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This research aims to present a design proposal that achieves the principle of zero loss, by producing an evening top made of lace material by using separate units of lace. Such top is used as an accessory that is matching more than one garment, which gives a different and new look to the clothes and helps to achieve sustainability. The design was produced by using Photoshop program to distribute the lace units in a manner inspired by the principle of self-similarity in fractal geometry to ensure compatibility as an aesthetic aspect of the product. As regards producing the clothing, the lace units were sewn by using the zigzag stitch.

Copyright of Journal of Plant Production is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Post-variceal band ligation bleeding ulcer is a severe complication with considerable mortality. We tried evaluating self-expandable metallic stent (SEMS) with concern to the ulcer morphology not well studied. Results We did a retrospective analysis of patients with bleeding post-band ulcers and treated by SEMS with concern to control bleeding and 6 weeks survival. Twenty-eight patients studied had their age (mean ± S.D.) 57.8 ± 8.6 years, and 85.7% were males. The Child-Pugh score range was 5–12]. Control of bleeding by SEMS was achieved in 23 (82.1%) patients, and overall, 6-week survival was 75%. Both post-band ulcer types B (oozing blood and type C (active spurted) were a risk for 6 weeks mortality (P = 0.04, OR 1.58, CI 95% 1.12–2.23). Conclusion SEMS is considered an excellent choice to control esophageal post-banding ulcer bleeding and a definite treatment bridge.

Abstract Background Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection in patients with liver cirrhosis in the absence of surgical causes. The drop of the ascitic fluid polymorphonuclear leukocyte count (AFPC) ≥25% of baseline 48h post-start of antibiotics is a predictor of antibiotic response. This study was designed to compare the diagnostic accuracy of AFPC 24h of antibiotic to the standard 48h. Three hundred ninety-nine SBP patients were classified into 2 groups. Group I (31.1%) are patients that lacked ≥25% drop and group II (68.9%) the opposite. Results The average age was 51.99 ±11.21 years. Most patients were males (70.9%), normotensive (75.8%), non-diabetics (50.8%), and without recent intake history of proton pump inhibitors (75.8%) and B-blockers (77%). Group II patients had statistically significant (p 0.05). Group II patients compared to group I had statistically (p =0.001) lower AFPC 24h [800 (970) vs. 1100 (1700) cell/mm3], higher percent drop of the AFPC 24h [28.09 (24) vs. −10.17 (35)], and ≥25% drop [154 (90.6%) vs. 16 (9.4%)]. The 24h AFPC >980 cell/mm3 was associated with AFPC 48h non-response (AUROC =0.634, p =0.001, 58.87% sensitivity, 64.36% specificity). The 24-h AFPC percent drop >8% was associated with AFPC 48h response (AUROC =0.849, p=0.001, 85.82% sensitivity, 80.49% specificity). Conclusion Concordance of 24- and 48-h diagnostic follow-up ascitic fluid polymorphonuclear leukocyte count in the guidance of the antibiotic therapy.

Introduction and aim: The interleukin-2 receptor antagonist; basiliximab is used to allow delayed introduction of Calcineurin inhibitors (CNI) after liver transplantation and thus delay their renal insult. However, there is only little evidence for the safety and the efficacy of this regimen. This study aimed to evaluate the effectiveness and safety of basiliximab induction in liver transplantation. Materials and methods: This study included 89 patients who were classified into two groups: standard triple immunosuppression (IS) regimen of steroid, tacrolimus (TAC) and mycophenolate mofetil (MMF) (n = 47) and induction IS regimen of basiliximab, low dose steroids and MMF with delayed introduction of CNI (n = 42). All patients were followed after liver transplantation for at least six months or until death. Results: There were no significant differences in patient survival, graft dysfunction, infection rate or type, or wound healing between both groups. The acute rejection rate was equivalent in both groups. Renal dysfunction in the first six months post-transplant was less in the basiliximab group in comparison to the other group (7.1% and 19.1% respectively). Conclusion: Basiliximab-induced IS protocol is a safe regimen that reduces medium-term renal dysfunction and achieves similar survival without increasing the acute rejection or infection rate in liver transplantation recipients.

Abstract Background Duodenoscope-emerging infection especially drug-resistant bacteria is considered a major concern nowadays. Different approaches were attempted to overcome this problem, like double high-level disinfection procedure. We performed a systematic review and meta-analysis to evaluate risk difference for positive cultures from duodenoscopes between double high-level disinfection (dHLD) and single (standard) high-level disinfection (sHLD). Main body A thorough literature search (in October and November 2019) for studies comparing dHLD and sHLD for duodenoscopes was performed by 3 researchers in the Web of Science, Scopus, PubMed, and Cochran databases. The search terms were “duodenoscope,” “ERCP endoscope,” “disinfection,” “sterilization,” and “reprocessing,” and only randomized clinical trials with the English language were accepted. Four trials were identified studying dHLD, and only 2 clinical trials comparing dHLD with standard sHLD were found reporting 6193 duodenoscope cultures. Overall sHLD cultures were 2972, and dHLD cultures were 3221; overall positive cultures were 140 in sHLD and 161 in dHLD. The results of a meta-analysis using the random-effect model showed no significant risk difference (RD) between the 2 procedures for duodenoscope positive cultures (p = 0.53, RD 0.003, 95% CI “− 0.007–0.013”). Conclusions Double HLD offered no significant difference over single HLD for duodenoscope disinfection. An alternative strategy to overcome duodenoscope-transmitted infection is a big issue to be resolved.

Abstract Background Ascites is one of the main complications of advanced liver cirrhosis. It is defined as a pathological accumulation if free fluid in the peritoneal cavity. Main body of the abstract Ascites is a sign of decompensation in patients with liver cirrhosis and is associated with decreased survival. Ascites is associated with bad cosmetic figure and poor quality of life. Ascites is a predisposing factor for developing hydrothorax, hernias, diastolic dysfunction, spontaneous bacterial peritonitis, and renal impairment especially hepatorenal syndrome. The main treatment is salt restriction and diuretics. By the time the patient become non-responder and develop tense ascites, abdominal large volume paracentesis is the treatment of choice. Its advantages are rapid, cheap, and 1 day hospitalization. The main drawback is the development of paracentesis-induced circulatory dysfunction (PICD) if no volume expanding drugs are used. PICD is associated with dilutional hyponatremia, renal impairment, so it is considered the silent killer. Albumin infusion is the standard preventive measure but since costly to other alternatives such as colloids, vasoconstrictors or lowering the standard doses of the albumin was studied and is promising. Conclusions This review summarized the effectiveness of other alternative drugs.

Abstract Background Liver transplantation is a final treatment for decompensated liver disease. Aim Description of post-liver transplant histopathology. We enrolled 89 patients divided into two groups according to if they underwent on demand liver biopsy (n = 34; 38.2%) or not (n = 55; 61.8%). Albumin-bilirubin (ALBI) score and model for end-stage liver disease (MELD) assessed the degree of liver dysfunction. Results Patient underwent liver biopsy (LB) was 44.65 ± 8.46 years old, mainly males (88.2%) with average MELD of 8.74 ± 4.71. Most patients were positive pre-transplant for HCV (91.2%) and 29.4% had hepatocellular carcinoma on top of hepatitis C. Patients underwent LB had worse liver dysfunction by ALBI score (− 2.62 ± 0.6 vs. − 2.96 ± 0.5; p = 0.014) but comparable MELD. The time till first biopsy was 19.88 ± 11.22 (4-44) months. It was not different statistically with various histopathology (p > 0.05). Histopathology of first biopsy was viral chronic hepatitis (50%), acute rejection (20.6%), steatohepatitis (11.8%), chronic rejection (5.9%), chronic hepatitis (5.9%), biliary obstruction (2.9%), and cytomegalovirus hepatitis (2.9%). Most patients were F1 (38.2%) and A1 (35.3%). The immunosuppressive drug regimen had no impact on the histopathology (p > 0.05). Patients with hepatitis C pre-transplant had in a descending manner the following histological diagnosis (p = 0.001): viral chronic hepatitis 16 (51.6%), acute rejection 7 (22.6%), steatohepatitis 4 (12.9%), chronic rejection 2 (6.5%), biliary obstruction 1 (3.2%), and CMV hepatitis 1(3.2%). Some patients required on demand second (n = 9) and third biopsied (n = 5) that were the same as the first biopsy or completely different. Conclusion Liver biopsy is a useful tool for diagnosis of liver transplantation complications.

Abstract Background Development of esophageal varices (EVs) is the main complication of portal hypertension. Early detection prevents variceal bleeding. Baveno VI consensus recommended endoscopy if transient elastography (TE) > 20 kPa and platelets below 150,000/mm3. Aim Assessment of the reliability of the albumin-bilirubin (ALBI), platelets-albumin-bilirubin (PALBI), albumin-bilirubin-platelets (ALBI-PLT) score, and gamma-glutamyl transferase-platelets (GAR) ratio as non-invasive models for prediction of EVs presence and the need for endoscopy in patients with HCV-related cirrhosis. Methods HCV-related F4 fibrosis by TE or cirrhosis patients were included (n = 661). Full metabolic profile, CBC, ultrasonography, and endoscopy were done. Results The average age was 42.89 years mainly males. Patients with EVs had statistically significant (p < 0.05) higher TE values, ALBI, ALBI-PLT, and PALBI than those without EVs. Both groups were comparable for GAR. Large varices were statistically (p < 0.05) associated with higher ALBI, ALBI-PLT, and PALBI. Both small and large varices had comparable TE and GAR. EVs detection cutoffs (sensitivity, specificity): TE > 20 kPa (83.64%, 91.62%), ALBI >− 2.43 (81.28%, 74.89%), ALBI-PLT > 3 (77.34%, 72.93%), and PALBI >− 2.28 (62.1%, 76.4%). On comparison of the ROCs, TE was better than ALBI (p < 0.05), ALBI-PLT, and PALBI. ALBI was better than ALBI-PLT and PALBI. Both ALBI-PLT and PALBI are comparable (p > 0.05). Positive indirect hemagglutination of schistosomiasis, portal vein diameter, splenic vein diameter, TE, ALBI, ALBI-PLT, and PALBI were independent predictors of EVs existence. On multivariate analysis, portal vein diameter, TE, and ALBI score were significant. Conclusion The ALBI, ALBI-PLT, and PALBI are useful predictors of EVs presence and the need of diagnostic endoscopy especially in centers that lack FibroScan.

Abstract Background Large-volume paracentesis (LVP) is a main pillar in treating patients with tense ascites. Without plasma expanders use, paracentesis-induced circulatory dysfunction (PICD) is a common complication with decreased survival. The aim was to compare low-dose albumin (2 g/L ascitic fluid removed n = 85) with standard-dose albumin (6 g/L ascitic fluid removed, n = 25) for prevention of PICD. Liver function tests, urea, creatinine, CBC, and abdominal ultrasonography were done. Plasma renin activity (PRA) was measured at baseline and on the 6th day post-LVP. The delta change (Δ) = day 6 variable minus baseline variable value. PICD was defined as increase in PRA of > 50% of the baseline value. Results Patients in low-dose albumin group were mainly Child B compared with Child C (85.9% vs. 52%; p = 0.001), underwent less paracentesis volume (9.78 ± 3.56 vs. 12.52 ± 3.6 L; p = 0.001), but had higher baseline PRA (859.62 ± 1151.34 vs. 165.93 ± 95.34 pg/mL; p = 0.001). In both groups, the PRA increased at day 6 compared with the baseline (1141.57 ± 1433.01 vs. 859.62 ± 1151.34 pg/mL; p = 0.01) and (192.21 ± 80.99 vs. 165.93 ± 95.34 pg/mL; p = 0.01) respectively. Both groups were comparable for Δ PRA (281.95 ± 851.4 vs. 26.28 ± 30.2 pg/mL; p = 0.102) and PRA percent increase (10.97 ± 30.77 vs. 12.57 ± 14.87; p = 0.844). They had comparable PICD incidence (24.7% vs. 12%; p = 0.27). Females were more liable for PICD occurrence than males (OR 2.91, 95% CI 1.125–7.547, p = 0.028) and so Child B patients than Child C (OR 8.4, 95% CI 1.072–65.767, p = 0.043). Conclusion Low-dose albumin infusion is comparable to the standard-dose albumin for the prevention of PICD.

Abstract Background Minimal hepatic encephalopathy (MHE) is a complication of liver cirrhosis causing low quality of life, driving skills and higher traffic violation. The neuro-psychometric tests are the gold standard but difficult clinically and time-consuming. The aim was to assess albumin-bilirubin (ALBI), platelets-albumin-bilirubin (PALBI) score, albumin-bilirubin-platelets (ALBI-PLT) grade and ammonia level as MHE predictors. All the patients (n = 257) underwent critical flicker frequency number connection, serial dotting and digit symbol test for MHE diagnosis (n = 166, 64.6%). Liver function, INR, CBC and arterial ammonia were measured. Results There was statistically significant difference (p < 0.05) between MHE patients and those without as regards ammonia (86.59 ± 23.25 vs. 63.56 ± 24.2 μmol/L), ALBI score (−2.13 ± 0.53 vs. −2.49 ± 0.38), PALBI score (−2.33 ± 0.39 vs. −2.55 ± 0.26) and ALBI-PLT (3.98 ± 0.49 vs. 3.70 ± 0.56). Patients with MHE were mainly Child-Pugh B and C and also ALBI grade 2 and 3. For MHE discrimination, ALBI, PALBI, ALBI-PLT and ammonia had the following cutoffs >−2.36 (57.23% sensitivity, 77.78% specificity), >−2.5 (60.84% sensitivity, 67.9% specificity), > 3 (87.35% sensitivity, 27.16% specificity) and > 76.5 (69% sensitivity, 72.5% specificity) respectively (p = 0.001). On comparison of the area under the curve, ALBI is comparable to PALBI (p = 0.245) and ammonia (p = 0.603). The ALBI-PLT is inferior to ALBI (p = 0.018) and ammonia (p = 0.021) but comparable to PALBI (p = 0.281). ALBI (odds = 5.64), PALBI (odds = 7.86), ALBI-PLT (odds = 2.86), ammonia (odds = 1.05), Child-Pugh score (odds = 2.13), MELD (odds = 1.26) are independent predictors of MHE. Conclusion ALBI, PALBI and ammonia are clinical useful model for MHE prediction.

Abstract Background Ascitic fluid polymorphonuclear leucocyte count (PMN) is known to be the gold standard for spontaneous bacterial peritonitis (SBP) diagnosis. The aim of this work was to assess ascitic calprotectin for SBP diagnosis. Serum C-reactive protein (CRP), high sensitivity C-reactive protein (hsCRP), nitrous oxide, ascitic PMN, ascitic leucocyte esterase and ascitic calprotectin were measured. Results The average age of our patients was 55.25 ± 7.89 years, mostly males (n = 51, 63.8%), anti-HCV antibodies were positive in (n = 61, 76.3%). Sixty-four patients (80%) were Child-Pugh C and their average MELD was 24.29 ± 8.06. Patients with SBP had statistically significant higher median MELD score (26.5 vs. 19) and higher average Child-Pugh score (12.18 ± 1.74 vs. 10.5 ± 1.97). Forty patients had SBP and 40 patients were without SBP. Both the serum and ascitic nitrous oxide did not differ statistically between patients with and without SBP. In contrast, patients with SBP had higher median serum CRP (49 vs. 12 mg/dL), hsCRP (58,000 vs. 23,750 ng/dL) and ascitic calprotectin (7.57 vs. 1.1 ng/mL). The ascitic leucocyte esterase test was positive in 95% of SBP patients in contrast to 2.5% patients without SBP. Ascitic calprotectin >2 ng/mL had 90% sensitivity, 92.5% specificity, 92.3% positive predictive value and 90.2% negative predictive value. MELD, CRP, hsCRP and ascitic calprotectin are independent predictors of SBP. Conclusion Ascitic calprotectin is a useful marker for SBP diagnosis.

Summary: Etiology of ascites of unknown origin varies with geographic area and ethnic origin. Tuberculous peritonitis and peritoneal carcinomatosis constitute a considerable proportion of patients. Differentiation between both is a major challenge. The role of omental thickness (OT) by ultrasonography to predict risk of malignancy in unexplained ascites. This prospective study was done at Kasr Alainy School of Medicine, Cairo University and included 100 adults with unexplained ascites and thickened omentum (>15 mm) on ultrasonography. An expert performed ultrasonography to assess peritoneum and peritoneal cavity and measure OT. Ascites was assessed regarding volume, echogenicity, and loculation. The ascitic fluid was analyzed to measure lactate dehydrogenase, adenosine deaminase, and total leukocytic count. Laparoscopic exploration with biopsy was done for final diagnosis that divided the patients into; TB Group (n = 44) and peritoneal carcinomatosis group (n = 56). Main Outcome Measures were to determine degree of omental thickness as a predictor of malignancy risk in unexplained ascites and other ultrasonographic features to predict malignancy risk including omental echogenicity and results of diagnostic ascitic tapping. We found that OT was greater in the PC group compared to the TB group (24.6 ± 4.6 mm vs. 17.9 ± 3.0 mm, respectively, p 19 mm is a sensitive and specific predictor of malignancy in patients with unexplained ascites. Keywords: Ultrasonographic, Omental thickness, Ascites

Copyright of Journal of Plant Production is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The study objective was to investigate the presence and antibiotic resistance of toxigenic E. coli strains in the raw milk of dairy cattle and to determine the prevalence of blaTEM and blaCTX-M genes in the selected isolates. Methods: Two hundred raw milk samples were collected from 20 dairy farms located in Kafr El Sheikh City. Results: Among the samples, 60 were positive for E. coli. The sensitivity of these isolates was detected against different antibiotics. Using the disk diffusion test, all the isolates were resistant to at least two beta-lactam antibiotics. The resistance to beta-lactam antibiotics by the selected E. coli was varied to be highly significant. Five percent of the tested E. coli was highly resistant with a multi-antibiotic resistant (MAR) index, of 1.0, while 8% had the lowest MAR (0.14). Both blaTEM and blaCTX-M resistant genes were detected in isolate No. 52, while, blaCTX-M was detected in isolate No. 34 and blaTEM was detected in isolates No. 9, 21, 28, and 40. The PCR products of blaTEM and blaCTX-M genes were sequenced and deposited in the GenBank of the NCBI database with the accession numbers OR450046 and OR879117, respectively. Conclusion: The macrolides group of antibiotics especially erythromycin should not be a suitable treatment of dairy herds for mastitis by E. coli in Egypt. The majority of E. coli was multiple-antibiotic resistant and co-carried many virulence genes, and it may pose a great potential risk to public health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT. OBJECTIVES: Analyze risk factors that can affect early (

Background: Direct acting antivirals (DAAs) are highly effective for treatment of hepatitis C (HCV) but brand products are priced beyond the means of most low and middle income countries (LMICs). Although a few DAAs are offered at reduced prices in access programs, they are still beyond affordability in limited resource settings with a large HCV infected population. Cheap generics might fill this economic need, but studies comparing their clinical efficacy to that of original products are limited. Aim: To compare efficacy of brand and generic DAAs used in the national treatment program in Egypt. Methods: HCV treatment eligible patients (n = 971) were enrolled. They were treated with 12 weeks of either sofosbuvir-daclatasvir (SOF-DCV) or SOF-ledipasvir (SOF-LDV). Ribavirin (RBV) was added to patients with cirrhosis and to SOF experienced patients. Patients with cirrhosis who were RBV intolerant were treated for 24 weeks without RBV. Results: Most patients were males (61.4%), treatment naïve (88.6%), without cirrhosis (61.7%), and the mean age was 51.3 ± 11.31 years. Baseline characteristics were not different in patients treated with brand or generic medications regarding age, liver tests, creatinine, platelets, MELD score, baseline HCV-RNA and transient elastography. Overall sustained virologic response (SVR) rate was 98.1%, which was similar for generic and brand drugs (98.2% vs. 98.1%; p = 1), and similar with both regimens used (SOF-DCV ± RBV: brand: 98.1%, generic 97.8%; p = 0.729, SOF-LDV ± RBV: brand 98.2%, generic 100%; p = 0.729). AST and ALT decreased significantly with initiation of therapy with both generic and original drugs. Conclusion: Generic and brand DAAs are equally effective for achieving SVR and improving aminotransferases. Keywords: HCV, Direct acting antivirals, Generic, Brand, Sofosbuvir, Ledipasvir, Daclatasvir, Sustained virological response

Background/AimsAscites is a dreadful complication of liver cirrhosis associated with short survival. Large volume paracentesis (LVP) is used to treat tense or refractory ascites. Paracentesis induced circulatory dysfunction (PICD) develops if no plasma expanders are given with ominous complications. To study the effect of ascites flow rate on PICD development.MethodsSixty patients with cirrhosis and tense ascites underwent LVP of 8 L were randomized into 3 equal groups of different flow rate extraction; group I (80 mL/minute), group II (180 mL/minute) and group III (270 mL/minute). Plasma renin activity (PRA) was measured baseline and on day six. PICD was defined as increase in PRA >50% of the pretreatment value.ResultsIn group I through 3; the mean age was (52.5±9.4 vs. 56.4±8.5 vs. 55.8±7.1 years; P>0.05), mean arterial pressure (81.4±5.6 vs. 81.5±7 vs. 79.5±7.2 mmHg; P>0.05), MELD (17.6±4.1 vs. 15.8±4.1 vs. 14.7±4.5). Baseline PRA was comparable (1,366.0±1244.9 vs. 1,151.3±1,444.8 vs. 951.9±1,088 pg/mL; P>0.05). There was no statistically significant (P>0.05) flow mediated changes (Δ) of creatinine (0.23±0.27 vs. 0.38±0.33 vs. 0.26±0.18 mg/dL), MELD (1.25±5.72 vs. 1.70±2.18 vs. 1.45±2.21) or PRA (450.93±614.10 vs. 394.61±954.64 vs. 629.51±1,116.46 pg/mL). PICD was detected in a similar frequency in the three groups (P>0.05). On univariate logistic analysis only female sex was a fairly significant PICD predictor (Wald 3.85, odds ratio 3.14; P=0.05).ConclusionsThe ascites flow rate does not correlate with PICD development.

This research aims to present a design proposal that achieves the pi'inciple of zero loss, by producing an evening top made of lace material by using separate units of lace. Such top is used as an accessory that is matching more than one garment, which gives a different and new look to the clothes and helps to achieve sustainability. The design was produced by using Photoshop program to distribute the lace units in a manner inspired by the principle of self-similarity in fractal geometry to ensure compatibility as an aesthetic aspect of the product. As regards producing the clothing, the lace units were sewn by using the zigzag stitch. [ABSTRACT FROM AUTHOR]