheduled for thoracic surgeries were enroled. Pain in the shoulder during activity was assessed using American Shoulder and Elbow Surgeons standardised assessment method. All potential predictors were analysed in a multivariable penalised logistic regression model, using ISP as the outcome variable., Results: Of the 296 patients, 118 (39.8%) patients developed ISP. Of the 296 patients, 170 patients underwent thoracotomy and 110 underwent video-assisted thoracoscopic surgeries. The incidence of ISP was higher in thoracotomy patients (45.29%) compared to video-assisted thoracoscopic surgeries (32.7%). Majority of patients (43.2%) were aged more than 65 years, which was statistically significant as per univariate analysis ( P = .007). The incidence of ISP was the highest at 41.89% among those who had lung cancer (n = 74), with disease involving right upper lobe and left upper lobe, 29% and 25.8%, respectively. The pain severity was moderate in 27.1% of patients during shoulder movements. Among the patients who had ISP, 77.1% expressed it as dull aching, whereas 21.2% described it as stabbing in nature., Conclusion: The incidence of ISP in those who underwent thoracic surgery was high and dull aching in nature, of mild to moderate intensity, commonly located on the posterior aspect of the shoulder. It was more common in those who underwent thoracotomy and more than 65 years of age., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Anaesthesia.)

Aim: To determine whether the novel method is successful in blocking both ilioinguinal nerves to lessen postoperative pain following caesarean surgery., Materials and Methods: Between January 2022 and January 2023, 300 patients were enrolled in this study at the Obstetrics and Gynaecology Departments of the Faculty of Medicine at Al-Azhar University. About 150 of these patients received bupivacaine infiltration on both sides close to the anterior superior iliac spine, and 150 received a normal saline injection at the same locations., Results: The study compared the two groups and discovered significant differences in the timing of analgesic requests, interval before the patient's first ambulation, length of hospital stay, postoperative pain score, and incidence of postoperative nausea and vomiting, with group A performing better., Conclusion: After a caesarean section, the local anaesthetic "bupivacaine" injection used to block the ilioinguinal nerves bilaterally is an efficient way to lessen postoperative discomfort and analgesic use.

Bench-scale and pilot-scale experiments were conducted in an outdoor environment to study the ability of some plant species in dewatering of sewage sludge collected from biological activated sludge treatment. In the bench-scale experiments, four types of plants were tested, including water hyacinth (Eichhornia crassipes), common reed (Phragmites austuralis), Samar (Cyperus alopecuroides), and El Nesila (Panicum echinochloa). Sludge dewatering in the plant reactors was compared with that in the control reactors (no plants). The bench-scale experiments were conducted in reactors with capacities of 17 L. All plants showed a growth in the sewage sludge matrix. High dewatering efficiencies of sewage sludge were obtained with the use of each type of plant, as compared with those in the controls. Among other plants tested in the current study, water hyacinth proved to have the highest dewatering efficiency and was selected for further testing in a pilot-scale experiment. Two identical drying beds were constructed as a pilot-scale, each with its own multi-layered underdrainage system. The plants were added to one of the beds while the other bed served as a control. The pilot study showed that the use of water hyacinth in conventional sludge drying beds can triple the sludge dewatering capacity of these beds. In addition, the quality of the dewatered sludge was also improved compared with that found in conventional drying beds.

Objectives: The development of abnormal glucose tolerance in β-thalassemia major (β-TM) is associated with alterations in the oxidant-antioxidant status. Zinc is an antioxidant and an essential element for insulin synthesis, storage, and secretion. This randomized controlled trial assessed the effect of oral zinc supplementation on glucose homeostasis in pediatric β-TM patients complicated with diabetes mellitus (DM)., Methods: Eighty patients were randomly assigned into two groups: an intervention group that received oral zinc in a dose of 40 mg/d for 12 wk and a placebo group. Hemolysis markers, serum ferritin, fasting blood glucose (FBG), fructosamine, fasting C-peptide, urinary albumin excretion (UAE), and serum zinc levels were assessed. Homeostasis model assessment insulin resistance index (HOMA-IR) was calculated., Results: Baseline clinical and laboratory parameters were consistent among both groups. Baseline zinc levels were decreased in both groups compared with control values. After 12 wk, supplementation with zinc for the intervention group resulted in a significant decrease in lactate dehydrogenase, serum ferritin, FBG, fructosamine, HOMA-IR, and UAE, whereas fasting C-peptide was higher compared with baseline levels and with the placebo group (P < 0.05). Baseline serum zinc was negatively correlated to FBG (r = -0.534, P < 0.001) and fructosamine (r = -0.555, P < 0.001) but positively correlated to fasting C-peptide (r = 0.777, P = 0.002)., Conclusions: Zinc supplementation as an adjuvant therapy in β-TM patients with DM reduced iron burden, decreased hyperglycemia, increased insulin secretion, and improved glycemic control without any adverse effects., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: Comparing the clinical efficacy of Abobotulinumtoxin A (ABO) and Onabotulinumtoxin A(ONA) using a dosing ratio of 2.5U:1.0U in the treatment of crow's feet wrinkles., Subjects and Methods: A single-blinded, randomized, split-face study, included 40 subjects, with moderate-to-severe crow's feet wrinkles. Patients were subjected to a dose equivalence of (ABO):(ONA); 2.5:1.0 U. Post treatment evaluation was done on 7, 30, and 120 days, comparing: Time, Duration, and Degree of Improvement; Patients Satisfaction., Results: No significant difference was found between ABO & ONA regarding duration and time to improvement on static posture. While on dynamic posture, ABO showed significantly less time and longer duration. Both products produced highly significant improvement of the wrinkles' severity on both static and dynamic posture in comparison to the baseline severity. Satisfaction was more with ABO., Conclusion: ABO is a safe, effective alternative to ONA in treating crow's feet wrinkles.

Background: Micronutrient deficiencies among pregnant women are widespread in low-income countries, including Egypt. Iron deficiency anemia (IDA) is the most frequent nutritional deficiency during pregnancy, with an impact on maternal and fetal morbidity and mortality. We aimed to evaluate the effect of maternal IDA and nutritional status on birth anthropometry, cord blood iron profile and breast milk micronutrients in 50 anemic (hemoglobin <11 g/dl) and 30 healthy pregnant women., Procedure: Maternal and neonatal anthropometric measures were recorded. Hemoglobin, red blood cell (RBC) indices, and indices of iron nutriture were measured in maternal and cord blood. Breast milk minerals; iron, copper, zinc, calcium, and magnesium were assessed., Results: Hemoglobin, RBC indices, and iron profile showed significant differences in the neonates born to anemic mothers compared to controls, particularly in moderate to severe anemia and linear correlations with maternal hemoglobin, iron, and ferritin levels were found (P < 0.01). Anthropometric measurements of anemic mothers and their neonates were positively correlated (P < 0.05). Breast milk micronutrients were significantly reduced in all anemic mothers showing significant relations with maternal serum iron (P < 0.01)., Conclusions: Maternal IDA wields a significant influence on maternal and fetal nutritional status. IDA during pregnancy adversely affects both cord blood iron and breast milk mineral status, particularly in moderate to severe anemia and concurrent micronutrient deficiencies occur in maternal IDA. Further investigations including larger population of pregnant women with severe anemia are needed to verify the nutritional interrelation between maternal anemia and breast milk mineral status., (Copyright © 2011 Wiley Periodicals, Inc.)