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Education is the foundation of progress, development, and the growth of individuals and societies. Knowledge-based education plays a significant role in enhancing educational systems, resulting in improved learning outcomes, enriched knowledge, job creation, and reduced unemployment. It also supports the alignment between educational outcomes and labor market needs by continuously adapting to innovations and advancements. In Oman, the educational system is governed and developed using modern technologies, in alignment with Oman Vision 2040. This research outlines strategies and methods to strengthen knowledge-based education in Oman, with the goal of reducing unemployment and providing suitable job opportunities for Omanis across various sectors. This approach heavily depends on the production and utilization of knowledge and information as key resources for economic growth, addressing gaps and shortcomings in the application of the knowledge economy. The proposed model involves leveraging technology, improving education, and fostering research and development with modern technologies and artificial intelligence tools to enhance educational systems and generate employment opportunities. The study aims to explore how education can contribute to reinforcing the knowledge economy in Oman by advancing educational systems and creating new jobs, focusing on the challenges and opportunities within the framework of Oman Vision 2040, which seeks to achieve sustainable economic growth. Additionally, the research discusses differences in averages among respondents' educational qualifications, with the highest average recorded for PhD holders at approximately 4.5% that holders of these qualifications are the ones who can be relied upon to convey and disseminate the culture of the knowledge economy among university and college students. The lowest for diploma holders is at less than 4.2%. The statistical significance (sig.) of the distribution of differences between groups was 0.926% for the first item, 0.601% for the second item, and 0.019% for the third item. The F-statistic in the ANOVA analysis revealed varying percentages, indicating different impacts of the studied factors on improving education and promoting the knowledge economy in Oman.

Background: Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. PATIENTS AND METHODS: This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). Results: A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Conclusions: Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Abstract Background Many indices have been suggested to help orthodontists in predicting the ideal dental arch width. One of these was Pont’s index which was established by Pont. He suggested equations to predict the ideal maxillary dental arch width (interpremolar and intermolar) from the combined mesiodistal width of the maxillary incisors. This study aimed to test the applicability of Pont’s index as an orthodontic diagnostic tool in Egyptian population and to compare the results with those obtained from studies of different ethnic subjects. Methods This study was performed using dental casts of 184 Egyptian individuals (82 males and 102 females; age range, 19–24 years). The casts were divided into 46 casts with normal occlusion, 46 casts with class I, 46 casts with class II and 46 casts with class III malocclusion, according to Angle’s classification. Alginate impressions were taken for all patients and poured immediately using dental plaster. The real models were transformed into digital models using three-dimensional laser scanner to allow digital model analysis. Predicted arch widths were calculated using Pont’s equations. The predicted values were compared to the measured values. Results Intra class correlation coefficient (ICC) (absolute agreement) between measured and predicted arch widths was determined. Poor absolute agreement was found between measured arch width values and the corresponding values calculated according to Pont’s index. Conclusion According to the results of this study, Pont’s index is not a reliable method for predicting the ideal dental arch widths in Egyptian populations.

Objective: Staphylococcus aureus (S. aureus) is a zooanthroponotic, nosocomial, and communi¬ty-associated pathogen that threatens livestock management and even public health. The goal of this investigation was to clarify the role of S. aureus in zoonotic illnesses. Besides that, a novel trial was conducted in the current Egyptian study using oil extracts such as cactus oil, tea oil, geranium oil, and thyme oil to demonstrate the susceptibility of methicillin-resistant S. aureus (MRSA) iso¬lates to these organic oils in response to the alarming global concern regarding the decreased sus¬ceptibility of S. aureus to known antibiotics, which exacerbates control and treatment protocols. Material and Methods: A total of 110 samples (45 raw cattle milk samples, 35 Karish cheese samples, and 30 human sputum samples) were collected. The bacterium was identified via traditional culturing methods, Gram staining, and the application of several biochemical tests. After that, various kinds of known commercial antibiotics were used to detect the antimicrobial susceptibility (AMS) of the obtained isolates. Furthermore, conventional polymerase chain reaction (PCR) testing was performed to identify S. aureus (nuc gene) and MRSA (mecA gene), with further application of multiplex PCR for screening of all the obtained isolates for vancomycin resistance via targeting vanA, vanB, and vanC genes. Finally, the agar gel diffusion method was performed to assess the antibacterial activity of four plant extracts (cactus oil, tea oil, geranium oil, and thyme oil) against the obtained MRSA. Results: The culturing method revealed S. aureus positivity in raw cattle milk (13.33%), in Karish cheese (28.57%), and in human samples (20%). The obtained isolates showed mainly resistance to amoxicillin-clavulanic and ampicillin antibiotics, while the dairy samples showed further resis¬tance against ceptaxime and an intermediate reaction against erythromycin. On the molecular side, PCR positivity was present in human samples (10%), raw cow milk (13.33%), and Karish cheese (14.29%). Nine of the fourteen PCR isolates were methicillin-resistant S. aureus (MRSA) isolates. Comparing the four oil extracts against the acquired MRSA isolates, cactus oil extract proved to be the most effective. Conclusion: The study's results are highly promising as they support the notion that certain essential oils possess strong antimicrobial properties against zoonotic S. aureus, thereby reducing the excessive use of antibiotics in veterinary and medical settings. [J Adv Vet Anim Res 2024; 11(2.000): 306-316]

Abstract Background Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. Methods A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022–2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). Results Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p

Background. The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance. Methods. A sample of 16 growing patients (5 boys and 11 girls; mean age: 9.50 years, standard deviation: 1.15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment. Results. The data showed a significant increase in SNB angle (P=0.002), leading to a significant decrease in ANB angle (P=0.001). The mandibular length significantly increased (P=0.008), the lower incisors were flared significantly (P=0.028), and the lower molars were extruded significantly (P≤0.001). Also, this study revealed a significant decrease in Wits appraisal (P≤0.001), overjet (P≤0.001), and overbite (P=0.041). Additionally, a significant increase in lower anterior facial height (P≤0.001), total facial height (P=0.001), and posterior facial height (P=0.037) were observed. Conclusion. The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.

Abstract Background While a connection has been established between serum interleukin-6 (IL-6) levels and the IL-6 gene (− 174G/C) polymorphism in allergic diseases such as asthma, its specific association with severe asthma remains unexplored. This study examined the relationship between the IL-6 (− 174G/C) gene polymorphism and mild and severe asthma, focusing on its influence on type 2 inflammation. Methods Our study comprised 98 patients with mild asthma and 116 with severe asthma. Additionally, we recruited 121 healthy participants to serve as controls for comparative analyses. The IL-6 gene (− 174G/C) polymorphism was assessed utilizing the polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) method. Results In our study, the risk of mild asthma exhibited a significant fourfold increase in individuals with the GG genotype pattern compared to healthy controls, yielding an odds ratio (OR) of 4.4 (p

The spread of fake news among Arabic media including social media represents a great challenge to the integrity of information and the trust of the public in it. In this paper, we introduce a comprehensive deep-learning framework, named ArabFake, that goes beyond the binary classification on Arabic fake news detection. ArabFake, built over MARBERTv2 (a state-of-the-art model for multi-dialectal Arabic tweets), proficiently address the complexity of the Arabic language while performing three unified tasks which are fake news detection, content categorization and its risk assessment. The framework promotes efficiency and performance both by enabling multi-task learning through shared knowledge representation across tasks. In order to facilitate development and evaluation, we present the ArabFake Dataset consisting of 2,495 manually labelled news items with labels that are verified by experts regarding fake news categories and risk levels. ArabFake demonstrates robust performance, achieving an F1 score of 94.12% for fake news detection, 84.92% for categorization, and 88.91% for risk zone assessment, highlighting its reliability and effectiveness across multiple tasks. We improve interpretability and extract insight into manipulative techniques by integrating valence scoring as part of the framework that emphasizes misleading linguistic cues used to disseminate fake news within the produced image. The results show that ArabFake is a holistic Arabic fake news detection framework that has practical implications on news organizations and fact checking projects.

Background: Hirschsprung’s disease (HD) is a congenital anomaly affecting the bowel of neonates, due to a defect in the ganglion cells presence in the colon in a caudo-cranial fashion, various surgical techniques used to correct the aganglionic segment, Duhamel procedure, Soave pull-through were used to correct the defect. Objectives: This study was conducted to compare the clinical outcome of two-stage Duhamel procedure and two-stage Soave pull-through in HD management. Patients and method: 40 patients diagnosed with Hirschsprung’s disease in the pediatric age group were enrolled in this study, 20 patients operated by Duhamel procedure, and 20 patients operated by Soave pull-through. Results: Enterocolitis was detected in 40% of patients after Soave pull-through while it was 5% in patients subjected to Duhamel procedure (p=0.020). Stricture was detected in 15% of cases subjected to Soave pull-through, Patients subjected to Duhamel procedure didn’t show stricture without significant difference. Regarding faecal continence, patients operated on by Duhamel procedure had better results compared to two-stage Soave pull-through (p

Abstract Background A significant breakthrough has been made in treating severe asthma, with the recognition of various asthma phenotypes and an updated management guideline. Type 2 targeted therapies, such as benralizumab and omalizumab; have been identified as an effective treatment for severe asthma, improving patient response, lung function tests and asthma symptom control. This study aimed to evaluate factors contributing to poor response to therapy. Methods A retrospective single-center cohort study of 162 patients with severe asthma who started biologic therapy; their data were retrieved from medical records for further analysis. Poor responders were patients remained clinically and functionally uncontrolled despite even after augmenting all treatment options. Results Childhood-onset asthma, bronchiectasis, poor symptom control (ACT below 19), severe airway obstruction (

Abstract This study investigates the intricate relationship between exposure to information sources, trust in these sources, conspiracy and misinformation beliefs, and COVID-19 anxiety among 509 Omani citizens aged 11 to 50, representing 11 governorates. Employing structural equation modeling, we not only examine these associations but also explore how trust and COVID-19 anxiety act as moderating variables in this context. Additionally, we delve into demographic factors such as age group, educational level, gender, and place of residence (governorate) to discern potential variations. Our findings reveal that trust in health experts is inversely related to belief in conspiracy theories, while trust in health experts negatively correlates with exposure to conspiracy and misinformation. Intriguingly, trust in health experts exhibits divergent effects across governorates: it diminishes conspiracy and misinformation beliefs in some regions but not in others. Exposure to personal contacts and digital media, on the other hand, is associated with heightened beliefs in misinformation and conspiracy theories, respectively, in select governorates. These distinctions may be attributed to proximity to Muscat, the capital city of Oman, where various media outlets and policy-making institutions are situated. Furthermore, lower educational attainment is linked to greater belief in conspiracy and misinformation. Females reported higher levels of conspiracy theory beliefs and COVID-19 anxiety while no significant differences were detected in misinformation beliefs. This study sheds light on the intricate dynamics of misinformation and conspiracy theories in the context of COVID-19 in Oman, highlighting the pivotal roles of trust and COVID-19 anxiety as moderating factors. These findings offer valuable insights into understanding and addressing the spread of misinformation and conspiracy theories during a public health crisis.

Abstract Background The American Society of Haematology defines immune thrombocytopenic purpura (ITP) as a common hematologic disorder characterized by a transient or long-term decrease in platelet counts (

Abstract Background The introduction of bone-anchored maxillary protraction eliminated the side effects of facemask in the early treatment of patients with maxillary retrusion. This study aimed to evaluate the effects of miniscrew-anchored maxillary protraction (MAMP) and compare them with the growth changes in an untreated control group in growing patients with Class III malocclusion. Methods Forty growing patients with Class III malocclusion and retrognathic maxilla were randomly allocated into two groups: treated and control groups. In the treated group, patients were treated with full-time intermaxillary Class III elastics (C3E) anchored by a hybrid hyrax (HH) in the maxilla and a bone-supported bar in the mandible. Protraction was stopped after obtaining a positive overjet. Cephalometric radiographs were acquired before and after the treatment. Data were statistically analyzed on an intention-to-treat basis. Intergroup comparisons were also made using analysis of covariance with the readings at T0 as a covariate. Results Forty patients agreed to participate, and 30 of them completed the study (treated group, n = 17; control group, n = 13). The average treatment duration was 11.9 months. MAMP resulted in a significant maxillary advancement (A-VR, 4.34 mm) with significant control over the mandibular growth. No significant increase in the mandibular plane angle was found in the treated group compared with the control group. The upper and lower incisors showed significant protrusion in the treated group. Conclusions Within the limitations of this study and high attrition rate, the MAMP protocol can effectively increase maxillary forward growth with good control over the growth of the mandible antero-posteriorly and vertically.

Abstract Mineral oil is the most frequent insulating liquid used in oil‐immersed transformers for electrical insulation and heat dissipation. However, oil‐based nanofluids are becoming more popular in scientific research as they have proved to have better dielectric and thermal characteristics. When applying these nanofluids into actual transformers, they would be exposed to thermal and electrical stresses. Thus, The aim of the authors is to investigate the generation pattern of dissolved gases in nanofluids under thermal and electrical faults and to assess the applicability of traditional Dissolved Gas Analysis (DGA) techniques if oil‐based nanofluids are used in transformers. Oil‐based nanofluid samples were prepared using a magnetic stirrer and an ultrasonic homogeniser and then subjected to simulated thermal and electrical faults in the laboratory using properly sealed test cells. Three types of metal oxides, Silicon dioxide, Titanium dioxide, and Aluminium oxide nanoparticles, have been used to prepare nanofluids with 0.02 g/L and 0.04 g/L concentrations. The gases released and dissolved into oil due to the simulated faults were analysed and compared to traditional mineral oil as a benchmark. The dielectric dissipation factor was obtained and analysed for all samples. According to the findings, the presence and concentration of nanoparticles were shown to influence the amount of gases produced. As a result, this research is crucial in guaranteeing that traditional DGA techniques can be employed in transformers that use oil‐based nanofluids.

Idiopathic intracranial hypertension (IIH) is a rare neurological disorder, characterized by raising intracranial pressure of unknown reason, increased cerebrospinal fluid pressure without changes in its composition, and usually it is presented by headache, papilledema. In this report, we will discuss the anesthesia management of cesarean section for a 31-year-old, morbidly obese patient (body mass index = 42 kg/m2), pregnant at 37 weeks, with IIH along with sepsis.

When there is collinearity among the regressors in gamma regression models, we present a new two-parameter ridge estimator in this study. We look into the new estimator's mean squared error characteristics. Additionally, we offer several theorems to contrast the new estimators with the current ones. To compare the estimators under various collinearity designs in terms of mean squared error, we run a Monte Carlo simulation analysis. We also offer a real data application to demonstrate the usefulness of the new estimator. The results from simulations and actual data reveal that the proposed estimator is superior to competing estimators.

Background The COVID-19 ongoing pandemic is one of the deadliest pandemics in history. It has put a significant strain on healthcare systems and frontline healthcare workers. This study attempted to assess and develop the emergency preparedness of hospitals affiliated to Alexandria University.Methods A quasi-Aquasi-experimental design was conducted in three phases; the pre-intervention assessment using ahospital emergency response checklist, then awareness intervention was implemented to provide information on emergency preparedness followed by post-intervention assessment after asix-month period following the first phase using the same checklist.Results The pre-intervention assessment showed that four hospitals had a good overall preparedness level (75% or more preparedness level), while the rest of the hospitals (7 hospitals) demonstrated a fair overall preparedness level (50%-

Pierre Robin sequence (PRS) is a rare congenital birth defect characterized by an underdeveloped jaw, backward displacement of the tongue, and upper airway obstruction. Babies born with PRS commonly experience trouble breathing and feeding, early in life, resulting from the tongue’s position, smaller jaw size, and the cleft palate formation. In this report, we will discuss the approach of emergency intubation outside an operating theatre in a 2-week-old preterm female neonate (33 weeks) weighing 2.2 kg diagnosed with PRS and an associated complete cleft palate. She needed emergency intubation immediately after admission due to desaturation and respiratory distress.

Objectives . To evaluate carotid artery intima-media thickness (CIMT) and lipid profile in children with epilepsy on long-term antiepileptic drug (AED) monotherapy. Methods . We included 60 children with epilepsy receiving valproate, carbamazepine, or levetiracetam monotherapy and 60 controls. A high-resolution B-mode ultrasound was used to measure (CIMT). Measurement of serum lipids was done. Results . Patients on valproate (0.44 ± 0.03, P ≤ .001), carbamazepine (0.43 ± 0.03with P ≤ .001), and levetiracetam (0.44 ± 0.02 with P ≤ .001) monotherapy showed significantly higher CIMT compared to controls. CIMT was correlated with age ( P = .041, r = .112) AEDs{valproate ( P = .005, r = .731), carbamazepine ( P = .038, r = .365), and levetiracetam ( P = .036, r = .155)}, duration of treatment ( P = .001, r = .313), TC( P = .001, r = .192), TG ( P = .014, r = .018), and LDL ( P = .001, r = .219). HDL ( P = .003, r = −.126). Seizure severity and Apo A1 were insignificantly involved. Conclusion . Long-term monotherapy with valproate, carbamazepine, and levetiracetam in epileptic children was associated with significant abnormalities in CIMT.

Keypoints 1. IgG pAbs detected G. duodenalis antigens in stool and water samples. 2. IgG pAbs protected mice from giardiasis. 3. IgG pAbs can be produced in large quantities.

Abstract Background To support bone regeneration, 3D-printed templates function as temporary guides. The preferred materials are synthetic polymers, due to their ease of processing and biological inertness. Poly(lactide-co-trimethylene carbonate) (PLATMC) has good biological compatibility and currently used in soft tissue regeneration. The aim of this study was to evaluate the osteoconductivity of 3D-printed PLATMC templates for bone tissue engineering, in comparison with the widely used 3D-printed polycaprolactone (PCL) templates. Methods The printability and physical properties of 3D-printed templates were assessed, including wettability, tensile properties and the degradation profile. Human bone marrow-derived mesenchymal stem cells (hBMSCs) were used to evaluate osteoconductivity and extracellular matrix secretion in vitro. In addition, 3D-printed templates were implanted in subcutaneous and calvarial bone defect models in rabbits. Results Compared to PCL, PLATMC exhibited greater wettability, strength, degradation, and promoted osteogenic differentiation of hBMSCs, with superior osteoconductivity. However, the higher ALP activity disclosed by PCL group at 7 and 21 days did not dictate better osteoconductivity. This was confirmed in vivo in the calvarial defect model, where PCL disclosed distant osteogenesis, while PLATMC disclosed greater areas of new bone and obvious contact osteogenesis on surface. Conclusions This study shows for the first time the contact osteogenesis formed on a degradable synthetic co-polymer. 3D-printed PLATMC templates disclosed unique contact osteogenesis and significant higher amount of new bone regeneration, thus could be used to advantage in bone tissue engineering.

Advances in stent design and technology have made stent loss during percutaneous coronary interventions rare. When an undeployed stent dislodges in the left main (LM) artery during percutaneous coronary angioplasty, the risk of life-threatening procedural complications is high. We report a 50-year-old male patient, a smoker, with a history of diabetes mellitus and hypertension with typical chest pain on minimal exertion. Electrocardiogram and echo revealed ischemic changes and regional wall motion abnormality. Culotte technique was used. A new 3 mm × 48 mm stent was inserted in the LM-left circumflex (LM-LCX) followed by stenting of the LM-left anterior descending (LM-LAD) ostia with a 3.5 mm × 18 mm stent. The two balloons were rewired and kissed. Stent slippage and dislodging in the LM artery can be corrected using the culotte technique to crush the undeployed stent behind the LM-LCX and LM-LAD stents.

There are several ways that economic units can become more efficient in energy use and reduce carbon emissions. Through re-engineering processes and the development of a systematic approach to the management of resources, environment, and individuals, economic units can achieve the same results as their competitors by reducing costs and increasing revenues, as the re-engineering of green processes aims to prevent the use of resources in an unsustainable way. Taking a comprehensive approach to achieving sustainability and integrating the Balanced Scorecard (BCS) with green process re-engineering can help improve the overall performance of economic units. This study aims to identify the theoretical concept of the balanced scorecard and re-engineering green processes. Improving the performance of the plant research sample through integration between the balanced scorecard ling technology and the process re-engineering technology. The study relied on the main hypothesis that the application of the steps of integration of the balanced scorecard technology and the re-engineering of green processes has a role in improving the performance of the factory sample of the study. The study reaches several conclusions, the most important of which is that the application of integration steps contributes to improving the overall performance of the factory sample of the research from 63% to 75% and that there is a low, uneven, and significant imbalance of performance according to the balanced scorecard perspectives, where the performance of the financial perspective 83%, and the environmental and community perspective by performance 33%.

Background: Since the Ministry of Health and Population [MOHP] in Egypt had declared the appearance of the first COVID- 19 confirmed case in Egypt on February 14, 2020. Strict measures were taken to control the virus spread, including the identification of some centers for triage and others for quarantine.The aim of the work: The goal of our research was to determine the clinical and hematological results of COVID-19 confirmed patients at two specialized triage hospitals.Patients and Methods: This was an observational prospective cohort in which we included all adult patients with laboratory-confirmed COVID-19 by RT-PCR of samples taken by nasopharyngeal swabs attended to two Egyptian hospitals that, assigned by MOHP as a triage center for COVID-19, in the period between 5th April to 27th August 2020. The clinical characteristics and hematological findings at presentation were studied.Results: This study included 200 consecutive COVID-19 confirmed patients from both hospitals, fever [75%] was the main presenting symptom followed by cough [71%] then dyspnea [20%]. [41%] of the patients had lymphopenia, [5%] had lymphocytosis, [11.5%] had neutrophilia, [2%] had thrombocytopenia, and [30.5%] had anemia.Conclusion: COVID-19 could be presented typically by pulmonary or atypically by various extrapulmonary manifestations in addition to different hematological laboratory findings.

Abstract Introduction Chronic hepatitis B (CHB) is associated with many serious clinical and social consequences. Despite Egypt being classified as a country of low endemicity, the infection is associated with a 15–25% risk of premature death from liver cancer or end-stage liver disease. The national committee of treatment and control of viral hepatitis has already offered a high-quality service for the diagnosis and treatment of CHB on a free basis. The current study aims to estimate the health care resources utilization and the annual direct medical cost associated with different clinical stages of CHB-related disease in Egypt. Methodology The data was retrieved through record review for three months in the General Administration of Hepatitis Viruses Control, Egypt. Then, the data was extrapolated to the population level by multiplying the prevalence in Egypt with a focus on the productive age groups (25–59 years). Results The cost and utilization of different health care resources increase with disease progression. The total annual direct medical costs due to CHB in Egypt is 21.3 L.E. Billion (4.7 Int$ billion/year) for the management of estimated 1,420,700 CHB patients. The direct medical costs among the productive age group (25–59 years) constitute more than half of the total cost (57%). The highest disease burden is encountered among (25–29 years) age group; 2.695 L.E. billion (0.59 Int$ billion/year). Despite liver transplantation phase being associated with the highest annual cost/patient, the number of patients in this stage is the lowest. Then, it only constitutes 0.04% of the disease direct medical cost in the country. The chronic hepatitis clinical stage constitutes 57.26% of the disease direct medical cost in Egypt’s working age group. Conclusion Strengthening the preventive and control measures is mandatory to alleviate the disease’s direct medical costs. Close monitoring of the chronic hepatitis stage is mandatory to prevent disease progression. Enhancement of vaccination efforts will lower the disease prevalence and its cost. The universal health insurance system which is gradually implemented in Egypt nowadays will be a cornerstone in relieving the economic stresses by allowing more access to high-quality health care services.

Summary: Background: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p

Ciclesonide (CIC), an inhaled corticosteroid for bronchial asthma is currently available as metered dose inhaler (CIC–MDI) which possesses a major challenge in the management of the elderly, critically ill patients and children. In this work, nebulized CIC nano-structure lipid particles (CIC-NLPs) were prepared and evaluated for their deep pulmonary delivery and cytotoxicity to provide additional clinical benefits to patients in controlled manner and lower dose. The bio-efficacy following nebulization in ovalbumin (OVA) induced asthma Balb/c mice compared to commercial (CIC–MDI) was also assessed. The developed NLPs of 222.6 nm successfully entrapped CIC (entrapment efficiency 93.3%) and exhibited favorable aerosolization efficiency (mass median aerodynamic diameter (MMAD) 2.03 μm and fine particle fraction (FPF) of 84.51%) at lower impactor stages indicating deep lung deposition without imparting any cytotoxic effect up to a concentration of 100 μg/ml. The nebulization of 40 µg dose of the developed CIC-NLPs revealed significant therapeutic impact in the mitigation of the allergic airways inflammations when compared to 80 µg dose of the commercial CIC–MDI inhaler (Alvesco®). Superior anti-inflammatory and antioxidative stress effects characterized by significant decrease (p

Background and Aim: Cystic echinococcosis (CE)/hydatidosis is one of the most prevalent neglected zoonotic diseases. It is initially asymptomatic and does not produce any clinical signs until the cyst becomes enlarged, causing localized pressure on internal organs and tissues. Therefore, the detection of Echinococcus granulosus antibodies is highly essential. This study evaluated the antigens of hydatid cyst fluid, protoscoleces, and germinal layers for efficient immunological diagnosis of CE in humans and camels. Materials and Methods: Hydatid cyst fluid (FLc), protoscoleces (Psc), and the germinal layer (GLc) antigens were prepared from camel-lung hydatid cysts. In the same way, hydatid cyst fluid (FLh) and protoscoleces (Psh) antigens from human-liver cyst aspirate were produced. The comparative immunodiagnostic efficacy of the prepared antigens was verified using indirect enzyme-linked immunosorbent assay (ELISA), SDS-PAGE, and immunoblotting. Results: ELISA proves that FLc and GLc antigens were higher than FLh and Psh antigens. This shows that binding reactivity in naturally infected human sera, camel sera, and Psc is the most potent, exhibiting 100% sensitivity with 78.26% and 76.47% specificity in camel and human sera, respectively. The CE prevalence using diagnostic Psc was 54.79% and 61.32% in tested human and camel sera, respectively. The electrophoretic profiles of all shared antigens showed similarities at 52, 41, and 22 kDa. Immunoblotting demonstrated common immune-reactive bands in all antigen types at 52 and 41 kDa against positive human and camel sera. Conclusion: This immunological study introduces camel hydatid cyst Psc as a potent diagnostic antigen and new immune-reactive fractions of 52 and 41 kDa for diagnosing hydatidosis in humans and camels.

Study Design: Prospective case series, therapeutic Level IV. Objectives: Functional and radiographic outcome evaluation of patients with spondylolysis treated with pars interarticularis defect repair with iliac bone grafting and application of a construct consisting of a pair of polyaxial pedicle screws connected by a U-shaped rod passing beneath the spinous process. Methods: Twenty-five patients (27 operated lumbar levels) with an average of 20 months of follow-up (range 12–24 m) with spondylolysis who met our inclusion criteria were treated with the above-mentioned technique. Functional assessment was by the Visual Analog Score (VAS) for low back pain (LBP) and Oswestry Disability Index (ODI). Fusion was confirmed with plain x-rays and when indicated with computed tomography scan. Return to activities of daily living (ADL) was also assessed. Results: There were 16 males (64%) and 9 females (36%), with a mean age of 18 ± 3 years at surgery, with a mean operating time of 79 ± 13 min and a mean blood loss of 186 ± 57 ml. ODI significantly improved from a mean of 63 ± 7 preoperatively to 10 ± 4 at 12 months postoperatively (P < 0.001). The mean preoperative LBP VAS score 8 ± 1 showed also a statistically significant decrease of values to 1 ± 1 at 12 months, (P < 0.001). At 12 m, all patients returned to unrestricted ADL. Pars healing was present in 19 patients (76%) at 6 months and in all patients at 12 months. Conclusions: Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.

Study Design This was a prospective case series of 30 patients with post-discectomy syndrome with an average of 18 months of follow-up (level IV). Purpose The efficacy of post-discectomy syndrome managed by minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) was evaluated. Overview of Literature In post-discectomy syndrome wherein conservative treatment had failed, the best surgical treatment modality still remains controversial. Methods Patients were functionally assessed using the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain (LP) and Oswestry Disability Index (ODI). Radiological fusion was confirmed with plain X-rays and when indicated with computed tomography scan at 12 months postoperatively. A total of 30 patients with 37 operated at lumbar levels with failed discectomy surgery who met our inclusion criteria were treated with MIS-TLIF. Results The ODI of all patients showed significant improvement from a mean of 73.78% preoperatively to 16.67% at 1 month and 14.13% at 12 months postoperatively. The preoperative LBP VAS score (mean, 4.37) showed a significant decrease (p

Gastroschisis is defined as a congenital anterior abdominal wall defect which is rarely associated with other congenital anomalies. Gastrointestinal anomalies are the most common associations including malrotation. Other gut anomalies like intestinal duplication and Meckel's diverticulum are very rare. Our report a rare case of gastroschisis who is associated with malrotation, intestinal duplication and Meckel's diverticulum.

Nanocomposite films based on spinel ferrite (Mg0.8Zn0.2Fe1.5Al0.5O4) in a PVA matrix were obtained. An increase in the spinel concentration to 10 wt.% caused an avalanche-like rise in roughness due to the formation of nanoparticle agglomerates. The lateral mode of atomic force microscopy (AFM) allowed us to trace the agglomeration dynamics. An unexpected result was that the composite with 6 wt.% of filler had a low friction coefficient in comparison with similar composites due to the successfully combined effects of low roughness and surface energy. The friction coefficient decreased to 0.07 when the friction coefficient of pure PVA was 0.72. A specially developed method for measuring nano-objects’ surface energy using AFM made it possible to explain the anomalous nature of the change in tribological characteristics.

Aim To assess efficacy of omalizumab in moderate to severe asthma and notable factors affecting it, such as treatment compliance during the period of ten years. This retrospective, observational real life study is the first of this kind in the Gulf region and one of the worldwide rare long term omalizumab treatment studies. Methods The treatment for 35 patients started in 2008. Twenty patients (ongoing group) proceeded with treatment and were assessed annually until 2017. Reasons for treatment discontinuation in 15 patients (drop-out group) were also assessed. Results Before starting omalizumab the ongoing group of patients had history of ≥2 asthma exacerbations per year, which significantly decreased during the first year of the treatment (p

The utilization of cellulose nano fibers (NCell) as reinforcement to cement composites may account for enhancing particle packing and decreasing the crack growth at the nano level. Besides that, their high specific surface area can improve the bond between the cement hydration products. nano silica particles can also influence the performance of fiber reinforced cement composites through increasing the calcium-silicate-hydrate gel content, as well as enhancing the fiber to matrix interface cohesion. The aim of this investigation is to evaluate the effects of different contents of nano silica particles (0, 1, 1.5, and 2% by weight of cement) on the mechanical properties, and microstructure of cement composites reinforced with various contents of nano cellulose fibers (0, 0.35, 0.55, and 0.75% by weight of cement). The results out of studying such nano systems revealed that the addition of the NCell particles separately, helped in improving the tensile strength by about twice the value of the control mix when appropriate content of NCell was incorporated (0.35%). Moreover, the microstructural analyses demonstrated the effectiveness of nano silica particles to modify the transition zone between the nano cellulose fiber and the cementitious matrix and subsequently allowing greater reinforcement efficiency especially when external compression or tensile forces were transferred to the composite.

Study Design: This was a retrospective observational study. Aim: The aim of this study was to evaluate the effectiveness of applying the platelet-rich fibrin (PRF) with bone graft in accelerating the rate of lumbar interbody fusion. Settings and Design: This was a retrospective study measuring the outcome of posterior lumbar interbody fusion (PLIF) combined with PRF versus PLIF alone in the management of lytic spondylolisthesis. Subjects and Methods: Forty patients were treated with instrumented PLIF for low-grade lytic spondylolisthesis and divided into two equal groups: one with addition of PRF to the bone graft and the other without. The minimum follow-up was 2 years. Clinical outcome was measured by the Oswestry Disability Index (ODI) and Visual Analogue Pain Scale (VAS) at 3, 6, and 12 months postoperatively. Radiological outcome was measured by standing X-ray at 3, 6, 12, and 24 months and computed tomography at 6 and 12 months postoperatively. Results: ODI for the PRF group improved by 60% and 79% at 6 and 12 months, respectively, whereas for the non-PRF group, it improved by 55% and 70%. Radiological outcome showed fusion in 15 of 20 cases in the PRF group (75%) by the 6th month and in 19 of 20 cases (95%) by 1 year and 100% at 2 years. In the control group, fusion was present in 12 of 20 cases (60%) by the 6th month and in 13 of 20 cases in the PRF group (65%) by 1 year and 90% at 2 years (P < 0.05). Conclusions: These preliminary results show that PRF accelerates the rate of fusion in low-grade lytic spondylolisthesis in short-term follow-up.

Introduction The increased prevalence of diabetes has led to an increase in its vascular complications such as coronary heart disease, stroke, diabetic nephropathy (DN), and end-stage renal disease. The growing epidemic of type 2 diabetes led to increased incidence of DN. DN is characterized by proteinuria. Objective The aim of the study was to estimate the prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus. Patients an methods This study included 151 patients with type 2 diabetes mellitus. After fulfilling the inclusion and exclusion criteria, all patients were submitted to these investigations: complete blood count, fasting blood glucose, and glycosylated hemoglobin, blood urea, serum creatinine, serum uric acid, calculation of estimated glomerular filtration rate using modification of diet in renal disease equation, lipid profile, serum albumin, urine analysis, and urinary albumin creatinine ratio. Results Of the patients, 60.3% have normoalbuminuria, 31.8% have microalbuminuria, and 7.9% have macroalbuminuria. Regarding glomerular filtration rate grades, 25.8% of the patients are of G1, 31.8% G2, 16.6% G3a, 16.6% G3b, 6.6% G4, and 2.6% are of G5. There is a significant increase in grading in patients with macroalbuminuria; also, most normoalbuminuric patients are G1 and G2. Of the studied patients, 53.6% are at low risk of chronic kidney disease progression, 9.9% are at moderate risk, and 36.4% are at high risk. Conclusion The prevalence of DN is increasing, partly due to the growing epidemic of type 2 diabetes so we have to detect it as early as possible to apply the proper measures to prevent or delay its progression.

The research aims to show the role of concurrent engineering in enhancing supply chain efficiency and reducing its costs. The Baghdad Tourism hotel suffers from many problems, including inappropriate pricing and poor quality of services that is rendered to customers. There are many tourist services provided efficiently by competitors in the hospitality sector to the customer. This factor has led customers to go to other rival companies, decreasing the revenues and leading to the loss of any competitive advantage. Supply chain costs rises lead to higher total tourism service costs. The research uses a statistical questionnaire on (60) respondents in the company leading to hypothesis testing by a statistical program (SPSS). Findings significantly showed that costs of supply chain activities can be reduced if services rendered are carried out concurrently by eliminating similar activities. Concurrent engineering is a tool which enhances supply chain capabilities by reducing the costs and increasing the revenues. The statistical analysis showed that the general average of research variables in which the calculated value of (T) amounted to (6.786) which is greater than the tabled value of (T) amounted to (1.671) with a degree of freedom (59) and a significant level (5%). This led the researchers to accept the research hypothesis. This study shows the concepts of concurrent engineering and supply chain can be integrated. Many of the previous studies refer to the study of concurrent engineering or supply chain separately, thus this is somewhat unique. The research presents important recommendations represented by the need to use the technique of concurrent engineering to reduce the supply chain costs such as purchasing, transportation, storage and quality costs. These recommendations may enhance the company's future performance.

Using the auto combustion flash method, Ni1−x+2Mgx+2Fe2+3O4 (x = 0, 0.2, 0.6, 0.8 and 1) nano-ferrites were synthesized. All samples were thermally treated at 973 K for 3 h. The structural analysis for the synthesized samples was performed using XRD, high-resolution transmission electron microscopy (HRTEM), and FTIR. Scanning electron microscopy (SEM) was undertaken to explore the surface morphology of all the samples. The thermal stability of these samples was investigated using thermogravimetric analysis (TGA). XRD data show the presence of a single spinel phase for all the prepared samples. The intensity of the principal peak of the spinel phase decreases as Mg content increases, showing that Mg delays crystallinity. The Mg content raised the average grain size (D) from 0.084 μm to 0.1365 μm. TGA shows two stages of weight loss variation. The vibrating sample magnetometer (VSM) measurement shows that magnetic parameters, such as initial permeability (μi) and saturation magnetization (Ms), decay with rising Mg content. The permeability and magnetic anisotropy at different frequencies and temperatures were studied to show the samples’ magnetic behavior and determine the Curie temperature (TC), which depends on the internal structure. The electrical resistivity behavior shows the semi-conductivity trend of the samples. Finally, the dielectric constant increases sharply at high temperatures, explained by the increased mobility of charge carriers, and decreases with increasing frequency.

Abstract Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of disease severity, starting from pure steatosis, leading to fatty inflammation labeled as non-alcoholic steatohepatitis (NASH), and finally fibrosis leading to cirrhosis. Activated hepatic stellate cells (HSCs) are known to contribute to fibrosis, but less is known about their function during NAFLD’s early stages prior to fibrosis. We developed an ex vivo assay that cocultures primary HSCs from mouse models of liver disease with healthy hepatocytes to study their interaction. Our data indicate that chemokine Ccl5 is one of the HSC-secreted mediators in early NASH in humans and in mice fed with choline-deficient, L-amino acid defined, high fat diet. Furthermore, Ccl5 directly induces steatosis and pro-inflammatory factors in healthy hepatocytes through the receptor Ccr5. Although Ccl5 is already known to be secreted by many liver cell types including HSCs and its pro-fibrotic role well characterized, its pro-steatotic action has not been recognized until now. Similarly, the function of HSCs in fibrogenesis is widely accepted, but their pro-steatotic role has been unclear. Our result suggests that in early NASH, HSCs secrete Ccl5 which contributes to a broad array of mechanisms by which hepatic steatosis and inflammation are achieved.

Background: The importance of whole-food antioxidants in terms of promoting antioxidant recycling in the body in complex human diseases is not fully understood. We aim to discuss the benefits of whole-food antioxidants in ameliorating the diabetic complications in vivo and to address the effect of germination versus heat processing or drying on the potential therapeutic effect of whole grains and legumes. We studied the antioxidant status of alloxan-diabetic (AD) male Spargue Dawley rats, injected intraperitoneally with alloxan dose of 150 mg/kg body weight, and fed on experimental diets based on the flour of soybean, broadbean and whole-wheat for five weeks. Results: Diabetes-induced oxidative stress in liver was manifested by significant increase in hepatic malondialdehyde (MDA), erythrocytes superoxide dismutase (eSOD) and plasma alpha-tocopherol (α-T) levels, reduction in hepatic glutathione (GSH) levels and catalase (CAT) activity. Consumption of soybean and whole-wheat both had beneficial effects on the oxidative status of AD rats more than broadbean. Feeding dried wheat was effective in improving MDA, GSH and α-T levels. Soybeans and wheat lowered triacylglycerols (TAGs) and tended to lower total cholesterol. Germination enhanced the effect of soybeans on TAGs and in the case of soy and wheat enhanced the effect on total cholesterol. Conclusion: Whole foods containing naturally occurring phytochemicals and antioxidant vitamins such as legumes and whole grains are recommended, alongside medication, for controlling hyperglycaemia, blood lipids and oxidative status in diabetes. Keywords: Isoflavones, Lignans, Germination, Reactive oxygen species, Alloxan, Rats

Background: Backing out and failure of pedicle screws in patients with osteoporosis is becoming a big problem due to wide use of these screws nowadays. Purpose: The aim of this study is to evaluate the purchase of fenestrated pedicle screws augmented with cement in patients with osteoporosis. Study Design: This was retrospective observational study. Patients and Methods: From May 2015 to January 2016, 25 patients with a poor bone stock condition underwent posterior fixation by fenestrated pedicle screws and cement augmentation. Assessment of pain improvement was done by visual analogue score (VAS) score while the long-term clinical outcome was assessed using Oswestry low back disability questionnaire (Oswestry disability index [ODI]). Implant stability was evaluated by plain radiography. Complications were evaluated in all cases. Results: All patients were followed up clinically and radiographically for a mean age of 24.84 months. There was a significant reduction in pain and improvement of the quality of life as detected using VAS scores and ODI questionnaire consecutively (P < 0.001). No radiological loosening or backing out of screws was observed. Cement leakage occurred in five cases. Conclusion: Augmentation of fenestrated screws with cement provided effective and lasting purchase in patients with osteoporosis. The only clinical complication strictly related to this technique was cement leakage.

Polyphenols are known dietary antioxidants. They have recently attracted considerable interest in uses to prevent skin aging and hyperpigmentation resulting from solar UV-irradiation. Prunus persica (L.) leaves are considered by-products and were reported to have a remarkable antioxidant activity due to their high content of polyphenols. This study aimed at the development of a cosmeceutical anti-aging and skin whitening cream preparation using ethanol leaves extract of Prunus persica (L.) (PPEE) loaded in solid lipid nanoparticles (SLNs) to enhance the skin delivery. Chemical investigation of PPEE showed significantly high total phenolic and flavonoids content with notable antioxidant activities (DPPH, ABTS, and β-carotene assays). A unique acylated kaempferol glycoside with a rare structure, kaempferol 3-O-β-4C1-(6″-O-3,4-dihydroxyphenylacetyl glucopyranoside) (KDPAG) was isolated for the first time and its structure fully elucidated. It represents the first example of acylation with 3,4-dihydroxyphenyl acetic acid in flavonoid chemistry. The in-vitro cytotoxicity studies against a human keratinocytes cell line revealed the non-toxicity of PPEE and PPEE-SLNs. Moreover, PPEE, PPEE-SLNs, and KDPAG showed good anti-elastase activity, comparable to that of N-(Methoxysuccinyl)-Ala-Ala-Pro-Val-chloromethyl ketone. Besides, PPEE-SLNs and KDPAG showed significantly (p < 0.001) higher anti-collagenase and anti-tyrosinase activities in comparison to EDTA and kojic acid, respectively. Different PPEE-SLNs cream formulae (2% and 5%) were evaluated for possible anti-wrinkle activity against UV-induced photoaging in a mouse model using a wrinkle scoring method and were shown to offer a highly significant protective effect against UV, as evidenced by tissue biomarkers (SOD) and histopathological studies. Thus, the current study demonstrates that Prunus persica leaf by-products provide an interesting, valuable resource for natural cosmetic ingredients. This provides related data for further studying the potential safe use of PPEE-SLNs in topical anti-aging cosmetic formulations with enhanced skin permeation properties.

Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency disease (PID) among adults. CVID consists of two phenotypes – one in which infections are the characteristic and another in which impressive inflammatory and/or hematological complications also develop, including lymphadenopathy, splenomegaly, autoimmune cytopenias, enteropathy, and granulomatous disease. These phenotypes appear to be stable, are related to immunological and inflammatory markers, and are predictive of outcomes. Both subcutaneous immunoglobulin (SCIG) and intravenous immunoglobulin (IVIG) are equally effective for replacement therapy. No data are available about specific factors affecting the quality of life related to switching from IVIG to SCIG in the Arabian Gulf area. We present the case reports of three adult CVID patients, who were shifted from IVIG to SCIG by the US conversion method (1 : 1.5). We followed-up patients for clinical outcomes, side-effects, immunoglobulin G (IgG) trough levels, annual infection rate, and quality of life using questionnaires (RAND-36) over a 3-year period. Three patients (two females and one male), with a mean age of 26 years, had received IVIG [Gamunex-C (Grifols Therapeutics Inc., NC, 27709 USA) 10%; Grifols] treatment for an average duration of 4 years and had average IgG trough levels of 7.7±2.9 g/dl. Patients were shifted to SCIG [Subcuvia (Baxalta Innovation GmbH, Vienna, Austria) 10%; Baxter] for different reasons. SCIG was administered, using an infusion pump, under medical supervision at the hospital, on a weekly basis. The average IgG trough level on SCIG was 10.4±1.5 g/dl. The annual infection rate of pneumonias, sinusitis, otitis media, and others significantly declined after switching to SCIG in all three patients. However, while on IVIG treatment, some patients reported headache and malaise, but when on the SCIG treatment the reactions were mild and infusion site-related such as erythema, swelling, and itching. Remarkably, all patients were successfully switched to SCIG with significant decrease in the annual rate of infections and a favorable steady-state of serum trough levels of IgG. The use of SCIG was generally associated with notable improvement in physical, emotional, and social health.

Purpose The purpose of this article is to evaluate and compare the outcomes of simultaneous and successive femtosecond laser-assisted intrastromal corneal kera-ring segments insertion and corneal collagen cross-linking in the treatment of keratoconus.

Background and Purpose. Equinovarus foot is a common sign after stroke. The aim of this study is to investigate the effect of task specific exercises, gait training, and visual biofeedback on correcting equinovarus gait among individuals with stroke. Subjects and Methods. Sixteen subjects with ischemic stroke were randomly assigned to two equal groups (G1 and G2). All the patients were at stage 4 of motor recovery of foot according to Chedoke-McMaster Stroke Assessment without any cognitive dysfunction. E-med pedography was used to measure contact time, as well as force underneath hind and forefoot during walking. Outcome measures were collected before randomization, one week after the last session, and four weeks later. Participants in G1 received task specific exercises, gait training, and visual biofeedback and a traditional physical therapy program was applied for participants in G2 for 8 weeks. Results. Significant improvement was observed among G1 patients (P≤0.05) which lasts one month after therapy termination. On the other hand, there were no significant differences between measurements of the participants in G2. Between groups comparison also revealed a significant improvement in G1 with long lasting effect. Conclusion. The results of this study showed a positive long lasting effect of the task specific exercises, gait training, and visual biofeedback on equinovarus gait pattern among individuals with stroke.

The jump problem and problems with defects on the type change line for model mixed-type equations in the mixed domains are investigated. The explicit solutions of the jump problem are obtained by the method of integral equations and by the Fourier transformation method. The problems with defects are reduced to singular integral equations. Some results for the solution of the equation under consideration are discussed concerning the existence and uniqueness for the solution of the suggested problem.