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Background: Percutaneous intramedullary K. wires fixation and mini-plates fixation are reasonable options for treating unstable metacarpal fractures as they provide anatomical reduction and rigid fixation, which is adequate to permit early mobilization. Objective: To compare between mini-plates and Kirschner wires in management of unstable metacarpal shaft fractures in adults. Patients and Methods: All patients (n=30) included in this prospective comparative study were managed and followed up at Al-Azhar University Hospital from January 2019 to February 2020. Thirty patients with fracture of shaft metacarpal were divided into 2 groups: group A (n=15) were managed by percutaneous intramedullary K-wires and group B (n=15) were managed by mini-plates. Results:27 Patients were males and 3 were females . Dominant hand affection were in 20 patients . All patients had a complete union between 4-8 weeks for group A with average of 6 weeks and 6-10 weeks for group B with average of 8 weeks. The total result according to TAF score, Quick DASH score, and handgrip was excellent in 10 cases, good in 4 cases, and fair in 1 case in group A, while group B was excellent in 10 cases, good in 3 cases, fair in 1 case and poor in 1 case. Conclusion: Both techniques are highly effective for fixation of metacarpal shaft fractures. Mini-plate fixation provides rapid recovery of hand function and K-wire fixation allows a wide range of hand motion and soft tissue preservation.

Cotton aphid, Aphisgossypii and whiteflies, Bemisia tabaci are an important pests incotton plants in Egypt.The present work was conducted during two successive seasons 2014 and 2015 in Beni- suef Governorate on the cotton crop by spraying the tested insecticidesalone and mixtures of both acetamipridand thiamethoxam with chloropyrifos to estimate the percentage of reduction of Aphisgossypii and Bemisia tabaci and their associated predators, Coccinella septempunctataand Chrysoperlacarnea,after different intervals which include (24 hours) to estimate theimmediate effect, as well as after 3 ,7 and 14 days to evaluate the latenteffect. Results indicated that acetamiprid, thiamethoxam and chloropyrifosalone proved to reduce Aphis gossypii and Bemisia tabaci populations up to 14days after treatment throughout both seasons. Whereas, combination ofacetamiprid and thiamethoxam with chloropyrifos at half recommended rate showedthe high efficiency with reduction percentage reached to 100.0% at same exposuretime during the successive seasons 2014 and 2015. In addition, acetamiprid,thiamethoxam and chloropyrifos proved the high reduction percent to thepopulations of Coccinella septempunctata and C. carnea when these insecticides were usedalone at recommended rate at 24h from treatments. Chlorpyrifos in mixtures with both acetamiprid, and thiamethoxam athalf recommended rate showed the high effect with reduction percentage reachedto 100.0% reductions for both predators in two seasons. Results suggested that,choosing suitable insecticide to control the tested cotton pests not onlydepends on its efficiency but also its toxicity tonatural enemies. Also, these results indicatedthat the initial kill and residual effect of these insecticides washighly persistent up to 14 days. The overall results appeared promising incombination with insecticides as result of significant increasing its reductionpercent.

Background While prevalence of Hepatitis B virus (HBV) in patients with end-stage renal failure (ESRF) who are undergoing dialysis has decreased significantly during the past few decades, it still remains a distinct clinical problem. The immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Egypt is among the countries with intermediate endemicity of HBsAg (range, 2%–7%). Large-scale geographic heterogeneity in HBV prevalence has been reported worldwide and HBV prevalence is especially heterogeneous in Egypt. Objectives To assess the prevalence of occult HBV infection (OBI) in hemodialysis patients with or without chronic hepatitis C (HCV) from Minia and Assuit, Upper Egypt, using HBV DNA assays. Patient and Methods Sera from 145 hemodialysis patients with negative HbsAg were investigated for HBV DNA using real-time polymerase chain reaction (RT-PCR). Only serum samples with repeatedly detectable HBV DNA were considered positive. Patients were divided into 2 groups: HCV RNA positive and HCV RNA negative, based on the results of a third generation enzyme linked immunosorbent assay (ELISA) anti-HCV test and HCV RNA PCR. Results HBV DNA was detected in 6 of the 145 patients (4.1%) and HBcAb was detected in 29/145 patients (20%). There were no statistically significant differences in the age, duration of hemodialysis, biochemical parameters, serological markers of HBV, or HBV DNA between patients with and without HCV infection. Conclusions Four percent of the hemodialysis patients had OBI. There was no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV co-infection.

Background Immediate mandibular reconstruction was performed using a patient-specific titanium mesh tray fabricated by electron beam melting (EBM) /rapid prototyping techniques. Methods Patient-specific titanium trays were virtually designed and fabricated using EBM technology/rapid prototyping for patients requiring mandibular resection and immediate reconstruction using an iliac crest bone graft. Dental implants were placed in the grafted sites and the patients received prosthetic rehabilitation with a follow-up of one year. Clinical data, postoperative bone formation and complications were evaluated. Results A symmetric appearance of facial contours was achieved. The titanium tray incorporated the particulate iliac crest bone graft that provided significant bone formation (mean 18.97 ± 1.45 mm) and predictable results. Stability of the dental implants was achieved. Conclusion The patient-specific titanium meshes and immediate particulate autogenous bone graft showed satisfactory clinical and surgical results in improving patients' quality of life and decreasing the overall treatment time with adequate functional rehabilitation.

Bone marrow stem cells (BMSCs) can differentiate into several cells that participate in the healing of meniscal wounds. To test this hypothesis, we examined the effects of injected BMSCs on the healing of meniscal wounds. Autologous BMSCs from eight adult dogs were injected into meniscal wounds (knee joints). After 12 weeks, the healing process was clinically and immunomorphologically evaluated using: (i) histochemical stains (haematoxylin and eosin, Masson trichrome and periodic acid-Schiff) and (ii) immunoperoxidase staining methods (CD3, CD79a, CD68, CD31 and alpha smooth-muscle actin for T, B lymphocytes, macrophages, endothelial cells and smooth-muscle lineage). Complete (six vs. three), partial (one vs. one) and no healing (one vs. four animals) of the meniscal wounds were observed in the injected and noninjected menisci. As compared with the noninjected menisci, examination of the tissues from the injected ones revealed: (i) marked angiogenesis (microvessel density: 3.22 +/- 0.66 vs. 6.50 +/- 2.10); (ii) chondrogenesis; (iii) prominent immune cell infiltrate (4.07 +/- 0.78 vs. 9.56 +/- 1.69, 8.33 +/- 0.77 vs. 3.67 +/- 1.00 and 4.38 +/- 0.62 vs. 11.1 +/- 1.43 for the total numbers of immune cells, lymphocytes and macrophages, respectively); and (iv) proliferation of the fibroblasts with marked deposition of collagen fibres (2.0 +/- 0.84 vs. 2.66 +/- 0.48). These values were statistically significantly higher for the injected menisci as compared with the noninjected ones (P >/= 0.05). Autologous BMSCs can improve meniscal wound healing. Whether this improvement occurs through BMSC differentiation into cells operational in the repair process, the release of certain mediator or other unknown mechanisms mandates further investigations.

Studies of poverty in the 1990s have been very successful--more successful than the fight against the phenomenon itself. Had the efforts exerted to combat poverty equalled the concern given to the study of the problem, the poor would have enjoyed better conditions and the level of poverty would have diminished locally and worldwide. The current study identifies the relation between impoverishment, marginalization of particular groups in society and the nature of the political, economic and social policies adopted by the state in Egypt, in one of the important stages of social structure formation in the country--1975-2000. These policies play a direct role in creating the mechanisms of impoverishment and marginalization in Egyptian society, leading naturally to producing and reproducing poverty.

Objectives Upper gastrointestinal endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. Simpler screening tests such as capsule endoscopy could be helpful, but gastric visualization is insufficient with the current passive capsules. A magnetically guided gastric capsule was prospectively evaluated in patients with routine indications for gastroscopy. Methods A total of 189 symptomatic patients (105 male; mean age 53 y) from 2 French centers subsequently and blindly underwent capsule and conventional gastroscopy by 9 and 6 examiners, respectively. The final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was accuracy (sensitivity/specificity) of capsule gastroscopy for diagnosis of major gastric lesions, defined as those lesions requiring conventional gastroscopy for biopsy or removal. Results Twenty-three major lesions were found in 21 patients. Capsule accuracy was 90.5% [95% confidence interval (CI), 85.4%-94.3%] with a specificity of 94.1% (95% CI, 89.3%-97.1%) and a sensitivity of 61.9% (95% CI, 38%-82%). Accuracy did not correlate with lesion location, gastric luminal visibility, examiner case volume, or examination time. Of the remaining 168 patients, 94% had minor and mostly multiple lesions; the capsule made a correct diagnosis in 88.1% (95% CI, 82.2%-92.6%), with gastric visibility and lesion location in the proximal stomach having significant influence. All patients preferred capsule gastroscopy. Conclusions In a prospective and strictly blinded study, magnetically guided capsule gastroscopy was shown to be feasible in clinical practice and was clearly preferred by patients. Improvements in capsule technology may render this technique a future alternative to gastroscopy.

International audience; The incidence of hepatitis C virus (HCV) genotype 4 infection in Egypt provides a unique opportunity to study the innate immune response to symptomatic acute HCV infection. We investigated whether plasmacytoid dendritic cells (pDCs) are activated as a result of HCV infection. We demonstrate that, even during symptomatic acute infection, circulating pDCs maintained a similar precursor frequency and resting phenotype, compared with pDCs in healthy individuals. Moreover, stimulation with a Toll-like receptor 9 agonist resulted in an intact inflammatory response. These data support the growing consensus that pDCs are not directly activated by HCV and therefore are viable targets for immunotherapy throughout HCV infection.