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Cloud computing has grown rapidly in the last decade, where many tenants are using various cloud applications. Cloud computing users expect and demand to run their applications with the highest performance, reliability, and best quality of service. So, load balancing techniques are essential components and widely used in the cloud data center network to manage users’ requests and distribute applications traffic among available data center resources. Software-defined networking is a highly flexible network architecture that automates network configuration using a centralized controller to overcome the traditional network limitations and manual configuration for every network device. This paper proposes a dynamic load balancing technique using software-defined networking for the cloud data center that can handle different application types in real-time based on traffic type and the required quality of service. The proposed method aims to bridge the gap between application requirements and the resources in the cloud data center by choosing the best path for data transmission and selecting the best performance server to process the users' requests according to traffic type for efficient resources’ utilization, minimizing response time, and maximizing throughput. The simulation results show that the proposed method enhances the performance of the running applications’ and utilizes the data center resources efficiently compared with the current load balancing techniques.

Hot sand baths are used for the treatment musculoskeletal diseases. The aim of this study was to assess beneficial effect of black sand bathing in the treatment of antenatal carpal tunnel syndrome (CTS). Study was conducted in single case with CTS of the right dominant hand. The treatment time was 20 min/day, 5 days/week for 2 weeks. CTS were evaluated using a visual analogue scale (VAS), pinch gauge dynamometer and Boston Carpal Tunnel Questionnaire (BCTQ) with electrophysiological studies at baseline and at week 2. Pain intensity (VAS) was decreased (34.2%), Tip, Key and Tripod pinch strengths were increased (14.29%), (19.23%) and (21.74%) respectively. Mean scores on the BCTQ-SSS and BCTSQ-FSS were decreased (23.69%) and (20.7%) respectively. Electrophysiological studies revealed that decreased mMDL (11.47%), increased mSNCV (9.23%) at the end of treatment. The black sand bathing is supported as a complementary therapy in antenatal CTS.

Background The sensori-motor manifestations of Guillain Barré Syndrome (GBS) are usually severe enough to mask the psychiatric and sleep problems which are in need for more attention for better functional outcome. Methods This study was performed on 20 GBS patients and 10 healthy controls. Patients were evaluated initially before immunotherapy using the Overall Disability Sum Score (ODSS), Neuropathy Pain Scale (NPS), Hamilton Anxiety Scale (HAS), Montgomery–Åsberg Depression Rating Scale (MADRS) and one-night polysomnography (PSG) followed by the multiple sleep latency test (MSLT) to evaluate the mean sleep latencies. Reevaluation was done using the same parameters 1 month after completing immunotherapy. Results The study showed significant increase in HAS in GBS patients which were positively correlated with the degree of motor disability. The mean sleep latencies of MSLT were significantly shortened and PSG showed shortening of the total sleep time, sleep efficiency, lowest O2 saturation and pulse transit time with increased wake after sleep onset, sleep stage transition index, apnea hypopnea index, desaturation index, arousal index, snore index and periodic limb movement index. One month after immunotherapy, the anxiety symptoms and sleep abnormalities showed non-significant improvements which were not correlated with the improvements in the sensori-motor manifestations. Conclusions GBS patients usually have sleep and psychiatric abnormalities which may take longer time to improve than the sensori-motor manifestations. So, they need more attention in the management protocol for early patients’ independence and return to usual daily activities.

Background Hepatitis C virus is associated with extrahepatic organ involvement including the nervous system especially peripheral nervous system, which is frequently affected due to the presence of hyper cryoglobulinemia (CG). Sensory and axonal neuropathy is the most frequent presentation in association with hyper CG. Peripheral neuropathy (PN) may also be observed in the absence of hyper CG. Aim The aim of this work was to study peripheral neurological complications related to chronic hepatitis C infection and the possible pathogenic mechanisms of these complications. Patients and methods This study was conducted on 60 patients with chronic hepatitis C infection who were subdivided into two subgroups: group I is composed of 30 chronic hepatitis C patients with clinically apparent neurological complications and group II is composed of 30 chronic hepatitis C patients, who were neurologically asymptomatic. The patients were subjected to clinical evaluation, estimation of hepatitis markers, cryoglobulins, and nerve conduction studies. Results Overt peripheral neuropathies occurred in 42 (70%) patients, detected subclinically in 12 (40%) patients. The chronic sensory peripheral neuropathy was the most common type, representing 60% of neuropathic patients. A statistically significant difference was found between groups I (80%) and II (33.3%), regarding the presence of cryoglobulin, being more common in group I. Results of nerve conduction studies have shown that nerves were more affected in group I and in cryoglobulin positive patients especially in the lower limb. Conclusion Peripheral neuropathies represent the most common hepatitis C virus-related peripheral neurological disorders especially when associated with cryoglobulins