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Background: Assessment of client’s satisfaction about healthcare services is an important tool for improvement of provided healthcare services as it enables the administrators of healthcare facilities to identify areas of least satisfaction from client’s point of view that can helps to make services more effective and efficient.Aim of the work: To assess and compare the degree of patient satisfaction at different levels of health care in Cairo, Egypt.Methods: An analytical cross-sectional study was carried out. The study included 1131 clients to assess their satisfaction about the received healthcare services after completing their visits and before discharge from the facility. Data was collected through patient interview questionnaire which asked about ten domains of patient satisfaction.Results: Of studied participants, 47.7% were in a state of acceptance about overall received medical services while 40.1% were not satisfied. 4.7% were not satisfied at all, 7.4% were satisfied and only 1% was very satisfied about overall healthcare services at outpatient clinics in the study sites. The mean satisfaction score was statistically significant higher among clients attending primary level regarding accessibility, reception service, environment of unit, doctor performance, nurse performance, pharmacy services, patient rights and overall satisfaction. On the other hand mean satisfaction score was statistically significant higher among clients attending tertiary level in comparison to secondary and primary level regarding effectiveness of health care.Conclusion: The majority of participants in our study were not satisfied with overall services in the study sites. Nurse performance, patient rights and continuity of services were the domains of least satisfaction.

This document provides a summary of the different topics presented at the Special Session organized by the International Geosynthetics Society (IGS) Technical Committee on Soil Reinforcement (TC-R). This Special Session brings together very interesting studies regarding soil reinforcement in the field of geosynthetics. Studies presented include topics both from theoretical and practical points of view of reinforcement geosynthetics including general products and applications, cases studies on road embankments under challenging site boundary conditions, research on deterministic and probabilistic design of reinforced fills over voids, numerical analysis of reinforced soil wall structures, encased granular column technique, and geosynthetic-reinforced bridge abutment behavior.

Abstract Background Anemia is a health problem among infants and children. It is often associated with a decrease in some trace elements (iron, zinc, copper) and an increase in heavy metals as lead. This study was done to determine the association of blood lead level > 10 μg/dl, with the increased risk to anemia, also, to investigate the relationship between anemia and changes in blood iron, zinc and copper levels, and measure lead level in drinking water. The study is a cross-sectional performed on 60 children. Venous blood samples were taken from the studied population for estimating hematological parameters as well as iron and ferritin levels. The concentrations of zinc, copper, and lead were measured. The studied population was divided into anemic and non-anemic (control) groups. The anemic group was further classified into mild, moderate and severe anemia. The study subjects were also categorized into low and high blood lead level groups. Findings Approximately 63.33% of children had blood lead levels ≥ 10 μg/dl. At the blood lead level range of 10-20 μg/dl, a significant association was found for mild and severe anemia. The blood level of iron and ferritin was found to be significantly lower in high blood lead level and anemic groups than those of the low blood lead level and control groups. Lead level in drinking water was higher than the permissible limit. Conclusion Lead level ≥ 10 μg/dl was significantly associated with anemia, decreased iron absorption and hematological parameters affection. High blood lead levels were associated with low serum iron and ferritin. Lead level in drinking water was found to be higher than the permissible limits.

Avian chlamydiosis is a serious avian infection that carries a significant zoonotic danger to the poultry industry. The respiratory co-infections caused by the low pathogenic avian influenza virus H9N2 (LPAIV H9N2) also cause significant financial losses in the poultry industry. The purpose of this study was to examine the pathogenicity of Chlamydophila psittaci, and LPAIV H9N2 individually and in combination in broiler chickens, as well as to determine whether or not aqueous neem (Azadirachta indica) leaf extract is effective against infections caused by these pathogens. Therefore, 120 broiler cobb chicks were equally divided into 4 groups (30 birds each) with triplicates with 10 birds. Broilers in group 1 (G1) were infected with only C. psittaci, broilers in group 2 (G2) were infected with only LPAIV H9N2, broilers in group 3 (G3) were infected with C. psittaci and LPAIV H9N2, and broilers in group 4 (G4) remained not challenged and non-treated with any therapeutic or preventive treatment (negative control). At 21 d postinfection (dpi), birds in G1, G2, and G3 were divided into 3 subgroups of 10 birds each: subgroup (A) remained infected and untreated (positive control), subgroup (B) infected and received oxytetracycline for 5 consecutive d, and subgroup (C) infected and received 8% aqueous neem leaf extract for 5 consecutive d. The multiplication of C. psittaci in birds in G1, in various tissues was evaluated using Giemsa staining and the data showed that multiplication was much higher in the lung, spleen, and liver from 6 h to 21 dpi, but low in the heart from 8 to 21 dpi. During simultaneous co-infection in G3, the birds developed significant clinical symptoms and postmortem lesions (PM). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect viral shedding from oropharyngeal and cloacal swabs between 2 dpi and 8 dpi, with cycle threshold (CT) values ranging from 22 to 24. In contrast, bacterial shedding began 6 h after infection and continued until 21 dpi, with CT values ranging from 23 to 26. Administration of an aqueous neem leaf extract at an 8% concentration (Group C) resulted in a numerical rise in average body weight across all treatment groups in the third and fourth week, as well as a reduction in LPAIV H9N2 and C. psittaci replication in the respiratory and gut of treated birds compared to those treated with oxytetracycline (Group B). Overall, respiratory co-infections pose a considerable risk to the poultry business, which is a big threat. To control C. psittaci and LPAIV H9N2 in broiler chickens, oral supplementation of 8% aqueous neem leaf extract is recommended. This treatment improves the birds' performance, as evidenced by an increase in their average body weight. In addition, the application of 8% aqueous neem leaf extract lowers C. psittaci replication within tissues and diminishes LPAIV H9N2 shedding., Competing Interests: DISCLOSURES The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Commercial embryo flushing of horses has required hormonal management of both the donor and recipient mares throughout the breeding season., Aim: This study aimed to find out the effect of using human chorionic gonadotropin (hCG) and prostaglandin F2α (PG) on the ovarian and uterine dynamics and hemodynamics, estradiol (E2), progesterone, oxidants-antioxidants, and blood biochemicals in embryo donor mares during the hottest months of the year in a subtropical climate., Methods: Three Control estrous cycles of native mares (10-20 years; N = 10) followed by two treated cycles with hCG and PGF2α were examined daily from May to August using Doppler ultrasound with blood sampling. Circulating, progesterone (P4), total cholesterol, total proteins, albumin, haptoglobin, nitric oxide (NO), catalase, alkaline phosphatase, lactate dehydrogenase (LDH), and myeloperoxidase were measured in blood serum., Results: Days during the control estrous cycle impacted the dominant follicle (DF) diameter ( p < 0.0001), antrum diameter ( p < 0.0001), area ( p < 0.0001), antral area ( p < 0.0001), and color area % ( p > 0.05), and corpus luteum (CL) diameter ( p < 0.0001). PG tended to impact DF diameter ( p > 0.05) but influenced its antrum diameter ( p < 0.05), color area ( p < 0.05), CL diameter ( p < 0.01), and area ( p = 0.013). Days after hCG tended to impact DF antrum diameter ( p > 0.05) and the antrum area ( p > 0.05), but influenced CL diameter ( p < 0.0001). PGF2α and hCG increased uterine horn area ( p = 0.016) and color area ( p = 0.023), total cholesterol ( p < 0.0001), and NO ( p < 0.0001) levels but hCG increased the levels of myeloperoxidase ( p < 0.005), total proteins ( p < 0.001), and albumin ( p < 0.0001). Globulins achieved the highest level ( p = 0.054) but the Albumin/globulin ratio reached a minimum value on Day 0 of the control mares ( p < 0.0001). PGF2α increased LDH ( p < 0.0001) and sharply declined ( p = 0.028) progesterone., Conclusion: In conclusion, the treatment protocols of hCG and PGF2α showed minimal effects on the produced ovulating follicles and can be used during the summer season to manage embryo donor mares., Competing Interests: The authors declare that they do not have any conflict of interest.

In this work, readily achievable synthetic pathways were utilized for construction of a library of N/S analogues based on the pyrazolopyrimidine scaffold with terminal alkyl or aryl fragments. Subsequently, we evaluated the anticancer effects of these novel analogs against the proliferation of various cancer cell lines, including breast, colon, and liver lines. The results were striking, most of the tested molecules exhibited strong and selective cytotoxic activity against the MDA-MB-231 cancer cell line; IC 50 1.13 µM. Structure-activity relationship (SAR) analysis revealed that N-substituted derivatives generally enhanced the cytotoxic effect, particularly with aliphatic side chains that facilitated favorable target interactions. We also investigated apoptosis, DNA fragmentation, invasion assay, and anti-migration effects, and discussed their underlying molecular mechanisms for the most active compound 7c. We demonstrated that 7c N-propyl analogue could inhibit MDA-MB-231 TNBC cell proliferation by inducing apoptosis through the regulation of vital proteins, namely c-Src, p53, and Bax. In addition, our results also revealed the potential of these compounds against tumor metastasis by downregulating the invasion and migration modes. Moreover, the in vitro inhibitory effect of active analogs against c-Src kinase was studied and proved that might be the main cause of their antiproliferative effect. Overall, these compelling results point towards the therapeutic potential of these derivatives, particularly those with N-substitution as promising candidates for the treatment of TNBC type of breast cancer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Phenylpyrazolo[3,4- d ]pyrimidine is considered a milestone scaffold known to possess various biological activities such as antiparasitic, antifungal, antimicrobial, and antiproliferative activities. In addition, the urgent need for selective and potent novel anticancer agents represents a major route in the drug discovery process. Herein, new aryl analogs were synthesized and evaluated for their anticancer effects on a panel of cancer cell lines: MCF-7, HCT116, and HePG-2. Some of these compounds showed potent cytotoxicity, with variable degrees of potency and cell line selectivity in antiproliferative assays with low resistance. As the analogs carry the pyrazolopyrimidine scaffold, which looks structurally very similar to tyrosine and receptor kinase inhibitors, the potent compounds were evaluated for their inhibitory effects on three essential cancer targets: EGFR WT , EGFR T790M , VGFR2, and Top-II. The data obtained revealed that most of these compounds were potent, with variable degrees of target selectivity and dual EGFR/VGFR2 inhibitors at the IC 50 value range, i.e., 0.3-24 µM. Among these, compound 5i was the most potent non-selective dual EGFR/VGFR2 inhibitor, with inhibitory concentrations of 0.3 and 7.60 µM, respectively. When 5i was tested in an MCF-7 model, it effectively inhibited tumor growth, strongly induced cancer cell apoptosis, inhibited cell migration, and suppressed cell cycle progression leading to DNA fragmentation. Molecular docking studies were performed to explore the binding mode and mechanism of such compounds on protein targets and mapped with reference ligands. The results of our studies indicate that the newly discovered phenylpyrazolo[3,4- d ]pyrimidine-based multitarget inhibitors have significant potential for anticancer treatment.

Sildenafil is a potent phosphodiesterase-5 (PDE5) inhibitor that effectively inhibits cGMP and increases the strength of nitric oxide. PDE5 was overexpressed in several carcinomas, including breast cancer, which inhibited tumor growth and cell division. The current research aims to investigate the in vivo sildenafil's immunomodulatory and antineoplastic potentials against Ehrlich Ascites Carcinoma. This study looked at the effects of sildenafil mono-treatment and co-treatment with cisplatin; tumor cell count, viability and the inhibition rate were determined. Apoptosis, cell cycle distribution, alterations in tumor cells and splenocytes proliferation, changes in splenocytes immunophenotyping using flowcytometry, plasma levels of malondialdehyde (MDA), reduced glutathione (GSH), interferone (IFN)-γ, granzyme B, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine and hematological alterations were detected. Additionally, docking study was conducted to get further insights on how Sildenafil exerts its activity. Sildenafil mono-treatment and co-treatment with cisplatin markedly reduced tumor cell count, viability, growth rate and proliferative capability accompanied by apoptosis enhancement and G 0 /G 1 and sub G 1 cells cycle arrest. Fortunately, sildenafil evoked efficient cellular immune response by increasing plasma levels of granzyme B and IFN-γ, proportion of splenic T cytotoxic (CD3 + CD8 + ) and T helper (CD3 + CD4 + ), accompanied by decrease in the proportion of splenic regulatory T cells. . Moreover, in silico data suggest LcK and MAPKs as the potential targets of sildenafil. Furthermore, sildenafil rebalanced the oxidant-antioxidant status by decreasing MDA and increasing GSH plasma levels. Sildenafil successfully retrieved various hematological values besides renal and hepatic functions in EAC-bearing animals. In conclusion, our results suggest that sildenafil could be potential safe anti-tumor agent with immuno-modulatory properties against Ehrlich ascites carcinoma., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Electronic nose devices (EN) have been developed for detecting volatile organic compounds (VOCs). This study aimed to assess the ability of the MENT-EGAS prototype-based EN to respond to direct sampling and to evaluate the influence of possible error sources that might affect the quality of VOC signatures. This study was performed on a dairy farm using 11 ( n = 11) multiparous Holstein-Friesian cows. The cows were divided into two groups housed in two different barns: group I included six lactating cows fed with a lactating diet (LD), and group II included 5 non-lactating late pregnant cows fed with a far-off diet (FD). Each group was offered 250 g of their respective diet; 10 min later, exhalated breath was collected for VOC determination. After this sampling, 4 cows from each group were offered 250 g of pellet concentrates. Ten minutes later, the exhalated breath was collected once more. VOCs were also measured directly from the feed's headspace, as well as from the environmental backgrounds of each. Principal component analyses (PCA) were performed and revealed clear discrimination between the two different environmental backgrounds, the two different feed headspaces, the exhalated breath of groups I and II cows, and the exhalated breath within the same group of cows before and after the feed intake. Based on these findings, we concluded that the MENT-EGAS prototype can recognize several error sources with accuracy, providing a novel EN technology that could be used in the future in precision livestock farming.

Research in plant pathology has increasingly focused on developing environmentally friendly, effective strategies for controlling plant diseases. Cyanobacteria, including Desmonostoc muscorum , Anabaena oryzae , and Arthrospira platensis , were applied to Capsicum annuum L. to induce immunity against Fusarium wilt. Soil irrigation and foliar shoots (FS) application were used in this investigation. The disease symptoms, disease index, osmotic contents, total phenol, Malondialdehyde (MDA), hydrogen peroxide (H 2 O 2 ), antioxidant enzymes (activity and isozymes), endogenous hormone content, and response to stimulation of defense resistance in infected plants were assessed. Results demonstrated that using all cyanobacterial aqueous extracts significantly reduced the risk of infection with Fusarium oxysporum . One of the most effective ways to combat the disease was through foliar spraying with Arthrospira platensis , Desmonostoc muscorum , and Anabaena oryzae (which provided 95, 90, and 69% protection percent, respectively). All metabolic resistance indices increased significantly following the application of the cyanobacterial aqueous extracts. Growth, metabolic characteristics, and phenols increased due to the application of cyanobacteria. Polyphenol oxidase (PPO) and peroxidase (POD) expressions improved in response to cyanobacteria application. Furthermore, treatment by cyanobacteria enhanced salicylic acid (SA) and Indole-3-Acetic Acid (IAA) in the infected plants while decreasing Abscisic acid (ABA). The infected pepper plant recovered from Fusarium wilt because cyanobacterial extract contained many biologically active compounds. The application of cyanobacteria through foliar spraying seems to be an effective approach to relieve the toxic influences of F. oxysporum on infected pepper plants as green and alternative therapeutic nutrients of chemical fungicides.

Background: Bacterial infection is a frequent complication in cancer and immunocompromised patients. The emergence of antibiotic resistance is a significant health problem and cancer patients are at risk of repeated infections with drug-resistant bacteria., Objective: This investigation aimed to identify predictors of repeat infections of Escherichia coli and Klebsiella pneumoniae and drug resistance in cancer patients admitted to the intensive care unit (ICU) in Upper Egypt., Methods: Blood, urine, sputum, pus, and mouth and nose swabs were collected from patients at the Pediatric Oncology and Medical Oncology ICUs during the period from February 2017 to May 2018. The samples were assessed by antibiotic susceptibility test and further evaluated by genetic testing for the temoniera (TEM) gene of β-lactamase. Samples positive for K. pneumoniae and E. coli were included and isolates positive for other microorganisms were excluded., Results: The study included 107 patients with malignant neoplasms and 136 samples. Repeated infection with K. pneumoniae and E. coli occurred in 31% and 22.45% of patients, respectively. Patients who stayed for a longer period in the ICU were more likely to have repeated infections (OR 1.25, 95%CI 1.10-1.44, p=0.001) after control of other confounding factors. The type of malignant neoplasm, whether it was a hematologic or solid tumor (OR 7.46, 95% CI 2.56-21.7, p=0.0002) and a longer prior stay in the ICU (OR 1.14, 95% CI 1.02-1.28, p=0.025) remained the independent predictors for the drug resistance in the last infection. The TEM type of β-lactamase was encoded in 48.68% and 66.67% of K. pneumoniae and E. coli, respectively., Conclusion: Reinfection with K. pneumoniae and E. coli in patients with cancer can occur as the number of days in the hospital increases. Total prior days spent in the ICU by cancer patients were independently associated with both repeated infections and drug resistance. Samples from patients with hematologic neoplasms were associated with drug resistance., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

A series of novel hybrid pyrazolo[3,4-d]pyramidine derivatives was designed and chemically synthesized in useful yields. The synthesized compounds were structurally characterized by the usual techniques. All the new synthesized compounds were biologically screened in vitro for their antiproliferative activities against a panel of four cancer cell lines, namely HepG-2, MCF-7, HCT-116, and Hela. The results of cytotoxic evaluation indicated that compound 14d was appeared to be the most prominent broad-spectrum cytotoxic activity and significantly more potent than sorafenib with IC 50 values of 4.28, 5.18, 3.97, and 9.85 µM against four cell lines (HePG2, Hela, HCT-116 and MCF-7). In addition, compound 15 was displayed promising antiproliferative effect against all tested cell lines with IC 50 value less than 11 µM compared with sorafenib as a control drug. Besides, structurally pharmacophoric features indicated that pyrazolo[3,4-d]pyrimidine scaffold having an amide linker and substituted with phenyl moiety at the 5-position was more potent than those possessing azomethine methyl, azomethine proton and carbomethene linkers, which lead to significant decrease in antiproliferative activity. The most potent compounds were further selected and evaluated for their activities against epidermal growth factor receptor (EGFR) kinase inhibitors according to homogenous time resolved fluorescence (HTRF) assay. The most potent compound 14d exhibited the most promising inhibitory activity against EGFR WT with IC 50 value of 56.02 ± 1.38 µM compared with gefitinib as control drug with IC 50 value of 41.79 ± 1.07 µM. Moreover, the inhibition of cell cycle progression and induction of apoptosis in the A549 cell line at G2/M and pre-G1 phases of cell cycle might contribute to cancer treatment that evaluated by Annexin V-FITC/PI double staining detection method. Finally, molecular docking studies were conducted to investigate that probable binding conformations of these anticancer agents and ADME properties were calculated to predict pharmacokinetics and toxic properties of the target compounds., (Copyright © 2021. Published by Elsevier Inc.)

Targeting the epidermal growth factor receptors (EGFRs) with small inhibitor molecules has been validated as a potential therapeutic strategy in cancer therapy. Pyrazolo[3,4-d]pyrimidine is a versatile scaffold that has been exploited for developing potential anticancer agents. On the basis of fragment-based drug discovery, considering the essential pharmacophoric features of potent EGFR tyrosine kinase (TK) inhibitors, herein, we report the design and synthesis of new hybrid molecules of the pyrazolo[3,4-d]pyrimidine scaffold linked with diverse pharmacophoric fragments with reported anticancer potential. These fragments include hydrazone, indoline-2-one, phthalimide, thiourea, oxadiazole, pyrazole, and dihydropyrazole. The synthesized molecules were evaluated for their anticancer activity against the human breast cancer cell line, MCF-7. The obtained results revealed comparable antitumor activity with that of the reference drugs doxorubicin and toceranib. Docking studies were performed along with EGFR-TK and ADMET profiling studies. The results of the docking studies showed the ability of the designed compounds to interact with key residues of the EGFR-TK through a number of covalent and noncovalent interactions. The obtained activity of compound 25 (IC 50  = 2.89 µM) suggested that it may serve as a lead for further optimization and drug development., (© 2021 Deutsche Pharmazeutische Gesellschaft.)

Background: Knee arthroplasty surgeries are in ever-increasing demand. With unicompartmental knee arthroplasty (UKA), patients may benefit from a higher range of flexion and a better Knee Society Score (KSS)., Aim: In this study, we compared the short-term clinical outcomes of total knee arthroplasty (TKA) and UKA using the patient-specific templating (PST) technique., Methods: Two groups of 20 knees each were divided into UKA and TKA groups depending on the Oxford criteria of UKA. Only patients with medial compartmental osteoarthritis were included. KSS, functional knee score (FKS), and ROF were assessed preoperatively and at 6 months postoperatively., Results: The TKA group has shown a significant improvement compared to the UKA group in KSS (MD = 39.35 vs. 31.2, respectively, p =0.003). Both TKA and UKA have shown no significant difference concerning both the FKS (MD = 32 and 31.75, respectively, p =0.926) and ROF (MD = 10.25 and 7.25, respectively, p =0.072). Discussion . The higher improvement of KSS in the TKA group can be attributed to the fact that patients in the TKA had significantly worse KSS preoperatively. Also, the small improvement in ROF in the UKA group might be related to their wider preoperative ROF., Conclusion: Preoperatively, the TKA group had lower KSS and ROF compared to UKA. The improvement of KSS from preoperative to postoperative was more significant in TKA. However, the TKA group has shown less range of flexion postoperatively., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Atef Mohamed Morsy et al.)

As the scarcity of published research that comprehensively and meticulously analyzed the patient, disease, and treatment factors of prognostic significance in Ewing sarcoma (EWS) in Egypt; This study aimed at assessing survival outcomes of EWS in Upper Egypt, delineating factors of prognostic significance in comparison to other leading oncology centers in Egypt and internationally. By retrospectively reviewing medical records of 85 patients with a verified diagnosis of EWS in the period from 2001 to 2015 at Pediatric and Medical Oncology Departments at South Egypt Cancer Institute; We gathered data relevant to the patient, disease, and treatment variables of the study. Survival was estimated using the Kaplan Meier method and differences between various groups were determined by log rank test. Univariable and multivariable analyses were performed using Cox regression. With a median follow-up period of 62.7 months (95% CI 52.2-73.2, SE=5.4) for the study patients, the estimates of event-free survival (EFS) and overall survival (OS) at 3 and 5 years were 42.1% and 50.6%, and 40.8% and 48.5%, respectively. Metastatic disease at initial presentation (HR=8.91, 95% CI, 4.00-19.9; P<0.0001) stood as the most powerful predictor of OS in the multivariable analysis, followed by surgery used as a local modality (HR=0.16, 95% CI, 0.06-0.44; P=0.0004). Response to neoadjuvant chemotherapy (HR=2.61, 95% CI, 1.11-6.13; P=0.028), primary tumor size (HR=2.49, 95% CI, 1.03-6.03; P=0.044) were also shown to be significantly associated with OS. Radiotherapy as a local modality, whose effect, apparently shown to increase the hazard of events occurrence in the univariable analysis, an effect that was reversed to reveal EFS advantage (HR=0.41, 95% CI, 0.18-0.95; P=0.036) after control of other variables. With 5-year OS of 48.5%, our survival results were comparable to those previously published from Egypt; however, differences still exist between centers due to varied representative study samples. However, outcomes in Egypt in general are still inferior to internationally published studies., Competing Interests: None., (AJCR Copyright © 2021.)

Background: Despite the significant progress in target therapy for the treatment of metastatic colorectal carcinoma (mCRC), the overall survival isn't satisfactory., Methods: We assessed the expression of Amphiregulin, PTEN, and P21 in sections from 23 paraffin blocks prepared from 23 patients with left-sided mCRC using immunohistochemistry (IHC). The relationship between their level of expressions, clinicopathological parameters, response to anti-EGFR, and prognosis were analyzed., Results: High Amphiregulin, PTEN and low P21 expression levels were associated with low tumor grade (p= 0.038 and 0.025 respectively), better response to anti-EGFR treatment (p <0.001), and favorable outcome {progression-free survival (PFS) and overall survival (OS)} (p <0.05). There was a direct relation between Amphiregulin and PTEN expressions (phi coefficient=+0.840), while there was an inverse relation between P21expression and both Amphiregulin (phi coefficient= -0.840) and PTEN expressions (phi coefficient = -1.000), which was statistically significant (P <0.001)., Conclusion: High Amphiregulin and PTEN expression levels and low P21 expression levels were associated with better response to anti-EGFR therapy and improved survival outcome. They might be considered predictive markers of response to anti-EGFR therapy in mCRC., , .

We study the absorptivity of coupled metamaterial resonators in the mid-infrared range. We consider resonators supporting either a bright mode or a dark mode, introducing an additional degree of freedom for spectral modulation relative to bright modes alone. In a dark-bright coupled resonator system, we demonstrate tunable spectral splitting by changing the separation between resonators. We show via coupled mode theory that resonator separation can be mapped to coupling constant. We further introduce a dark-dark coupled resonator system, which gives rise to an emissive bright mode only in the presence of inter-resonator coupling. The dark-dark system yields a broadband emissivity that decays to zero exponentially with resonator separation, providing a design method for strong thermal emissivity control.

Many shreds of evidence have recently correlated A2B receptor antagonism with anticancer activity. Hence, the search for an efficient A2B antagonist may help in the development of a new chemotherapeutic agent. In this article, 23 new derivatives of [1,2,4]triazolo[4,3-a]quinoxaline were designed and synthesized and its structures were confirmed by different spectral data and elemental analyses. The results of cytotoxic evaluation of these compounds showed six promising active derivatives with IC 50 values ranging from 1.9 to 6.4 μM on MDA-MB 231 cell line. Additionally, molecular docking for all synthesized compounds was performed to predict their binding affinity toward the homology model of A2B receptor as a proposed mode of their cytotoxic activity. Results of molecular docking were strongly correlated with those of the cytotoxic study. Finally, structure activity relationship analyses of the new compounds were explored.

We present an experimental demonstration of passive, dynamic thermal regulation in a solid-state system with temperature-dependent thermal emissivity switching. We achieve this effect using a multilayered device, comprised of a vanadium dioxide (VO 2 ) thin film on a silicon substrate with a gold back reflector. We experimentally characterize the optical properties of the VO 2 film and use the results to optimize device design. Using a calibrated, transient calorimetry experiment we directly measure the temperature fluctuations arising from a time-varying heat load. Under laboratory conditions, we find that the device regulates temperature better than a constant emissivity sample. We use the experimental results to validate our thermal model, which can be used to predict device performance under the conditions of outer space. In this limit, thermal fluctuations are halved with reference to a constant-emissivity sample.

Importance: In low resource countries, there has been scarcity of research on the risk factors associated with neutropenic enterocolitis, a serious complication that commonly develops during treatment of cancer patients., Objective: To identify the pattern of intestinal complications in pediatric leukemia patients treated with intensive chemotherapy, including those with neutropenic enterocolitis; to assess the outcome; and to evaluate the risk factors associated with the mortality in these patients., Methods: During the period from June 2015 to December 2016, a prospective study was carried out on pediatric patients diagnosed with acute leukemia who received induction/or re-induction phases of chemotherapy at South Egypt Cancer Institute. Patients with documented episodes of intestinal complications were included in the study. Recovery or death from an episode of intestinal complication was utilized as the primary outcome measure for the study. Using univariable and multivariable methods, potential risk factors associated with mortality were delineated by logistic regression analysis, both for the entire intestinal complications episodes as a whole and for those episodes of neutropenic enterocolitis only., Results: Out of 88 documented episodes of intestinal complications from 77 patients; 58 episodes were identified as neutropenic enterocolitis from 47 patients. In those patients who were having episodes of neutropenic enterocolitis, the presence of abdominal tenderness ( OR 4.529, 95% CI 1.062-19.317, P = 0.041); a longer duration of neutropenia ( OR 1.215, 95% CI 1.030-1.434, P = 0.021); and hemodynamic instability ( OR 17.023, 95% CI 4.095-70.772, P < 0.001), were found to be independently associated with worse outcome., Interpretation: In Upper Egypt, the use of intensive systemic chemotherapy during the induction phase of acute leukemia was found to be associated with potentially lethal intestinal complications. A high index of clinical suspicion is warranted., Competing Interests: None., (© 2020 Chinese Medical Association. Pediatric Investigation published by John Wiley & Sons Australia, Ltd on behalf of Futang Research Center of Pediatric Development.)

Aim: The aims of this study were to assess survival outcome of pediatric patients with localized osteosarcoma of the extremities in Upper Egypt, identify factors of prognostic significance for survival, and to determine factors predictive of surgical methods used in these patients, as well as developing a clinical model for risk prediction., Patients and Methods: A retrospective analysis of data assembled from medical records of 30 pediatric patients with a histologically verified nonmetastatic osteosarcoma of the extremities treated at South Egypt Cancer Institute with a unified chemotherapy protocol between January 2001 and December 2015 was carried out. Prognostic factors were determined using univariable and multivariable methods. A model for surgical outcomes in these patients based on the baseline clinical factors, and the parameters predictive of their tumor response to chemotherapy, was developed., Results: With a median follow-up of 63 months for the study population, the estimates for event-free survival and overall survival (OS) at 3 and 5 years were 69.5% and 79% and 65.2% and 65.3%, respectively. Age 16 years or above was independently associated with both worse metastasis-free survival (hazard ratio [HR]=6.05, 95% confidence interval [CI]: 1.43-25.6, P=0.015) and OS (HR=7.9, 95% CI: 1.71-36.2, P=0.008). In the multivariable analysis, a proximal location within the limb gained a statistical significance to be independently associated with worse OS (HR=2.4, 95% CI: 1.13-22.1, P=0.003). Poor response to chemotherapy was marginally associated with worse metastasis-free survival (HR=4.9, 95% CI: 1.02-23.8, P=0.047) only in the univariable analysis. The patients found to be more likely to undergo an amputation surgery (odds ratio=14.1, 95% CI: 1.34-149.4, P=0.028) were those in whom a tumor was poorly responding to chemotherapy., Conclusion: In Upper Egypt, despite the reasonable survival outcomes in nonmetastatic osteosarcoma, a relatively high limb amputation rate has been encountered. The development of a clinical prediction model for future planning of possible outcome improvement in these patients, however, is still feasible.

Aim: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a 15-year period., Materials and Methods: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015., Results: With a median follow-up of 61 months for the entire cohort, estimates of overall survival (OS) for 3- and 5-year were 50.9% and 42.1%, respectively. While the estimates of OS for 3- and 5-year in the nonmetastatic group were 79% and 65.2%, respectively. In the multivariable analysis, both metastatic disease at diagnosis and poor response to chemotherapy retained their statistical significance as independent predictors for event-free survival. Whereas for OS, a metastatic disease at diagnosis remained as the lone predictor of a dismal outcome, while a poor response to chemotherapy became marginally associated with an inferior outcome., Conclusions: In Upper Egypt, whereas slightly less than two thirds of children with localized osteosarcoma of extremities survives their disease, metastasis at presentation remains the key predictor of dismal survival outcomes.

Recent work has proposed an approach to design materials that regulate their own temperature. The concept is based on a temperature-dependent thermal emitter that has minimal emissivity below a target temperature, and maximal emissivity above it. Here we propose a microparticle approach suitable for scaling to large areas. We use electromagnetic and thermal simulations to show that the designed particles provide a 13x reduction in temperature variation relative to an uncoated aluminum substrate.

Background: Prior acute coronary syndrome (ACS) registries in Saudi Arabia might not have accurately described the true demographics and cardiac care of patients with ACS. We aimed to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia., Methods: We conducted a 1-month snap-shot, prospective, multi-center registry study in 50 hospitals from various health care sectors in Saudi Arabia. We followed patients for 1 month and 1 year after hospital discharge. Patients with AMI included those with or without ST-segment elevation (STEMI or NSTEMI, respectively). This program survey will be repeated every 5 years., Results: Between May 2015 and January 2017, we enrolled 2233 patients with ACS (mean age was 56 [standard deviation = 13] years; 55.6% were Saudi citizens, 85.7% were men, and 65.9% had STEMI). Coronary artery disease risk factors were high; 52.7% had diabetes mellitus and 51.2% had hypertension. Emergency Medical Services (EMS) was utilized in only 5.2% of cases. Revascularization for patients with STEMI included thrombolytic therapy (29%), primary percutaneous coronary intervention (PCI); (42.5%), neither (29%), or a pharmaco-invasive approach (3%). Non-Saudis with STEMI were less likely to undergo primary PCI compared to Saudis (35.8% vs. 48.7%; respectively, p <0.001), and women were less likely than men to achieve a door-to-balloon time of <90 min (42% vs. 65%; respectively, p = 0.003). Around half of the patients with NSTEMI did not undergo a coronary angiogram. All-cause mortality rates were 4%, 5.8%, and 8.1%, in-hospital, at 1 month, and at 1 year, respectively. These rates were significantly higher in women than in men., Conclusions: There is an urgent need for primary prevention programs, improving the EMS infrastructure and utilization, and establishing organized ACS network programs. AMI care needs further improvement, particularly for women and non-Saudis., Competing Interests: Astra Zeneca and Algorithm pharmaceutical companies are the commercial funders of the (STARS-1 Program). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

A new series of NSAID thioesters were synthesized and evaluated for their in vitro antitumor effects against a panel of four human tumor cell lines, namely: HepG2, MCF-7, HCT-116 and Caco-2, using the MTT assay. Compared to the reference drugs 5-FU, afatinib and celecoxib, compounds 2b, 3b, 6a, 7a, 7b and 8a showed potent broad-spectrum antitumor activity against the selected tumour cell lines. Accordingly, these compounds were selected for mechanistic studies about COX inhibition and kinase assays. In vitro COX-1/COX-2 enzyme inhibition assay results indicated that compounds 2b, 3b, 6a, 7a, 7b, 8a and 8 b selectively inhibited the COX-2 enzyme (IC 50  = ∼0.20-0.69 μM), with SI values of (>72.5-250) compared with celecoxib (IC 50  = 0.16 μM, COX-2 SI: > 312.5); however, all the tested compounds did not inhibit the COX-1 enzyme (IC 50  > 50 μM). On the other hand, EGFR, HER2, HER4 and cSrc kinase inhibition assays were evaluated at a 10 μM concentration. The selected candidates displayed limited activities against the various tested kinases; the compounds 2a, 3b, 6a, 7a, 7b and 8a showed no activity to weak activity (% inhibition = ∼0-10%). The molecular docking study revealed the importance of the thioester moiety for the interaction of the drugs with the amino acids in the active sites of COX-2. The aforementioned results indicated that thioester based on NSAID scaffolds derivatives may serve as new antitumor compounds.

In our attempt to develop effective EGFR-TKIs, two series of 1H-pyrazolo[3,4-d]pyrimidine derivatives were designed and synthesized. All the newly synthesized compounds were evaluated in vitro for their inhibitory activities against EGFR WT . Compounds 15 b , 15 j , and 18 d potently inhibited EGFR WT at sub-micro molar IC 50 values comparable to that of erlotinib. Moreover, thirteen compounds that showed promising IC 50 values against EGFR WT were tested in vitro for their inhibitory activities against mutant EGFR T790M . Compounds 17 d and 17 f exhibited potent inhibitory activities towards EGFR T790M comparable to osimertinib. Compounds that showed promising IC 50 values against EGFR WT were further tested for their anti-proliferative activities against three cancer cell lines bearing EGFR WT (MCF-7, HepG2, A549), and two cancer cell lines bearing EGFR T790M (H1975 and HCC827). Compounds 15 g , 15 j , 15 n , 18 d and 18 e were the most potent anticancer agents against the EGFR WT containing cells, while compounds 15 e , 17 d and 17 f showed promising anti-proliferative activities against EGFR T790M containing cells. Furthermore, the most active compound 18 d was selected for further studies regarding to its effects on cell cycle progression and induction of apoptosis in the HepG2 cell line. The results indicated that this compound is good apoptotic agent and arrests G 0 /G 1 and G 2 /M phases of cell cycle. Finally, molecular docking studies were performed to investigate binding pattern of the synthesized compounds with the prospective targets, EGFR WT (PDB: 4HJO) and EGFR T790M (PDB: 3W2O)., (Copyright © 2018. Published by Elsevier Inc.)

We report the use of aluminum patterning to make highly selective UV bandpass filters. We design and fabricate a periodic array of nanoholes in Al thin film on a bare silicon substrate as an analog for potential integration with a Si photodetector. Arrays were designed to operate in the wavelength range of 200-400 nm. Our results show that we can obtain a single dominant peak filter with a linewidth of 30 nm at normal incidence, in contrast to similar structures on glass substrates, where multiple modes influence the UV spectrum. Varying the angle of incidence is shown to split the plasmonic mode and further decrease the linewidth of the maximum wavelength mode down to 10 nm. Our results therefore show high potential for applications in solid-state image sensors for astronomy and planetary studies.

This study aims to (1) evaluate the immunohistochemical expression of ERα, ERα36 and ERβ in combination in human renal cell carcinoma (RCC) and nearby non-tumorous tissue (2) correlate their expression pattern with the clinicopathological parameters and prognosis of the patients; this may provide a new insight into prediction of the disease outcome and understanding its progression. The three markers showed positive cytoplasmic (± membranous) staining pattern in tumor cells. The tubules in the nearby non-tumorous tissue showed either nuclear (± cytoplasmic) staining pattern (ERα and ERβ) or only cytoplasmic staining pattern (ERα36). The mean of cytoplasmic expression of ERα, ERα36 and ERβ was significantly higher in association with poor prognostic factors: larger tumor size (P<0.0001) for each, late clinical stage (P<0.0001) for each, higher nuclear grade (P = 0.003, P = 0.002 and P = 0.022) respectively, and presence of lymphovascular invasion (P<0.0001, P = 0.006 and P<0.0001) respectively. We have demonstrated for the first time that patients whose tumors express high cytoplasmic levels of ERα, ERα36 or ERβ experience shorter overall survival and disease-free survival. The independent role of ER subunits as markers of poor prognosis is proven only for ERβ and ERα36 but not ERα. In conclusion, our results indicate that the main staining pattern of ERα, ERα36 and ERβ in RCC is cytoplasmic with relation of this pattern to bad prognosis. So we can suggest the assessment of these receptors as markers of poor prognosis in RCC patients., Competing Interests: None., (IJCEP Copyright © 2018.)

We study the use of nanopatterned silicon membranes to obtain optically-induced heating in water. We show that by varying the detuning between an absorptive optical resonance of the patterned membrane and an illumination laser, both the magnitude and response time of the temperature rise can be controlled. This allows for either sequential or selective heating of different patterned areas on chip. We obtain a steady-state temperature of approximately 100 °C for a 805.5nm CW laser power density of 66 µW/μm 2 and observe microbubble formation. The ability to spatially and temporally control temperature on the microscale should enable the study of heat-induced effects in a variety of chemical and biological lab-on-chip applications.

A novel series of 3-benzyl-substituted-4(3H)-quinazolinones were designed, synthesized and evaluated for their in vitro antitumor activity. The results of this study demonstrated that 2-(3-benzyl-6-methyl-4-oxo-3,4-dihydroquinazolin-2-ylthio)-N-(3,4,5-trimethoxyphenyl)acetamide, 2-(3-benzyl-6,7-dimethoxy-4-oxo-3,4-dihydroquinazolin-2-ylthio)-N-(3,4,5-trimethoxyphenyl)acetamide and 3-(3-benzyl-6-methyl-4-oxo-3,4-dihydroquinazolin-2-ylthio)-N-(3,4,5-trimethoxyphenyl)-propanamide have shown amazing broad spectrum antitumor activity with mean GI(50) (10.47, 7.24 and 14.12 µM. respectively), and are nearly 1.5-3.0-fold more potent compared with the positive control 5-FU with mean GI50, 22.60 µM. On the other hand, compounds 6 and 10 yielded selective activities toward CNS, renal and breast cancer cell lines, whereas compound 9 showed selective activities towards leukemia cell lines. Molecular docking methodology was performed for compounds 7 and 8 into ATP binding site of EGFR-TK which showed similar binding mode to erlotinib, while compound 11 into ATP binding site of B-RAF kinase inhibited the growth of melanoma cell lines through inhibition of B-RAF kinase, similar to PLX4032.

Biosorption has gained important credibility during recent years because of its good performance and low cost. This work is concerned with studying the potentiality of the chitin component of the shrimp shells for uranium biosorption from nitric acid liquid solutions. The structural characteristics of the working chitin have been determined via Fourier Transform Infrared Spectroscopy (FTIR). The surface morphology was examined using Scanning Electron Microscopy (SEM). The adsorption capacity of biomass was investigated experimentally. The influence of contact time, pH, metal ion concentration, solution volume to mass ratio and temperature were evaluated and the results were fitted using adsorption isotherm models. The kinetic of uranium biosorption was also investigated as well as biosorption thermodynamic., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Introduction: It has been repeatedly demonstrated that presence of erectile dysfunction (ED) may predate the occurrence of overt event of coronary artery disease. However, the association between severity of ED and left ventricular diastolic dysfunction (LVDD) was rarely reported., Aim: The aim of this study was to assess the association between severity of ED and LVDD in patients without overt cardiac complaint., Main Outcome Measures: The International Index of Erectile Function (IIEF) was used to assess erectile function. Diastolic Doppler parameters measurements and tissue Doppler imaging were used to assess left ventricular diastolic function., Methods: A total of 230 male ED patients without overt cardiac complaint were enrolled in this study. Erectile function was assessed using the IIEF. Patients were also screened for socio demographic data and medical comorbidities that included age, smoking, diabetes, hypertension, and dyslipidemia. All patients were referred to cardiologist for cardiac assessment. Left ventricular diastolic function that included diastolic Doppler parameters measurements and tissue Doppler imaging were also assessed., Results: Mean age±standard deviation was 57.5±5.6 (range of 42-81). There were significant associations between the following risk factors: age, obesity, smoking, hypertension, dyslipidemia, and increased severity of ED (P<0.05 for each). Of the patients, 77.4%, 74.8%, 80%, and 66.1% had abnormal transmitral E/A (E/A) ratio, deceleration time (DT), isovolumic relaxation time (IVRT), mitral E velocity/tissue Doppler imaging E velocity (E/Em) ratio, respectively. Only the means of IVRT and (E/Em) ratio had significant associations with increased severity of ED (P<0.001 for each). There were significant associations between increased severity of ED and the following categorical echo parameters: grades 1 and 2 of E/A ratio, DT, IVRT, and grades 1, 2, and 3 of (E/Em) ratio (P<0.05 for each)., Conclusions: The current study clearly demonstrated that LVDD is prevalent among patients with ED-associated medical comorbidities without overt cardiac complaint. There were significant associations between increased severity of ED and presence of LVDD in those patients., (© 2011 International Society for Sexual Medicine.)

Background: In post-mastectomy patients, lymphedema has the potential to become a permanent progressive condition and become extremely resistant to treatment. Thus, it can results in function impairment and decrease quality of life. The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on limb volume, shoulder mobility, and hand grip strength., Material and Methods: Fifty women with breast cancer-related lymphedema were enrolled in a double-blind, placebo controlled trial. Patients were randomly assigned to active laser (n = 25) and placebo (n = 25) groups and received irradiation with Ga-As laser device that had wavelength of 904 nm, power of 5 mW, and spot size of 0.2 cm(2) over the axillary and arm areas, three times a week for 12 wk. The total energy applied at each point was 300 mjoules over seven points, giving a dosage of 1.5 joules/cm(2) in the active group. The placebo group received placebo therapy in which the laser had been disabled without affecting its apparent function. Limb circumference, shoulder mobility, and grip strength were measured before treatment and at 4, 8, and 12 wk., Results: The two groups had similar parameters at baseline. The reduction of limb volume tended to decline in both groups. The trend being more significantly pronounced in active LLLT group than placebo at 8 and 12 wk, respectively (P < 0.05). Goniometric data for shoulder mobility and hand grip strength were statistically significance for LLLT group than for placebo., Conclusion: Laser treatment was found to be effective in reducing the limb volume, increase shoulder mobility, and hand grip strength in approximately 93% of patients with postmastectomy lymphedema., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Triphenyltin (TPT) is known to cause endocrine disruption, reproductive toxicity and a decrease in testosterone production. It is involved in the production of reactive oxygen species. Propolis has been reported to be an important antioxidant. Therefore, the present study aimed to elucidate the possible protective effects of propolis in alleviating the toxicity of triphenyltin chloride (TPTCl) on reproductive performance, testosterone levels, lipid peroxidation and enzyme activities in seminal plasma of male New Zealand white rabbits. Animals were orally administered the doses of propolis, TPTCl and propolis plus TPTCl every day for 12weeks. Results showed that semen quality was deteriorated following treatment with TPTCl. Also, testosterone levels, body weight (BW), relative weights of testes (RWT) and epididymis (RWE) were decreased. Thiobarbituric acid-reactive substances and lactate dehydrogenase were increased, while glutathione S-transferase, transaminases and phosphatases were decreased in seminal plasma of rabbits treated with TPTCl compared to control. Propolis alone significantly increased testosterone levels, BW, RTW, REW, semen characteristics and seminal plasma enzymes, and decreased the levels of free radicals and lactate dehydrogenase. Furthermore, the presence of propolis with TPTCl alleviates its toxic effects. From the present study, it can be concluded propolis can be effective in the protection of TPTCl-induced reproductive toxicity., (2010 Elsevier Ltd. All rights reserved.)

Balanites aegyptiaca is a naturally grown desert plant at some radioactive places in Wadi El-Gemal area, Southeastern Desert. The aim of the present study was to highlight on the B. aegyptiaca species grown naturally at radioactive places in Wadi El-Gemal area (fruit part) on the ability of using the fruit in some biomedical application (glucose, cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol and diabetes). The investigated plant was collected from different location at Wadi El-Gemal area. The uranium content was determined previously and different concentrations from the fruit with highest uranium content were used to examine the effect of B. aegyptiaca (fruit part) on the glucose, triglycerides, total cholesterol (HDL and LDL-cholesterol) levels using experimental rats. Different analysis techniques were used in order to determine different parameters. The obtained data suggest the beneficial role of B. aegyptiaca fruit as an anti-diabetic and hypo-lipidimic agent., (Copyright 2010 Elsevier B.V. All rights reserved.)

Introduction: Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED)., Aim: To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate of EECP on patients with IHD-associated ED., Main Outcome Measures: We compared pre- and post-EECP responses to erectile function (EF) domain, Q3 and Q4 of the International Index of Erectile Function score in patients who received one or two courses of EECP and those who had <5- or >or=5-years duration of IHD., Methods: As mentioned in part I a total of 44 male patients with intractable angina caused by coronary insufficiency were enrolled in this study. Treatment course of EECP consists of 35 1-hour sessions over 7 weeks. Another 35 1-hour sessions over another 7 weeks were offered to patients who received one course and required a second course because of no or minimal improvement from class IV to class III angina after the first course., Results: Patients who received only one course (N = 34) had significantly higher EF domain, Q3 and Q4, in pre- and post-EECP results than patients who received two courses (N = 10) after they completed the first course. Patients who had <5-years duration of IHD had significantly higher pre- and post EECP than patients who had >or=5 years regarding EF domain, Q3 and Q4. Considering the global efficacy question, overall satisfaction, and angina, there were significant improvements of post EECP in patients with <5 years than in patients with >or=5-years duration of IHD., Conclusion: The efficacy and satisfaction rate of EECP in patients with IHD-associated ED were negatively influenced by longer duration of IHD and requirement of a second course of EECP.

Aim: The aim of the present study was to investigate the effectiveness of one total-etch self-priming adhesive and two one-step self-etching adhesive systems on the adhesion of a resin composite to both dentin and enamel. The effect of thermocycling on the adhesion was also investigated. The null hypothesis tested was thermocycling would not affect bond strengths to enamel and dentin treated with self-etching adhesives or a total-etch adhesive., Methods and Materials: Two single-step self-etching adhesives [Xeno III (XE3) and Prompt L-Pop (PP)] and one two-step total-etch adhesive system (Prime & Bond NT) (P&B NT) were used in this study. Thirty caries-free unrestored human third molars were used to make specimens of enamel and dentin. Different adhesives were applied on enamel and dentin surfaces according to the manufacturer's instructions then hybrid composite restorative material was condensed on the surface using a mold. The bonded specimens were stored in distilled water at 37 masculineC for 24 hours before being tested. Half of the bonded specimens were tested for shear bond strength without thermocycling. The other half of the test specimens were thermocycled using a thermocycling apparatus in water baths held at 5 masculineC and 55 masculineC with a dwell time of one minute each for 10,000 cycles prior to shear testing. The mean shear bond strength before and after thermocycling was calculated, and the results were subjected to two-way analysis of variance (ANOVA) and repeated measure design to show the interaction between different materials and different times., Results: The results showed shear bond strength on both enamel and dentin of the total-etch adhesive and the self-etching adhesives decreased after the specimens were subjected to thermocycling., Conclusions: The null hypothesis tested "thermocycling would not affect bond strengths treated with self-etching adhesives" was rejected. Furthermore, the study revealed the following: 1. The shear bond strength to both enamel and dentin of the total-etch adhesive and the self-etching adhesives decreased after the specimens were subjected to thermocycling. 2. XE3 achieved the highest bond strength to both enamel and dentin (26.994+/-1.17 and 25.22+/-1.26, respectively). 3. XE3 showed even better bonding after thermocycling to enamel and dentin than the total-etching system or PP. 4. Although PP bonded to enamel showed lower shear bond strength value than XE3, it has durable bond strength even after thermocycling.

Aluminium (Al) has been proposed as an environmental factor that may contribute to some diseases, affect several enzymes and other biomolecules and induced free radical-mediated cytotoxicity. Also, Al induced reproductive toxicity and exerted a significant adverse effect on the steroidogenesis. The antioxidant ascorbic acid (AA) plays an important role in various physiological processes in the body including detoxification of different toxic materials. Therefore, the present investigation aimed to elucidate possible protective effects of AA in alleviating the toxicity of aluminium chloride (AlCl3) on reproductive performance, lipid peroxidation and enzyme activities in seminal plasma of male New Zealand white rabbits. Six rabbits per group were assigned to one of four treatment groups: 0 mg AA and 0 mg AlCl3 /kg body weight (BW) (control); 40 mg AA/kg BW; 34 mg AlCl3 /kg BW; 34 mg AlCl3 plus 40 mg AA/kg BW. Rabbits were orally administered their respective doses every other day for 16 weeks. Results obtained showed that AlCl3 significantly (P<0.05) decreased libido (by increasing the reaction time), ejaculate volume, sperm concentration, total sperm output, sperm motility (%), total motile sperm per ejaculate (TMS), packed sperm volume (PSV), total functional sperm fraction (TFSF), normal and live sperm and semen initial fructose. While initial hydrogen ion concentration (pH) and dead and abnormal sperm were increased (P<0.05). Live body weight (LBW), feed intake (FI) and relative weights of testes (RTW) and epididymis (REW) were significantly (P<0.05) decreased. Concentrations of thiobarbituric acid-reactive substances (TBARS) were significantly (P<0.05) increased in seminal plasma of rabbits treated with AlCl3 compared with control. While, activities of glutathione S-transferase (GST), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and acid phosphatase (AcP) were significantly (P<0.05) decreased. Ascorbic acid alone significantly increased LBW, FI, RTW, REW, semen characteristics and seminal plasma enzymes, and decreased the levels of free radicals. Also, the present study showed that ascorbic acid might be effective in the protection of aluminium-induced reproductive toxicity. It was suggested that AlCl3 exerted a significant adverse effect on reproductive performance of male rabbits. Furthermore, AA could be able to antagonize the toxic effects of AlCl3 and improved semen quality of male rabbit.

Objectives: To assess the role of measuring cavernosal artery blood flow as a screening tool for ischemic heart disease in patients with erectile dysfunction (ED)., Methods: A total of 303 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function. The penile vasculature was assessed using color Doppler ultrasonography and the Digital Inflection Rigidometer. All patients were referred to a cardiologist for evaluation of ischemic heart disease (IHD). All patients underwent routine laboratory investigations, plus total testosterone and prolactin assessments., Results: Seventy-six percent of the patients had organic causes of ED. Of the 303 patients, 31.4% had different degrees of IHD. A statistically significant association was found between the presence of IHD and arteriogenic causes of ED, a poor response to intracorporal injection, poor rigidity in the Digital Inflection Rigidometer, and low peak systolic velocity (PSV) in the cavernosal arteries (P <0.05 for each). No statistically significant association was found between the presence of IHD and increasing end-diastolic velocity values or decreasing resistive index in the cavernosal arteries (P >0.05 for each). A statistically significant association was found between a higher grade of IHD and a decreasing PSV value (P <0.05)., Conclusions: The results of this study established that a reduced PSV of the cavernous artery is associated with IHD. Determining the PSV could be a reliable screening tool for the detection of IHD in patients with ED.

Purpose: We evaluated the risk factors of coronary artery disease in patients with erectile dysfunction (ED)., Materials and Methods: A total of 417 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function. All patients were also screened for sociodemographic data and risk factors for ischemic heart disease (IHD), including age, smoking, diabetes, hypertension, dyslipidemia and psychological disorders. Patients underwent routine laboratory investigation plus testosterone and prolactin assessment. All patients were referred to a cardiologist for IHD evaluation., Results: Mean age +/- SD was 59.1 +/- 10.3 years. Of the patients 27.3% were younger than 50 years, 37.2% were current or former smokers, and 27.6% had mild, 30% had moderate and 42.4% had severe ED. Of the patients 26.9% had different degrees of IHD, of whom 84.8% were older than 50 years. There was a significant association between age and IHD (p <0.05). There were significant associations between IHD, and the increased severity and progressive course of ED (each p <0.05). Furthermore, higher degrees of IHD were significantly associated with severe ED. Diabetes, hypertension, dyslipidemia and psychological disorders were present in 75.1%, 39.3%, 45.6% and 8.2% of the patients, respectively. Overall 92.1% of the patients with ED had 1 or more coronary artery risk factors. The presence of at least 1 risk factor is significantly associated with ED in patients with IHD (p <0.05)., Conclusions: Coronary artery risk factors are significantly associated with erectile dysfunction. A significant association between higher degrees of IHD and the increased severity of ED was detected.

Treatment failure is a serious problem facing some national tuberculosis (TB) control programmes. Irregularity of treatment is a factor that can lead to treatment failure. A case-control study was carried out in TB centres in Egypt during April 2001-December 2002 aimed at investigating the predictors of treatment failure. We interviewed 119 people with treatment failure and an equal number of cured cases (controls) and their families regarding sociodemographic characteristics, information about TB, information about drugs, treatment compliance, family support and patient-family interaction. Significant risk factors for treatment failure were non-compliance to treatment, deficient health education to the patient, poor patient knowledge regarding the disease and diabetes mellitus as co-morbid condition.

We present our experience with reconstruction after resection of tumors around the knee, using free vascularized fibular grafting. The study included 23 patients. The lower femur was involved in 17 cases, the upper tibia in 6. The cases included giant cell tumor of the lower femur (2 patients), giant cell tumor of the upper tibia (1 patient), malignant fibrous histiocytoma of the lower femur (1 patient), parosteal osteosarcoma (1 patient), and periosteal osteosarcoma (1 patient). The remaining patients suffered from conventional osteogenic sarcomas. The size of the defect ranged from 12 to 16 cm in length. Skin flap necrosis after tumor resection was the most common complication encountered. Other complications included peroneal nerve involvement in one case and rupture of the arterial anastomosis in another. All transferred fibulas progressed to union within 7-9 months. Union time of both upper and lower ends of the fibula and time of appearance of periosteal reaction were identical. In evaluating periosteal hypertrophy of the fibula, the hypertrophy (de Boer) index (de Boer HD, Wood MB, J Bone Joint Surg 1989;71B:374-378) proved unreliable. False positive results are obtained, when callus formation around the lower end of the femur is far more abundant than at the upper end of the fibula. For this reason, we introduced the graft index. The latter is the ratio between the diameter of the graft at its thinnest portion at latest follow-up to its diameter on the day of operation, as calculated on plain radiographs. Two of the viable fibulas developed stress fractures after plate removal. Functional and quality-of -life results were satisfactory. It is concluded that the free vascularized fibular graft remains a valuable reconstruction option after the resection of tumors around the knee, provided certain precautions are followed. First, before closure of the wound, the skin flaps should be assessed for their viability. Necrotic parts should be excised. Stable fixation is a necessary prerequisite at the time of operation. Removal of the fixation device should not be guided by union or periosteal hypertrophy, but by true widening of the medullary canal., (Copyright 2000 Wiley-Liss, Inc.)