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Introduction: Coronavirus Disease 2019 (COVID-19) is by far the most world-altering pandemic to ever hit modern humanity. Three years after the very first case emerged in December 2019, the virus continues to bring upon global disarray in the acute phase of the infection as well as months afterwards, causing the virus’s morbidity and mortality to further skyrocket. This systematic literature review was conducted up till December 2022, comprising all the case reports that thoroughly discuss a myriad of non-Multisystem Inflammatory Syndrome In Children (non-MIS-C) post-acute sequalae of COVID-19 (PASC) in the paediatric population, also known as Long COVID Syndrome. In this review, we aimed to highlight the prevalent time interval between COVID-19 infection and the development of various non-MISC post-infectious sequalae (PIS). Methods: We conducted a holistic literature search on PubMed, Google Scholar, Google Search, and Scopus. Data bases were searched for studies that met our inclusion and exclusion criteria. The systematic review was performed on all case reports containing relevant outcome parameters such as age, sex, the interval between COVID-19 infection and subsequent PASC and, lastly, the need for hospitalization during the course of the disease. Results: We collected a total of 78 case reports discussing the various post-infectious immune sequalae following COVID-19 infection in the paediatric population, consisting of a total of 109 patients. The final screening revealed an equal sex distribution, whereas the two commonest age intervals were school-aged children and adolescents, with 38% of the patients having been older than six years. Interestingly, hospital admission throughout the course of COVID-19 wasn’t a predictor of the subsequent PASC; forty-nine patients (44.9%) were hospitalized while sixty patients (55.1%) were not hospitalized. More importantly, the most predominant time interval between COVID-19 infection and the developing PASC was observed to be within 14 days since the start of COVID-19 infection, accounting for 61% of the cases. Conclusion: These findings suggest a crucial link is slowly but surely unfolding between COVID-19 and an abundance of systemic post-infectious immune sequalae in the paediatric population, especially amongst children older than six years. Accordingly, meticulous follow-up and prompt management is largely encouraged for the paediatric population in case of unusual symptoms and signs following COVID-19 infection, regardless of COVID-19’s severity.

Introduction: Coronavirus Disease 2019 (COVID-19) is by far the most world-altering pandemic to ever hit modern humanity. Three years after the very first case emerged in December 2019, the virus continues to bring upon global disarray in the acute phase of the infection as well as months afterwards, causing the virus’s morbidity and mortality to further skyrocket. This systematic literature review was conducted up till December 2022, comprising all the case reports that thoroughly discuss a myriad of non-Multisystem Inflammatory Syndrome In Children (non-MIS-C) post-acute sequalae of COVID-19 (PASC) in the paediatric population, also known as Long COVID Syndrome. In this review, we aimed to highlight the prevalent time interval between COVID-19 infection and the development of various non-MISC post-infectious sequalae (PIS). Methods: We conducted a holistic literature search on PubMed, Google Scholar, Google Search, and Scopus. Data bases were searched for studies that met our inclusion and exclusion criteria. The systematic review was performed on all case reports containing relevant outcome parameters such as age, sex, the interval between COVID-19 infection and subsequent PASC and, lastly, the need for hospitalization during the course of the disease. Results: We collected a total of 78 case reports discussing the various post-infectious immune sequalae following COVID-19 infection in the paediatric population, consisting of a total of 109 patients. The final screening revealed an equal sex distribution, whereas the two commonest age intervals were school-aged children and adolescents, with 38% of the patients having been older than six years. Interestingly, hospital admission throughout the course of COVID-19 wasn’t a predictor of the subsequent PASC; forty-nine patients (44.9%) were hospitalized while sixty patients (55.1%) were not hospitalized. More importantly, the most predominant time interval between COVID-19 infection and the developing PASC was observed to be within 14 days since the start of COVID-19 infection, accounting for 61% of the cases. Conclusion: These findings suggest a crucial link is slowly but surely unfolding between COVID-19 and an abundance of systemic post-infectious immune sequalae in the paediatric population, especially amongst children older than six years. Accordingly, meticulous follow-up and prompt management is largely encouraged for the paediatric population in case of unusual symptoms and signs following COVID-19 infection, regardless of COVID-19’s severity.

Introduction: The rapid emergence of COVID-19 as a global crisis has led to the approval of many vaccinations, which were unfortunately associated with high complication rates due to a lack of sufficient safety studies. Objectives: The following manuscript focuses on discussing the demyelinating disorders that were noticed after COVID vaccine administration. Methods: We conducted a retrospective study using anonymous medical records from the US vaccine adverse events reporting system, complications retrieved included Acute disseminated encephalomyelitis (ADEM), Guillain Barre syndrome (GBS), and Multiple sclerosis (MS), outcome parameters were age, sex and the dose after which this complication was observed. Patients younger than 18 years-old were excluded as some of the vaccines, namely Janssen (JNJ-78436735) is not yet approved below this age. Results: Our analysis showed that demyelinating disorders were more likely to occur in patients over the age of 50 compared to other age groups, regardless of the type of vaccination, except for MS and ADEM occurrences after the Jansen vaccine. In addition, demyelinating complications were more likely to occur after the first dose of vaccination. Conclusion: Further research and observation of demyelinating diseases in different vaccinations, as well as additional in vitro studies, are recommended to further explain the pathogenesis of demyelinating disorder occurrence.

Global overpopulation, industrial expansion, and urbanization have generated massive amounts of wastes. This is considered as a significant worldwide challenge that requires an urgent solution. Additionally, remarkable advances in the field of biomedicine have impacted the entire spectrum of healthcare and medicine. This has paved the way for further refining of the outcomes of biomedical strategies toward early detection and treatment of different diseases. Various nanomaterials (NMs) have been dedicated to different biomedical applications including drug delivery, vaccinations, imaging modalities, and biosensors. However, toxicity is still the main factor restricting their use. NMs recycled from different types of wastes present a pioneering approach to not only avoid hazardous effects on the environment, but to also implement circular economy practices, which are crucial to attain sustainable growth. Moreover, recycled NMs have been utilized as a safe, yet revolutionary alternative with outstanding potential for many biomedical applications. This review focuses on waste recycled NMs, their synthesis, properties, and their potential for multiple biomedical applications with special emphasis on their role in the early detection and control of multiple diseases. Their pivotal therapeutic actions as antimicrobial, anticancer, antioxidant nanodrugs, and vaccines will also be outlined. The ongoing advancements in the design of recycled NMs are expanding their diagnostic and therapeutic roles for diverse biomedical applications in the era of precision medicine.

The aim of this study was to explore effect of young rural women’s general characteristics on their knowledge and compliance with healthy practices during postpartum period Research design: A descriptive study design was utilized. Setting: This study was conducted in Obstetrics &Gynecological outpatient clinic at Benha University Hospital. Sample: A simple random sample included 183 postpartum women Tools of data collection 1) a structured interviewing sheet to collect data about general characteristics and knowledge of women regarding healthy practices during postpartum period 2) self-reported measures to assess women's compliance with healthy practices during postpartum period .Results: 43.17% of studied women aged from 23 to 25 years with the mean age 22.248 ±1.794. Also 89.86% of studied women had incorrect total knowledge score about postpartum care, 99.28% of them not compliance with health practices about postpartum care. Conclusion: it can be concluded that around the most of studied women had poor knowledge about postpartum care and the majority of them not compliance with health practices about postpartum care. Reveals that, statistically significant relation between general characteristics of young rural women, total knowledge and total practices score toward postpartum care. Also there was a positive highly significant relation between total knowledge score and total practices score. Recommendation: Designing and implementing guidelines, brochure among pregnant women during third trimester and women during postpartum period to raising awareness about the care during postpartum period. Implementing counseling session to enhance women to seek antenatal, labour and postpartum health services.

Background: Preeclampsia is the leading cause of maternal and perinatal morbidity and mortality worldwide, but it is more prevalent in developing countries. Aim was to investigate the effect of implementing continuous care model on health-related behaviors and quality of life among women with preeclampsia. Design: A quasi-experimental research design was utilized. Setting: The study was conducted at the Obstetrics and Gynecology Outpatient Clinic of Benha University Hospital. Sample: A purposive sample of 70 pregnant women diagnosed with preeclampsia was recruited and divided equally into study and control groups (35 women per group). Tools: Three tools were used to collect data; a structured interviewing questionnaire, health-related behaviors regarding preeclampsia questionnaire, and World Health Organization quality of life-BREF. Results: There was no statistically significant difference between mean scores of health-related behaviors regarding preeclampsia and quality of life before implementation of the continuous care model in both groups (P ˃ 0.05). After implementing the continuous care model, the mean scores of health-related behaviors and quality of life in the study group were significantly higher than in the control group (p ≤ 0.001). A significant positive correlation between total scores of health-related behaviors regarding preeclampsia and quality of life in both groups before and after implementation of continuous care model (P ≤ 0.001). Conclusion: Implementing the continuous care model had a positive effect on improving preeclampsia-related health behaviors and the quality of life for women with preeclampsia. Recommendations: The continuous care model should be incorporated as a nursing intervention for promoting women's health behaviors and improving quality of life within preeclampsia care.

The COVID-19 death toll has involved to date more than 1 million confirmed deaths. The death rate is even higher in the obese COVID-19 patients, as a result of hypoxia, due to the interplay between adipose tissue hypoxia and obstructive sleep apnea. The discrepancy of manifestations seen in COVID-19 seems to be mediated by a differential immune response rather than a differential viral load. One of the key players of the immune response is HIF. HIF-1β is a stable constitutively expressed protein in the nucleus; and under hypoxic changes, its activity is unaffected, whereas the HIF-α subunit has a short half-life and because of its degradation by an enzyme known as propyl hydroxylase; under hypoxic conditions, propyl hydroxylase gets deactivated thus leading to the stabilization of HIF-1α. As mentioned before, HIF-1α expression is triggered by hypoxic states, this crippling condition will aggravate the pro-inflammatory characteristics of HIF-1α. The vast majority of decompensated COVID19 cases manifest with drastic lung injury and severe viral pneumonia, the infection-induced hypoxia will the existing hypoxia in obesity. This will additionally augment HIF-1α levels that will provoke the already existing cytokines' storm to fulminant. Consequently, this will directly correlate the effect of a hypoxic environment with the increase of HIF-1α level. HIFɑ exists in two main isoforms HIF-1α and HIF-2α. HIF-1α and HIF-2α act in distinct ways in how they work on different target genes. For example, HIF-2α may act on hemopoietin genes (heme-regulating genes); while HIF-1α acts on EPO. HIF-1α release seems to be markedly augmented in obesity due to adipose tissue hypoxia and obstructive sleep apnea resulting in cyclic hypoxia. HIF-1α can also be secreted by direct viral proteolytic effects. Whereas, HIF-2α is stimulated by chronic hypoxia. HIF-1α exerts detrimental effects on the immune system, characterized by unopposed pro-inflammation at the macrophages, dendritic cells, T cells, and complement levels resulting in cytokines’ storm, which is linked to the poor outcomes of COVID-19. On the other hand, HIF-2α role is regulatory and largely opposes the actions mediated by HIF-1α. In view of this, inhibiting HIF-1α release or switching its production to HIF-2α by natural products such as resveratrol or by synthetic drugs, offer a good therapeutic strategy that can prevent COVID-19 worst outcome in infected patients. The approach of breaking the vicious circle between lung damage-induced hypoxia and HIF-1α pro-inflammatory stimulant through drugs is considered to be extremely promising as a therapeutic manner to combat further deterioration of COVID19 cases., Highlights • HIFɑ exists in two isoforms HIF-1α (pro-inflammatory) and HIF-2α (regulatory); HIF-1α is increased in obesity, due to the presence of ATH and OSA. • Despite being a transcription factor, HIFɑ circulates to nearby cells through the so called extracellular vesicles. • COVID-19 associated lung damage induces an acute hypoxic state, which activates HIF-1α. • HIF-1α, in turn, exacerbates the production of pro-inflammatory cytokines, thus increasing the likelihood of cytokine storm in COVID-19. • In view of the above, HIF-1α inhibitors or alternatively switchers to HIF-2α can prevent COVID-19-induced cytokine storm.

Background: Numerous oncoplastic procedures are now available for treatment of breast cancer. Oncoplastic procedures had expanded the spectrum of breast conservative surgery. It is difficult to plan for resection of medial breast tumors as the scars are apparent and deformity is so eminent. The aim of the work is to assess the latero- central glandular pedicle technique as an oncoplastic procedure for treatment of medial quadrant breast cancer as regard oncological safety, surgical outcomes and patient satisfaction. Patients and method: This study included 15 female patients with a mean age of 43 years (20-60 years) and with invasive breast cancer at upper and lower medial quadrants. They were treated by wide in excision with safety margin followed by reconstruction of defects using latero-central glandular pedicle technique. The patients were followed for 6 months for postoperative complications and cosmetic outcome. Result: In our study the mean age of the 15 patients was 43 years (20-60 years). 60% of the breast tumors were in the upper inner quadrant and 40% of them were in the lower inner quadrant. The largest tumor size was 3.2 cms, the smallest one was 1cm and the mean tumor size was 2 cms±0.47. The mean breast cup size for the whole study was 4.33±1.56 which stand for D. Our mean operation time was 107±14.50 minutes (1 hour and 45 minutes). The longest post-operative stay period was 3 days. The postoperative complications occurred three cases (20%) in the form of: 2 cases(13%) of wound infection and 1case (7%) of stitch sinus . none of the patients had recurrence during postoperative follow up period of six months duration.as regard the cosmetic outcome which was estimated via a score system graded from one to five, The overall mean score of our study was 4.23±0.86 which falls between very good and excellent. Conclusion: The latero-central glandular pedicle technique is an oncoplastic procedure for treatment of medial quadrant breast cancer with main advantages of low rate of postoperative complications and better cosmetic outcome.

Background: LSG became very popular among all the community. Traditionally, it is performed through 3-5 incisions. SILSG is done through one incision, improving the aesthetic outcome. SILSG has some advantages over the conventional LSG which are less abdominal pain, less admission in hospital, and rapid return to work. Aim: In this study we are going to assess the safety and feasibility of SILSG in a group of patients and report the outcomes and complications. Materials and Methods: We collected the data of 50 consecutive patients with morbid obesity who underwent SILSG in our department from May 2017 till August 2018. The inclusion criteria were a body mass index (BMI) ≥40 or ≥35 kg/m2 associated with co-morbidities. The exclusion criteria were patients with a BMI >60 kg/m2, previous upper abdominal surgeries, large abdominal hernias, or large hiatus hernia. Results: 50 patients were included in our study. Their median age was 41 years, and 78% were females. The median BMI was 44.5 kg/m2. The median operating time was 72 minutes (range 56–145). There was no intraoperative complications. Six patients (12%) required 1 or 2 additional trocars. Only 6% had early complications. There was no cases of wound infection or incisional hernia. There was no conversion to open surgery or conventional LSG. There was no mortality. The mean reduction in excess weight was 68%. All patients were satisfied with their wound. Conclusion: SILSG is a safe and feasible technique if performed by an expert surgeon. It has low complication rates and no reported mortality. Randomized studies are still needed after improvement of the associated learning curve, to assess the long-term results.

Background: Phyllodes tumors are rare distinctive fibro-epithelial tumors of the breast and their management continues to be questioned. Between 10% and 40% of phyllodes tumors have a tendency for LR and general dissemination. The aim of our study was to review the management of Phyllodes Tumour (PT) and to examine the determinants of local recurrence (LR). Methods: A retrospective cohort study of female patients with histologically proven PT who presented to Ain Shams University Hospital (ASUH) between August 2014 and August 2018. Data collected from their files were analyzed to correlate LR after surgical intervention to demographic characteristics, tumour site, tumour size, tumour pathological grade, safety margin and type of performed surgery. Results: Our study included 24 patients who presented to ASUH and were diagnosed to have PT, with follow up a mean of 30 months ±10. Only 6 patients (25%) demonstrated LR after the surgical intervention by a mean of 1.250 years ± 0.354 (range 1-1.5 years). In the recurrent group, the mean age was 39.333 (range 27-51) (P 0.636), the lesion size was between 5-15 cm (mean 11.667) (P 0.016), and safety margin was exceeding 10mm (P 0.422). Conclusion: Benign and small PTs should be removed with safety margin rather than simple excision, and their malignant potential should be considered. Wider-scale studies are vital in understanding the recurrence behavior of this rare disease.

Introduction: Vomiting is a postoperative complication in all bariatric surgical interventions since the focus of the procedure is related to the stomach, research efforts are required to reveal the best management course for this issue. Aim of the work: The primary study objective is to assess the percentage of postoperative vomiting occurrence after laparoscopic bariatric surgeries for two months, its causes with investigations and ways of management. Patients and methods: The current research study is a retrospective clinical research trial that recruited 100 cases. All study subjects have undergone Laparoscopic Bariatric Surgeries over a 6 months period in Ain Shams University Hospitals during the period from December 2017 to June 2018. Results: A large percentage of patients (39%) developed Postoperative Vomiting during the first 48 postoperative hours. While (4%) of cases who continued to suffer from Vomiting during the postoperative 2 months. Conclusions: Postoperative vomiting after Laparoscopic Bariatric Surgeries (LBS) represents a considerable complication which occurs commonly. Vomiting of medical causes responds well to centrally acting antiemetic and to a lesser extent, endoscopic and surgical interventions were required for technical problems.

Background: Physical activity behaviour during the postpartum period is very important to improve maternal health and prevent complications both in the short and long term. This study aims to evaluate the effect of a trans-theoretical model based intervention on physical exercises behaviour among postpartum women at Benha City, Egypt. Methods: A quasi-experimental design was utilized. The study was conducted at family planning outpatient clinic affiliated to Benha teaching hospital. A purposive sample of 86 postpartum women were included in the present study. Three tools were used for data collection; first tool: structured interviewing schedule to collect data about the subjects' demographic characteristics, medical and obstetric history and knowledge towards postpartum exercises. Second tool; the trans-theoretical model of behaviour change questionnaire, it composed of the four main dimensions that are stage of change, self-efficacy, decisional balance (pros and cons), experiential and behavioural process of change. Third tool; international physical activity questionnaire short-form to assess the postpartum physical activity level. Results: The mean age of the studied women was 28.885.89 years. There were statistically significant improvements (PConclusion: The trans-theoretical based intervention was efficient in improving women's knowledge, postpartum exercise behaviour. This was observed in increasing women's self-efficacy, decisional balance pros, experimental and behavioural processes of change. While reducing decisional balance cons. Recommendation: The nurse should implement trans-theoretical model based interventions for postpartum women to promote postpartum exercise behaviour.

Ever since the uncovering of the severe discrepancy of COVID-19 manifestations, irrespective of viral load, scientists have raced to locate and manage factors contributing to the genesis of a critical state. Recent evidence delineates the role of oral dysbiosis in the development of low-grade inflammation, characterized by the increase of inflammatory cytokines common to those fundamental to the development of severe COVID. Furthermore, high periodontopathic bacteria were recorded in severe acute respiratory syndrome in COVID patients as well as its common provoking comorbidities such as diabetes and hypertension. This can be explained by the immigration and elimination of oral bacteria into the airways, which, in the context of an injured lung, allows for their preferential overgrowth familiar to that causing the progression to advanced lung diseases. This is why we indicate the promising usage of oral microbiome transplantation as a treatment of the oral microbial dysbiosis, not only associated with worst outcomes of COVID-19 but also in other disorders of low-grade inflammation., Graphical abstract Image 1

Supplemental Digital Content is available in the text., To date, coronavirus disease 2019 (COVID-19) has affected over 6.2 million individuals worldwide, including 1.46 million deaths. COVID-19 complications are mainly induced by low-grade inflammation-causing vascular degeneration. There is an increasing body of evidence that suggests that oral dysbiotic taxa are associated with worse prognosis in COVID-19 patients, especially the Prevotella genus, which was retrieved from nasopharyngeal and bronchoalveolar lavage samples in affected patients. Oral dysbiosis may act by increasing the likelihood of vascular complications through low-grade inflammation, as well as impairing respiratory mucosal barrier mechanisms against SARS-CoV-2. Salivary markers can be used to reflect this oral dysbiosis and its subsequent damaging effects on and the lungs and vasculature. Salivary sampling can be self-collected, and is less costly and less invasive, and thus may be a superior option to serum markers in risk stratification of COVID-19 patients. Prospective studies are needed to confirm such hypothesis. Video Abstract: http://links.lww.com/CAEN/A28

Adult multipotent stem/progenitor cells, with remarkable regenerative potential, have been isolated from various components of the human periodontium. These multipotent stem/progenitor cells include the periodontal ligament stem/progenitor cells (PDLSCs), stem cells from the apical papilla (SCAP), the gingival mesenchymal stem/progenitor cells (G-MSCs), and the alveolar bone proper stem/progenitor cells (AB-MSCs). Whereas inflammation is regarded as the reason for tissue damage, it also remains a fundamental step of any early healing process. In performing their periodontal tissue regenerative/reparative activity, periodontal stem/progenitor cells interact with their surrounding inflammatory micro-environmental, through their expressed receptors, which could influence their fate and the outcome of any periodontal stem/progenitor cell-mediated reparative/regenerative activity. The present review discusses the current understanding about the interaction of periodontal stem/progenitor cells with their surrounding inflammatory micro-environment, elaborates on the inflammatory factors influencing their stemness, proliferation, migration/homing, differentiation, and immunomodulatory attributes, the possible underlying intracellular mechanisms, as well as their proposed relationship to the canonical and noncanonical Wnt pathways.