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El estudio de la imagen de las minorías religiosas (copta y judía) y la convivencia en la trilogía de Ibn Dāniyāl no han recibido el interés necesario, a pesar de que estas minorías tuvieron un impacto significativo a nivel social, económico e intelectual en la época de los sultanes mamelucos. Por ello, el presente trabajo pretende estudiar y traducir los pasajes relacionados con este importante aspecto. La metodología del estudio se inspira en determinados postulados teóricos: el carnaval, la parodia y el humor, partiendo de las ideas que la crítica literaria contemporánea destaca. Los resultados logrados revelan que el texto de Ibn Dāniyāl no solo se trata de un texto literario de alto vuelo, sino también de un documento sobre la atmósfera sociopolítica y cultural que debe ser leído en su contexto para tener conocimiento de la situación de las minorías en su época. El examen sistemático de los episodios traducidos descubre también la presencia determinante de la cultura popular y fol-klórica, impregnada de la cosmovisión carnavalesca, que vive a la sombra de la cultura oficial sustentándose en la tradición oral y la realidad cotidiana., Topics such as the image of religious minorities (Coptic and Jewish) and coexistence in Ibn Dāniyāl's trilogy have not been sufficiently studied. These minorities had a significant social, economic and intellectual impact during the period of the Mamluk sultans. This paper studies and offers a translation of the passages related to this subject. The methodology of the study is inspired by certain theoretical postulates: carnival, parody and humour, using ideas frequently highlighted in contemporary literary criticism. The results reveal that Ibn Dāniyāl's text is not only a high-flying literary text, but also a document about the socio-political and cultural atmosphere that must be read in context in order to understand the situation of minorities in that period. The systematic examination of the translated episodes also reveals the decisive presence of popular culture and folklore, impregnated with the carnival worldview, which lives in the shadow of official culture and is supported by oral tradition and everyday reality.

Purpose We aimed to assess the clinical and radiological outcomes of a modified anatomical posterolateral corner (PLC) reconstruction technique using a single autograft. Methods This prospective case series included 19 patients with a posterolateral corner injury. The posterolateral corner was reconstructed using a modified anatomical technique that utilized adjustable suspensory fixation on the tibial side. Patients were evaluated subjectively using the international knee documentation form (IKDC), Lysholm, and Tegner activity scales and objectively by measuring the tibial external rotation angle, knee hyperextension, and lateral joint line opening on stress varus radiographs before and after surgery. The patients were followed-up for a minimum of 2 years. Results Both IKDC and Lysholm knee scores significantly improved from 49 and 53 preoperatively to 77 and 81 postoperatively, respectively. The tibial external rotation angle and knee hyperextension showed significant reduction to normal values at the final follow-up. However, the lateral joint line opening measured on the varus stress radiograph remained larger than the contralateral normal knee. Conclusion Posterolateral corner reconstruction with a hamstring autograft using a modified anatomical reconstruction technique significantly improved both the subjective patient scores and objective knee stability. However, the varus stability was not completely restored compared with the uninjured knee. Level of evidence Prospective case series (Level of evidence IV).

Elderly in the world is expected that are double by 2050 and triple by 2100, Elderly who suffer from hip fractures must have tasks and routines that are performed on a daily basis in order to live independently, being able to successfully manage routine tasks. Assess daily living activities of the elderly suffering from hip fractures. Descriptive research design was used. Purposive sample include 200 elderly. The study results revealed that more than two thirds of elderly have unsatisfactory knowledge; nearly two fifths of elderly were partially dependent in doing daily living activities. There was highly statistically significant correlation between elderly total knowledge and total daily living activities. Less than two fifths of elderly were partially dependent in doing their activities and more than three fifths of elderly have unsatisfactory knowledge about hip fractures. Also, there was a positive relation between elderly total knowledge about hip fractures and total daily living activities with highly statisticallysignificantcorrelation.

We present a case of indolent neurolymphomatosis in a 55-year-old male patient with worsening pain and weakness in his right leg over the past few months. The patient has a past medical history of type II diabetes mellitus, four-year history of worsening left foot drop, left lower limb pain and weakness attributed to diabetic amyotrophy, and back pain. The new right-sided symptoms prompted further imaging which revealed a left sciatic nerve mass which was biopsied. Initial biopsy results were inconclusive. 18F-FDG PET/CT revealed the full extent of this patient's disease and helped plan for a more representative biopsy site, which finally established a diagnosis of diffuse large B-cell lymphoma involving the lumbosacral nerve roots. The patient underwent a course of chemotherapy. 18F-FDG PET/CT was ordered again at the end of treatment showing partial response to therapy. He underwent radiation therapy to the site of residual disease, with complete metabolic response of lesions on follow up PET CT.

AIM: To detect the quantitative expression levels of the pro-inflammatory interleukin-8 (IL8), antimicrobial peptides human beta defense-2 (HBD2), and human beta defense-3 (HBD3) genes in bacterial conjunctivitis. METHODS: The human conjunctival epithelial cells were obtained using the impression cytology technique from healthy controls and patients. The genes expression levels were determined utilizing a reverse transcription quantitative polymerase chain reaction (RT-qPCR). The contribution of causative agent type, the number of isolates and severity of clinical features, in the increase of genes expression was also determined. RESULTS: The RT-qPCR showed that IL8, HBD2, and HBD3 expression increased in bacterial conjunctivitis as compared to healthy control (P

Gray zone thyroid tumors for which benignity or malignancy cannot be assessed are constantly increasing and accurate prediction of their malignant behavior is vital to avoid both violent surgical intervention for benign tumors and lax treatment of malignant tumors. The retrospective study included 120 blocks of thyroid lesions; 60 patients underwent partial thyroidectomy for query atypical adenoma and 60 blocks of complementary thyroidectomy of the same patients. Complementary thyroidectomy blocks included 21cases of thyroid cancer and 39 cases were multinodular goiter, while partial thyroidectomy blocks included 15 cases of thyroid adenoma, 17 cases were colloid nodules and 28 cases were tumors of uncertain malignant potential (TUMP). The expression levels of both telomerase reverse transcriptase (TERT) promoter mutations and proEx C antibodies were assessed in all blocks; analysis and correlation of marker expression of both groups (complementary and partial thyroidectomy) were done. 20 patients out of 28 suffering from TUMP developed thyroid carcinoma. Ten of them had positive TERT promoter mutation, all of which turned into cancer thyroid in a mean time of 8.2 ±2.61 years, and seventeen who a had high proEx C labeling index (LI) underwent a malignant transformation in 7.52 ±1.17 years in a shorter time than the group with negative TERT/proEx C expression which transformed within 12.31 ±3.57 years, whereas only one case diagnosed first as thyroid adenoma transform into thyroid carcinoma. TERT promoter mutation and proEx C expression are promising markers for determining the malignant potential in tumors of uncertain malignant potential.

Background Atherosclerotic intracranial arterial stenosis (ICAS) is one of the most common causes of stroke worldwide and is associated with a high risk of recurrent stroke. Patients with a recent transient ischemic attack (TIA) or stroke and severe stenosis (70 to 99% of the diameter of a major intracranial artery) are at particularly high risk for recurrent stroke in the territory of the stenotic artery (approximately 23% at 1 year) despite medical treatment. Therefore, alternative therapies are urgently needed for these patients. Objective To determine the efficacy and safety of angioplasty with stenting in medically refractory ICAS and to compare its effectiveness with optimal medical treatment. Subjects and methods Fifty patients with symptomatic ICAS despite medical treatment (i.e, recurrent stroke or TIA) were enrolled and equally randomized in a prospective study where twenty-five patients underwent angioplasty with stenting and twenty-five patients received optimal medical treatment. Clinical assessment with NIHSS and mRS were done at 0, 3, and 6 months, and transracial Doppler (TCD) assessment of ICAS was done at 0 and 3 months after treatment. Results The interventional group had a better clinical outcome with mean NIHSS scores (5.2 ± 4.2, 4.43 ± 4.28 and 3.9 ± 4.7) at baseline, 3 and 6 months, respectively, in comparison to the medical group with mean NIHSS (4.5 ± 4.2, 11.42 ± 6.3, and 8.5 ± 5.1) and better functional outcome with mean mRS scores (1.3 ± 0.96, 1.2 ± 1.13, and 1.0 ± 1.13) at baseline, 3 and 6 months, respectively, in comparison to the medical group (0.84 ± 0.75, 2.28 ± 1.2, and 2 ± 1.24). TCD assessment of ICAS showed a marked reduction of the percentage of stenosis on 3 months of follow-up among the interventional groups (only 5.6% had > 70% stenosis) in comparison to the medical group (85.7% had > 70% stenosis). Recurrent ischemic events on 6 months of follow-up were 16% among interventional groups in comparison to 84% among medical groups. The mortality rate was 8% among interventional groups due to subarachnoid hemorrhages (SAH) related to procedure in comparison to 28% among medical groups secondary to ischemic events. The intraoperative success rate was 96% with the failure of stent deployment in 1 patient due to the tortuous anatomy of vessels. Early post interventional complication rate, i.e, SAH was 8%. Late post interventional restenosis and occlusion rates were 8% on 3 months of follow-up. Conclusion Endovascular stenting of medically refractory ICAS is more efficacious and effective with better clinical and functional outcomes than optimal medical treatment; however, its safety is still debatable. Trial registration Done at ClinicalTrials.gov. Trial ID (NCT Number) NCT04393025.

Background and purpose The National Institutes of Health Stroke Scale (NIHSS) has been found to be biased toward the left hemispheric and motoric functions providing minimal assessment to the right hemispheric language and cognitive functions. The need to complement the role of the NIHSS is necessary in accurate and rapid assessment of AIS patients and better management. We hypothesized that combining the NIHSS with a quantitative analysis of Spoken Picture Description scale of Comprehensive Aphasia Test (SPD-CAT) could provide valuable data regarding side, site, and size of stroke. Subjects and methods Eighty-six AIS patients presented within 48 h of onset of stroke were enrolled from Stroke Units of Ain-Shams University Hospitals (ASUHS). Clinical Assessment with NIHSS and SPD-CAT were correlated with the radiological MRI Brain lesions of stroke regarding (site, side, size/volume and lesion volume percent to the whole brain volume “LV% WBV”). Results Total and subscale scores of NIHSS and SPD-CAT have a highly statistically significant correlation with the ischemic “LV% WBV.” Quantitative analysis (content units) of SPD-CAT may help in prediction of the lobar site of the stroke with higher significance in the tempro-parietal and brainstem regions. Right hemispheric strokes have clinically and statistically significant scores on SPD-CAT in comparison to NIHSS scores. Also, the left to right ratio of content units of information carrying words (ICWs) in SPD-CAT gives a significant difference between right and left hemispheric strokes. Recording and analysis time of SPD-CAT makes it easy and rapidly applicable in emergency room (ER) and stroke units. Conclusion Combining the quantitative analysis of NIHSS and SPD-CAT can better predict the side, size, and site of AIS within reasonable time table and without urgent MRI for AIS assessment and management.

Background New-onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. A first-ever seizure can be the first manifestation of epilepsy. Or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome that deserves special attention and treatment. This study aims to identify the etiology of NOS among different age and sex groups of adult Egyptian patients. A hundred and twenty adult Egyptian patients (> 18 years) presented with acute NOS were enrolled in a hospital-based cross-sectional observational study from the emergency room and neurology outpatient clinics of our hospitals within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination, laboratory, neuroimaging, and electroencephalogram investigations. Results Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (age group > 55 years) were the most prevalent cohort (60%). Cerebrovascular diseases (CVDs) were the most common identified etiology of NOS (44.17%), followed by idiopathic epilepsy syndrome (18.33%), symptomatic mainly “metabolic” (11%), brain tumors (9.17%), post-traumatic epilepsy (6.67 %), encephalitis (5.83%), and cryptogenic (5%). Idiopathic epilepsy syndrome was the most common etiology (55.56%) of new-onset seizures among the young adult age group ( 55 years). Also, CVDs were the most common etiology among males (43.4%) as well as females (45.4%). However, male predominance was the highest among post-traumatic seizures (87.5%). And female predominance was the highest among brain tumors identified etiology of NOS (54.5%). Conclusion NOS among adults are prevalent in elder males. CVDs are the most commonly identified etiology of adult NOS across males and females. Idiopathic epilepsy syndromes are the predominant etiology among younger adults.

Background New onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. Cluster seizures (CS) or status epilepticus (SE) can be the first manifestation of epilepsy or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome. This study aims to determine the etiology of CS and SE in NOS among adult Egyptians. One hundred twenty adult Egyptian patients presented with NOS were enrolled in a hospital-based cross-sectional observational study within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination including mini mental status examination, laboratory, neuroimaging, and electroencephalogram. Results Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (> 55 years) were prevalent (60%). Of the patients, 25% presented by CS, while 11% presented by SE. Post-stroke epilepsy (41%) was the predominant etiology of NOS. Cerebrovascular diseases (CVDs) were the prevalent etiology of SE in NOS (35%). NOS presented by CS were more prevalent among patients with brain tumors (29%) in comparison to CVDs (25%). Conclusion CS represented 25% of NOS in adult Egyptian patients. SE is prevalent among 11% of NOS. Despite CVDs being the most prevalent etiology of NOS in adult population (41%) including those presented with SE (35%), brain tumors are the most prevalent etiology of new onset CS (29%).

Background: Spleen is the most common intra-abdominal organ injury in blunt abdominal trauma. Splenectomy (open or laparoscopic) is the role in treatment of severe injuries of spleen or after failure of conservative treatment.Aim of the work: Compare the outcomes between open versus laparoscopic in high grade splenic injuries.Methods: This study includes 70 patients with various grades of splenic injuries in abdominal trauma. The patients were 15 years and older. They were categorized into two groups: open splenectomy group (35 patients) and laparoscopic splenectomy group (35 patients). The study was performed from January, 2012 to July 2017. Variables included demographics data, splenic injury graded by computerized tomography, duration of operation (in minutes), intra-operative blood loss (in ml), and intraoperative blood transfusion, length of hospital stay (in days), complications and mortality.Results: There was no significant difference or association between groups as regard age, sex and causes of splenic injury (p=0.374, 0.41, 0.38).Most cases were under 35 years old male patients exposed to motor car accidents. As regard intraoperative data, no statistically significant difference between both groups except for blood loss and transfusion that were statistically significant to the open group (p=0.039*).In the laparoscopic group, operational time was longer than open but no statistically significant (p=0.11).as regard conversion, we found that 14% of laparoscopic group (5 cases) had conversion. Most cases operated by laparoscopic approach were in grade III, IV with no cases tried in grade V (p=0.06). No statistically significant difference between both groups as regard postoperative variables except Pain (p=0.0003), and hospital stay(p=0.00) that were significantly longer among open group.The immediate postoperative complications showed that Wound infection, Missed injuries, pancreatic fistula and ileus were significantly higher among open group (p=0.00, 0.006, 0.02, 0.0004).The delayed postoperative complications where Incisional hernia (p=0.001) and Adhesive intestinal obstruction (p=0.00) were significantly associated with open group.Conclusion: In high-grade splenic injuries patients, this study found that laparoscopic splenectomy is safe.

Introduction: Cancer rectum and sigmoid is increasing nowadays. Resection is done by open and laparoscopic approaches. Laparoscopic approach is not available in many sites worldwide. Aim of this study: To analyze the outcomes of open side to end (antegrade) colorectal single stapling anastomosis versus open end to end (retrograde) Trans-anal colorectal stapling anastomosis in non-emergent sigmoid and rectal cancers open surgery in adults.Patients and Methods: Randomized controlled trial was performed on patients with sigmoid and rectal cancers between September 2016 and September 2018. Results: The majority of studied group were between 50-70 years with mean of 62.58±12.3 years and 61.03±13.98 years in group A and group B respectively. Intraoperative data showed no significant difference was founded between studied group except at operative time and mean anastomotic time as group A was significantly shorter. Univariate analysis showed that perioperative blood loss, length of stay, reoperation, inpatient death, infection and bleeding were significantly associated with leakage. Multivariate analysis of anastomotic leak showed that infection is the only independent predictors for anastomotic leak. There is statistically significant change as regard range of bowel frequency in end to end group only (p=0.04) and there is statistically significant difference as regard incontinence for Flatus in side to end group only (p=0.00) .There is statistically significant change in both group regard Incontinence for liquid stools(p=0.00) and Clustering of stool(p=0.00 and p=0.043).The quality of life in Antegrade group significantly drop at 6 months and return to baseline after that as regard PWB, FWB and CCS with no difference as regard SWB & EWB while in retrograde group, the same change happened only as regard PWB & FWB but SWB and CCS percentage didn’t return to baselineConclusion: The side-to-end anastomoses approach is a safe approach of anastomosis and may be used as alternative to retrograde approach.

espanolEl tema de un Mesias procedente de la descendencia del Profeta, con matizaciones politicas bien marcadas, con reivindicaciones de justicia, de liberacion politica y dominacion sobre los enemigos ha sido una idea predominante que corre a traves de la literatura escatologica. El presente trabajo tiene la finalidad de estudiar y traducir el retrato de al-Mahdī, el Mesias esperado, en la obra de Ibn ‘Arabī: genealogia, acciones profeticas, dimension politica, Consejeros, ciencia. EnglishThe theme of a Messiah coming from the offspring of the Prophet with well-marked political nuances, with claims of justice, political liberation and domination over enemies has been a predominant idea that runs through eschatological literature. The present study has the purpose of studying and translating the portrait of al-Mahdī, the expected Messiah, in the work of Ibn ‘Arabī: Genealogy, prophetic actions, political dimension, councillors, science.

Background: multiple sclerosis (MS) is an inflammatory disorder of the brain, spinal cord, and optic nerves. MS affects more than two million people worldwide; sleep disorders are very common in the general population; their high prevalence rate suggests that MS patients will certainly be suffering from comorbid sleep disorders. Objective: study the prevalence of sleep disorders among MS patients by clinical and Polysomnography (PSG) studies. Patients and Methods: twenty-five MS patients and 12 healthy controls were examined by expanded disability status scale (EDSS) for functional disability, Pittsburg sleep quality index (PSQI) for sleep quality, Epworth sleepiness scale (ESS) for excessive daytime sleepiness, international restless leg syndrome scale (IRLSS) for restless led syndrome (RLS). PSG studies were done for all subjects for assessment of quality of sleep and sleep parameters. Magnetic Resonance Imaging (MRI) Brain was done for MS patients g to subtype it according to McDonald criteria 2010. Results: seventy six percent of MS patients had poor sleep quality according to PSQI (8.6 ±3.7). While 44% had excessive daytime sleepiness according to ESS (12.2±3.6) and 40% had RLS according to IRLSS. Patients with progressive MS (PMS) either primary (PPMS) or secondary (SPMS) subtypes had poorer sleep quality index and excessive daytime sleepiness compared to relapsing remitting MS (RRMS) subtype. PSG study showed decreased total sleep time (TST) and sleep efficiency index in MS patients with prolonged sleep latency and decreased rapid eye movement (REM) latency and higher total arousal index and periodic limb movement (PLM) index than control. EDSS of MS patients had positive correlation with PSQI and ESS. Also EDSS had inverse correlation with TST and sleep efficiency index on PSG. Conclusion: sleep disorders are prevalent among MS patients. PPMS and SPMS patients showed more prevalence of sleep disorder than RRMS with poorer sleep parameters on PSG.

El tema picaresco gozó de una larga tradición en la literatura árabe. Tras un breve repaso histórico de sus principales representantes, el presente trabajo se centra en el estudio y traducción de la presencia de la figura del pícaro en la obra de Ibn Dāniyāl (m. 710/1310). Poeta y renovador del teatro de sombras, es considerado uno de los escritores más destacados de la época mameluca. Ibn Dāniyāl confunde la realidad con la imaginación, los personajes reales con los inventados en toda su obra de una manera natural y espontánea. Ante todo, el artículo aplica la crítica del modelo picaresco a la obra del dramaturgo egipcio. Trata de seguir la pista de los aspectos relevantes hasta su fuente más temprana, tanto en la forma como en el contenido. Por último, un detallado análisis de los tex- tos muestra que Ibn Dāniyāl no se limita a adoptar el material consabido sino que aporta avances al dar vida al personaje principal, espejo de su sociedad, en el lenguaje hablado y en un proceso proteico.

Es bien sabido el reconocimiento del relieve que los textos de carácter homoérotico, tanto en verso como en prosa, poseen dentro de la literatura árabe Medieval. No obstante, quedan algunos rasgos por estudiar, sobre todo de la época mameluca, caracterizada en términos generales por la libertad de palabra y la tolerancia con los homosexuales. Basándose en un examen directo de la producción literaria de uno de los escritores más celebres de la época, Ibn Dāniyāl, y valiéndose de las tradiciones tanto literarias como folklóricas y festivas, este trabajo se centra en el aspecto lingüístico y literario de la tercera pieza dramática, al-Mutayyam wa al-Yutayyam, enfocada en el homoerotismo masculino, exponente de una sociedad, vida y sensibilidad que nace en el seno de la cultura popular. Por último, el análisis revela que la obra es una parodia de géneros, temas, convenciones literarias, incluso prácticas sociales, parodia llevada al límite gracias a la tradición carnavalesca.

El propósito de este artículo es presentar un estudio y traducción de una parte representativa de la poesía de Abū Madyan. Se divide en dos secciones. Tras unos breves apuntes de la vida del maestro, la segunda parte se centra en el análisis de su poemario: las fuentes, los temas y la relación entre la experiencia mística y el uso del lenguaje y los símbolos. El examen de su poesía pone de manifiesto su influjo en posteriores poetas sufíes como Ibn ˁArabī y al-Šuštarī, especialmente en lo relativo a los símbolos de la mujer, el viaje y el vino. The aim of this article is to present a study and translation of a representative part of Abū Madyan’s poetry, which consists of two parts. After a brief sketch of the master’s life, the second part focuses on the analysis of his poems: sources, themes and relationship between mystical experience and the use of language and symbols. An examination of his poetry reveals his influence on later Sufis poets like Ibn ˁArabī and al-Šuštarī, especially with regard to the symbols of woman, travel and wine.