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Background Erectile dysfunction (ED) and metabolic syndrome (MeTS) are highly prevalent in chronic plaque psoriasis (CPP). Objective The aim of this lifestyle modification study is to explore the response of MeTS components and ED to a 12-week lifestyle modification program (low-calorie diet and moderate-intensity treadmill walking) in 60 obese men with CPP, mild and moderate ED, and MeTS. The design, settings, participants, and intervention In this lifestyle modification randomized study, a university-based hospital recruitment of 60 obese men with CPP, mild and moderate ED, and MeTS was randomly performed. Men were randomly assigned to the lifestyle modification group (n = 30, received low-calorie diet and moderate-intensity treadmill walking programs) or waitlist group (n = 30). The following outcomes were assessed as follows: body mass index, psoriasis severity (assessed via psoriasis area and severity index), ED (assessed by the five-item internal index of erectile function), and components of MeTS (waist circumference, blood pressure, serum high-density lipoprotein, serum triglycerides, and serum fasting blood glucose). Results Trends of significant improvements in all outcomes were documented in favor of the lifestyle modification group. All outcomes of the waitlist group did not show the same reported significant improvements of the lifestyle modification group. Conclusion A 12-week lifestyle modification program as a tool for weight loss in obese men with CPP is a good therapeutic method to improve psoriasis severity and psoriasis-associated ED and MeTS.

Background Lifestyle modification is a newly recommended complementary treatment for dry eye (DE) disorder. Objective To investigate the effect of a 6-month high-intensity interval aerobic exercise (HIIAE) (conducted 30 min, 3 times weekly) alone or combined with a caloric-restriction approach, the Mediterranean diet (MD), on DE parameters in obese hypertensive elderly. The design, settings, participants, and intervention This is a randomized controlled trial included sixty obese hypertensive elderly with DE based on university-based hospital recruitment. Elderly were randomly assigned to the experimental group (n = 30 elderly received HIIAE plus MD) and control group (n = 30 elderly received only HIIAE). Besides anthropometry (abdominal circumference, body weight, and body mass index) and blood pressure (measured in systole and diastole), DE parameters (tear film break-up time, DE scoring system, ocular surface disability index questionnaire, Schirmer’s test, and Oxford grading system) were evaluated. Results Significant improvements in anthropometry, blood pressure, and DE parameters were higher in the experimental group than in the control group. Conclusion Aging-related DE symptoms and signs can be prevented and/or treated with HIIAE alone or combined with MD in obese hypertensive elderly with DE disorder.

In the era of data revolution, availability and presence of data is a huge wealth that has to be utilized. Instead of making new surveys, benefit can be made from data that already exists. As enormous amounts of data become available, it is becoming essential to undertake research that involves integrating data from multiple sources in order to make the best use out of it. Statistical Data Integration (SDI) is the statistical tool for considering this issue. SDI can be used to integrate data files that have common units, and it also allows to merge unrelated files that do not share any common units, depending on the input data. The convenient method of data integration is determined according to the nature of the input data. SDI has two main methods, Record Linkage (RL) and Statistical Matching (SM). SM techniques typically aim to achieve a complete data file from different sources which do not contain the same units. This paper aims at giving a complete overview of existing SM methods, both classical and recent, in order to provide a unified summary of various SM techniques along with their drawbacks. Points for future research are suggested at the end of this paper.

A lot of time is spent on exercising the body parts while the lips are neglected, despite the evidence on the wide-ranging effects of lips on overall health and quality of life. Oral rehabilitation by Patakara lip muscle trainer leads to a strong lip closure which can stand as the first-line defense mechanism against many oral dysfunctions related to aging. In the absence of a narrative review presented on this trainer, this paper focuses on the components, instructions for use, and oral health indications of the Patakara lip muscle trainer. This trainer could enhance many oral dysfunctions in the elderly as oral breathing, snoring, halitosis, dry mouth, and oral/gastrointestinal dysfunction, but future studies are needed in this field.

Introduction Distal penile and coronal hypospadui constitutes about 70% of the total hypospadui number yet there is no magical wand to solve the problem. Materials and Methods Twenty nine patients were followed up for average of 2 years, (range between 6 months to 5.4 years) age ranged between 1.4 years to 5.2 years. No stent was left, no urethral catheter was left, with minimal tissue dissection and the average operation time was 25 minutes. And patients were discharged on the same day. Results Of the 29 patients, all patients were free at long term follow up with no complications but 3 had different degrees of urethral cover suture loss ranged from 1-2 sutures loss to complete cover loss. No urethral meatal stenosis, no urethral diverticulum and no urethral fistula were found. Discussion Aseel’s operation provides simple easy and time saving alternative for distal penile and coronal hypospadui closure with less complication even in the case of complications and complete cover loss there is no problem ok in redoing it or any other alternative because of the minimal tissue dissection. Conclusion Aseel’s operation is a good alternative for distal penile and coronal hypospadui closure but nothing is complete, yet it is a good alternative for hypospadius repair. Keywords: Hypospadias; Aseel operation; Penile; Coronal.

Background Lupus nephritis can be seen in up to 60% of all SLE patients with 10–15% of nephritis patients progressing to end-stage renal disease; late diagnosis of lupus nephritis is correlated with a higher frequency of renal insufficiency. The study aim is determination of the value of urinary human epidermal growth factor (urinary EGF) as an early biomarker of lupus nephritis in SLE patients and its relevance to disease activity and renal histopathology. Results The study included 58 SLE patients and 30 healthy controls; a significant difference was noticed between SLE and controls in urinary protein, creatinine, protein/creatinine ratio, and urinary EGF. The mean level of urinary EGF was less in classes IV and V renal nephritis than in classes I, II, and III. There is a significant difference in urinary EGF (33±29, 27±16, P = 0.04) between class II and class III lupus nephritis, with no significant differences in urinary protein, creatinine, protein/creatinine ratio, and SLEDAI. On the other hand, the comparison between classes II and IV showed significant difference not only in urinary EGF (33±29, 11.7±4.9 m, P=0.003), but also in SLEDAI (37.4±8, 70.5±27, P= 0.007), and protein/creatinine ratio (0.98±0.62, 3±1.8, P=0.006). Conclusion This study raises the attention to test the sensitivity of urinary EGF in detecting the early and the subsequent changes in renal pathology of SLE patients as an easy, non-invasive, accurate, cheap marker that could help in following up the nephritis progression and adjusting the plan of treatment; also, it can be used to guide the time of biopsy or as an alternative in cases where renal biopsy is contraindicated.

Introduction: Systemic Lupus Erythematosus (SLE) is adisease primarily affecting women in their child-bearing years. SLE can affect any component of the respiratory system and manifest with pleuritis (with or without effusion), interstitial lung disease (ILD), alveolar hemorrhage, diaphragmatic weakness, pulmonary hypertension, airways disease, or pulmonary embolism. ILD occurs with a lower frequency in SLE compared with other connective tissue disease (CTD) subtypes. It is not known whether SLE-ILD differs from ILD in other CTD subtypes. Aim of the work: estimate the possible relationship between interstitial lung diseases and different antinuclear antibodies among patients with systemic lupus erythematosus.Patients and Methods: Cross sectional clinical study. A total of 100 SLE patients attending to Sohag University Hospitals will be included in the study. Patients included in this study will be classified as SLE patients according to either the 2012 SLICC criteria or the new 2017 ACR/EULAR SLE classification criteria. Results: ANA (antinuclear antibody) positivity, chest manifestations like (cough, dyspnea, expectoration, fever&hemoptysis) are predictive variates for SLE-ILD. Conclusion: We observed a population of SLE-ILD and concluded that ANA (antinuclear antibody) positivity, chest manifestations like (cough, dyspnea, expectoration, fever&hemoptysis) are predictive variates for SLE-ILD. Also ANAIF speckled pattern has specificity to SLE-ILD and AntiSS-A/Ro52KD antibody is more specific to SLE-ILD. We recom‌mend HRCT and PFT scan in these SLE patients.

In chronic subjective tinnitus (CST) studies, the effect of bee-humming respiratory training (BHRT), a type of pranayama breathing technique, on autonomic cardiovascular/respiratory physiological functions (systolic pressure, rates of breathing and pulse, and diastolic pressure), tinnitus annoyance (TA), tinnitus loudness (TL), and quality of life measures as tinnitus handicap inventory (THI) did not receive significant attention.This study aimed to investigate the efficacy of BHRT on TL, THI, TA, and cardiovascular/respiratory autonomic functions in bilateral CST elderly (aged ≥65 years old).The current study employs a prospective, single-blind design; it is a randomized-controlled for-tinnitus behavioral intervention. Forty-six CST elderly subjects were randomly assigned to one of two groups: the BHRT group (23 patients) or the control group (23 patients). The 4-week BHRT intervention was applied 30 min daily.TL, THI, TA, and cardiovascular/respiratory autonomic functions were evaluated.Significant BHRT-induced reductions of all measures were detected in the BHRT group, whereas no significant changes were observed in the controlled elderly group.The complementary choice for BHRT is considered an effective method to improve TL, TA, THI, and cardiovascular/respiratory autonomic functions in CST elderly.

Yoga is used as a complementary therapy to control the symptomatic and complicated consequences of type 2 diabetes mellitus (T2DM) but the effect ofThe patients with a 52- to 67-year range and body mass index below 30 kg/mA significant decrease (p0.05) was identified after the comparison between the pre and post SBP, RR, DBP, FBG, IOP of both eyes, and PR in the study group while the control group exhibited no significant changes of all measures (p0.05). In-favor-of the study group, the between-group post-treatment comparison showed a significant improvement of all measures (p0.05).

Despite enactment of devolution by the constitution of Kenya 2010, Garissa County was still marginalized. The expectation of Garissa resident was that significant development could have been achieved. However, this was never the case. This study was aimed at investigating challenges of devolution of public service in Garissa County. Kenya adopted devolution as an approach of governance. When the constitution of Kenya 2010 was promulgated, the governance structure transformed from centralized governance to devolved subunits referred to as county government. The country had witness a gradual but rather comprehensive transfer of resources, power and responsibility from the central government to the 47 county governments as stipulated in the constitution of Kenya 2010. Essential services that has been devolved included; primary and vocational education, health, water and sanitation and rural feeder roads. Similarly, the findings of this study can be applied to other counties in the country since they have similar structures of governance. The population of the study majorly constituted of the staff employed by the Garissa County public service board. Stratified random sampling was used to select 129 respondents from the employees of Garissa County. Both primary and secondary data were employed in this study. The study has established that employment and procurement law have not been effectively adhered. Resource mobilizations needed to be encouraged instead of depending funding from central government. For successful implementation of devolution, the county government of Garissa needed to allocate sufficient funds for capacity building of staff to promote quality service delivery.

Our aim in this work was to explore any possible association between ecNOS 4 b/a polymorphism and rheumatic heart disease (RHD). In this study, leukocyte DNA was extracted from 139 patients with RHD and 79 healthy control children. After amplification by PCR, the products were separated by electrophoresis in 6% polyacrylamide gel and visualized after ethidium bromide staining with UV light. PCR resulted in a 420-bp fragment (ecNOS4b) when five 27-bp repeats were present in intron 4 of the ecNOS gene, a 393-bp product (ecNOS4a) when only four repeats were present, and 420-bp and 393-bp fragments in heterozygous individuals (ecNOS4b/a). ecNOS4b/a genotyping in the control group gave the following results: b/b genotype (77.2%), b/a genotype (21.5%) and a/a genotype (1.3%). The frequencies in RHD group were as follows: b/b genotype (67.6%), b/a genotype (31.7%), and a/a genotype (0.7%). The b allele/a allele ratio was (88%/12%) in the control group and (83.5%/16.5%) in the RHD group. We found no statistical difference in genotype or allele frequency between these groups. The present study is the first to study the association between ecNOS 4b/a gene polymorphism and RHD, and to find a lack of any association between them. Further investigations of this gene polymorphism alone and in combination with other genes should be encouraged.

Angiotensin converting enzyme (ACE) gene polymorphism was previously studied in some cardiovascular diseases. There are only few studies which investigated this polymorphism in patients with rheumatic heart disease (RHD). The results of these investigations are inconsistent. Furthermore, gene polymorphism distribution is different in various ethnic populations. We conducted this study to demonstrate this gene polymorphism in Egyptian children with RHD. Leukocytes DNA was extracted from 139 patients with RHD and 79 healthy control children. After amplification by the PCR, the products were separated by electrophoresis in 6% polyacrylamide gel and visualized after ethidium bromide staining with UV light. The PCR product is a 190-bp fragment in the absence of the insertion (D allele) and a 490-bp fragment in the presence of the insertion (I allele). Gene polymorphism was as follows: DD gene when lane contains only 190-bp fragment, II gene when lane contains only 490-bp fragment and ID gene when lane contains both fragments. We found that gene polymorphism in both control and patients groups followed the following order of distribution from highest to lowest: ID, II, DD gene. The frequency in control group was 49.4, 36.7, and 13.9%, respectively. In patients groups, the gene frequency was 42.5, 30.9, and 26.6%, respectively. DD gene frequency differs significantly between the two groups. We concluded that patients with RHD have a higher ACE-DD genotype than normal control. ACE-DD genotype may be a risk factor for RHD in Egyptian children.