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Abstract The disposal of sharp waste generated at home by diabetic patients poses a major public health problem. This study evaluated an educational program designed to improve patients’ knowledge and practices around sharps disposal. A non-equivalent quasi-experimental study was performed at a main diabetic center in Egypt on 100 participants divided into intervention and non-intervention groups. The effect of the interventional program was tested by the evaluation of the improvement in participants’ knowledge and practice after two and four months of the program. Initially, there were no differences in knowledge or practice scores between the groups. After the implementation of the program, there was a noticeable difference in subjects’ knowledge levels and scores between the two groups, with the intervention group significantly outperforming the non-intervention group (p

Abstract Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. Most studies evaluated the post-alteplase haemorrhagic transformation of brain infarction as a homogeneous entity but we evaluated the predictors of each subtype of haemorrhagic transformation of brain infarction. Our trial included 616 AIS alteplase-treated patients. We evaluated the ability of different risk factors, clinical presentation, and imaging features to predict different haemorrhagic transformation (HT) subtypes. HT was seen in 152 patients (24.7%), higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction, in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 (odds ratio [OR], 11.04; 95% CI, 9.81 to 12.70; P-value > 0.001) and type2 (OR, 11.89; 95% CI, 9.79 to 14.44; P-value > 0.001), while older age was also an independent predictor of parenchymal hematoma type1 (OR, 1.312; 95% CI, 1.245 to 1.912; P-value 0.02). In AIS patients treated with alteplase in Egypt and Saudi Arabia, higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction; in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 and 2, while older age was also an independent predictor of parenchymal hematoma type1. Trial registration: (clinicaltrials.gov NCT06337175), retrospectively registered on 29/03/2024.

Digital elevation models (DEMs) are crucial for numerous assessments of the Earth's surface, so this research aim to evaluate the quality of several open source DEMs like advanced spaceborne thermal emission and reflection radiometer global DEM (ASTER GDEM), shuttle radar topography mission DEM (SRTM DEM), SENTINEL-1, and TerraSAR-X for digital elevation measurement (TanDEM-X). TanDEM-X is one of the newest DEM models; however, ASTER and SRTM are still the most used. To evaluate the qualities of these DEMs, the vertical accuracies of ASTER, STRM (all 30 m), SRTM, TanDEM-X (90 m), and SENTINEL 1 (range from 5 to 12.5 m) were tested using GPS reference points and The RMSE gave the values of ± 3.56 m ± 57.68 m, ±5.89 m, ±10.21 m and ± 20.25 m for used SRTM1, SENTINEL-1, SRTM3, TanDEM-X, and ASTER DEMs respectively. As is well known, obtaining a high-quality DEM is exceedingly challenging since it is time-consuming, expensive, and often constrained, therefore this study examined how to enhance SRTM1 as it gave the best result and assessed the effects of increasing the number of points on digital elevation model accuracy by using raster calculator and merge model in ArcGIS. The results showed that the merge model method gave the best result and, by increasing the number of reference points, the accuracy increased. The DEM produced by the enhanced SRTM (iSRTM) demonstrated noticeably better outcomes than the baseline SRTM DEM, with around 3.56 m RMSE.In this research, STRM-1 DEM is used to determine watershed basin delineation. The topographic map showed significant variations in the level of the Earth's surface, as the heights of the area ranged between 20 m and 120 m. The number of watersheds extracted in the Benban is 132 with different areas, the large area is about 72.14 km2, while the small area is about 1.13 km2, and between those areas, there are various areas. The largest recorded watershed circumference reached 48.94 km in area (72.14 km2), while the lowest recorded perimeter is 5.40 km for the area (1.13 km2).

Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation.

Introduction Parental stress related to their infants’ hospitalization is a significant concern that affects both parents and their infants. Fathers’ experiences tend to be understudied compared to mothers. Further research on fathers’ stress levels is necessary. While parental stress has been correlated with infant health severity, the specific causes and risk factors contributing to heightened stress levels in parents of neonatal intensive care unit (NICU) infants are not yet fully understood and require further investigation. Objective This study aimed to examine the stress levels experienced by parents of premature infants in the NICU and to explore the factors associated with parental stress in this specific context. Methods A cross-sectional observational design was used to accomplish this study, which was carried out on 743 parents from nine different NICUs located in governmental hospitals across various locations in Egypt. We used characteristics of parents and premature infants, and Parent Stress Scale was used for data collection. Results A majority of parents reported experiencing high stress in the following domains: sight and sound (80.3%), infants’ appearance (69%), and the parent-infant relationship (81.4%). Additionally, about three-quarters (73.6%) of parents experienced high stress overall, with a mean score of 167.56 (21.3). Conclusion About three-quarters of the parents experienced high overall stress levels. Also, factors that were found to affect parents’ stress levels included premature infants connected to mechanical ventilators, previous neonatal death, parents living far from hospitals, infants delivered through cesarean section, insufficient income, and prolonged hospitalization beyond 5 days.

New EL Alamein city (NAC) is located on the northwestern coast of Egypt 110 km western of Alexandria and just west of Marina resort. The city layout includes internal artificial lagoons circulated by jetties’ inlets connected to the Mediterranean Sea. Intermediate and multigrade groynes have been proposed to reduce intermediate and downdrift expected erosion. Shoreline erosion at the downdrift area of coastal jetties and sedimentation at lagoons inlets are considered critical issues which shall be balanced and modeled. Marina resort lagoons and protections are considered a prototype for NAC coastal structures and inlets. For Marina resort lagoons case study, shoreline changes have been digitized from Google Earth historical images and field measurements data between 1988 and 2021 by using the Digital Shoreline Analysis System (DSAS) software. Cutting natural longshore sediment deposits by Marina jetties has significantly eroded the downdrift area eastern of Marina border. Most of Marina downdrift area was under accretion(up to + 10 m/year) and little erosion areas before the protection work from 1985 to 1988 and with an average rate of −1.00 m / year from 1988 to 2001 during the construction of the jetties and groynes and with an average rate of −1.20 m/ year after the construction stages between 2005 and 2018. High rates of erosion with an average rate of −4.30 m/year were identified between 2019 and 2021 with the start of NAC coastal proposed structures. This research aims to assess the historical and current situation of NAC shoreline changes and use the similar near project of Marina resort to identify and mitigate the side effects of the proposed protection works of New EL Alamein City.

Abstract Background Chronic frontal sinusitis is being treated with less invasive transnasal endoscopic treatments. Surgery relieves illness and prevents recurrence. Our study was conducted on 80 patients who suffer from frontal opacity with sinonasal polyposis and divided randomly into 2 groups: group A: 40 patients candidate for anterior ethmoidectomy without identification of frontal sinus ostium and group B: 40 patients candidate for anterior ethmoidectomy with identification of frontal sinus ostium. The study was conducted in the otolaryngology department faculty of medicine Cairo university. Results CT score and sinonasal endoscopy score were statistically significantly improved postoperatively compared to preoperative scores in both groups. There are no significant differences between the 2 groups regarding recurrence rate and complications. Conclusion Ethmoidectomy without frontal sinusotomy is a potential substitute for frontal sinusotomy for the treatment of chronic frontal sinusitis with sinonasal polyposis, and it can achieve similar improvements in symptoms and radiological evidence of frontal sinusitis.

This study examines the factors affecting media researchers’ selection of media research problems. Combining qualitative and quantitative methods, in-depth interviews with a purposive sample of Arab media researchers were conducted, followed by applying a 22-item questionnaire on a sample of 247 from Arab media researchers. The impact of internal/subjective factors and external/objective factors, on the selection of research problems by Arab media researchers, and their perceptions were investigated. Findings revealed that internal factors are perceived to have a higher impact than external factors. However, external factors are perceived to have a stronger negative impact than positive ones. Findings also raise several issues regarding scientific considerations, institutional requirements, and socio-political conditions that lead researchers to either avoid certain topics or change the angle of their view for their research. The study proposed a theoretical framework regarding the process of selecting research problems in the media field of Arab countries.

Water shortage is considered as a major problem worldwide. Moreover, the adverse effects of climate change would make the issue worse. Most classical dental facilities had inappropriate water consumption practices. Green dentistry is an innovative approach to a dental procedure that is environmentally sustainable while also saving money and time by minimizing waste, conserving water and energy, and lowering pollution through the use of cutting-edge techniques and procedures. However, scarcity of studies about this topic represented the main challenge to our study which was overcome by carrying out precise data collection. Our main objective was to clarify the role of eco-friendly dental technology in water saving. Environmental case study approach was used to answer research question and formulate a hypothesis. Data was collected from several evidence based sources. The study results showed that there was a significant reduction in water consumption after the implementation of Eco dental options. The current findings shed light on the significant role of green dentistry on water saving and serves as a base of future research.

Abstract Background Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary hemorrhage could be serious. We introduced Daflon as a safe and effective complementary medication in reducing these risks. This prospective study was designed to evaluate the effect of using (Daflon oral medication) on post-tonsillectomy pain and hemorrhage rates. This study was conducted on 60 patients of both sexes, above 21 years, and underwent tonsillectomy using bipolar diathermy. Patients were randomly distributed between 2 groups; each group has 30 patients and with the same post-operative protocol; in group 2, an addition of Daflon 500 mg tablet twice daily for 14 days post-operatively was given. Results In group 2, agonizing pain start day, pain duration, analgesia duration, and need for another type, all were significantly different from group 1, starting day in group 1 (4.3 ± 4.0) and (7.2 ± 1.3) in group 2, pain duration in group 1 (7.3 ± 1.5) and (4.2 ± 1.4) in group 2 and need for more analgesia 80% in group 1 and 50% in group 2. Post-operative hemorrhage was 4 cases (13.3%) in group 1, and 2 cases (7%) in group 2, also severity of post-operative bleeding were less in group 2. Healing membrane detaching time was (12.2 ± 2.2) in group 1 and (9.1 ± 1.9) in group 2. Conclusion The use of Daflon 500 mg tablet after bipolar tonsillectomy added to effectiveness of pain control also could help in reducing bleeding rates and its severity. Overall, its use enhances recovery and improves quality of life.

Introduction There is a noticeable increase in the incidence of acute invasive fungal sinusitis which coincides with the ongoing coronavirus pandemic. It is a potentially-lethal fungal infection, with the most common form being the rhino-orbito-cerebral presentation. Objectives The aim of the present study is to discuss the different epidemiological factors, risk factors, clinical presentations and outcomes of acute invasive fungal sinusitis which is noticeably related to the coronavirus disease 2019 (Covid-19) pandemic. Methods The present cross-sectional cohort study included 22 adult patients who presented with Covid-19-related acute invasive fungal sinusitis. The diagnosis of acute invasive fungal sinusitis was confirmed by histopathological biopsy. All data, including demographics, risk factors, clinical findings, different lines of treatment and their outcomes, were recorded and analyzed. Results All patients had diabetes mellitus (100%), and 17 (77.3%) had been submitted to systemic steroids. All patients (100%) had unilateral sinonasal disease. Proptosis was found in 15 patients (68.2%), ophthalmoplegia was observed in 12 patients (54.5%), and intracranial affection occurred in 10 patients (45.5%). A total of 20 patients (90.9%) received liposomal amphotericin B. Surgical debridement was performed in 18 patients (45.5%). Non-septated mycelia was present in 19 biopsies (86.4%), while 3 (13.6%)showed septated mycelia. Total improvement was achieved in 10 patients (45.5%), while the mortality rate was of 27.3% (6 out of 22 participants). Conclusion Diabetes mellitus is the most common preexisting medical condition associated with Covid-19-related acute invasive fungal sinusitis. Systemic corticosteroid therapy is considered a predisposing factor. It is necessary to raise the level of awareness to diagnose this condition, especially in patients with Covid-19 infection or those who have recently recovered from it.

Despite the great manufactures' efforts to achieve customer satisfaction and improve their performance, social media opinion mining is still on the fly a big challenge. Current opinion mining requires sophisticated feature engineering and syntactic word embedding without considering semantic interaction between aspect term and opinionated features, which degrade the performance of most of opinion mining tasks, especially those that are designed for smart manufacturing. Research on intelligent aspect level opinion mining (AOM) follows the fast proliferation of user-generated data through social media for industrial manufacturing purposes. Google's pre-trained language model, Bidirectional Encoder Representations from Transformers (BERT) widely overcomes existing methods in eleven natural language processing (NLP) tasks, which makes it the standard way for semantic text representation. In this paper, we introduce a novel deep learning model for fine-grained aspect-based opinion mining, named as FGAOM. First, we train the BERT model on three specific domain corpora for domain adaption, then use adjusted BERT as embedding layer for concurrent extraction of local and global context features. Then, we propose Multi-head Self-Attention (MSHA) to effectively fuse internal semantic text representation and take advantage of convolutional layers to model aspect term interaction with surrounding sentiment features. Finally, the performance of the proposed model is evaluated via extensive experiments on three public datasets. Results show that performance of the proposed model outperforms performances of recent the-of-the-art models.

During summer seasons of 2015 and 2017, a field experiment was conducted at the Research and Experimental Station (30°19′ N, 31°16′ E), Faculty of Agriculture, Ain Shams University at Shalakan, Kalubia Governorate, Egypt, to investi-gate the effects of combinations between hydroxyl apatite nanoparticles (0, 3, and 6 kg/fad) and cal-cium carbonate nanoparticles (0, 500g/fad) as nano-fertilizers under irrigaton intervals, (irrigation every 2 or 3 weeks whereas irrigation every 2 weeks as a recommended practice) on growth of soybean plants. Irrigation intervals had statistically significant effect on plant height (cm), number of branches per plant, number of leaves per plant, leaf area index, number of pods per plant, number of root nodules per plant, root dry weight per plant, stem dry weight per plant, leaves dry weight per plant and pods dry weight per plant. These results were fairly true in the two studied seasons 2015, 2017 and combined result. plant height, numbers of branches per plant, numbers of leaves per plant, leaf area index, number of nodules per plant and number of pods per plant of soybean plants which treated with 500 g/fed surpassed untreated plants in the two studied seasons 2015, 2017 and com-bined. Soybean plants treated with 6 kg hydroxyl apatite nanoparticles per feddan out-numbered other plants in its numbers of leaves per plant, leaf area index, number of root nodules per plant and number of pods per plant in the two growing sea-sons 2015, 2017 and combined data. Results showed that normal irrigation x 500g/fed calcium carbonate nanoparticles x 6kg/fed hydroxyl apatite nanoparticles was the effective combination for producing the highest values of plant height (cm), number of branches per plant, number of leaves per plant, leaf area index, number of pods per plant, number of root nodules per plant, root dry weight per plant (g), stem dry weight per plant (g), leaves dry weight per plant (g) and pods dry weight per plant (g). There weren’t significant results be-tween plants treated with nano-mineral fertilizers under irrigation every 3 week and plants untreated but irrigated every 2 week in all growth traits, which reflect appositive result of this chemical substance in mitigation harmful effect of water shortage in season 2015, 2017 and combined data.

Late blight disease of potato and tomato, caused by Phytophthora infestans, results in serious losses to Egyptian and global potato and tomato production. To understand the structure and dynamics of the Egyptian population of P. infestans, 205 isolates were collected from potato and tomato plants during three growing seasons in 2010–2012. The characterization was achieved by mating-type assay, metalaxyl sensitivity assay, and virulence pattern. Additionally, genotyping of 85 Egyptian isolates and 15 reference UK isolates was performed using 12 highly informative microsatellite (SSR) markers and five effector (RxLR) genes. Mating-type testing showed that 58% (118 of 205) of the isolates belonged to mating type A1, 35% (71 isolates) to mating type A2, and the rest 8% (16 isolates) were self-fertile. The phenotype of metalaxyl response was represented as 45% resistant, 43% sensitive, and 12% as intermediate. Structure analysis grouped the 85 identified genotypes into two main clonal lineages. The first clonal lineage comprised 21 isolates belonging to A2 mating type and 8 self-fertile isolates. This clonal lineage was identified as Blue_13 or EU_13_A2. The second main clonal lineage comprised 55 isolates and was identified as EU_23_A1. A single isolate with a novel SSR genotype that formed a distinct genetic grouping was also identified. The effector sequencing showed good correspondence with the virulence data and highlighted differences in the presence and absence of loci as well as nucleotide polymorphism that affect gene function. This study indicated a changing population of P. infestans in Egypt and discusses the findings in the context of late blight management.

Reconfigurable multipoint forming is a flexible sheet forming technique aimed at customised sheet metal products. However, one drawback of multipoint forming is the cost and time needed to set up and align the upper and lower pin matrices. This study introduces an optimisation study of a novel hole-type rubber punch replacing the top pin matrix of multipoint incremental forming, aiming to reduce pins setting up and alignment complexity and time. Finite element modelling and design of experiments were used to investigate the effect of hole-type rubber punch configuration such as hole size, hole type, and the compression ratio on the wrinkling, thickness variation, and shape deviation. This research shows that the most significant process parameter in all responses was the hole size. The compression ratio of the material was found to be insignificant in wrinkling and shape deviation. The hole-type rubber punch parameters were found to be a hole size of 9 mm, circular hole type, and a compression ratio of 75%. This experimentally resulted in an improved parts wrinkling of 80%, when compared to using solid rubber punch, with the added benefits of reduction of the cost and time needed to set up and align the pin matrices.

Purpose The aim of this study was to compare the central corneal thickness (CCT) measurements by three different techniques: pentacam, noncontact specular microscopy, and ultrasound biomicroscopy (UBM) devices. Patients and methods This prospective observational cross-sectional study was performed on patients seeking medical care at the outpatient clinic of Ophthalmology Center at Mansoura University. They were consecutively recruited and selected, and measurement of CCT by pentacam, UBM, and specular microscopy was done. Thereafter, the results were compared as an evaluation study of all techniques. Results This study included 200 eyes of 100 patients. The age of the included patients in the study ranged from 20 to 50 years. The mean age was 34.56±9.94 years. The CCT ranged from 465 to 630 µm, with a mean of 532.88±34.15 µm when measured by pentacam. When measured by specular microscopy, it ranged from 456 to 601 µm, with a mean 531.92±33.64 µm, and when measured by UBM, it ranged from 463 to 602 µm, with a mean 533.97±31.10 µm, with P value of 0.824 (nonsignificant). Conclusion CCT measurements obtained by UBM tend to be thicker than those obtained by pentacam and noncontact specular microscopy, but the measurements of all three are strongly positively correlated with each other. So, any of these devices can be easily substituted by the other for the measurement of CCT.

Abstract Introduction Sometimes it is difficult to differentiate between acute cardiogenic pulmonary edema (APE) and acute respiratory distress syndrome (ARDS) on clinical basis only. Chest ultrasonography (CUS) may be helpful in providing ultrasonographic pleuropulmonary signs, which aids in such differentiation. Aim The aim of this study was to evaluate the role of CUS in differentiating between ARDS and APE through the characterization of comparative peculiar ultrasonographic pleuropulmonary signs. Patients and methods On admission, CUS was performed in Ain Shams University Hospital and Al-Abbassia Chest Hospital ICUs on 28 consecutive patients who presented with ARDS (15 cases) or APE (13 cases). CUS examination focused on the detection of the following pleuropulmonary signs in both ARDS and APE: alveolar–interstitial syndrome (AIS), pleural line abnormalities, absent or reduced lung sliding, consolidation, and pleural effusion. Results AIS was found in 100% of patients with ARDS and in 100% of patients with APE. Pleural line abnormalities were observed in 100% of patients with ARDS and in 0% of patients with APE (P=0.001). Absent or reduced lung sliding was observed in 100% of patients with ARDS and in 0% of patients with APE (P=0.001). Consolidations were present in 93.3% of patients with ARDS in 7.5% of patients with APE (P=0.001). Pleural effusion was present in 40% of patients with ARDS and in 76.9% of patients with APE (P=0.049). All pleuropulmonary signs, except the presence of AIS, presented a statistically significant difference in presentation between ARDS and APE, resulting peculiar ultrasonographic pleuropulmonary signs of ARDS. Conclusion CUS represents a useful tool for differentiating ARDS from APE in ICU patients. In fact, the presence of absent or reduced lung sliding, pleural line abnormalities, and lung consolidations on a background of AIS seems diagnostic of ARDS.

Introduction: Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. (1) The main purpose of this study was to determine the prevalence of bacterial wound infection in critically ill burn patients in surgical intensive care unit in Egypt. Objectives: The aim of this study was to determine the bacterial isolates in sever burn wound infection, suitability to antibiotics and there are mortalities. Methods: We conducted a one year retrospective study in the surgical ICU. Wound swab Culture and sensitivity reports of admitted patients. All the patients of all age groups suffering with flame burnt and both sexes having complete Culture and sensitivity reports were included. Results: The main finding of the current study described herein was the percent of isolates from burn wound (60%). The most common organism was pseudomonas (49%). Multidrug resistant gram negative organisms represent about 60% of the isolates. Pattern of antibiotic sensitivity was 84% for colistin, 39% for amikacin and 35% for imipenem. The mortalities in our study were 80%.

Background: Anesthesia for cochlear implantation in pediatrics mandates deliberate hypotension to provide a better surgical field. Dexmedetomidine is α2 adrenoceptor agonist that provides adequate sedation with high cardiovascular stability. We aimed to compare it with fentanyl as an anesthetic adjuvant. Methods: 52 pediatric patients (ASA I or II), undergoing cochlear implantation were randomized into dexmedetomidine (D) group and fentanyl (F) group (n = 26 for each). Anesthesia was induced by I.V. dexmedetomidine in (D) group at a bolus dose of 0.4 μg/kg slowly infused over 10 min, then continuous infusion by a rate of 0.4 μg/kg/h until the end of surgery. In (F) group; anesthesia was induced by I.V. fentanyl at a dose of 1 μg/kg over 10 min, then continuous infusion by a rate of 1 μg/kg/h. This is followed by I.V. propofol and atracurium for both groups. Maintenance was done without additional muscle relaxant to allow monitoring of the facial nerve. Both groups were compared as regards the quality of the surgical field, intraoperative hemodynamics, recovery and discharge time, postoperative pain using objective pain score and the need for rescue analgesics and anti-emetics in postanesthesia care unit (PACU). Results: Dexmedetomidine group showed a decreased heart rate and mean arterial pressure than fentanyl group. These parameters were significantly decreased compared to the baseline throughout the procedure in D group. The quality of the surgical field was significantly better in D group than in F group. Postoperative pain and complications were not different between the two groups. Recovery and discharge time was significantly shorter for the patients in D group than in F group (p

Recently, the metabolites separated from endophytes have attracted significant attention, as many of them have a unique structure and appealing pharmacological and biological potentials. Isocoumarins represent one of the most interesting classes of metabolites, which are coumarins isomers with a reversed lactone moiety. They are produced by plants, microbes, marine organisms, bacteria, insects, liverworts, and fungi and possessed a wide array of bioactivities. This review gives an overview of isocoumarins derivatives from endophytic fungi and their source, isolation, structural characterization, biosynthesis, and bioactivities, concentrating on the period from 2000 to 2019. Overall, 307 metabolites and more than 120 references are conferred. This is the first review on these multi-facetted metabolites from endophytic fungi.

Hydraulic jump is generally helped in the dissipation of excess kinetic energy downstream of hydraulic structures such as gates, spillways, and weirs. This paper presents a comprehensive review of the available literature on the hydraulic jump properties on corrugated beds. In the present study the effect of spaced triangular strip corrugated bed on submerged jump characteristics has been experimentally investigated. Thirty experimental runs were carried out considering wide range of Froude numbers ranging from 1.68 to 9.29. Experiments were conducted for both smooth and rough bed. The results confirm that sequent depth and jump length were reduced by average values 15.14% and 21.03%, respectively, whereas, jump efficiency was increased by 50.31% at optimum spaced roughness compared to a classical jump respectively. Dimensionless relationships were deduced to predict the jump characteristics. Results of the present study were agreed satisfactorily with the previous studies.

Local scour downstream of hydraulic structures due to hydraulic jump is considered one of the tedious and complicated problems facing their stability. Throughout this paper, an experimental study was conducted to study the effect of using different spaced corrugated aprons on the downstream local scour due to submerged jump. Sixty runs were carried out in a horizontal rectangular flume to determine the optimal corrugation wavelength which minimizing the scour. A case of flat apron included to estimate the influence of corrugated aprons on scour holes dimensions. Two types of non-cohesive soil were used. Experiments were performed for a range of Froude numbers between 1.68 and 9.29. The results showed that using spaced triangular corrugated aprons minimize the scour depth and length of fine sand by average percentage of 63.4% and 30.2%, respectively and for coarse sand by 44.2% and 20.6% in comparing with classical jump.

Purpose. To evaluate the anterior segment, the anatomical position of the implantable collamer lenses (ICL), and its relationship to adjacent ocular structures using Ultrasound Biomicroscopy (UBM). Methods. In a prospective study, 142 myopic eyes of 93 patients implanted with Visian ICL were subjected to UBM examination between March 2010 and January 2015. The relative position of ICL to the adjacent structure and the overall iris configuration were evaluated. The machine calibers were used to measure the minimum central distance between the ICL and anterior lens capsule (vault) and the vertical central distance between the corneal endothelium and the ICL (E-ICL). Results. The mean ICL vault was 376±105 μm. The mean E-ICL was 2826±331 μm. Contact between ICL and the posterior epithelium of the iris was present in all eyes. The overall iris configuration was flat in 89 eyes. Central anterior convexity was present in 41 eyes and mild peripheral iris bombe in 12 eyes. The haptics could be imaged in the ciliary sulcus in 112 eyes and at least one haptic resting on the lens periphery and zonules in 30 eyes. Conclusion. UBM can provide valuable anatomical information that allows detailed postoperative in vivo assessment of ICL.

INTRODUCTION: the prevalence of extensively drug resistant gram negative bacilli (XDR-GNB) is rapidly progressing; however in Egypt data are sparse. We conducted the present study to quantify the incidence, risk factors and outcome of patients harboring XDR-GNB. METHODS: a one year prospective study was done by collecting all the bacteriological reports for cultures sent from the surgical intensive care unit, Cairo university teaching hospital. XDR-GNB were defined as any gram negative bacilli resistant to three or more classes of antimicrobial agents .Patients with XDR-GNB compared with those sustaining non extensively drug-resistant infection. A multivariate logistic regression model was created to identify independent predictors of multi-resistance. RESULTS: during one-year study period, a total of 152 samples (65%) out of 234 gram negative bacilli samples developed extensively drug resistant infection. XDR strains were significantly higher in Acinetobacterspp (86%), followed by Pseudomonas (63%), then Proteus (61%), Klebsiella (52%), and E coli (47%). Fourth generation cephalosporine (Cefipime) had the lowest susceptibility (10%) followed by third generation cephalosporines (11%), Quinolones (31%), Amikacin (42%), Tazobactam (52%), Carbapinems (52%), and colistin (90%).Relaparotomy was the only significant risk factor for acquisition of XDR infection. CONCLUSION: extensively drug-resistant gram negative infections are frequent in our ICU. This is an alarming health care issue in Egypt which emphasizes the need to rigorously implement infection control practices.

Introduction: Perforations of the tympanic membrane result mainly from otitis media or trauma, and we need grafting when a perforation is chronically persistent to prevent recurring infections and to enhance hearing. In the present study, we assessed the success rate, feasibility, and efficacy of endoscopic transcanal tympanoplasty using tragal cartilage grafts via the clip technique. Methods: This prospective study was performed between September 2017 and December 2021 and was conducted in ENT departments in tertiary hospitals. Forty patients underwent endoscopic clip technique tragal cartilage type 1 tympanoplasty. Patients with dry (for 3 months at least) small (less than 3 mm), medium (3-5 mm), or large (more than 5 mm) central perforations but not marginal perforations. Results: TM perforation healing following the procedure for 6 months was achieved in 100% of the patients with small perforations, 18 of 19 (94.73%) with medium perforations and 11 of 12 (91.6%) with large perforations. At 6 months post-surgery, hearing improvement, as confirmed by audiometric results, was approximately 12.41 ± 1.01 dB. There was a highly significant improvement in the A-B gap (air-bone gap). Conclusion: Endoscopic chondro-perichondrial tragal graft with the clip technique for the repair of small-, medium-, and large-sized nonmarginal TM perforations is a minimally invasive, safe and effective technique compared with the conventional myringoplasty technique. It provided good results (closure of both the perforation and the air-bone gap), minimized morbidity, reduced the operative time, increased patient compliance, and reduced the duration of hospital admission. [ABSTRACT FROM AUTHOR]

1. Introduction Peptic ulcers are one of the world's major gastrointestinal disorders, embracing both gastric and duodenal ulcers and affecting 10% of the world population (Venkateswararao and Venkataramana 2013). Non-steroidal [...], Peptic ulcers are one of the world's major gastrointestinal disorders, embracing both gastric and duodenal ulcers, and affecting 10% of the world population. The current study aimed to investigate the possible protective effect of tadalafil and pentoxifylline (PTX) on indomethacin-induced peptic ulcers. Male albino rats were divided into five groups: control group; ulcerated group; Indomethacin + Tadalafil, in which animals were pretreated with tadalafil orally before indomethacin; Indomethacin+ PTX, in which animals were pretreated with PTX orally before indomethacin; and Indomethacin + Tadafil + PTX. Indomethacin treatment revealed histopathological changes and ulcer scoring and ulcer index were markedly increased. Serum levels of prostaglandin and heme oxygenase- 1 were significantly decreased. The ulcerogenic also induced marked oxidative stress as evident from the increased malondialdehyde, decreased in gastric glutathione content and superoxide dismutase activity, while the gastric myeloperoxidase was increased. Gastric nitric oxide content was decreased and the expression of vascular endothelial growth factor was downregulated while the tumor necrosis factor [alpha] (TNF-[alpha]) level was dramatically increased. Pretreatment of the ulcerative group by either tadalafil or PTX or their combination improved all these pathological changes. Tadalafil or PTX may have a role in protecting gastric mucosa damage caused by indomethacin which may be useful in the future for the treatment of gastric ulceration. Key words: gastric ulcer, tadalafil, pentoxiphylline, indomethacin. L'ulcere peptique est l'une des principales maladies gastro-intestinales a l'echelle mondiale, comprenant les ulceres tant gastriques que duodenaux, et touchant 10 % de la population mondiale. La presente etude portait sur l'effet protecteur eventuel du tadalafil et de la pentoxifylline (PTX) sur les ulceres peptiques causes par l'indometacine. Nous avons reparti des rats albinos males dans cinq groupes. Groupe temoin, groupe ulcereux. Indometacine + tadalafil, ou nous avons administre aux animaux au prealable du tadalafil par voie orale avant de l'indometacine. Indometacine + PTX, ou nous avons administre aux animaux au prealable de la PTX par voie orale avant de l'indometacine. Indometacine + l'association des deux medicaments. L'indometacine a entraine des modifications histopathologiques, avec une augmentation marquee du score ulcereux et de l'indice ulcereux. Nous avons observe une diminution notable des taux seriques de PGE2 et de HO-1. En provoquant des ulceres, le medicament a aussi entraine un stress oxydatif marque mis en evidence par une hausse du MDA, un abaissement des taux gastriques de GSH et de l'activite de la SOD, tandis que les MPO gastriques etaient a la hausse. Nous avons observe une diminution des taux gastriques de NO et une regulation a la baisse de l'expression du VEGF avec une augmentation spectaculaire des taux de TNF-[alpha]. Dans le groupe ulcereux, l'administration prealable de tadalafil, de PTX ou de leur association permettait d'attenuer l'ensemble de ces modifications pathologiques. Le tadalafil et la PTX pourraient avoir un role protecteur contre les dommages causes par l'indometacine dans la muqueuse gastrique, ce qui pourrait etre utile a l'avenir dans le traitement de l'ulcere gastrique. [Traduit par la Redaction] Mots-cles : ulcere gastrique, tadalafil, pentoxifylline, indometacine.

The disposal of sharp waste generated at home by diabetic patients poses a major public health problem. This study evaluated an educational program designed to improve patients' knowledge and practices around sharps disposal. A non-equivalent quasi-experimental study was performed at a main diabetic center in Egypt on 100 participants divided into intervention and non-intervention groups. The effect of the interventional program was tested by the evaluation of the improvement in participants' knowledge and practice after two and four months of the program. Initially, there were no differences in knowledge or practice scores between the groups. After the implementation of the program, there was a noticeable difference in subjects' knowledge levels and scores between the two groups, with the intervention group significantly outperforming the non-intervention group (p < 0.001). There was a significant improvement in overall practice scores in the intervention group across post-intervention visits, and they registered a score of 14/16, which matches a good practice level, while in the non-intervention group, the score remained unchanged at 4.4/16, which corresponds to a poor practice level (p < 0.001). These findings suggest that educational programs can effectively increase diabetic patients' knowledge and improve their sharps waste disposal practices. Clinical trial registration number: PACTR202310841894237. Date: 05 October 2023, "retrospectively registered". [ABSTRACT FROM AUTHOR]

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Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. Most studies evaluated the post-alteplase haemorrhagic transformation of brain infarction as a homogeneous entity but we evaluated the predictors of each subtype of haemorrhagic transformation of brain infarction. Our trial included 616 AIS alteplase-treated patients. We evaluated the ability of different risk factors, clinical presentation, and imaging features to predict different haemorrhagic transformation (HT) subtypes. HT was seen in 152 patients (24.7%), higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction, in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 (odds ratio [OR], 11.04; 95% CI, 9.81 to 12.70; P-value > 0.001) and type2 (OR, 11.89; 95% CI, 9.79 to 14.44; P-value > 0.001), while older age was also an independent predictor of parenchymal hematoma type1 (OR, 1.312; 95% CI, 1.245 to 1.912; P-value 0.02). In AIS patients treated with alteplase in Egypt and Saudi Arabia, higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction; in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 and 2, while older age was also an independent predictor of parenchymal hematoma type1. Trial registration: (clinicaltrials.gov NCT06337175), retrospectively registered on 29/03/2024. [ABSTRACT FROM AUTHOR]

Background: For ambulatory cases with spastic diplegic cerebral palsy, single event multilevel surgery (SEMLS) has replaced previous methods of treatment for improving gait. This research aimed for investigation if single event multilevel surgery improved gait and function among cases with spastic cerebral palsy. Patients and methods: This was a prospective interventional study carried out on 24 children with spastic lower limbs attending to pediatric orthopedic unit in Zagazig University Hospital and managed with lower limb single event multilevel surgery. Clinical as well as radiological assessments were applied pre-and 6 months post-operative. Results: Single event multi-level surgeries performed in the children with CP generated positive outcomes in the GMFM which changed significantly from (45.67±3.70) in the preoperative assessment to (52.63±3.34) in follow up after 2 years postoperative with p value<0.001. A paired samples t-test revealed that spasticity significantly decreased from pre- (M=15.46, SD=2.187) to post- (M=10.71, SD=2.293) intervention, t(23)=17.53, p<.05, d=1.327, for Spasticity (after intervention) a statistically significant difference was found between groups (2, 21) = 17.502, p < 0.001. Also, a marked improvement occurred in the range of motion (ROM) as determined by ROM score which changed from (44.67±8.67) preoperatively to (33.00±9.09) after 6 months with P value <0.001. Conclusion: The results of SEMLS regarding deformity correction and quality of life improvement are considered satisfactory with minimal complications. [ABSTRACT FROM AUTHOR]