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Summary Objective Zinc, copper and selenium are essential for normal development and function of the central nervous system. This study aimed at assessment of serum levels of zinc, copper and selenium in children with severe acute malnutrition (SAM) with & without cerebral palsy both before and after nutritional rehabilitation. Methods A prospective case control study involved 2 groups (Group I); included160 children with SAM of both sex, aged 6–59 months, this group was subdivided into 2equal subgroups; subgroup A: SAM without cerebral palsy, subgroup B: SAM with cerebral palsy. Group II (control group) included 96 apparently healthy children matching age and sex with the first group. Both groups were subjected to a detailed history including nutritional history. Anthropometric measurements were recorded and laboratory assessment for serum levels of (copper, zinc, & selenium) before and after nutritional rehabilitation were performed for all children. Results Group I (A&B) showed a significant decrease in anthropometric measurements, serum zinc, serum selenium but normal copper level before nutritional rehabilitation in comparison to control. After nutritional rehabilitation, all cases of the group I showed a significant improvement of the three parameters except for (45%) of cerebral palsy cases, experienced a resistant low selenium. Conclusion Nutritional rehabilitation significantly improved micronutrients' serum level in SAM children with and without cerebral palsy. Selenium supplementation is advised for children with cerebral palsy in order to reach normal values with observation of effect on neurological state.

Summary: Objective: Zinc, copper and selenium are essential for normal development and function of the central nervous system. This study aimed at assessment of serum levels of zinc, copper and selenium in children with severe acute malnutrition (SAM) with & without cerebral palsy both before and after nutritional rehabilitation. Methods: A prospective case control study involved 2 groups (Group I); included160 children with SAM of both sex, aged 6–59 months, this group was subdivided into 2equal subgroups; subgroup A: SAM without cerebral palsy, subgroup B: SAM with cerebral palsy. Group II (control group) included 96 apparently healthy children matching age and sex with the first group. Both groups were subjected to a detailed history including nutritional history. Anthropometric measurements were recorded and laboratory assessment for serum levels of (copper, zinc, & selenium) before and after nutritional rehabilitation were performed for all children. Results: Group I (A&B) showed a significant decrease in anthropometric measurements, serum zinc, serum selenium but normal copper level before nutritional rehabilitation in comparison to control. After nutritional rehabilitation, all cases of the group I showed a significant improvement of the three parameters except for (45%) of cerebral palsy cases, experienced a resistant low selenium. Conclusion: Nutritional rehabilitation significantly improved micronutrients’ serum level in SAM children with and without cerebral palsy. Selenium supplementation is advised for children with cerebral palsy in order to reach normal values with observation of effect on neurological state. Keywords: Severe malnutrition, Cerebral palsy, Zinc, Copper, Selenium

Background: Emergency physicians are often challenged with a comatose patient; 30% of patients with coma of unknown origin are due to intoxication. Comatose patients are at high risk for morbidity and mortality. Objective: The present study assessed poisoning-induced coma regarding demographic and intoxication data, causative agents, clinical data, management modalities and outcome. In addition to evaluation of the role of creatine phosphokinase (CPK) level on admission and other variables as predictive factors for the outcome in toxic coma. Subjects and Methods: This study was conducted prospectively on one hundred comatose intoxicated patients, admitted to Poison Control Center Ain Shams University Hospitals (PCCASU). Results: The majority of patients (64%) were in the age group 18-40 year, and there was male predominance (56%). Organophosphorus, carbamazepine and tramadol were the most common toxic agents inducing coma. Death rate was 12% and mortality is much higher in patients with older age, elevated admission creatine phosphokinase, longer duration of hospital stay and higher grade of Reed’s classification of coma. Conclusion: Organophosphorus followed by carbamazepine and tramadolwere the most common toxic agents inducing coma. Older age, elevated admission creatine phosphokinase, longer duration of hospitalization and higher grade of Reed’s classification of coma can predict the mortality. In addition, respiratory acidosis and the need of intubation and mechanical ventilation indicated poorer outcome, while administration of antidotes was correlated with better outcome.

Aim: Rats are accused in disseminating many zoonotic diseases. This study aimed to isolate and identify bacteria from internal organs of rats captured in Baghdad City, Iraq. Materials and Methods: A total of 120 black rats (R. rattus) were trapped from different areas in Baghdad city. Rats were kept in individual plastic cages for 3 h before euthanizing. Deep pharyngeal swab, intestinal content, urine, and pieces of the liver and spleen, lung, kidney, and brain were obtained aseptically. The specimens were inoculated into peptone water and incubated at 37°C for 24 h for enrichment. A loopful of each specimen was then subcultured onto MacConkey Agar, Blood Agar, and Mannitol Salt Agar. CHROMagar O157 H7 and CHROMagar Listeria were used to detect Escherichia coli 157:7 and Listeria spp., respectively. Biochemical tests on analytical profile index, microscopic examination, and commercial kit for latex agglutination test for serotyping E. coli O157:H7 were used. Results: Mixed bacterial isolates were recorded as 116, 52, 36, 28, 18, 6, and 4 from intestinal contents, deep pharyngeal, liver and spleen, urine, lung, brain, and kidney, respectively. Microorganisms included E. coli, Staphylococcus aureus, Streptococcus spp., Bacillus spp., Pseudomonas aeruginosa, Citrobacter freundii, Proteus vulgaris, E. coli O157:H7, Enterobacter cloacae, Listeria spp., Klebsiella spp., Ochrobactrum anthropi, Aeromonas spp., Brucella spp., Pseudomonas fluorescens, Escherichia fergusonii, Micrococcus spp., Morganella spp., Proteus mirabilis, Pseudomonas luteola, and Streptobacillus spp. The highest bacterial prevalence (88; 73.33%) was recorded for E. coli, where 68 isolates were identified from the intestinal contents. Of these, four isolates were E. coli O157:H7. Conclusion: Rats are important carriers and transmitters of a number of pathogens and can disseminate these microorganisms to humans and animals.

Background: Caustic ingestion is still a difficult medical problem, and the outcome is often unexpected. Objectives: This study assessed the usefulness of intoxication data, clinical data and some laboratory parameters in predicting the outcome following caustic ingestion, and test the applicability of DROOL Score (DS) as a prognostic indicator of oesophageal stricture. Methods: Ninety-two patients with caustic ingestion admitted to Poison Control Centre Ain Shams University (PCCASU), during the period from 1st June to November 30, 2015 were prospectively studied. Diagnoses of stricture made via barium study. Results: Sixty-six percentage of cases were children under 5 years. In 48.9% of cases, the caustic agent was alkaline. Symptoms and signs can adequately predict the outcome of corrosive patients. DROOL Score and Total Leucocytic Count (TLC) ≥ 20,000 are useful tools for predicting both stricture formation and mortality, in addition blood pH ˂ 7.2 can also predict mortality. A new value of DS ≤ 5.5 to predict stricture formation and mortality of corrosive patients was proposed. Conclusion: Clinical manifestations can adequately predict the outcome also; DS and TLC ≥ 20,000 have predictive value for outcome prediction of corrosive patients. Moreover, blood pH ˂ 7.2 can predict mortality. A new value of DS ≤ 5.5 was identified as a prognostic indicator of outcome in caustic patients.

Compounds having their chemical structure based on coumarin framework have enticed much research concern not only because of the variance structural characteristic but also the pluralism of the bioactivities. In this report, four derivatives of 7-halo-4-coumarinylacetic acid referred to as RY1-RY4 were synthesized, and their chemical backbones were confirmed via the employed spectrophotometers. The pharmacokinetic profiles of the synthesized halocoumarins were inspected in silico using a free online software named the pre-ADMET program. The potential of the synthesized halocoumarins as antitumor applicants was evaluated utilizing 5-fluorouracil as a reference drug and the well-authenticated protocol based on the MTT as a visible indicator against eight standard tumor-cell lines. The outcomes acquired from this assessment indicated that the synthesized halocoumarins, except RY1, have less impact as antitumor agents comparing with the standard drug. Also, the halocoumarins revealed roughly the same fashion of activity versus the test cell lines with the greatest inhibitory influence reported against MCF-7 and HeLa. From the calculated pharmacokinetic data and outcomes exhibited from antitumor assessment, the authors concluded that the synthesized halocoumarins, particularly RY1, offered potential applicants as antitumor agents with broad-ranged activity. Besides, the compounds RY1 and RY2 may provide highly valuable scaffolds for synthesizing agents with a powerful antitumor activity versus the breast and cervical cancer phenotypes.

Addressing the global need for the development of safe and potent NSAIDs, new series of oxadiazolo and thiadiazolo fused pyrmidinones were synthesized and initially tested for their analgesic activity. All tested compounds showed promising analgesic activity compared with the reference standard indomethacin. Moreover, anti-inflammatory activity evaluation, ulcerogenic liability, and in vitro COX-1, COX-2 enzyme inhibition assays were also performed for the most active derivatives. The methoxyphenyl piperazinyl derivative 3d showed analgesic activity surpassing indomethacin with protection of 100%, and 83%; respectively. Also 3d showed good anti-inflammatory activity with relatively lower ulcer index compared with other tested compounds, and potent COX-1 and COX-2 inhibitory activity with IC50 = 0.140, 0.007 μm, respectively, and with a selectivity index of 20.00 which was better than the reference standards and the other tested congeners. Additionally, compounds 3b, 3g and 3h revealed moderate selectivity (SI = 3.53, 3.70 and 5.87, respectively). Moreover, in silico physicochemical parameters revealed that the new fused pyrimidinones demonstrated promising pharmacokinetic properties. Furthermore, computational studies in form of 2D-quantitative structure-activity relationship (2D-QSAR) and 3D-pharmacophore confirmed the potential analgesic properties of the new target compounds.

Nicotine is the major alkaloid present in cigarettes that induces various biochemical and behavioral changes. Nanonaringenin (NNG) and vitamin E are antioxidants that are reported to mitigate serious impairments caused by some toxins and oxidants. Thus, we aimed to investigate the efficacy of NNG, vitamin E, and their combinations to ameliorate behavioral, biochemical, and histological alterations induced by nicotine in rats. Adult male albino rats were randomly grouped into six equal groups (10 rats/group): control, N (nicotine 1 mg/kg b.w./day S/C from 15th to 45th day, 5 days a week), NNG (25 mg/kg b.w./day orally for 45 days), N + NNG, N + E (nicotine + vitamin E 200 mg/kg b.w./day orally), and N + NNG + E (nicotine + NNG + vitamin E at the aforementioned doses). Behavioral tests were conducted on day 15 and 30 postnicotine injection, while memory tests, brain neurotransmitters, antioxidants, and histopathological examination were examined at day 30 only. As a result, nicotine impaired rats’ activity (hypoactivity and hyperactivity) and memory, induced anxiolytic and anxiogenic effects on rats, and altered neurotransmitters (acetylcholinesterase, serotonin, and dopamine), and redox markers (MDA, H2O2, GSH, and catalase) levels in brain homogenates. Thickening and congestion of the meninges and degeneration of the cerebral neurons and glia cells were observed. Cosupplementation with NNG, vitamin E, and their combination with nicotine was beneficial in the alleviation of activity impairments and improved short memory and cognition defects and exploratory behaviors. Our results indicate the antioxidant potential of NNG and vitamin E by modulating redox markers and neurotransmitters in the brain. Thus, data suggest that the prophylactic use of NNG, vitamin E, and/or their combination for (45 days) may have a successful amelioration of the disrupted behavior and cognition and biochemical and histopathological alterations induced by nicotine.

Background Axillary nodal status is crucial for the management of cases with recently diagnosed breast cancer; usually addressed via axillary ultrasonography (US) along with tissue sampling in case of suspicion. Axillary nodal dissection and sentinel biopsy may be done, but are rather invasive, carrying a potential complication risk, which raises the need for non-invasive, reliable, pre-operative axillary imaging. We aimed at evaluating the performance of diffusion-weighted imaging (DWI) regarding preoperative axillary evaluation, using functional information derived from diffusion capacity differences between benign and malignant tissue. We included 77 axillary nodes from 77 patients (age range 20–78 years, mean 50 ± 12.6 SD) in our prospective study, presenting with variable clinical breast complaints, all scoring BIRADS 4/5 on sonomammography (SM). They underwent axillary evaluation by both US and DW-MRI where US classified nodes into benign, indeterminate, or malignant by evaluating nodal size, shape, cortical thickness, and hilar fat. Qualitative DWI classified them into either restricted or not and a cut-off apparent diffusion coefficient (ADC) value was calculated to differentiate benign and malignant nodal involvement. Results for each modality were correlated to those of final histopathology, which served as the standard of reference. Results The calculated sensitivity, specificity, accuracy, PPV, and NPV for US was 100%, 36.6%, 75.3%, 71.2%, and 100%, respectively. Statistical indices for qualitative DWI were 76.6%, 63.3%, 76.6%, 63.3%, and 71.4%, respectively (P value −3 mm2/s concluding statistical indices of 76.6%, 63.3%, 76.6%, 63.3%, and 71.4%, respectively (P value Conclusion Combining DW-MRI to conventional US improves diagnostic specificity and overall accuracy of preoperative axillary evaluation of patients with recently discovered breast cancer.

Eight new mixed ligands metal complexes have been prepared by the reaction of Fe(II), Co(II), Ni(II) and Cu(II) with (1:1:1 molar ratio) of ciprofloxacin - eugenol or levofloxacin - eugenol mixed ligands in alkaline medium. The coordination of the mixed ligands toward metal ions has been anticipated in the light of elemental analysis, molar conductance, spectral infrared (IR), ultraviolet-visible (UV-Vis) and magnetic measurments were bidentate ligands. Electronic and magnetic data suggested the octahedral configuration for all these new complexes. The molar conductance data for the metal complexes show non-electrolytic behavior in DMF solvent and non-electrolytic properties, also they were no conducting electrical current.The biological activity of the prepared complexes was studied with positive and negative Gram-positive bacteria and good antibacterial results.

Joining the global fight against Tuberculosis, the world's most deadly infectious disease, herein we present the design and synthesis of novel isatin-nicotinohydrazide hybrids (5a–m and 9a–c) as promising anti-tubercular and antibacterial agents. The anti-tubercular activity of the target hybrids was evaluated against drug-susceptible M. tuberculosis strain (ATCC 27294) where hybrids 5d, 5g and 5h were found to be as potent as INH with MIC = 0.24 µg/mL, also the activity was evaluated against Isoniazid/Streptomycin resistant M. tuberculosis (ATCC 35823) where compounds 5g and 5h showed excellent activity (MIC = 3.9 µg/mL). Moreover, the target hybrids were examined against six bronchitis causing-bacteria. Most derivatives exhibited excellent antibacterial activity. K. pneumonia emerged as the most sensitive strain with MIC range: 0.49–7.81 µg/mL. Furthermore, a molecular docking study has proposed DprE1 as a probable enzymatic target for herein reported isatin-nicotinohydrazide hybrids, and explored the binding interactions within the vicinity of DprE1 active site., GRAPHICAL ABSTRACT

Brain tumor is an abnormal cell population that occurs in the human brain. Nowadays, medical imaging techniques play an essential role in tumor diagnosis. Magnetic resonance imaging (MRI) is a medical imaging technique that uses radio waves and a magnetic field as sound waves are created to produce detailed images of tissues and organs in the human body by computer. In this study, three different methods were reviewed and compared to the tumor’s extraction from a set of MRI brain images. These methods are seeded region growing, k-means, and global thresholding. The images used in this study are obtained from the Cancer Imaging Archive (TCIA) and Kaggle. All images are grayscale and in JPEG format. The images from TCIA dataset are 100 images that contain abnormal (with a tumor) brain MRI images while there are 35 images in the Kaggle dataset. The Kaggle dataset contains 20 normal images and 15 abnormal images. The results show that the k-means segmentation algorithm performed better than the others on TCIA dataset according to the Root Mean Square Error (RMSE), the Peak to Signal Noise Ration (PSNR), and Segmentation Accuracy while global thresholding is the best on Kaggle dataset.

Background: Effective discharge planning is a vital component to maintain care continuity for head traumapediatric patient. Despite this, there is a critical gap in the process and quality of discharge planning in Egypt.Aim of this studywas to assess the effect of discharge plan on parents having children suffering from headtrauma.Design: A quasi- experimental design was used.Settings: This study was conducted in Emergency Department, Pediatric Intensive Care Unit (PICU) andNeurological Department at children Hospital affiliated to Ain Shams University and El-Menshawy Hospitalin Tanta affiliated to Ministry of Health.Subject: A convenient sample consist of 40 parents accompanied their children suffering from head traumawho attended in the previously mentioned settings.Tools: 1)- Pre-designed questionnaire sheet which included two parts: part I: concerned with characteristicsof studied parents and characteristics of the studied children,Part II: knowledge of the parents regardingcaring of their children suffering from head trauma, 2)- Observational check list and 3)- Child MedicalRecord.Results: All of studied parents reported that no one gave them any information about head trauma. There wasa marked improvement in parents’ knowledge and reported practices post implementation of discharge plan.There were strong positive correlations between studied parents’ total knowledge and their total reportedpractices related to care of children after head trauma pre/post discharge plan.There was highly statisticalsignificance difference between parents’ total knowledge regarding care of head trauma in children andtheir level of education post implementation of discharge plan. There was statistical significance differencebetween parents’ total reported practices regarding care of head trauma in children and their level of educationpost implementation of discharge plan.Conclusion: All of research hypothesis were accepted and implementation of discharge plan led to significantimprovements in parents’ knowledge and reported practices regarding care of their children suffering fromhead trauma. Recommendations: Discharge plan for all parents having children suffering from head trauma must beginwith parents at their first day of admission.

Background: Breast milk is important for brain development as it contains high concentration of long chain polyunsaturated fatty acids, also it contains cholesterol, amino acids as taurine and also lactose which broken to glucose and galactose, All are important nutrients for the brain and central nervous system tissues. Auditory Brainstem Response (ABR) is considered to reflect brain function of the infant and is widely used to determine/measure the brain development / maturation of the infant. Objective: to assess auditory brainstem maturation in breast-fed and formula fed infants as part of brain maturation using ABR. Methodology: thiscase-control was study carried out upon 100 apparently healthy infants; 50 infants of them were exclusively breast-fed and 50 infants were exclusively formula-fed, all of them aged 4-6 months. Each infant was subjected to detailed history, a full physical and neurological examination together with estimation of ABR. Results: There was statistically significant prolongation of absolute latencies of wave III and wave V of ABR of right and left ear in bottle feeding infants in comparison to breast feeding infants. Also, there was statistically significant increase of mean wave interpeak latencies I-III, III-V and I-V of right and left ear in bottle feeding infants compared to breast feeding infants. Conclusion: Better brain maturation in breast-fed infants compared to formula-fed infants evidenced by ABR.

Background: Diabetes mellitus (DM) is a heterogeneous metabolic disorder characterized by the presence of hyperglycemia due to impairment of insulin secretion, defective insulin action or both.Diabetic retinopathy (DR) is a vision threatening neurovascular disease and the most dangerous complication of DM. Brain-Derived Neurotrophic Factor (BDNF) is an important protein for the neurons survival. It is produced in the retina by retinal ganglion cells (RGCs) and encoded by BDNF gene. Objective: to clarify the association of serum BDNF levels and its gene polymorphism Val66Met (rs6265) with the development of diabetic retinopathy in type 2 diabetic patients. Methodology: This case-control study was conducted on was conducted on 60 diabetic patients (30 of them having diabetic retinopathy, while the other without retinopathy), In addition to 30 healthy subjects as controls. Serum BDNF was detected by Enzyme-linked immunosorbent assay (ELISA) and BDNF Val66Met polymorphism genotyping was performed by real time PCR. Results: No statistically significant difference between DR patients, diabetic without retinopathy patients, and healthy control subjects regarding BDNFgenotypes frequency distribution (p> 0.05), and/or serum BDNF levels (p > 0.05). Conclusions: This study demonstrated that, neither BDNF Val66Met polymorphism nor serum BDNF levels were associated with development of DR.

To eliminate schistosomiasis, appropriate diagnostic tests are required to monitor its prevalence and transmission, especially in the settings with low endemicity resulting from the consecutive mass drug administration. Antibodies that react with either crude soluble schistosome egg antigens or soluble worm antigen preparations have been used to monitor infection in low-prevalence regions. However, these detection methods cannot discriminate current and past infections and are cross-reactive with other parasites because both antigens contain numerous proteins and glycans from schistosomes, and standard preparations need maintenance of the life cycle of the schistosome. To evaluate the potential utility of nine recombinant Schistosoma mansoni proteins as single defined antigens for serological diagnosis, we monitored the kinetics of antibodies to each antigen during S. mansoni infection in mice before and after the treatment with praziquantel. C57BL/6 mice were infected with 50 cercariae. The levels of immunoglobulin G (IgG) raised against five recombinant antigens (RP26, sm31, sm32, GST, and LAP1) significantly increased as early as 2–4 weeks after infection and rapidly declined by 2 weeks after the treatment, whereas those raised against crude S. mansoni egg antigens or other antigens remained elevated long after the treatment. The IgG1 raised against RP26, sm31, and serpin decreased after the treatment with praziquantel, whereas the IgE raised against serpin declined strikingly after the treatment. This study clarifies the dynamics of the serological responses to recombinant S. mansoni proteins during infection and after the treatment with praziquantel and identifies several candidate antigens with potential utility in the monitoring and surveillance of schistosomiasis toward the elimination of schistosomiasis., Author summary Schistosomiasis is the second most important human parasitic disease in tropical and subtropical areas: estimates show that at least 218 million people required treatment in 2015 and remains a major Neglected Tropical Disease impacting the health of the poorest populations. The global strategy for schistosomiasis control is focused on eliminating disease through periodic, large-scale population treatment with praziquantel (PZQ). With the progress towards the control and the elimination of schistosomiasis by mass drug administration (MDA) with PZQ, more sensitive diagnostics that can monitor the dynamics of schistosomiasis transmission are required to instruct MDA programs and assess reinfection. Detecting antibodies react with either crude soluble schistosome egg antigens or soluble worm antigen preparations have been used to monitor infection in low-prevalence settings. However, these detection methods cannot discriminate current and past infections and are cross-reactive with other parasites because it contains numerous proteins and glycans from schistosomes, and standard preparations need maintenance of the life cycle of the schistosome. This study clarified that the dynamics of the serological responses to defined recombinant proteins during S. mansoni infection in mice before and after the treatment with PZQ and identifies several candidate antigens with potential utility in the monitoring and surveillance of schistosomiasis toward the elimination of schistosomiasis.

Background: More than 5000,000 people are working in tanneries around the world. Work related accidents and diseases continue to have series consequence, with an estimated 2.3 million fatalities per year and economic losses of 4% of global gross domestic product. Aim of the study: To assess occupational health hazards among leather tannery workers at Minia and Assuit city. Research design: Across –sectional descriptive study was utilized in this study. Subjects: comprised 50 workers in leather tannery whose age ranged between 17 to 58years. Setting: This study was carried out at leather tannery in Minia and Assuit city. Tools of data collection: Two tools were utilized to measure the variables of the study included socio demographic part &workers knowledge about occupational health safety ,knowledge score this section contain 7 questions with a total score of 7 divided to :scoring 5-7 indicates good knowledge ,scoring 1-4 indicates poor level of knowledge. (Aliyu and Ibrahim, 2015). Results: The majority of the workers were single (48%) followed by married (44%). More than half of them were from rural areas. More than one third of them were illiterate. 72% of the participants were workers. Workers working in tanning represent 44% followed by 30% working in salting .Conclusion: The prevalence of occupational hazards is high in the studied tannery workers. Workers working in tanning and Beam house or salting phase affected more than others.personal protective equipment not available enough in tanneries. This high prevalence of occupational skin diseases could result from: lack of occupational safety training, and poor concepts on utilization of PPE in working environment. Recommendation: Government should enforce compliance to health and safety measures in industries so as to minimize to minimum the level of occupational risks and hazards. In the same light government and supervising institutions should enforce compliance to occupational health and safety measures in the industries.

Background: Though creation of an ostomy is a life saving procedure and increased lifespan it may result in significant number of complications which impact body image, daily functioning, social activities and a significant reduction in the quality of life. So persons living with colostomy require comprehensive education, training to manage their stoma and to identify, prevent stomal or peristomal complications during the early postoperative period. Aim of the study: To evaluate the effect of a designed nursing and patients self care protocol on reducing the colostomy and peristomal skin complications among the elderly patients. Research design: A Quasi-experimental research design was utilized in the current study. Subjects: A purposive sample including (60) elderly patients from both sexes (males & females) aged 60yrs old and older were included in the current study, they were classified into two equal groups (no=30) for the study group and (no=30) for the control group. Setting: This study was carried out at General Surgical Department and Surgical Outpatient Clinics in Minia University Hospital. Tools of data collection: Four tools were utilized to collect data. Tool I: Patient assessment sheet, Tool II: Designed colostomy nursing and patient’s self-care protocol. Tool III: Observation Check list designed by the researcher, Tool IV: Peristomal skin assessment scale. Results: The results of the current study revealed that, the majority of the study group had normal skin along all observations, while all of the control group didn’t have normal skin along the 7 observations. Also, there were statistically significant differences among the study and control groups regarding total DET score along the 7 observations. Conclusion: It was concluded that implementation of the educational guideline about stoma self care had a positive effect on improving awareness regarding practice among the study group which leading to prevention of the peristomal skin complications. Also, it was found the majority of study group didn’t have peristomal skin complications along all observations while among the control group there was an increase of peristomal skin complications. Recommendations: proper counseling sessions as well as pre and post operative education for ostomy patients that will help them to adjust to their stoma care in a better way. There is need for a simplified illustrated and comprehensive Arabic–language booklet to be used as reference educational guidance for patients with colostomy. In-service educational programs and job training to upgrade nurse’s knowledge, attitudes and practices toward providing essentials components of nursing care.

Cattle are one of the farm animals of huge economic significance as the main source for meat and milk production in Egypt but their productivity is thought to be greatly reduced by blood protozoan parasitic diseases caused by tick borne blood parasite such as babesiosis and theileriosis Babesiosis and theileriosis are one of the most important and serious pathogenic protozoan diseases infect these animals in Egypt with highly prevalent and caused by Babesia and Theileria species The most practical and widely used method to control such disease is the chemical control of ticks with acaricides and treatment of infected animal but both way of control are not always fully effective and hence vaccination is the most sustainable option Many epidemiological factors are responsible for causing parasitic infections in cattle So proper monitoring diagnosis immunization and control of parasitic infections in cattle in Egypt are required for sustainable growth and proper development of cattle management program Therefore knowledge of prevalence of blood protozoan parasites and current species will help to minimize the economic losses in cattle sector So this short review might have been spotted the light on the current prevalence of such infections in cattle in Egypt with special attention to diagnostic tools and treatment used for this purpose

Background Female genital cutting, also termed female genital mutilation (FGM), is a damaging practice with no health benefits for girls or women, and is considered to be a violation of children’s rights. Methods A cross-sectional, community-based study using interview administered questionnaire to explore knowledge and attitude of people living in a rural area in Minia. Systematic random sampling was used to interview 618 males and females above the age of 18 in the period from September to November 2016. Results FGM was performed on 76.6% of females, complications occurred in 35.6% of them. Females demonstrated a higher level of knowledge than males. Nearly 56% of respondents believed that this practice should continue. Females were more supportive of the continuation of FGM than men (60.3% vs. 47.9%). The attitude that FGM is a good practice, knowledge level, women’s status and religion were significantly associated with women’s willingness to subject their daughters to FGM in the future. Attitude was the only significant predictor associated with men’s willingness to subject their daughters to FGM. Conclusion The strong correlation between social pressure and intentions to carry out FGM means that FGM practice will continue to be embraced among future generations unless policies are put in place to eradicate this practice through empowering females by education and reasonable income.

المقدمة :- لاحظ في مرضى العجز الكلوي المزمن زيادة حالات النزف . بصورة عامة حالة النزف تكون موازية الى شدة تركيز النتروجين في الدم .الفسلجة المرضية لحالة النزف معقدة وفيها نلاحظ خلل في وظائف الصفائح الدموية والتخثر اضافة الى قلة الاقراص الدموية التي تشاهد في بعض المرضى. الهدف من الدراسة :- لتحديد تغيرات في بعض مؤشرات توقف نزف الدم عند مرضى عجز الكلى المزمن, وتحديد فعالية عمليات البزل (الديلزة) على هذه التغيرات. اسلوب العمل والمرضى :- يتضمن البحث (75) مريضا مصابا بعجز كلوي مزمن . (50) منهم ممن اجرى عملية ديلزة.(25) الاخرون ممن لم يجروا اي عملية ديلزة . تم اخذ عينات دم لاجراء التحاليل المختبرية و تشمل عينة الدم التي تحتوي على مادة EDTA لاجراء صورة الدم الكاملة و عدد الصفيحات الدموية. و تم اخذ بلازما الدم مع مادة (ستريت) لاجراء اختبارات تخثر الدم و التي تشمل (زمن البروثرومبين , زمن الثرومبوبلاستين الجزئي المفعل , الفايبرينوجين , تحديد تفاعل د – مزدوج , زمن الثرومبين) . تم فحص زمن النزف باستعمال طريقة IVY’s . كذلك تم أخذ مصل عينة الدم المتخثر لقياس نسبة اليوريا ونسبة الكرياتينين . النتائج :- تم تسجيل ارتفاع زمن النزف للمرضى الذين لم يجروا اي عملية ديلزة الى حد الوصول الى دلالة حسابية بالمقارنة مع المرضى الذين اجروا عملية ديلزة , و كذلك لوحظ وجود دلالة حسابية موجبة بين ايجابية تفاعل د – مزدوج مع ارتفاع زمن النزف (r=0.3) . انخفاض عدد الاقراص الدموية , زمن البروثرومبين , زمن الثرومبوبلاستين الجزئي المفعل , مستوى الفايبرينوجين , زمن الثرومبين لم يسجل اي دلالة حسابية موجبة . الاستنتاج :- نستنتج بالمقارنة مع دراسات اخرى شيوع تغير مؤشرات توقف نزف الدم بين مرضى العجز الكلوي المزمن , و لهذا يجب النظر في الاساليب العلاجية التي يتلقاها المرضى .

Hemophilia is a coagulation disorder arising from a genetic defect of the X chromosome; the defect can either be inherited or result from spontaneous gene mutation. In each type of hemophilia (A, B, C, and willebrands disease), a critical coagulation protein is missing, causing children to bleed for long periods of time before clotting occurs. Aim: this study was a quasi- experimental aimed to evaluate the outcomes of the instructional module on the studied sample. Setting: the study was carried out at hematology departments at children's hospitals affiliated to Ain Shams University Hospital (Al Demerdash) Cairo University Hospital (Abo Elreesh) and Benha children's Hospital affiliated to ministry of health. The Sampling: A convenient sample involved Fifty nurses from the previously mentioned settings. Tools of data collection: involved a structure questionnaire to assess nurses' knowledge and observational checklists to assess performance regarding care of children with hemophilia and instructional module about hemophilia. Results: Slightly less than half (46.0% &48%) of the studied nurses their ages were 30 years and more, had nursing diploma from technical institute of nursing respectively, less than two thirds of the nurses (62%) had experience ≥ 6years, Post implementation of the instructional module most of the studied nurses had satisfactory level of knowledge and competent practice in comparison to pre implementation of the instructional module. Conclusion: The designed instructional module led to significant improvement of knowledge and performance of the studied nurses towards care of hemophilic children. Recommendations: continuous refreshing training should be provided for all of nurses working in hematological departments and caring of children with hemophilia. A manual guided booklet about hemophilia should be available to all nurses working in hematological departments.

The intracellular accumulation of gentamicin acts on mitochondria directly (by increasing oxidative stress) and indirectly (by increasing the proapoptotic BAX gene expression levels) and thus activates intrinsic pathway of apoptosis. This study intended to investigate the probable prophylactic effect of wheat germ as a nephro-protective agent in relation to vitamin E as a well-known natural antioxidant on a nephrotoxic model induced by gentamicin. Forty male Sprague Dawley rats were divided randomly into four groups; of 10 rats each: control group, gentamicin group (120 mg/kg/day i.p. for 15 days), vitamin E group (200 mg/kg orally for 45 days) and wheat germ group (20% of the diet for 45 days). Gentamicin injection was started on the 30th day for both groups (3) and (4). It was noticed that wheat germ significantly decreased BAX/BCL-2 ratio. The significant decrement in MDA level and the significant increment in total antioxidant capacity (TAC) level and catalase (CAT) activity of wheat germ treated rats reflecting its antioxidant activity. Additionally, the wheat germ succeeded in improvement of the kidney function of rats of this group which was manifested by amelioration of deteriorated serum creatinine, urea, sodium and potassium levels. In conclusion, the efficacy of wheat germ as anti-apoptotic and antioxidant was higher than that of vitamin E and it effectively protected against the direct and indirect toxic effects of gentamicin on kidney through regulation of BAX-BCL-2 gene expressions and further inhibition of mitochondrial cytochrome c translocation into cytosol. Keywords: Nephrotoxicity, Gentamicin, Wheat germ, Oxidative stress, Apoptosis, BAX and BCL-2

Background Firearm injuries are a common cause of death in cases typically investigated by medical examiners. Postmortem multislice computed tomography (PMCT) provides valuable information that enhances the autopsy examination. This study was conducted to compare PMCT and autopsy for the detection of injuries and causes of death in cases of fatal firearm injuries. Thirty cadavers were scanned with PMCT and then underwent autopsy. The results of the two techniques were compared regarding entry wounds, wound channels, detection of foreign bodies, organ and skeletal injuries, and causes of death to determine the concordance or discordance between the two techniques. Results The results revealed excellent agreement between PMCT and autopsy for the detection of injuries and causes of death in cases of gunshot injury. Furthermore, PMCT revealed injuries such as pneumothorax and surgical emphysema that were found to be undetermined by autopsies where the special dissection technique was not part of our routine procedures. Conclusion PMCT could be a valuable complementary tool for autopsies to determine and localize injuries and causes of death in cases of gunshot injury.

The current study aimed to identify the effect of strategic flexibility as approach to achieve the sustainable competitive advantage through an analytical study for opinions of Asiacell managers in Iraq. The study problem focused on that to which range the strategic flexibility impact in achieving sustainable competitive advantage. Based on that, a hypothetical model was designed to reflect the correlation and effect relationships between the main factors of study and their dimensions. A group of hypotheses were emerged from the model that reflects these relationships. The study sample included 80 persons, and the questionnaire was the essential instrument to collect the data. Statistical Package for the Social Sciences (SPSS) was used to analyze the data. The main results of study were: There are high level of significant correlation between the strategic flexibility and sustainable competitive advantage. The focus of company on the strategic flexibility leads to enhance the competitive advantage through the service that provides to the customers in compare with competitors. The strategic flexibility and their dimensions (speed, innovative, agility, and alignment) affect the sustainable competitive advantage. Agility, innovative, and alignment was the most important dimensions of strategic flexibility.

Epilepsy is a disorder of the brain that causes recurrent seizures. Effects people at all ages, but with higher rates at primary school age. Children with epilepsy face several social, cultural and learning problems, so that school health nurses and teachers have essential role to decrease these problems. Aim: Evaluate the educational program for school health nurses and teachers regarding primary school children with epilepsy. Design: A quasi experimental design was adopted. Setting: Governmental primary schools in Sammanoud City, Gharbia Governorate, Egypt. Sampling: Two samples were used: For school health nurses, all of them participated in the study, these were 21 school health nurses, and for teachers; simple random sample was used to select 249 teachers, with the following criteria: Direct contact with students in the class or during providing activities. Tools: An interviewing questionnaire which includes 4 parts, 1) Demographic characteristics, 2) School health nurses and teachers' knowledge about meaning of epilepsy, 3) School health nurses and teachers' attitude toward primary school children suffering from epilepsy, and 4) School health nurses and teachers' practice toward primary school children with epilepsy. Results: This study showed, highly statistically significant improvement of school health nurses and teachers' knowledge, attitude, and practices regarding epilepsy (4.23±1.23 to 5.14±1.08 and 1.49±1.07 to 4.57±1.46,) (6.91±1.60 to 10.68±2.06and 2.59±2.32to 9.26±2.21) (2.27±2.55 to 3.18±2.46 and 0.78±1.79 to 3.27±2.38) respectively post educational program implementation. Conclusion: Educational program improved the school health nurses and teachers' knowledge, attitude and practices regarding primary school children with epilepsy. The study results also showed a highly statistically significant and positive correlation between knowledge, attitude and practices of studied samples after educational program implementation. Recommendation: Dissemination of the educational program for school health nurses and teachers at all governmental and nongovernmental schools; Clarified booklet should be provided to school health nurses and teachers to deal them how to deal with children suffering from epilepsy; Training the school health nurses before work to determine how apply educational program for teachers to determine how to deal with children suffering from epilepsy during and after seizure.

Body dissatisfaction is an important component of a variety of prevalent health problems. This study aimed to assess the media influences on body dissatisfaction among female college students. This study included a sample of 408 adolescent females who were chosen randomly from Minia University and completed a survey using the the Sociocultural Attitudes Towards Appearance Scale (SATAQ-4) and Body Shape Questionnaire (BSQ) in the period from 1 March to 1 April 2017. In addition, their body mass index (BMI) was measured. It was found that adolescents who showed marked concern with body shape had higher SATAQ-4 scores. The independent variables (BMI, SATAQ total score and its subscales) explained 58% of the variance in body shape dissatisfaction. The most significant predictors of body dissatisfaction were BMI and subjective feelings of media pressure to have an ideal appearance (β = 0.38 and 0.31, respectively). There was a relation between media influence and body dissatisfaction in this sample of Egyptian female students. Media literacy training could represent a promising approach to eating and body disturbance prevention.

Objectives To assess the patients' awareness of their rights, the predictors of knowledge of patients' rights and the degree of adherence to these rights by the medical team from the patients' perspective. Design A cross-sectional study. Setting Minia University Hospital, Minia, Egypt. Participants Hospitalized patients in Minia University Hospital, from 1 January to 1 February 2017. Methods In total, 514 patients were interviewed during their hospital stay. Data were collected using a structured questionnaire that inquired about their knowledge of the patient rights and the level of practicing these rights from their point of view. Main outcome measures The awareness about different aspects of the patient rights was assessed by a mean knowledge score. Factors affecting the patients' awareness about their rights were evaluated. The extent to which physicians and nurses apply the patient rights from the patients' point of view was measured. Results About 76% of patients did not know that there is a charter of patient rights. The mean knowledge score of patient rights in this study was 7.2 ± 2.71 out of 14. Patients' education associated significantly with their knowledge score. The majority (98.1%) of interviewed patients stated that the medical team did not inform them about the available treatment choices. Conclusions The greater part of the patients was not aware of their rights at a satisfactory level. Health care providers should place more emphasis on increasing the patients' awareness about their rights and involve them in making decisions regarding their treatment choices. The Ministry of Health needs to be more sensitive to this issue.

Amebiasis is an infectious disease caused by Entamoeba histolytica, an anaerobic protozoan parasite, and is a major public health problem worldwide, particularly in areas with inadequate sanitation and poor hygiene. Th1 responses, represented by interferon gamma (IFN-γ), play a protective role by clearing the amebae from the gut, whereas Th2 responses are responsible for chronic infection. Th17 responses preconditioned by vaccination or by modulating the intestinal microbiome protect mice from the settlement of E. histolytica. However, the role of interleukin-17A (IL-17A), which is upregulated during the natural course of intestinal amebiasis, has not been clarified. The aim of this study was to investigate the role of IL-17A during intestinal amebiasis in a mouse model. IL-17A knockout and wild-type CBA/J mice were challenged intracecally with 2×106E. histolytica trophozoites, and their infection, pathology, and immune responses were monitored. Neither the initial settlement of E. histolytica nor the inflammation of the cecum was affected by the absence of IL-17A for week 1, but the infection rate and parasite burden declined in a late stage of infection, accompanied by an increased IFN-γ/IL-4 ratio. Therefore, IL-17A contributes to the persistence of E. histolytica and modulates the immune response, including the IFN-γ/IL-4 ratio, which may be responsible for the reduction of the parasite burden in the IL-17A knockout mice during the chronic phase of intestinal amebiasis.

Since the industrial revolution in the 1800s, plastic pollution is becoming a global reality. This study aims to assess knowledge and attitude about plastic pollution among secondary school students in Sharjah city, United Arab Emirates. A cross-sectional study was conducted among 400 students in 6 different secondary schools in Sharjah city. Self-administered questionnaires were distributed through probability stratified random sampling method between February and April 2016. Majority of the population understands how harmful plastic wastes are to the environment (85.5%). However, the students’ mean knowledge score was 53%, with females (P

Parasites of fish are of concern since they often produce a weakening of the host`s immune system thereby increasing their susceptibility to the secondary infections, resulting in the nutritive devaluation of fish ,compete for food, depriving fish of essential nutrients, inhibiting growth leading to morbidity and mortality and subsequent economic losses. Few data has been reported to identify major parasite of fish in Qena Governorate, Egypt. Accordingly,the study aimed to estimate the prevalence of gastrointestinal parasite infecting fish. Afield study was conducted during the period from the beginning of January 2015 to the end of December 2016.A total of 144 Clarias gariepinus (Carmoot) fish samples were collected either alive from fishermen or fresh as possible from fish markets at Qena Governorate for parasitological studies. Parasite collected and prepared then identified under the microscope. Out of 144 examined fish 84 (58.3%) samples were infected with different gastrointestinal parasites. The obtained results found that the most frequent parasitic infection among examined fish was cstodes with an infection rate of (35.4%) ,followed by trematodes infection (27%), while the lowest infection rate, were recorded in nematodes infection(16.7%),Regarding to the seasonal prevalence of the recovered parasites, we concluded that the highest rate of parasite infection was observed during Spring season (83.3%), followed by Winter (66.7%), Summer recorded (50%) and Autumn season which represented the lowest rate of infection (33.3%). The most common species of cestodes were Monobothrium sp which recorded the highest infection rate (27.8%) and Polyonchobothrium clarias (5.6%), followed by trematode species Orientocreadium batrachoides (24.3%) and nematode species Paracamallanus cyathopharynx (10.4%) and Procamallanus laevionchus (5.6%).

Background This study aimed to assess the effect of cotton dust on respiratory symptoms and spirometric functions test among cotton textile workers. Patients and Methods This prospective study was conducted at El-Mahalla Chest Hospital on 115 subjects (100 workers exposed to cotton dust from Misr Company for Spinning and Weaving and 15 healthy subject not exposed to cotton dust). All subjects, were subjected to a standardized questionnaire which was patterned according to American Thoracic Society questionnaire and spirometric functions test [Forced expiratory in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, peak expiratory flow rate (PEFR)% and maximum midexpiratory flow (MMEF) %]. Results There was a highly significant statistical difference on comparing presence of respiratory symptoms between control group and cotton exposed groups. There was significant statistical difference on comparing the presence of respiratory symptoms between control group and weaving, spinning, opening of cotton bales and carding groups. Respiratory symptom was the highest prevalent in spinning and weaving workers. Cough, expectoration and chest tightness were the highest prevalent symptoms in cotton exposed groups. Cough, expectoration were the highest prevalent in spinning and weaving workers. There was significant statistical difference on comparing FEVI%, FVC%, FVC/FEV1% and PEFR % between control group and cotton exposed groups. There was no significant statistical difference on comparing MMEF% between control group and cotton exposed groups. There was positive correlation between presence of respiratory symptoms and duration of exposure to cotton dust, the longer the duration of exposure to cotton dust the higher the presence of respiratory symptoms. There was no correlation between period of exposure to cotton dust and spirometric functions. Conclusion Cotton workers are at risk for developing respiratory symptoms. Respiratory symptoms was highest prevalent in worker works at spinning and weaving. Spirometric functions were less in cotton exposed workers as compared to control.

Background: Continually rising prevalence of obesity and overweight in children and adolescents is a major public health concern. This is due to its various and serious health hazards on one side and its preventable nature on the other side. This study aims at identification of prevalence of overweight and obesity and its risk factors among children between 6 - 14 years of age in Sohag, Egypt. Method: A cross sectional study was conducted on 711 school children between 6 - 14 years in four months’ period from February to May 2016. Weight and height of the studied children were measured to calculate BMI, which was compared with standard Egyptian growth charts for determining overweight and obesity. Then a questionnaire containing data about socio demographic, parental obesity, early life and dietary risk factors was completed by the children’s parents. Result: Out of 711 studied children, 117 (16.5%) were overweight and 104 (14.6%) were obese. Residing in urban area, having an obese parent or both of them, low level of maternal education, being on formula feeding during early life and lack of fresh vegetables and fruits in diets were significant risk factors for overweight and obesity in the studied children (P value < 0.05). Conclusion: Improperly educated mothers together with sedentary life style manifested in obesity among the parents and lack of sport practice among children constituted the majors risk factors for childhood obesity. This emphasizes the need for increased health awareness of the community about the importance of proper nutrition and physical activity.

Despite the wide application of iron oxide nanoparticles (IONPs), little is known about the specific mechanism of their nephrotoxic effect. We aimed to evaluate the nephrotoxic effects of iron oxide nanoparticles (IONPs) in vivo and the protective effect of ellagic acid (EA) as a silent information regulator sirtuin 1 (SIRT1) activator against the induced nephrotoxicity. Forty male albino Wistar rats were randomly distributed into four equal groups (10 rats each): the control group (oral saline for 30 days), ellagic acid (EA) group (10 mg/kg b.w. EA, orally for 30 days), IONP group (20 mg/kg b.w. IONP I/P injection at the 24th–30th day), and EA + IONP group (10 mg/kg b.w./day EA for 30 days + 20 mg/kg b.w. IONPs at the 24th–30th day). In the present study, the potent antioxidant and antiapoptotic effects of EA were indicated by the significant overexpression of SIRT1 in renal tissues that leads to significant decreases in renal MDA content, P53 protein level and forkhead-box transcription factor1 (FOXO1) expression, and significant increases in renal GSH level, catalase activity, growth arrest and DNA damage-inducible protein 45 alpha (GADDα45), and renal inhibition of apoptosis protein (KIAP) gene expression levels in the EA + IONP-treated group. These results were confirmed by the improved histopathological renal features with EA administration. In conclusion, the present study provides the first evidence for the usefulness of EA as a sirtuin1 activator in the prevention or treatment of renal damage. Thus, EA could be used as a promising therapy for the prevention of IONP-induced nephrotoxicity.