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We hypothesized that an accurate assessment of preoperative venography could be useful in predicting transvenous lead extraction (TLE) difficulty.A dedicated preoperative venogram was performed in consecutive patients with cardiac implantable electronic device who underwent TLE. The level of stenosis was classified as without significant stenosis, moderate, severe, and occlusion. The presence of extensive lead-venous wall adherence (≥50 mm) was also assessed. A total of 105 patients (median age: 71 years; 72% male) with a median of 2 (1-2) leads to extract were enrolled. Preoperative venography showed moderate to severe stenosis in 31 (30%), complete occlusion in 15 (14%), and extensive lead-venous wall adherence in 50 (48%) patients. Complete TLE success was achieved in 103 (98%) patients. A total of 55 (52%) were advanced extractions as they required a powered mechanical and/or laser sheath. They were more prevalent in the group with extensive lead-venous wall adherence (72% vs. 34%, p .001), while no differences were found between patients with and without venous occlusion. In multivariate analysis, the presence of adherence was a predictor of advanced extraction (odds ratio: 2.89 [1.14-7.32], p = .025). The fluoroscopy time was also significantly longer (14.0 [8.2-18.7] vs. 5.1 [2.1-10.0] min, p .001). The rate of complications did not differ based on the presence of venous lesions.Although procedural success and complication rates were similar, patients with extensive lead-venous wall adherence required a longer fluoroscopy time and were three times more likely to need advanced extraction tools. Conversely, the presence of total venous occlusion had no impact on the procedure complexity.

Fungal eye infections are caused mainly by an eye injury and can result in serious eye damage. Fluconazole (FLZ), a broad-spectrum antifungal agent, is a poorly soluble drug with a risk of hepatotoxicity. This work aimed to investigate the antifungal activity, ocular irritation, and transport of FLZ-loaded poly (ε-caprolactone) nanoparticles using a rabbit eye model. Three formulation factors affecting the nanoparticle’s size, zeta potential, and entrapment efficiency were optimized utilizing the Box-Behnken design. Morphological characteristics and antifungal activity of the optimized nanoparticles were studied. The optimized nanoparticles were loaded into thermosensitive in situ hydrogel and hydroxypropylmethylcellulose (HPMC) hydrogel ophthalmic formulations. The rheological behavior, in vitro release and in vivo corneal transport were investigated. Results revealed that the percentage of poly (ε-caprolactone) in the nanoparticle matrix, polymer addition rate, and mixing speed significantly affected the particle size, zeta potential, and entrapment efficiency. The optimized nanoparticles were spherical in shape and show an average size of 145 nm, a zeta potential of −28.23 mV, and a FLZ entrapment efficiency of 98.2%. The antifungal activity of FLZ-loaded nanoparticles was significantly higher than the pure drug. The developed ophthalmic formulations exhibited a pseudoplastic flow, prolonged the drug release and were found to be non-irritating to the cornea. The prepared FLZ pegylated nanoparticles were able to reach the posterior eye segment without eye irritation. As a result, the developed thermosensitive in situ hydrogel formulation loaded with FLZ polymeric nanoparticles is a promising drug delivery strategy for treating deep fungal eye infections.

Background An innovative therapy for symptomatic hemorrhoids has been recently proposed it relies on the reduction of hemorrhoidal vascular flow by suturing hemorrhoidal arteries, which are previously located by means of an ultrasound transducer. Objective To evaluate retrospectively the outcome of Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids. Patients and Methods Aretrospective study. The study conducted in Ain Shams University Hosptial (El Demerdash) under supervision of these supervisors. Study period: Six months. Results In our series, the HAL technique has achieved complete control of symptoms in 93.3% of patients after six-monthes follow-up. Conclusion Hemorrhoid ligation with mucopexy is a simple, safe and cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. It can be performed on an outpatient or day care basis on all grades of hemorrhoids to control bleeding and prolapsing hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.

Background Emergence agitation (EA) in children early after sevoflurane anaesthesia is a common postoperative problem, with incidence ranging up to 80%, It is characterized by behavior that can include crying, disorientation, excitation and delirium, several drugs have been tried in this regard including but not limited to propofol, midazolam, ketamine and ketorolac among other drugs. Aim of the Work To compare the effect of intravenous Midazolam vs intravenous Haloperidol & in prevention of Sevoflurane Emergence Agitation in pediatric patients undergoing Inguinal Surgeries. Patients and Methods This prospective randomized study was done after approval of institutional ethics committee in Ain Shams university Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include sixty-two pediatric patients, aged 3 to 12 years of both genders, with physical status ASA Ι and ASA ІІ. All surgical procedures were elective of an expected duration of 30 - 60 minutes e.g. inguinal hernia repair, hydrocele, orcheopexy under general anesthesia and caudal block to relief pain. All operations were performed in supine position. Results Our study was applied on age group between 3- 12 years old Haloperidol was associated with 24% EA and was also associated with significant delay in eye opening and time till discharge from PACU when compared to Midazolam. Conclusion I.V Midazolam is more efficient than I.V Haloperidol for prevention of Sevoflurane Emergence agitation in pediatric patients undergoing inguinal surgeries.

Hepatitis B virus (HBV) infection is a significant health issue worldwide.. We attempted to fulfill the molecular mechanisms of epigenetic and genetic factors associated with chronic HBV (CHBV). Expression levels of the lncRNA growth arrest-specific 5 (GAS5) and miR-137 and their corresponding SNPs, rs2067079 (C/T) and rs1625579 (G/T) were analyzed in 117 CHBV patients and 120 controls to investigate the probable association between these biomarkers and CHBV pathogenesis in the Egyptian population. Serum expression levels of GAS5 and miR-137 were significantly down-regulated in cases vs controls. Regarding GAS5 (rs2067079), the mutant TT genotype showed an increased risk of CHBV (p p = 0.004). Regarding miR-137 rs1625579, the mutant genotype TT was reported as a risk factor for CHBV (p p = 0.007). Concerning miR-137 rs1625579, the mutant TT genotype was significantly associated with a lower serum expression level of miR-137 (p = 0.018). We revealed the dysregulated expression levels of GAS5 and miR-137 linked to their functioning SNPs were associated with CHBV risk and might act as potential therapeutic targets.

Background Anal fistula is abnormal communication between the anal canal and the perianal skin or perineum or buttocks. Anal fistula is almost always a consequence of an anorectal abscess that was drained. While the abscess represents the acute phase of the disease, fistula represents the chronic phase as the fistulous pathway may persist in about 1/3 of cases. Aim of the Work In this study we will perform fistulotomy with primary sphincter repair in high cryptoglandular fistula with assessment of recurrence rate, incontinence rate and patient satisfaction according to pain score, wound healing, discharge and return to daily activity parameters. Methods This was prospective cohort study on 30 patients of high peri-anal fistulae and fistulotomy and reconstruction (primary suture repair) of anal sphincter was done., the patients were followed up 6 months postoperatively regarding their continence using Wexner score, recurrence, discharge and their return to work by scheduled outpatient clinical examination. Results Among 30 patients only three patients complaining usual incontinence mostly as post defecation soiling. Three patients reported anal fistula recurrence: One occurred at the 5th month, while the other two occurred at the 6th month after surgery. The procedure was well tolerated by the patients as most of them complaining only minimal pain and returned to work after two weeks without need of other stage like other procedures. Conclusion Fistulotomy with primary sphincter repair is an effective therapeutic option for patients with high anal fistula. Our study demonstrated that immediate reconstruction of the sphincters after fistulotomy achieved high success rates and low risk of postoperative fecal incontinence, compared to reported rates after simple fistulotomy.

This work aimed to develop a three-dimensional printed (3DP) tablet containing glimepiride (GLMP) and/or rosuvastatin (RSV) for treatment of dyslipidemia in patients with diabetes. Curcumin oil was extracted from the dried rhizomes of Curcuma longa and utilized to develop a self-nanoemulsifying drug delivery system (SNEDDS). Screening mixture experimental design was conducted to develop SNEDDS formulation with a minimum droplet size. Five different semi-solid pastes were prepared and rheologically characterized. The prepared pastes were used to develop 3DP tablets using extrusion printing. The quality attributes of the 3DP tablets were evaluated. A non-compartmental extravascular pharmacokinetic model was implemented to investigate the in vivo behavior of the prepared tablets and the studied marketed products. The optimized SNEDDS, of a 94.43 ± 3.55 nm droplet size, was found to contain 15%, 75%, and 10% of oil, polyethylene glycol 400, and tween 80, respectively. The prepared pastes revealed a shear-thinning of pseudoplastic flow behavior. Flat-faced round tablets of 15 mm diameter and 5.6–11.2 mm thickness were successfully printed and illustrated good criteria for friability, weight variation, and content uniformity. Drug release was superior from SNEDDS-based tablets when compared to non-SNEDDS tablets. Scanning electron microscopy study of the 3DP tablets revealed a semi-porous surface that exhibited some curvature with the appearance of tortuosity and a gel porous-like structure of the inner section. GLMP and RSV demonstrated relative bioavailability of 159.50% and 245.16%, respectively. Accordingly, the developed 3DP tablets could be considered as a promising combined oral drug therapy used in treatment of metabolic disorders. However, clinical studies are needed to investigate their efficacy and safety.

Background Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for earlystage breast cancers. Objectives The aim of this work is to evaluate the Effectiveness of Ultrasound Guided Pectoral nerve block (PEC1) versus Serratus Anterior plane block (SAPB) for postoperative Analgesia in Modified Radical Mastectomy Patients and Methods After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 15 patients group I in which patients received PEC 1 and group II in which patients received Serratus Anterior Plane Block (SAPB). Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed. Conclusion SAPB was effective in reducing postoperative pain scores for 6 -12 hours and lower total 24-h postoperative opioid and analgesic consumption after Modified Radical Mastectomy under general anesthesia, compared to PEC 1 block.

Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

Background Injectable in situ gel (ISG) systems suffer from high initial drug release that may result in toxic effects. Objective This work aimed to develop an injectable sustained release rosuvastatin (RSV) ISG formulation with minimum initial drug burst and improved hyperlipidemic efficacy. Methods Six formulation factors that affect RSV release after 0.5, 2 and 24 hrs have been screened and the significant ones were optimized utilizing an experimental design tool. The optimum ISG formulation components were physicochemically characterized. Kinetic treatment, dissolution efficiency and mean dissolution time were investigated for the developed ISG formulations. Pharmacodynamic effects of the optimized ISG formulation were studied and compared to ISG formulation loaded with free RSV and to a marketed oral drug product. Results The concentration polylactide-co-e-caprolactone (25: 75), the surfactant hydrophilic lipophilic balance (HLB) and the ratio of surfactant to polyethylene glycol 400 were significantly affecting the release of RSV during the first 24 h. Physicochemical characterization demonstrated complete dispersion of RSV in the polymeric matrix with slight changes in the drug crystalline structure. The optimized formulation demonstrated acceptable syringeability, good flow rate and was able to extend the in vitro drug release for 34 days. The ISG formulations complied with Weibull model. Pharmacodynamic study revealed a sustained reduction in the lipid profile that lasted for 21 days with a marked decrease in the lipid level during the first 24 hrs from the ISG system loaded with free RSV. Conclusion The optimized RSV ISG formulation could be considered a promising strategy due to a reduction in dosing frequency and enhancement in hypolipidemic efficacy.

Background: T regulatory cells (Tregs), through variable mechanisms, play a crucial role in Hepatitis C virus (HCV) chronicity and infection tolerance. A great speculation is posed regarding the le...

Block ciphers cryptanalysis is serious challenge specially with the existing of the powerful block ciphers that require massive number of plaintext-ciphertext pairs to perform a successful attack. Algebraic attack is superior among different attack types as it does require the smallest number of such pairs. On the other hand, the equations describe the input/output relations should be in hand to execute the algebraic attack. In this paper, we present the method of collecting the input/output algebraic equations for 2-key simplified 3-DES as a miniature example of the 2-key 3-DES. The simplified DES has similar structure and characteristics to DES with the privilege of using smaller parameters than DES. Also, we prove that the complementation property of DES can be used to double the number of obtained algebraic equations for 3-DES variants and consequently decreasing the required number of plaintext-ciphertext pairs. Finally, we compared the expected number of obtained equations and variables in both 2-key simplified 3-DES and 2-key 3-DES.

As the cost of solar photovoltaic (PV) systems decreases and incentives such as feed-in tariffs (FiTs) are offered, solar-PV homes are becoming popular. Furthermore, solar-PV homes integrated with hybrid or electric vehicles (EVs) are emerging as a paradigm for future homes. Given the fact that there exists a considerable price difference between grid electricity supply and FiTs, decision making of energy storage using batteries becomes an imperative topic. This research proposes an innovative and generic framework for the decision making of energy storage using batteries based on Smart Meter data, which incorporates the actual energy generation and consumption patterns of solar-PV homes. The proposed energy storage decision is based on a developed economic model, with the consideration of the electricity price from the grid, the FiTs, and the storage cost using batteries (i.e. the average price per kWh of battery capital cost and maintenance cost). Moreover, an intelligent algorithm is developed to calculate the electricity quantities, i.e. electricity supplied from the grid, fed into the grid and stored in a battery of a given capacity, based on the monitored data obtained from a Smart Meter over a year. The results reveal that at the present utility prices of $0.3/kWh and a feed-in-tariff of $0.10/kWh in the studied region, energy storage with a battery cost of $0.2/kWh or more is excessive and not economically feasible. However, with the increasing cost of electricity in recent years and constant changes in battery price, the outcomes could quickly reverse. This research contributes an innovative framework for battery storage decision-making of solar-PV homes, based on economic analysis and Smart Meter data.

Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease. We aimed to measure the level of miR-155 and its genetic variant rs767649 in patients with RA and to evaluate their rela...

Background: Vinpocetine (VPN) is a synthetic derivative of the Vinca minor alkaloids. The drug is characterized by a short half-life, limited water solubility and high hepatic first-pass effect. The objective was to develop different lipid-based nanocarriers (NCs) loaded into a thermosensitive in situ gelling (ISG) system to improve VPN bioavailability and brain targeting via intranasal (IN) delivery. Methods: Different lipid-based NCs were developed and characterized for vesicle size, zeta potential, VPN entrapment efficiency (EE) and morphological characterization using transmission electron microscope (TEM). The prepared NCs were loaded into ISG formulations and characterized for their mucoadhesive properties. Ex-vivo permeation and histological study of the nasal mucosa were conducted. Pharmacokinetic and brain tissue distribution were investigated and compared to a marketed VPN product following administration of a single dose to rats. Results: VPN-D-α-Tocopherol polyethylene glycol 1000 succinate (TPGS) micelles nano-formulation showed the smallest particle size, highest EE among the studied NCs. TEM images revealed an almost spherical shape for all the prepared NCs. Among the NCs studied, VPN-loaded TPGS micelles demonstrated the highest percent cumulative VPN ex vivo permeation. All the prepared ISG formulations revealed the presence of mucoadhesive properties and showed no signs of inflammation or necrosis upon histological examination. Rats administered IN VPN-loaded TPGS-micelles ISG showed superior VPN concentration in the brain tissue and significant high relative bioavailability when compared to that received raw VPN-loaded ISG and marketed drug oral tablets. VPN-D-α-Tocopherol polyethylene glycol 1000 succinate (TPGS) micelles nano-formulation showed the smallest particle size, highest EE among the studied NCs. TEM images revealed an almost spherical shape for all the prepared NCs. Among the NCs studied, VPN-loaded TPGS micelles demonstrated the highest percent cumulative VPN ex vivo permeation. All the prepared ISG formulations revealed the presence of mucoadhesive properties and showed no signs of inflammation or necrosis upon histological examination. Rats administered IN VPN-loaded TPGS-micelles ISG showed superior VPN concentration in the brain tissue and significant high relative bioavailability when compared to that received raw VPN-loaded ISG and marketed drug oral tablets. Conclusion: VPN-loaded TPGS-micelles ISG formulation is a successful brain drug delivery system with enhanced bioavailability for drugs with poor bioavailability and those that are frequently administered.

Let α be an ordinal and L be a unimodal logic (like S4 or S5). A modal cylindric algebra of dimension α, an LCAα, is a cylindric algebra of dimension α, expanded with α-many L modalities. F...

Background Data: Povidone-iodine is very effective broad spectrum antiseptic solution against different types of pathogens including methicillin-resistant Staphylococcus aureus and some strains of Enterococcus faecium based on the antiseptic properties of iodine. Purpose: To evaluate the effect of intraoperative 3.35 % povidone-iodine irrigation in lumbar spine fusion surgeries. Study Design: Retrospective clinical case study. Patients and Methods: 93 spine fusion surgeries in 2016 (Group I) and 112 fusion surgeries in 2017 (Group II). Both groups were retrospectively compared regarding infection rate, fusion rate, and Oswestry Disability Index (ODI) score. Group I had intraoperative saline irrigation and Group II was irrigated with 3.35 % povidone-iodine. Results: There were no reported infections in Group II. Two superficial and two deep wound infections were observed in Group I. Complete wound dehiscence was found in one patient with deep wound infection. The pathogens were methicillin-resistant Staphylococcus aureus in two cases, Klebsiella pneumonia in one case, and combination of methicillin-sensitive Staphylococcus aureus and Staphylococcus epidermidis in the last case. There was insignificant difference between the two groups in fusion rates and with no linear correlation relationship between povidone-iodine soaking time and the fusion rate in Group II. There was significant postoperative ODI improvement in the two groups relative to the preoperative scores with insignificant statistical difference when comparing this improvement of the two groups. Conclusion: Povidone-iodine 3.35% irrigation in lumbar spine fusion surgery is effective in decreasing postoperative infection with no negative influence on the fusion rate or clinical outcome. (2019ESJ177)

Despite the increased proof that long noncoding RNAs (lncRNAs) can control gene expression and broadly affect the normal physiological and disease conditions, the part of lncRNAs in rheumatoid arthritis (RA) is not well known. This study aimed to assess the serum expression levels of lnc-Cox2 and HOTAIR in RA and to investigate their role as novel noninvasive biomarkers in diagnosis of RA. Also, their relations with the levels of interleukin (IL)-6 and matrix metalloproteinase (MMP)-9 and with other clinicolaboratory data in RA patients were analyzed. LncRNAs-Cox2 and HOTAIR expression levels were detected in serum by real-time quantitative polymerase chain reaction. Both IL-6 and MMP-9 levels in serum were measured by enzyme-linked immunosorbent assay. The mRNA expression of lncRNA-Cox2 and HOTAIR was significantly upregulated in RA patients compared with healthy controls. Serum levels of both IL-6 and MMP-9 were significantly higher in RA patients than in healthy subjects (P 0.001 each). Receiver operating characteristic (ROC) curve demonstrated that lncRNA-Cox2 and HOTAIR could discriminate RA patients from healthy controls. HOTAIR (not lnc-Cox2) was observed to be an independent predictor for RA using multiple logistic regression analysis. We concluded that lnc-Cox2 and HOTAIR serum expression levels can be used as novel noninvasive biomarkers for the diagnosis of RA.

Background The role of the long non-coding RNAs (lncRNAs) in the pathogenesis of systemic lupus erythematosus (SLE) is mostly unknown, despite increasing evidence that lncRNAs extensively participate in physiological and pathological conditions. Aim To detect the level of lncRNA-Cox2, HOTAIR, IL-6, and MMP-9 in the serum of SLE patients and to correlate these levels with disease activity and patients’ clinical and laboratory data to evaluate the value of these biomarkers for SLE diagnosis and assessment of disease activity. Methods Blood samples from 58 SLE patients, and 60 healthy controls (HCs) were used for detection of lncRNAs-Cox2 and HOTAIR expression levels by real-time polymerase chain reaction. Both IL-6 and MMP-9 serum levels were assayed by enzyme-linked immunosorbent assay. Lupus activity was assessed with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Results The serum expression levels of lncRNA-Cox2 and HOTAIR were significantly up-regulated in SLE patients vs HCs (fold change [median (IQR) was 1.29(0.81–1.71, PP = 0.038) for lncRNA-Cox2 and HOTAIR, respectively. Serum levels of both IL-6 and MMP-9 were significantly high in SLE patients compared with HCs (P≤0.001 for each). The up-regulated lncRNA-Cox2 was positively associated with the presence of neurological manifestations in SLE patients (P = 0.007). Furthermore, HOTAIR expression level had significantly positive correlation with IL-6 (r = 0.578, P(r = 0.762, Pr = 0.296, P = 0.024) and proteinuria (r = 0.287, P = 0.035). LncRNA-Cox2 showed sensitivity and specificity 72.4%, and 100.0% respectively. HOTAIR sensitivity was 60.3%, and specificity was 100.0%. By multiple logistic regression analysis, lncRNA-Cox2 and HOTAIR were found as SLE independent predictors. Conclusion LncRNA-COX2 and HOTAIR can be used as new non-invasive biomarkers for the diagnosis of SLE.

Genetic variants in microRNAs (miRNAs) can alter the miRNAs expression and/or function, accordingly, affecting the related biological pathways and disease risk. Dysregulation of miR-155 and miR-146a expression levels has been well-described in viral hepatitis B (HBV). In the current study, we aimed to assess rs767649 T/A and rs57095329 A/G polymorphisms in miR-155, and miR-146a genes, respectively, as risk factors for Chronic HBV (CHBV) in the Egyptian population. Also, we aimed to do in silico analysis to investigate the molecules that primarily target these miRNAs. One hundred patients diagnosed as CHBV and one hundred age and sex-matched controls with evidence of past HBV infection were genotyped for miR-155 (rs767649) and miR-146a (rs57095329) using real-time polymerase chain reaction. The rs767649 AT and AA genotypes in CHBV patients confer four folds and ten folds risk respectively, as compared to control subjects [(AOR = 4.245 (95%CI 2.009–8.970), pppp = 0.004] and [AOR = 5.604 (95%CI 2.157–14.563), p

Reconstruction of a tendon rupture is surgically challenging as each end of the tendon retracts, leaving a substantial gap and direct repair is often not feasible. A tendon graft is required to bridge this defect and restore function. Presently, these gaps are filled with auto-, allo-, or synthetic grafts, but they all have clinical limitations. To address this issue, we developed tissue-engineered grafts by a rapid process using compressed type I collagen, which is the most dominant protein in the tendon. However, biomechanical properties were found to be unsuitable to withstand complete load-bearing in vivo. Hence, a modified suture technique was previously developed to reduce the load on the engineered collagen graft to aid integration in vivo. Using this technique, we tested engineered collagen grafts in vivo on a lapine model in three groups up to 12 weeks without immobilization. Gross observation at 3 and 12 weeks showed the bridge integrated without adhesions with a significant increase in the mechanical, structural and histological properties as compared to 1 week. Insertion of a tissue-engineered collagen graft using a novel load-bearing suture technique which partially loads in vivo showed integration, greater mechanical strength and no adhesion formation in the time period tested. This collagen graft has inherent advantages as compared to the present-day tendon grafts.

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This study aimed to enhance the dissolution of simvastatin (SMV) through its formulation in liquisolid tablets (LSTs) to improve its bioavailability and hypolipidemic activity after oral administration. SMV-LSTs were optimized using Box-Behnken design to maximize the rate and extent of SMV dissolution. The optimized SMV-LST was evaluated for pharmacokinetic parameters and potential hypolipidemic activity on induced hyperlipidemic rats. The dissolution parameters revealed a shortening of mean dissolution time from 10.99 to 6.82 min, increasing of dissolution rate during the first 10 min from 1253.15 to 1667.31 μg/min, and enhancing of dissolution efficiency after 60 min from 71.92 to 86.93% for SMV-LSTs versus the commercial SMV tablets. The obtained data reflected an improvement in the relative bioavailability of SMV with 148.232% which was confirmed by the significant reduction of the levels of circulating total cholesterol, triglycerides that reached the normal level after 12 h. In particular, the optimized SMV-LSTs reduced serum low-density lipoproteins (LDL) by 44.6% which was significantly different from the commercial SMV tablets. In contrast, the level of serum high-density lipoprotein (HDL) was significantly augmented after 4 h in rats treated with the optimized SMV-LSTs by 47.6%. Finally, the optimized SMV-LSTs showed a significant lower atherosclerotic index value which could maximize its potential in decreasing the risk of coronary disease and atherosclerosis. Overall enhancement in pharmacokinetics and pharmacodynamics in comparison with the commercial tablets confers the potential of the liquisolid approach as a promising alternative for improved oral bioavailability, hypolipidemic, and cardioprotective effects of SMV. Graphical abstract.

Rosuvastatin is a hypolipidemic drug of limited oral bioavailability. The aim was to develop rosuvastatin flexible chitosomes and loading into a pullulan-based tablet to improve the bioavailability and maximize the antihyperlipidemic and antioxidant activities. Chitosomes nanoparticles were developed and characterized. Pullulan-based lyophilized fast dissolving tablets were developed and evaluated. The tablets' outer and inner structures were morphologically investigated. In vivo disintegration of the prepared tablets was studied in healthy human volunteers. The pharmacokinetics, antihyperlipidemic, antioxidant, and biochemical markers activities were conducted after administration of the tablets into male Wister rats. Liver histopathology was also investigated. The prepared chitosomes illustrated an average particle size of 342.22 ± 2.90 nm, a zeta potential value of +28.87 ± 1.39 mV and a drug entrapment efficiency of 94.59 ± 1.62%. The developed tablets showed an acceptable quality control characteristics and in vivo disintegration time of 1.48 ± 0.439 min. Scanning electron microscopy revealed distinct porous surface and sponge-like inner structure. The chitosomes based tablets demonstrated higher relative bioavailability by more than 30% and 36% when compared with the corresponding pure rosuvastatin and the marketed drug tablets, respectively. Moreover, the chitosomes based tablets showed a significant improvement in the hepatic serum biomarkers and a dramatic decrease in the serum antioxidants in response to Poloxamer 407 intoxication. The prepared tablets did not exhibit marked histopathological changes in the hepatic tissues. Accordingly, the pullan-based lyophilized fast-dissolving tablets loaded with chitosomes nanoparticles could be considered as a promising drug formulation for enhancing rosuvastatin bioavailability and pharmacodynamics activity.

With the trends of comfort modelling moving more towards the application of Adaptive Models, the influences of several parameters as used in the traditional ISO7730 standard are therefore non-existent. The proposed work considers the conventional ISO 7730 standard as conservative in its calculation; however extremely useful, in cases where actual measurements of spaces are considered (ISO 7730, 1994). Measurements from a comfort cart built according to ASHRAE-55 standards (ANSI/ASHRAE 55, 2005) together with thermal imaging temperatures are combined. In doing so, an ISO 7730 thermal comfort assessment applying the CBE – ASHRAE 55-2004 Comfort Tool allows for changes in the environment to be examined for improved comfort (Huizenga, 2006; Tyler et al, 2017). Results for two cases in a severe Darwin climate yield an improved PPD by 2.5-2.7 times when implementing extremely low- energy measures.

In this paper, we give new proofs of the celebrated Andreka-Resek-Thompson representability results of certain axiomatized cylindric-like algebras. Such representability results provide com...

Egypt, as a developing country, is facing many environmental, social, and economic issues in its cities. Those issues are the challenges for The Egyptian government to achieve sustainability and improve inhabitants' quality of life in the future cities vision of the nation. The fourth cyber-physical revolution and the growing exponentially innovations of information and communications technologies (ICT) were the catalyst for the Egyptian stakeholders to target the sustainable smart city concept for the new future Egyptian cities generation. The research aims to characterize the smart concept for the Egyptian environment by proposing an ICT architecture for the smart city model within the Egyptian cities and highlight the innovative ICT that it will affect the future performance of such smart cities. The research attempts also to identify the main Egyptian smart initiatives that would offer appropriate sustainable solutions and improve the quality of life of the Egyptian inhabitants. To achieve the research objectives the innovative ICT installation requirements were studied to propose a compatible ICT architecture for the future city structure and an interview for experts were statistically analyzed to determine the Smart city initiatives and smart component systems prioritization for the future generation Egyptian cities. The research concluded that there is no unique standards of the city smartness concept and a community requirements study must be considered before deciding the smart initiatives and the smart systems components to be installed. The research determines that nowadays mobility, infrastructure and governance are the main smart initiatives of smartness for the Egyptian cities. Water and energy smart components of infrastructure initiative and the solid waste smart component systems of the environmental initiative are the main requirements for the Egyptian cities. Other smart component system requirements depend on the city concerns and the quality of life state of economic district level of the city.

Aim of work To determine level of ischemia-modified albumin (IMA) in patients with Behçet’s disease (BD) and to assess its role in disease manifestations and activity. Patients and methods The study included 48 patients with BD and 38 matched controls. Disease activity was estimated by the BD current activity form. Serum IMA was measured. Results Mean age of the patients was 33.8±7.9 years. There were 42 males and six females, and the disease duration was 52.9±48.8 months. The serum IMA level was significantly increased in the patients with BD (50.9±12.9 U/ml) compared with the control (7.76±1.6 U/ml) (P

In this article, C6H9NaO7 fluid is considered over an accelerated vertical plate. The plate is heated from the bottom. Non-Newtonian model of C6H9NaO7 (Sodium Alginate) is considered. Convection term in momentum equations is also taken. The dimensionless form of the problem is constructed based on the dimensionless variables. The integral transformation of Laplace is used for developing the exact solution to the problem. Explicit expressions are obtained the field of velocity and distribution of temperature. Based on that, the skin-friction and Nusselt number results for corresponding are computed. Equations for entropy generation (EG) and Bejan number (BN) are developed. Results are plotted and discussed for embedded parameters. Most significantly, the results for EG and BN are computed and discussed.

Background: The generalized muscle weakness found in Chronic Kidney Diseases (CKD) patients on hemodialysis primarily affects the lower limbs and the proximal muscles. Patients also present decreased endurance and decreased respiratory muscle strength.Aim of Work: The purpose of this study was to evaluate the effect of incentive spirometer training on diaphragmatic excursion and Quality of Life (QOL) in Hemodialysis (HD) patients.Subjects and Methods: Sixty HD patients (30 men and 30 women) selected from the National Institute of Urology and Nephrology participated in the study, their ages ranged from 45-55 years from July 2017 to January 2018. They were assigned randomly into two groups equal in number; 30 patients each: Group (A) received incentive spirometer training with hemodialysis for 8 weeks, 3 sessions per week. Group (B) maintained on hemodialysis only for 8 weeks 3 sessions per week with pre and post assessment of diaphragmatic excursion by ultrasonography and QOL questionnaire.Results: Incentive spirometer training induced a significant improvement in diaphragmatic excursion and quality of life questionnaire in study group with percent of change 24.62% and 55.67% respectively while a deterioration was observed in control group with percent of change 26.49%, and 38.68% respectively.Conclusions: Incentive spirometer training for 8 weeks in HD men and women results in an improvement of diaphrag-matic excursion and QOL.

Osama AA Ahmed,1,2 Khalid M El-Say,1,3 Bader M Aljaeid,1 Shaimaa M Badr-Eldin,1,4 Tarek A Ahmed1,3 1Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Minia University, Minia, Egypt; 3Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt; 4Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt Background: Vinpocetine (VNP), a semisynthetic natural product, is used as a vasodilator for cerebrovascular and age-related memory disorders. VNP suffers from low oral bioavailability owing to its low water solubility and extensive first-pass metabolism. This work aimed at utilizing D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) and alpha lipoic acid (ALA) to develop efficient micellar system for transdermal delivery of VNP. Materials and methods: VNP-TPGS-ALA micelles were prepared, characterized for particle size using particle size analyzer, and investigated for structure using transmission electron microscope. Optimization of VNP-TPGS-ALA micelles-loaded transdermal films was performed using Box–Behnken experimental design. The investigated factors were percentage of ALA in TPGS (X1), citral concentration (X2), and propylene glycol concentration (X3). Elongation percent (Y1), initial permeation after 2hours (Y2), and cumulative permeation after 24 hours (Y3) were studied as responses. Results: Statistical analysis revealed optimum levels of 16.62%, 3%, and 2.18% for X1, X2, and X3, respectively. Fluorescent laser microscopic visualization of skin penetration of the optimized transdermal film revealed marked widespread fluorescence intensity in skin tissue after 0.5, 2, and 4 hours compared with raw VNP transdermal film formulation, which indicated enhancement of VNP skin penetration. Conclusion: The obtained results highlighted the potentiality of VNP nanostructure-based films for controlling the transdermal permeation of the drug and improving its effectiveness. Keywords: bioavailability, box behnken design, citral, fluorescent laser microscope, nanostructured-based films, permeation