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The Seven Countries Study showed that traditional Japanese and Mediterranean diets are protective against cardiovascular diseases (CVDs). The Japanese diet is considered the healthiest because it provides Japanese populations with the highest longevity and health. DASH and Mediterranean-style diets are also considered healthy diets, although the Indo-Mediterranean-style diet may provide better protective effects among patients with CVDs compared to other diets. The concept of the Indo-Mediterranean type of diet was developed after examining its role in the prevention of CVDs in India, the value of which was confirmed by a landmark study from France: the Lyon Heart Study. These workers found that consuming an alpha-linolenic acid-rich Mediterranean-style diet can cause a significant decline in CVDs and all-cause mortality. Later in 2018, the PREDIMED study from Spain also reported that a modified Mediterranean-style diet can cause a significant decline in CVDs, type 2 diabetes mellitus (T2DM), and cancer. The Indo-Mediterranean diet may be superior to DASH and Mediterranean diets because it contains millets, porridge, and beans, as well as spices such as turmeric, cumin, fenugreek, and coriander, which may have better anti-inflammatory and cardioprotective effects. These foods are rich sources of nutrients, flavonoids, calcium, and iron, as well as proteins, which are useful in the prevention of under- and overnutrition and related diseases. It is known that DASH and Mediterranean-style diets have a similar influence on CVDs. However, the Indo-Mediterranean-style diet may be as good as the Japanese diet due to improved food diversity and the high content of antioxidants.

While a consensus has emerged on the importance of creativity in graphic design and multimedia field, little systematic research has attempted to understand its facilitators or inhibitors in the graphic and multimedia education across colleges and universities. The current investigation surveys a sample of experts as well as professors teaching across the Arab World concerning their perceptions on the most significant correlates of creative thinking among students. Results point to the importance of: (1) instructors’ engagement; (2) appropriate use of instructional strategies, tools, and resources; (3) institutional support; (4) peer support; and (5) the removal of red-tape regulatory frameworks. Most importantly, this research highlights the need to move away from the rigid higher education creativity model assuming perfection, precision, accuracy, and optimal effectiveness to a more flexible creativity framework. The Multi-Layered Autonomous Phases Model (MLAPM) is proposed as an alternative approach to cultivating creativity at the higher education level. The MLAPM applies to all levels beginning with the students and the instructor in the classroom and all instructional tools applied, moving upward to the institutional administration levels. The model offers cost-effective, flexible, dynamic, and effective practices that improve levels of creativity and creative thinking among students without the need to invest in new costly equipment, tools, curriculum, or instructional programs.

Chronic heart failure (CHF) has different stages and includes pre-HF (PHF), a state of high risk of developing myocardial dysfunction and advanced CHF. Some major behavioral risk factors of PHF might predispose to biological risk factors such as obesity, diabetes mellitus, dyslipidemia, hypertension, myocardial infarction, and cardiomyopathy. These risk factors damage the myocytes leading to fibrosis, apoptosis, cardiac hypertrophy, along with alterations in cardiomyocyte' size and shape. A condition of physiological subcellular remodeling resulting into a pathological state might be developed, conducting to PHF. Both PHF and heart failure (HF) are associated with the activation of phospholipases and protease, mitochondrial dysfunction, oxidative stress and development of intra-cellular free Ca

Background Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) can be used as an imaging-based liver function test. This study aims to further corroborate its validity. Purpose To compare Gd-EOB-DTPA-enhanced MRI as an imaging-based liver function test with the 13C-methacetin breath test. Material and Methods Fifty-three patients who underwent Gd-EOB-DTPA-enhanced MRI T1 relaxometry before and 20 min after intravenous Gd-EOB-DTPA administration as well as a 13C-methacetin breath test (LiMAx test) were retrospectively analyzed. T1 relaxation times of liver parenchyma, total liver volume (TLV), and functional liver volume (FLV) were determined. Pearson correlations, multiple linear regression analysis, and receiver operating characteristic curve analysis were performed with indices derived from T1 relaxometry, liver volumetry, and laboratory parameters to identify the best predictor of liver function as determined by the LiMAx test. Results T1 reduction rate (T1 RR), T1 RR × TLV, T1 RR × FLV, and T1 relaxation time 20 min after intravenous Gd-EOB administration showed a statistically significant correlation with LiMAx and discriminatory capacity between patients with LiMAx of > and Conclusion Gd-EOB-DTPA-enhanced MRI as an imaging-based liver function test also correlates with the LiMAx test which in turn reflects cytochrome P450 function. The T1 reduction rate of the liver on Gd-EOB-DTPA-enhanced MRI allows prediction of liver function as determined by the LiMAx test both for 1.5 and 3.0 T.

هدفت هذه الدراسة الى التعرف على مستوى النشاط البدني باستعمال اداة مراقبة الحركة على عينة من طلاب كلية التربية بالدمام بلغت (29 ) طالب ، وتم قياس مدى مشاركتهم بالنادي التعليمي على مستوى النشاط الرياضي ، ومقارنة نتائجهم بطلاب الكليات العلمية (31) طالب . تم قياس مستوى النشاط لكلا المجموعتين وهم طلاب كلية التربية وطلاب الكليات العلمية ، واظهرت النتائج بان مانسبته (94-53 %) من طلاب السنة الأولى لم يشارك بادنى حد من المشاركة البدنية ، وبعد (2) طالب عن كل مجموعة وهذا يعكس مستوى السمنة وزيادة الوزن . هذه الدراسة تؤكد على ما أشارت اليه الدراسات السابقة من زيادة الوزن وكذلك نقص مستوى الحركة .

Introduction: Very little is known about the role of atherosclerotic carotid plaque morphology, vulnerability, and Total Plaque Area (TPA) in the development of Major Cardiovascular Events (MCVE). Aim of this study: To assess the role of carotid atherosclerosis and the plaque morphology in the prediction of MCVE.\ud Importance of the study: A better understanding of the role of detection of atherosclerosis and unstable plaque morphology can help to improve strategies for prevention of Acute Cardiovascular Events (ACVE) worldwide. Methods: This study analyzed the medical records of 452 patients with 2.5-years follow-up. The primary outcomes were the composite of first occurrence of stroke, cardiovascular death, and Acute Coronary Syndromes (ACS) hospitalization.\ud Results: The results show that carotid atherosclerosis was present in 44% of patients (n=103) and this was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 2.5 years\ud follow-up, 10% of patients experienced ≥ 2 MCVE. After adjustment for cardiovascular risk factors, the risk of ACS and stroke increased by 23% (95% Confidence Interval [CI]), and 45% (95% confidence interval), respectively in patients with carotid ultrasonic (US) evidence of advanced carotid atherosclerosis in comparison to control (P

The purpose of this thesis is to investigate what type of work-related stress that social workersexperience in working with abused children and how they handle this stress. The study uses the qualitative method approach, which has conducted interviews with six social workers who are professionals in three different municipalities in Stockholm. The results of the interviews were further analyzed using coping theory, which is the theoretical methodology of the study. It was clear from the results that all interviewees experienced feelings of, for instance, grief and anger while working with abused children. They also stated that the interaction with this group of children; and the organization's workload; added different types of work-related stress. Despite the help of long work experience, the majority of the interviewees have managed to acquire different strategies for coping with the work with these children. Strategies such as support from colleagues, managers, self-care, and relaxing from work were consistent aspects; in the results for dealing with work-related stress.

Paradoxical valvular aortic stenosis (VAS) is a challenging area of clinical cardiology for the practitioners. It involves a small aortic valve area, low flow rate and mean pressure gradient although there is normal left ventricular ejection fraction. The aim of this study was to assess left ventricular (LV) dysfunction in a symptomatic severe aortic valve stenosis which is of crucial importance in identifying patients at risk of heart failure, postoperative complications and increased mortality. There are new insights which are involved in assessment of LV myocardial function including global longitudinal strain (GLS) by two-dimensional speckle tracking echocardiography (2D STE), myocardial performance index (MPI) and maximum rate of LV pressure rise (+dP/dt) during isovolumetric contraction time of the LV. This information can provide both diagnostic and prognostic information in addition to standard echocardiographic and clinical parameters. However, a profound understanding of the complex interaction between loading conditions, chamber geometry and contractility is necessary for the correct interpretation of myocardial deformation in order to draw appropriate conclusions in patients with aortic valve disease. This mini review is related to new and novel insights into the assessment of left ventricular function (LVF) in paradoxical low flow aortic stenosis patients with normal left ventricular ejection fraction (LVEF).

This study aims at identifying and analyzing the transformation of the Egyptian press during the past century. It looks at its development, business model, legal environment, and the role the press has played in social and political changes over the decades. The chapter overviews decades of press history in Egypt, and it covers models of ownership, competition, and legal regulations, as well as press freedoms and the role of the press in social and political changes in Egypt.

The purpose of this research is to explore the patterns of journalistic treatments for issues of Arab Language in Al Arab Qatari newspaper during the year of 2017. It also seeks to understand the degree to which this journalistic behavior enhances Qatar National identity. The importance of this research, which is funded by Qatar National Research Fund, No. UREP21-095-5-009 is to test the relationship between journalistic practices in relation to coverage of Arabic language issues and national identity. As interdisciplinary research combining Arabic language and journalism studies, its data were gathered by students of Arabic and Mass Communication Departments. The study adopted the descriptive and analytical approach to explore a sample of 841 publications that covered 10 linguistic forms including folk literature, translation, sermon, thought, novel, narration, poetry, story, drama and others as well as 6 editorial forms including investigative report, news report, dialogue, news, article, feature story and others. We analyze both the editorial content and the layout treatment. The results showed a statistical significance in the use of different editorial forms to demonstrate the Arabic language topics in Al Arab Qatari newspaper as well as the use of different layout techniques such as positioning, size, headline style and the accompanying visual elements. Future studies can compare the influence of different journalistic practices on national identity.

OBJECTIVE We aimed to compare the safety and efficacy of pectoral nerve block (Pecs) I and II with control or other techniques used during breast cancer surgeries such as local anesthesia, paravertebral block, and erector spinae plane block (ESPB). METHODS We searched 4 search engines (PubMed, Cochrane Library, Scopus, and Web of Science) for relevant trials, then extracted the data and combined them under random-effect model using Review Manager Software. RESULTS We found 47 studies, 37 of them were included in our meta-analysis. Regarding intraoperative opioid consumption, compared with control, a significant reduction was detected in Pecs II (standardized mean difference [SMD]=-1.75, 95% confidence interval [CI] [-2.66, -0.85], P=0.0001) and Pecs I combined with serratus plane block (SMD=-0.90, 95% CI [-1.37, -0.44], P=0.0002). Postoperative opioid consumption was significantly lowered in Pecs II (SMD=-2.28, 95% CI [-3.10, -1.46], P

Introduction: The increasing prevalence of heart failure (HF) in coronary artery disease (CAD) urgently requires the establishment of new imaging techniques for early diagnosis and also to guide treatment of patients presented with acute coronary syndromes (ACS). Conventional echocardiography (CE) and electrocardiogram (ECG) are the gold standard methods in assessing myocardial ischemia (MI) and the function of the heart in patients with coronary artery disease (CAD). The lack of ST elevation by ECG and regional wall motion abnormalities by CE in non-ST segment elevation myocardial infarction (NSTEACS) in ACS patients reflect limited sensitivity of ECG and CE in identifying patients with acute coronary occlusion (ACO) and proper assessment of myocardial viability.\ud Aim of this study: This study now evaluates the ability of strain parameters in grading the severity of CAD to detect myocardial viability in ACS through a comparative meta-analysis in two cohorts of patients living in the UAE and Qatar. The study investigates the diagnostic accuracy of left ventricular longitudinal systolic strain function (GLS) by 2D-speckle tracking echocardiography (2D-STE), Territorial Longitudinal Strain (TLS) analysis and post systolic strain (PSS) in ACS patients admitted at the emergency departments. All the patients had acute chest pain which is highly suggestive of NSTEACS along with coronary angiography (CA).\ud Methods: The study recruited two groups, comprising of 347 patients, who were presented with acute coronary syndrome (NSTEACS) at the emergency department. The first group had 214 consecutive patients who had acute chest pain and high-risk profile and they were admitted to the emergency department at Eastern Emirates Hospitals, El-Fujairah-Dibba (EEEH), UAE. The second group consisted of 133 from emergency department at Heart Hospital- Hamad Medical Corporation (HHHMC), Qatar. In both groups, 85% of the patients were men with ages from 32 to 65 years (mean ± SD: 49.4 ± 9.5 years). Significant CAD was defined as having at least one epicardial vessel with ≥ 70% or left main>50% stenosis. All patients enrolled in this study underwent basic echocardiography, speckle tracking analysis, and coronary angiography. In 70 patients, PSS was calculated and myocardial perfusion imaging (MPI) was utilized as gold standards for the assessment of myocardial viability in patients with documented NSTEACS.\ud The sensitivity, specificity, positive and negative predictive values of peak longitudinal systolic strain (2D-STE) and PSS were calculated. Left ventricular systolic strain was displayed as bull’s eye plot and territorial longitudinal strain (TLS) in the territory of the infarct-related artery. They were obtained within 24 hours from admission. Coronary angiography (CA) was performed within 24 hours from admission and used as a reference tests to assess the severity of CAD.\ud Results: Echocardiogram obtained from the patients showed any no wall motion abnormalities at rest, although speckle tracking analysis was abnormal in 167 patients. In the first group of patients from the UAE, GLS showed a high sensitivity of 80% and a very high specificity of 93% for detection of significant CAD. In addition, PSS demonstrated a high sensitivity of 80% with an average specificity of 57%. The combination of GLS and PSS showed a further increase in sensitivity, specificity with positive and negative predictive values of 98%, 91%, 99% and 97%, respectively. Therefore, a very high correlation of GLS and PSS with coronary angiography was demonstrated: =0.90, p

Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide, with more than 1 million new cases diagnosed every year. Liver transplantation (LT) has been used as a curative treatment for patients with HCC. In countries where the liver allograft allocation is based on the Model for End-Stage Liver Disease (MELD) system, patients with HCC within the Milan criteria (MC) receive exception points, preventing dropout from the list. Objective The aim of this study is to analyse the different risk factors leading to delisting in liver transplant patients with hepatocellular carcinoma. Methods This study was a retrospective cohort study which had been carried out during the period between January 2017 to June 2018. During it, 48 patients were listed for LDLT at Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams Specialized Hospital till liver transplantation. By the end of this period 29 patients were delisted due to several reasons while 12 got transplanted and 7 were still on the waiting list. The study protocol was approved by the medical ethics committee of Ain Shams University. Results Regarding this study’s results, 25% were transplanted, 60.42% were delisted and 14.58% remained on the waiting list. 51.72% of patients in this study were delisted due to unavailability of related donor. In this center only related donors were allowed to donate as it follows Egypt’s organ donation policies, there are no organ allocation systems and deceased donor liver transplantation is illegal limiting availability of donors. Conclusion At the end of this study we can conclude that, age and tumour classification were independent predictors of delisting HCC patients candidates for liver transplantation.

Background type 2 diabetes mellitus (T2DM) is a known risk factor of coronary artery disease (CAD). Cardiovascular disease is the leading cause of death in T2DM patients. Antecedent to and associated with epicardial coronary artery stenosis, T2DM patients develop abnormal microvascular function in systemic circulatory beds. Glycosylated hemoglobin (HgbA1c) has been established as a risk factor for T2DM patients developing microvascular atherosclerosis. Aim of the Work the Effect of Glycosylated Hemoglobin Control on Post-Operative Coronary Artery Bypass Graft Surgery Outcomes this is widely across studies and patient populations, and this heterogeneity must be controlled when using the literature to indicate safety. Patients and Methods this study was performed on 60 patients, who underwent CABG at Cardiothoracic Academy from January 2018 to August 2018. Retrospective Descriptive Observational Study. Cardiothoracic Academy, Ain Shams University Hospitals. Study Period: 6 Months. This study included all patients operated upon for CABG in our hospital and who fulfilled our inclusion and exclusion criteria. Results preoperative HbA1c is not the only predictor of surgical site infection after cardiac surgery in diabetic patients and in patients with previously undiagnosed diabetes. Baseline HbA1c 8.6 was associated with the higher risk of chest wound infection. Interestingly, in this series. Conclusion this study shows that the incidence of chest and leg wound infections are significantly related to the value of the glycosylated hemoglobin and rate of infection increases with poor control of diabetes and from this study we recommend measurement of glycosylated hemoglobin value for all patient undergoing cardiac surgery.

Background The importance of sleep and the impact of its deprivation on development of brain pathology became a recent subject of interest in medicine. The restorative effect of sleep on the brain and the harmful effects of insomnia have been recently revealed through the discovery of the glymphatic system and its association with sleep. Aim of work Specific objectives are: To detect histological and apoptotic changes in the neurons and dendrites of the cornu Amonis and the dentate gyrus in sleep deprived rats in comparison to rats with undisturbed sleep pattern (control). To detect deposition of neurotoxic metabolites in comu Amonis and dentate gyrus in sleep deprived rats in comparison to controls. Methods Twenty four adult male Albino rats were used in the present experiment. randomly categorized into four equal groups; Group A1 served as the control group, Group .A2 one day sleep deprivation, Group A3 three days sleep deprivation and Group A4 seven days sleep deprivation. They were deprived of sleep using grid over water method where the animals placed over a grid suspended above tank filled with water with free access to food (rat chew) and water. Hippocampai specimens were collected, processed for paraffin blocks and examined by light microscopy. Results there were neurodegenerative signs appeared from day one sleep deprivation, increased by day three and prevailed by day seven. It was confirmed by apoptotic changes detected by caspase 3 immunohistochemical staining. Furthermore, deposition of beta amyloid appeared in rats deprived of sleep and confirmed by congo red stain. Conclusion Adequate sleep is essential for integrity of the newly discovered glymphatic system responsible for clearance of the brain from waste products including the area most involved in learning and memory function; the hippocampus. Correction of SD could be a viable therapeutic strategy to prevent the onset or slow the progression of AD. Recommendations Further characterization of the glymphatic system in humans are required, it may lead to new therapies and methods of prevention of neurodegenerative diseases. Correction of SD could be a viable therapeutic strategy to prevent the onset or slow the progression of AD.

The properties of hard anodizing layers formed on 2014 Al alloy in sulphuric acid electrolyte containing sodium lignin sulphonate were investigated. The corrosion behavior of 2014 Al alloy has been studied using potentiodynamic polarization technique. Anodic layers morphology and composition were examined by scanning electron microscope, energy dispersion X-ray (EDX), X-ray diffraction (XRD) and Fourier infrared spectroscopy (FTIR). The results showed that the corrosion resistance has been enhanced after hard anodizing of 2014 Al alloy. Addition of lignin sulphonate to the sulphuric acid electrolyte significantly improved the corrosion resistance of the anodized 2014 aluminum alloy by adsorption on copper-intermetallic phases. Adsorption of sodium lignin sulphonate on oxide surface has been confirmed by SEM, EDX, and FTIR. Phenolic and carboxylic groups in sodium lignin sulphonate are functional groups, which are responsible of complex formation on oxide surface. The morphology of the hard anodizing layer is non-homogenous due to the high copper content of 2014 Al alloy. Addition of sodium lignin sulphonate resulted in the formation of anodic layers with more homogeneity and fewer cracks. Keywords: Hard anodizing, Al-Cu alloy, Corrosion, Potentiodynamic polarization, FTIR, Sodium lignin sulphonate, Green inhibitor, SEM