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Background: Gastrointestinal tract (GIT) complications are associated with increased morbidity and mortality after cardiac surgery. Therefore, The goal of this research was to estimate the frequency of GIT and hepatic complications after cardiac surgery and to determine the risk factors for these complications. Additionally, we studied the effect of these complications on the outcomes of surgery. Methods: This longitudinal study included 139 consecutive patients who underwent elective cardiac surgery. Patients were grouped according to the GIT and hepatic complications into two groups. Postoperative outcomes were compared between the two groups. Results The mean age was 59.43 years, and 106 patients were males (76%). The GIT and hepatic complications rate was 15.8% (n= 22). Hepatic dysfunction occurred in 8.6% of cases, GIT bleeding in 2.9%, paralytic ileus in 2.2%, fulminant hepatic failure in 2.2%, and GIT bleeding combined with paralytic ileus in 0.7%. The overall mortality was 7.2 % (n= 10). The mortality rate in patients who developed GIT and hepatic complications was 45.5% (n= 10 out of 22 patients). There was statistically significantly higher mortality (10 (45.5%) vs. 0; P= 0.001), cardiac arrest (10 (45.5%) vs. 3 (2.6%); P= 0.001), and reoperation rate (5 (22.7%) vs. 6 (5.1%); P= 0.005) among patients with GIT or hepatic complications. Conclusion: Patients with hepatic and GIT complications could have higher mortality, morbidity, and longer hospital stay than the non-complicated group.

Nowadays bronchial asthma and increased body weight represent major problems in children. Asthmatic attacks in obese patients are not well controlled using the conventional treatment regimens. Asthma has been associated with increased systemic and exhaled levels of hydrogen peroxide and thiobarbituric acid-reactive products in expired breath condensate of asthmatic patients. Thiobarbituric acid reactive substances formed from peroxidation of lipids. The aim of the Study is to show the action of Thiobarbituric acid reactive substances activity in asthma among overweight children suffering from asthma and to detect the connection between this biomarker and the etiology, degree of severity among children with bronchial hypereactivity. The study is cross-sectional study, was conducted on Egyptian children on regular follow up at the outpatients pediatric allergy clinic in Bab El-shariea university Hospital, Al-Azhar University. The study group included 96 child divided into 4 groups. Group A which included overweight children with (mild persistent asthma). Group B which included non-overweight children with (mild persistent asthma).Group C which included overweight non-asthmatics children and Group D The control group (non-overweight non-asthmatics). The results showed significant increase in the Thiobarbituric acid reactive substances level in Overweight asthmatic patients in relation to non-overweight patients with asthma. We found that they can distinguish asthma controlled patients from non-asthma controlled patients. This study showed high level of oxidative stress with high asthma severity as measured by Thiobarbituric acid reactive substances. These substances were good markers of relation between bronchial hyper activity and oxidative stress which became high with asthma severity.

A single phase nanoflake NiS2 layer synthesized by a facile chemical bath deposition showed good solar light photocatalytic degradation of phenol with good stability and reusability.

The present study was designed to investigate the effect of curcumin, anise ground seeds levels and their interactions on growth performance, some carcass traits and economic evaluation of broiler chicken. Two hundred and ninety seven birds were randomly assigned in factorial design (3×3) experiment. Three curcumin levels (0 ,50,100 mg/kg diet) and three anise ground seeds levels (0 ,0.50% and 1% in diet) were used in nine treatments of 33 birds each (three replicates of 11 birds each).During the experiment the body weight and feed intake were measured and consequently, weight gain and feed conversion ratio were calculated. At the end of the experiment, three birds from each group were slaughtered to record carcass parts. Also ,economical evaluation of the diets was calculated in the end of experiment. The results showed that chickens were fed curcumin at level of 100 mg/kg diet achieved higher body weight at 14 days of age and body weight gain during the period of 7-14 days than control and level of 50 mg/kg diet. The addition of anise ground seeds at level of 1% achieved higher feed intake than control and 0,5% level. The addition of 50 mg/kg diet of curcumin and 1% anise ground seeds achieved better feed consumption during the period from 14-21 and 21-28 days of age than other interactions. No significant (P

Background: Insecticides such as lambda-cyhalothrin(LCT), dibenzalacetone (DBA) and heptanone HD are teratogenic substances. Skeleton is one of the organs sensitive to teratogens during the period of organogenesis. Material and methods:This study was conducted on fifty adult female albino mice, divided randomly into four groups: Group I (control group, n= 5 received corn oil orally in adose of 10 mg /kg body weight), group II (LCT group, n=10 received LCT (nano 8%)10, 20 mg /kg body weight for each subgroup), group III (DBA group, n=20, received DBA (main) 10, 20 mg /kg body weight and DBA (nano 8%)) 10,20mg /kg body weight for each subgroup) and group IV (HD group, n=15, received HD (main) 10 mg /kg body weight and HD (nano 8%)) 10,50mg /kg body weight for each subgroup),The calculated treatment dissolved in 1 ml of corn oil by orogastric tube was given to the pregnant mice during the first week of pregnancy (1st, 3rd and 5th day).The delivered live and dead pups were examined externally, then double stained and prepared for skeletal examination by dissecting microscope. Results: All experimental groups showed various anomalies that can be categorized as the following: 1) presence of dead pups and resorption sites 2) macroscopic anomalies in the form of anencephaly, extended forelimb, cranioshisis, macroglossia, lowset ears, lage eye bulge, half body, amelia, internal rotation of forelimb and encephalocele. 3) skeletal anomalies by double staining of fetal skeleton showed incomplete ossification of nasal and interparietal bones, open arch of atlas, incomplete ossification of vertebrae, supernumerary ribs, wavy ribs, incomplete ossification of ribs and sternebrae, incomplete ossification of sternum, incomplete ossification of 5th metacarpal and terminal phalangal bones and incomplete ossification of tarsal , and phalangal bones. Conclusion: Lambda-cyhalothrin, dibenzalacetone and derivatives of heptanone result in numbers of congenital gross and skeletal abnormalities that indicate their teratogenic effect. KEY WORDS: Lambada, Congenital, Skeletal, Dibenzalacetone, Heptanone, Teratogenic.

The consumption of a significant quantity of energy in buildings has been linked to the emergence of environmental problems that can have unfavourable effects on people. The prediction of energy consumption is widely regarded as an effective method for the conservation of energy and the improvement of decision-making processes for the purpose of lowering energy use. When it comes to the generation of positive results in prediction tasks, the Machine Learning (ML) technique can be considered the most appropriate and applicable strategy. This article presents a Modified Wild Horse Optimization with Deep Learning approach for Energy Consumption Prediction (MWHODL-ECP) model in residential buildings. The MWHODL-ECP method that has been provided places an emphasis on providing an up-to-date and precise forecast of the amount of energy that residential buildings consume. The MWHODL-ECP algorithm goes through several phases of data preprocessing in order to achieve this goal. These steps include merging and cleaning the data, converting and normalising the data, and converting the data. A model known as deep belief network (DBN) is used here for the purpose of predicting energy consumption. In the end, the MWHO algorithm is utilised for the hyperparameter tuning procedure. The results of the experiments demonstrated that the MWHODL-ECP approach is superior to other existing DL models in terms of its performance. The MWHODL-ECP model has improved its performance, with effective prediction results of MSE-1.10, RMSE-1.05, MAE-0.41, R-squared-96.28, and Training time-1.23.

Rapid industrialization has led to the generation of a considerable amount of waste, both solid and liquid, in industrial fields like food processing, sugar, pulp, sago or starch, dairies, paper, fruit processing, poultry, distilleries, slaughterhouses, tanneries, and so forth. Despite the requirement for pollution control measures, the waste is discharged into water bodies or generally dumped on land without appropriate management, and thus becomes a significant source of environmental pollution and health hazards. The most essential step of waste management is the segregation of waste into the various elements, and normally this process is done automatically by hand-picking. A smart waste material classification technique is required to simplify the procedures. Therefore, the study presents a new Metaheuristics with Deep Transfer Learning Enabled Detection and Classification Methods for Industrial Waste Management (MDTLDC-IWM) method. The presented MDTLDC-IWM model facilitates the use of DL models for the identification and classification of waste materials in the IWM system. To accomplish this, the presented MDTLDC-IWM model follows two key phases, namely waste object recognition and waste object classification. At the initial stage, the YOLO-v5 object detector with the Harris Hawks Optimization (HHO) algorithm is used. Next, in the second stage, the stacked sparse auto encoder (SSAE) model is applied for the waste object classification method. The SSAE model is effectively optimized using the Aquila Optimization Algorithm (AOA), which helps to accomplish maximum classification of waste objects. The MDTLDC-IWM model has achieved a precision of 96.84 percent and an F score of 96.71 percent. A benchmark dataset is used to test the experimental validity of the presented MDTLDC-IWM model. Extensive comparative analysis reported the enhanced performance of the MDTLDC-IWM model over recent state-of-the-art approaches.

Background: Postoperative infection of the spine is a feared complication due to increased morbidity and poor patient outcomes and financial burden to health system. Prevention, early diagnosis, and successful treatment strategies are important to reducing morbidity and health care costs. Surgeons should maintain a high index of suspicion for infection and initiate proper diagnostic workup and evaluation when concerned. Objective: The aim of this work is to review preoperative and intraoperative prognostic factors that contribute to develop surgical site infections after spine surgery and discussion of the preventive strategies to minimize risk of infection. Patients and Methods: This is a prospective cross sectional study including 300 patients with one or more prognostic factors who underwent spinal surgeries was surveyed from January 2018 to January 2020 at different levels in neurosurgery department at Al-Hussein University Hospital and Mansoura international hospital. The patients were followed up over period of six months. When patients developed symptoms or signs of surgical site infection, patients were re-admitted to the hospital where the confirming diagnosis and proper management were done. Results: The most relevant factors associated with post spinal surgery infections are spine level, followed by diabetes mellitus and fixation instrumentation. Less relevant factors associated with post spinal surgery infections are sex and smoking. Conclusion: Special concern toward prognostic factors will lead to identification of high risk group, close follow up of these patients by clinical and laboratory and radiological investigations will lead to early diagnosis, early initiation of proper management and taking of preventive measures to reduce this complication.

BackgroundThe diagnosis of meningitis in HIV patients is challenging due to altered immune responses. Diagnostic scoring systems were recently proposed for use in research settings to help prompt and easy differential diagnosis. The objective of this study was to create a clinical prediction rule (CPR) for meningitis in HIV-infected patients and to address the enigma of differentiating bacterial (BM), TB (TBM) and cryptococcal (CCM) meningitis based on clinical features alone, which may be enhanced by easy-to-obtain laboratory testing.MethodsWe retrospectively enrolled 352 HIV patients presenting with neurological manifestations suggesting meningitis over the last 18 y (2000–2018). Relevant clinical and laboratory information were retrieved from inpatient records. The features independently predicting meningitis or its different types in microbiologically proven meningitis cases were modelled by multivariate logistic regression to create a CPR in an exploratory data set. The performance of the meningitis diagnostic score was assessed and validated in a subset of retrospective data.ResultsAIDS clinical stage, injecting drug use, jaundice and cryptococcal antigen seropositivity were equally important as classic meningitic symptoms in predicting meningitis. Arthralgia and elevated cerebrospinal fluid Lactate dehydrogenase (LDH) were strong predictors of BM. Patients with cryptococcal antigenemia had 25 times the probability of having CCM, whereas neurological deficits were highly suggestive of TBM.ConclusionThe proposed CPRs have good diagnostic potential and would support decision-making in resource-poor settings.

Background: Helicobacter pylori (H. Pylori) infection has been notified to enhance the progression of distinct extra-digestive manifestations, embraced type 2 diabetes, liver, and cardiovascular diseases. Currently, the association between H. pylori infection and nonalcoholic fatty liver disease (NAFLD) was suggested. Conversely, evidence from various studies was doubtful. Aim of the study: This study was performed to assess the prevalence of H. Pylori infection and the possible predictors of H. Pylori infection among NAFLD patients. Patients and Methods: This prospective observational case-control study included a total of 60 patients with NAFLD and 20 apparently healthy subjects served as control, attending at the Outpatient Clinic and Internal Medicine Department, Sayed Galal; Al-Azhar University Hospitals. This study was conducted between February 2018 to March 2019. All participants were submitted to full history taking, complete physical examination, and routine laboratory investigations. H. pylori Ag in stool test was tested to reveal the existence of infection along with abdominal ultrasonography using Hamaguchi scoring system for assessment of NAFLD. Results: An overall 80 participants were included in the current investigation. Based on the presence of NAFLD, participants were assorted into healthy control group (20 candidates) and NAFLD group (60 patients) with a mean age of 35.65±10.73 and 39.72±11.14, respectively. An overall 48 patients were infected with H. Pylori. Of them, 6 (30%) were among the healthy control group, whereby 42 (70%) were among NAFLD group (P

Objective Previous reports show conflicting results regarding hepatitis B virus (HBV) vaccine efficacy in Hepatitis C virus (HCV) infected individuals and in those with isolated hepatitis B core antibodies (HBcAb). We aimed to evaluate the effectiveness of HBV vaccine and identify possible factors that may contribute to hyporesponsivness in HCV-treated patients, including those with isolated HBcAb. Methods We conducted a prospective study with 118 enrolled chronic HCV patients who followed a 12-week regimen of direct acting antivirals (DAAs) and were evaluated for HBV serological markers. Eventually, 98 received appropriate HBV vaccination and were assessed for response. Results A total of 57.1% were vaccine responders although only 5.1% achieved a seroprotective level of HBsAb titre. The response rate was significantly lower among treated HCV patients with isolated HBcAb [2 (5.6%) vs. 40 (64.5%) respectively]. On multivariate analysis, advanced age [OR (95% CI) = 1.09 (1.02-1.17)] and presence of isolated HbcAb [OR (95% CI) = 39.59 (7.98-196.63)] were predictors of vaccine non-response. In our cost-effectiveness models, the cost of HBV serological screening was less than the nationally adopted non-screening approach. A model ratifying reinforced vaccination in non-responder HBcAb seropositive HCV patients would incur extra cost. Conclusion Hyporesponsiveness to the HBV vaccination is frequent in chronic HCV patients even after achieving SVR following DAAs. Although there is no consensus on the clinical management of patients with isolated HBcAb, our cost-effectiveness options may support decision-making for better clinical benefit and proper health investments.

Background: As SARS-CoV-2 infection is sweeping the globe, early identification and timely management of infected patients will alleviate unmet health care demands and ultimately control of the disease. Remote COVID-19 self-assessment tools will offer a potential strategy for patient guidance on medical consultation versus home care without requiring direct attention from healthcare professionals. Objective(s): This study aimed to assess the validity and interrater reliability of the initial and modified versions of a COVID-19 self-assessment prediction tool introduced by the Egyptian Ministry of Health and Population (MoHP) early in the epidemic. The scoring tool was released for the public through media outlets for remote self-assessment of SARS-CoV-2 infection connecting patients with the appropriate level of care. Methods: We evaluated the initial score in the analysis of 818 consecutive cases presenting with symptoms suggesting COVID-19 in a single-primary health care clinic in Alexandria during the epidemic in Egypt (mid-February through July). Validity parameters, interrater agreement and accuracy of the score as a triage tool were calculated versus the COVID-19 polymerase chain reaction (PCR) test. Results: A total of 818 patients reporting symptoms potentially attributable to COVID-19 were enrolled. The initial tool correctly identified 296 of 390 COVID-19 PCR +ve cases (sensitivity = 75.9%, specificity = 42.3%, positive predictive value = 54.5%, negative predictive value = 65.8%). The modified versions of the MoHP triage score yielded comparable results albeit with a better accuracy during the late epidemic phase. Recent history of travel [OR (95% CI) = 12.1 (5.0–29.4)] and being a health care worker [OR (95% CI) = 5.8 (2.8–11.9)] were major predictors of SARS-CoV-2 infection in early and late epidemic phases, respectively. On the other hand, direct contact with a respiratory infection case increased the risk of infection by three folds throughout the epidemic period. Conclusion: The tested score has a sufficient predictive value and potential as a triage tool in primary health care settings. Updated implementation of this home-grown tool will improve COVID-19 response at the primary health care level.

Background: ficolin-2 is a kind of human serum complement lectin with a structure similar to mannan-binding lectin (MBL) and it has been implicated in innate immunity. Recent studies have shown that complement pathway activation may contribute to hepatitis. However, the relationship between ficolin-2 and viral hepatitis remains largely elusive. Aim of the work: this study aimed to determine the dynamics of ficolin-2 in patients with chronic hepatitis C. Patients and Methods: Thirty patients who had not yet received therapy and twenty normal control subjects were included in this study. A sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the ficolin-2 concentrations in all serum samples of patients and 20 healthy donors. Results: we found that the concentrations of ficolin-2 were significantly higher in chronic hepatitis C patients with abnormal ALT values than in chronic hepatitis C patients with normal ALT values and healthy controls. Ficolin-2 concentrations in chronic hepatitis C patients with abnormal ALT values were positively correlated with ALT levels (*P 0.05). Conclusion: our findings suggested that early increased ficolin-2 is highly correlated with hepatic inflammation and rapid viral response.

Background: Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long- term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels. Type 2 diabetes (T2D) is characterized by a condition of systemic low-grade inflammation. IL-8 is an important member of the chemokine family of proinflammatory chemotactic cytokines. IL-8 was initially characterized as a potent chemoattractant of neutrophils and was later shown to also activate neutrophils. IL-8 is also known to be a potent promoter of angiogenesis. Objective: It was the Assessment of Interleukin (8) in Type 2 Diabetes Mellitus. Patients and Methods: Serum IL 8 level in Type 2 Diabetes Mellitus. 30 patients compared to 30 normal individuals were included in this study. Results: There was a highly statistical significant difference between all patients and control groups as regard serum IL 8 level (mean of serum IL 8 in patients and control groups were 69.9 ± 20.5 and 5.4 ± 3.3 respectively, p= < 0.001). Conclusion: Type 2 diabetes mellitus patients showed marked elevation of circulating IL-8 levels which identify subjects with worse inflammatory state and metabolic control and therefore it may be used as a marker for the rate of development of diabeteic complications.

BACKGROUND The novel coronavirus SARS-CoV-2 is responsible for the current global pandemic. There is a concerted effort within the global scientifi c community to identify (and thereby potentially mitigate) the possible modes of transmission through which the virus spreads throughout populations. OBJECTIVE Summarize the ways in which SARS-CoV-2 is transmitted and provide scientifi c support for the prevention and control of COVID-19. EVIDENCE AQUISITION We conducted an extensive literature search using electronic databases for scientifi c articles addressing SARSCoV-2 transmission published from December 28, 2019 through July 31, 2020. We retrieved 805 articles, but only 302 were included and discussed in this review. The report captured relevant studies investigating three main areas: 1) viral survival, 2) transmission period and transmissibility, and 3) routes of viral spread. DEVELOPMENT Currently available evidence indicates that SARSCoV-2 seems to have variable stability in different environments and is very sensitive to oxidants, such as chlorine. Temperature and humidity are important factors infl uencing viral survival and transmission. SARSCoV-2 may be transmitted from person to person through several different routes. The basic mechanisms of SARS-CoV-2 transmission person-to-person contact through respiratory droplets, or via indirect contact. Aerosolized transmission is likely the dominant route for the spread of SARS-CoV-2, particularly in healthcare facilities. Although SARS-CoV-2 has been detected in non-respiratory specimens, including stool, blood and breast milk, their role in transmission remains uncertain. A complicating factor in disease control is viral transmission by asymptomatic individuals and through what would otherwise be understood as innocuous human activities. CONCLUSIONS This article provides a review of the published research regarding human-to-human transmission of SARS-CoV-2 and insights into developing effective control strategies to stop viral propagation. KEYWORDS COVID-19, SARS-CoV-2, transmission, pandemics, microbial viability.

Cu2ZnSnS4 (CZTS) thin films and solar cells were successfully prepared using a new process based on spray pyrolysis technique. The main advantage of the proposed process is the avoiding of sulphurisation process at high temperature and in toxic gases like H2S. X-ray diffraction studies and Raman spectroscopy confirmed the formation of good-quality microcrystalline CZTS films in a tetragonal structure. Optical measurements showed that CZTS films have a direct band gap and high absorption coefficient (4 × 104 cm−1) as requested for solar cell application. CZTS solar cell prototypes deposited on low-cost flexible plastic substrates were prepared and tested.