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Effect of mechanical closure of dead space in reducing seroma formation after modified radical mastectomy

Prof. Dr. Haroun Abd Al-Karim Allam¹, Dr. Mohamed Mahfouz Mohamed² and Gamal Abdel Nasser Mohamed³

¹Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

²Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

³Resident of General Surgery, Nasser Institute for Research and Treatment, Cairo, Egypt.

drgamnasser87@yahoo.com

Abstract: Seroma formation is the most frequent post operative complication after breast cancer surgery. It occurs in most patients after mastectomy. The surgical technique performed commonly has its role in seroma formation as the heavy dissection and elevation of skin flaps are the most important risk factors. Suture flap fixation is a surgical technique for securing flaps to underlying tissues to close the dead space with sutures. Although this technique is not commonly performed, it is interesting to note that this technique reduces seroma formation in patients undergoing mastectomy. In association with this, it has been proved that mastectomy without drainage does not increase seroma formation when this technique is applied. In our study the incidence of seroma in the flap fixation group was 20% versus 50% in the control group also we found that; the flap fixation technique significantly decreases the total amount of fluid drained with mean drainage volume of 524 cc versus 2017cc in the control group. We found that, this technique significantly decreases the drainage period. The mean duration of drainage is 5 days in the flap fixation group versus 13.4 days in the control group (P < 0.001). Additionally the flap fixation in our study was found to significantly decrease the mean days to seroma disappearance, the total aspirated volume, and the number of aspirations.

[Haroun Abd Al-Karim Allam, Mohamed Mahfouz Mohamed and Gamal Abdel Nasser Mohamed. Effect of mechanical closure of dead space in reducing seroma formation after modified radical mastectomy. Nat Sci 2017;15(8):1-6]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj150817.01.

Key words: breast cancer, mastectomy, seroma, flap fixation

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Evaluation of role of femur length / mid thigh circumference ratio in differentiation between small for gestational age but healthy fetuses and intrauterine growth restricted fetuses

Ahmed M. Ibrahim ¹, Alaa S. Hassanin ², Enas M. A. Mohammed³

¹Professor of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Egypt.

²Assistant Professor of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Egypt.

³Resident of Obstetrics and Gynecology, Zagazig General Hospital, Egypt.

nosa172003@yahoo.com

Abstract: Background: Intrauterine growth restriction represents pathological inhibition of fetal growth and failure of the fetus to attain its growth potential. There is a strong association between stillbirth and fetal growth restriction. A newborn infant is classified as growth restricted or small for gestational age, if his birth weight falls below the 10^th percentile for his particular gestational age. Objective: The aim of the work is to evaluate the femur length / mid thigh circumference ratio in intrauterine growth restricted fetuses in comparison to small for gestational age but healthy fetuses. Subject and Methods: An observational case-control study was conducted at the department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, during the period from (June 2015 to May 2016), included 89 women pregnant ladies in third trimester with singleton pregnancy aged between 20 and 40 years old. They were diagnosed as having small for gestational age fetus and followed up for two weeks to differentiate their pregnancy into healthy small for gestational age fetus or intrauterine growth restricted fetus. They did not have medical disorders, the fetus did not have any congenital anomalies and is viable. Result: All women were either primigravida (45.5% vs. 11.8%) or multigravida (54.5% vs. 88.2%) with highly significant difference between both groups with more incidence of primigravida in SGA group than in IUGR group (P <0.001). But, there was no statistically significant difference between both groups regarding maternal age (29+/-4 vs. 31+/-5) (P> 0.05). Also there was statistically significant difference between both groups regarding gestational age being more in SGA group (34+/-1 week vs. 33+/-2 weeks) (P < 0.05). There was no statistically significant difference between both groups regarding BMI, blood pressure, history of CS or history of abortion (P>0.05). In IUGR group AFI was decreased (3.5 +/-1.4 vs. 8.4+/-4) with sensitivity 97.1% and specificity 89.1% and umbilical artery Doppler ultrasound (RI) significantly increased (0.8+/-0.08 vs. 0.61+/- 0.05) and when compared with the SGA this showed statistically highly significant difference (P<0.001) with sensitivity 87.1% and specificity 92.7%. In SGA group the BPD, HC was bigger (78.6mm+/-5.9mm vs. 74.7mm+/-8.9mm), (291.2mm+/-16.4 vs. 276.8mm+/-30mm) respectively, which indicate statistically significant difference between both groups (P<0.05). The FL also was longer in SGA group (60.2mm+/-4.7mm vs. 56mm+/-6.7mm) which indicate statistically significant difference between both groups (P<0.01). There was no statistically significant difference between both groups regarding FL/MCT ratio (P >0.05). Conclusion: Femur length / mid thigh circumference ratio cannot differentiate between small for gestational age but healthy fetuses and intrauterine growth restricted fetuses, but amniotic fluid index in case of intact membranes and umbilical artery resistance index can be used to differentiate between both groups.

[Ahmed M. Ibrahim Alaa S. Hassanin, Enas M. A. Mohammed. Evaluation of role of femur length / mid thigh circumference ratio in differentiation between small for gestational age but healthy fetuses and intrauterine growth restricted fetuses. Nat Sci 2017;15(8):7-11]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj150817.02.

Keywords: Small for gestational age; IUGR; FL/MTC Ratio

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Production of a pharmaceutically important metalloprotease by bacillus polymyxa upon biore mediation of some agricultural wastes

Ayman S. Eldourghamy

Environmental Biotechnology Department. Genetic Engineering and Biotechnology Research Institute. Sadat City University, Egypt.

eldourghamy@yahoo.com

Abstract: Agricultural wastes are very rich in nutrients that can be used as complete balanced microbiological media for growing microbes in order to produce valuable commercial products. In this study, a biodegradation process of wheat bran was carried out to produce metalloprotease enzyme from B. polymyxa 1301 strain which is considered to be a hyper producer for that enzyme. Metalloprotease was partially purified by ammonium sulfate precipitation followed by application on Sephadex G-75 column. Gel filtration step resulted in more than 40 times fold purification of the purified enzyme. The enzyme activity was inhibited by EDTA and EDTA disodium (95% and 80%, respectively) at 15 mM concentration. This agro-industrial waste was used as a substrate for economic production of the enzyme from B. polymyxa compared with some bacterial isolates collected from different sites in Menofiya governorate, Egypt. Optimum temperature for enzyme activity was 40 °C. It also exhibited a broad pH activity range (4-12) with an optimum pH of 10.

[Ayman S. Eldourghamy. Production of a pharmaceutically important metalloprotease by bacillus polymyxa upon biore mediation of some agricultural wastes. Nat Sci 2017;15(8):12-17]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj150817.03.

Key words: metalloprotease, B. polymyxa, EDTA and EDTA disodium, agro-industrial waste, Sephadex G-75.

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Dental Caries Experience, and Oral Health Attitude and Behaviors among Undergraduate Dental Students at Umm Al Qura University

Essa Abdullah Al-Ghamdi¹, Adel Fathi Hussein²

¹Demonstrator, Faculty of Dentistry, Al-Baha University, Kingdom of Saudi Arabia

²Assistant Professor of Pediatric Dentistry, Faculty of Dentistry, Umm Al Qura University, Kingdom of Saudi Arabia

essa.alghamdi@hotmail.com

Abstract: Background: Dental students are generally motivated to maintain good oral health. Their behavior and attitudes towards their own oral health reflect their understanding of the importance of preventive dental procedures and improving the oral health of their patients. Aim: this study was done to investigate dental caries experience and oral health attitudes and behaviors among undergraduate dental students in faculty of dentistry, Umm Al-Qura University (UQUDENT) at different years of study. Materials and Methods: This study included 50 under graduate dental students, in the Faculty of Dentistry, Umm Al Qura University, Makkah, KSA. Dental caries experience was measured through clinical examination using (DMFT) index according to the WHO standard criteria for dental caries experience assessment. Examination was done in the male clinics at the faculty. Quantitative data of Oral health attitude and behavior among the students were collected through a questioner including questions about general information, personal experience and habits of dental care, oral hygiene behavior such as frequency of brushing, use of dental floss and mouthwashes, dietary habits, smoking and dental visiting habits. Results: A total of 50 students (males) were included and all of them completed the study. The prevalence of dental caries was 88%. Most of students were brushing their teeth at least twice daily, while approximately 64 % of the subjects reported using a toothbrush and toothpaste to clean their teeth. 56 % reported using dental floss. About 34 % of the subjects took at least two minutes to brush, while 32% took one minute. Most of the subjects were aware that sweets (96%) and soft drinks (98%) have a negative impact on dental health. Almost 62% of study sample were non-smoking. Conclusion: Oral health attitudes and behavior of the dental students and also their knowledge about oral and dental health care improved with increasing the year of dental faculty education.

[Essa Abdullah Al-Ghamdi and Adel Fathi Hussein. Dental Caries Experience, and Oral Health Attitude and Behaviors among Undergraduate Dental Students at Umm Al Qura University. Nat Sci 2017;15(8):18-28]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj150817.04.

Key Words: Dental Caries, Oral Health Attitude and Behaviors, Undergraduate Dental Students, DMFT

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Oral hygiene practice and oral health knowledge in relation to sugar and dental caries among dental students from Taibah University

Saif Abdulrahman Alrashidi and Khalid Lafi Alrashedi

Faculty of Dentistry, Al-Baha University, Kingdom of Saudi Arabia

kalleed106@gmail.com

Abstract: Oral health is as important as general health. Dental caries is most common disease and prevalence is high instead of taking preventive measure. Carbohydrate in the form of sugar drinks or added in the confectionaries are one of the main causative factor. Prevalence of caries is influenced if it is taken in between meal or during the meal. Observational cross sectional study was conducted on dental students at college of dentistry, Taibah University. The students who participated in the study were conveniently selected. Questionnaire was prepared to assess oral hygiene practice and sugar intake by them and to know their knowledge about time of sugar intake and its relation with dental caries prevalence. Total 103 students participated in this study and the response rate was 91%. There were 52 males and 51 females among the participants. Among all, about 50% participants were brushing their teeth for 1 min while the rest were 2 min and a very small percentage told that they did not observe the time of cleaning. Most of the final year students were brushing up to 2 min. Females were taking more sugar in between meal as compared to male students. Knowledge regarding effect of intake of sugar in between meal was more to female students. The prevalence of taking sugar in between meal is quite high among the students even they know that prevalence of dental caries increase.

[Saif Abdulrahman Alrashidi and Khalid Lafi Alrashedi. Oral hygiene practice and oral health knowledge in relation to sugar and dental caries among dental students from Taibah University. Nat Sci 2017;15(8):29-33]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj150817.05.

Key words: Dental caries, oral health, carbohydrates, brushing

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Investigation Energy Optimization in Architecture of Residential Buildings

Hamidreza Salehi

PhD student of Architecture, Baku State University, Baku, Azerbaijan

Abstract: The main purpose of this study is investigation energy optimization in architecture of residential buildings. So, thermal perceptual aspect from daily activities in residential buildings have been evaluated. To drive renewable energy technologies for practical application on a large scale, highly efficient energy conversion and high-density power storage technologies, together with cost-effective production process, are urgently required. The research uses the cases of small detached houses in Bangkok to examine the best manipulation of architectural elements to optimally provide thermal comfort in the Thai living context applying a multi-facet research methodology. Nanostructured materials tend to agglomerate because of their high surface energy, which usually inhibits their cycle-life stability. Test result indicates that the various combinations of voids and interior configurations are responding to wind directions, which could obtain the interior air velocity.

[Hamidreza Salehi. Investigation Energy Optimization in Architecture of Residential Buildings. Nat Sci 2017;15(8):34-38]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj150817.06.

Keywords: Energy Optimization; Residential Building; Architecture

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Study of Meteorological Conditions Risks for the Aviation over Sudan

Hossam M. M. Al Haj¹, S. M. Robaa² and M. M. Abdel Wahab²

¹Faculty of Aviation Sciences, Karrary University, Sudan.

²Astronomy, Space Sciences and Meteorology Department, Faculty of Science, Cairo University, Egypt.

hmotwakl43@gmail.com

Abstract: Weather is a very important factor in aviation. Severe weather may lead to dangerous situations in air transportation. While National Transportation Safety Board (NTSB) reports most commonly find human errors to be the direct accident causes, weather is a primary contributing factor in 23 percent of all aviation accidents. This study is provided to clear up different factors contributing flight safety.

[Hossam M. M. Al Haj, S. M. Robaa, M.M. Abdel Wahab. Study of Meteorological Conditions Risks for the Aviation over Sudan. Nat Sci 2017;15(8):39-43]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj150817.07.

Keywords: Study; Meteorological Condition; Risk; Aviation; Sudan

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Bilateral lateral rectus muscle recession versus unilateral recession resection in management of unilateral comitant exotropia

Attiat Mostafa El Sayed, MD, Hany Mahmoud Sammor, MD, Mohammed Ahmed El Malah, MD, Ahmed Abd El Aziz El Sayed, M.Sc.

Ophthalmology Department, Faculty of Medicine Al-Azhar University, Cairo, Egypt

Ahmedaziz3@yahoo.com

Abstract: Purpose: To compare between bilateral lateral rectus recession and unilateral recession resection in the management of unilateral comitant exotropia as regards efficacy and maintaining the postoperative alignment. Methods: Fifty patients of exotropia with an invariably fixating eye were enrolled to this study. Patients were assigned randomly to two groups, those who underwent bilateral lateral rectus (BLR) recessions (BLR group) or unilateral recession/resection procedures on the nondominant eye (RR group); surgical outcomes were compared. An outcome was considered satisfactory if there was between 10 prism diopters of exophoria/tropia and 10 prism diopters of esophoria/tropia at 6 months after surgery. Results: In the BLR group, 19 of the 25 patients (76%) had a satisfactory outcome, and 6 patients (24%) had recurrence. There was no case of overcorrection in the BLR group. In the RR group, 21 of the 25 patients (84%) had a satisfactory outcome; 2 patients (8%) had recurrence, and 2 patients (8%) were overcorrected (P < 0.128). All overcorrected patients in the RR group had poor stereoacuity and constant exotropia before the operation. Conclusion: In the patients with exotropia with a dominant eye, the unilateral RR procedure resulted in a better outcome than BLR recession surgery. But, the overcorrection rate was significantly higher in the unilateral RR procedure group, especially in those patients with a poor preoperative stereopsis status and constant exotropia.

[Attiat Mostafa El Sayed, Hany Mahmoud Sammor, Mohammed Ahmed El Malah, Ahmed Abd El Aziz El Sayed. Bilateral lateral rectus muscle recession versus unilateral recession resection in management of unilateral comitant exotropia. Nat Sci 2017;15(8):44-49]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj150817.08.

Keyword: BLR, recession resection, unilateral XT

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Analysis of the Frontal Sinus Drainage Pathways Classifications in Computed Tomography by Radiological Image Viewer

Amr F. El-badry¹, Mohammed F. Ramadan¹, Mohammed H. Abdel-Azim¹, Elsayed M. Abd Elhamid², Mohamed A. Mohamed¹

¹Otorhinolaryngology Department. Faculty of Medicine, Al-Azhar University, Egypt

²Radiology Department. Faculty of Medicine, Al-Azhar University, Egypt

dr.toha81@yahoo.com

Abstract: Background: Over the last decade there has been increasing interest in the anatomy and surgical approaches to the frontal sinus. The frontal sinus is often cited as the most challenging area to approach in endoscopic sinus surgery (ESS). Aim: analysis of the frontal sinus drainage pathways classifications in computed tomography by radiological image viewer. Methods: A total of 200 cases met the inclusion criteria; 400 frontal recesses were reviewed. Gender distribution was 84 men and 116 women. The mean age was 43 years (range, 16-69 years). Indications for obtaining the CT scan are outlined in Table. None of the patients had clinical history or radiographic evidence of frontal sinus disease. Results: This study shows that the interrater agreement of ABC is higher than with the MBKC for both the air spaces anterior and posterior to the FSDP. Conclusion: The frontal sinus drainage pathways and the surrounding anterior ethmoid sinus represent one of the most complex anatomic regions of the skull base. An intimate knowledge of its anatomy and a clear understanding of its physiology and anatomic variants are required for safe and effective surgical management of frontal sinus drainage pathway problems.

[Amr F. El-badry, Mohammed F. Ramadan, Mohammed H. Abdel-Azim, Elsayed M. Abd Elhamid, Mohamed A. Mohamed. Analysis of the Frontal Sinus Drainage Pathways Classifications in Computed Tomography by Radiological Image Viewer. Nat Sci 2017;15(8):50-55]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj150817.09.

Keywords: Frontal Sinus drainage pathway; Anatomy; Computed Tomography

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Role of Hysteroscopy in Evaluation of Recurrent Pregnancy Loss

Abdel Monem Mohamed Zakaria; Abdel Monsef Abdel Hamed Sedek and Mohamed Ahmed Badr El-Sayed

Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Egypt.

mohamedbadr1911@gmail.com

Abstract: The purpose of this study was to the usage of hysteroscopy to assess the prevalence and types of uterine defects in patients with recurrent pregnancy loss. Hysteroscopy was found that 72% of patients have normal hysteroscopy findings, while 28% of patients showing abnormal findings with 16% congenital anomalies and 12% acquired, the most common anomaly was septate uterus in 8% of patients. No statistically significant difference between both groups as regard uterine anomalies. Comparison between recurrent 1^st versus 2^nd trimester miscarriages as regard age and prior deliveries found that, patients with recurrent first trimester miscarriages are older than patients with recurrent second trimester miscarriages with statistically significant difference by using chi-square test. No significant difference as regard prior deliveries. There was no significant correlations between age prior deliveries and number of miscarriages.

[Abdel Monem Mohamed Zakaria; Abdel Monsef Abdel Hamed Sedek and Mohamed Ahmed Badr El-Sayed. Role of Hysteroscopy in Evaluation of Recurrent Pregnancy Loss. Nat Sci 2017;15(8):56-60]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj150817.10.

Key words: Hysteroscopy, Uterine Defects, Pregnancy Loss, Congenital Anomalies

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Pregnancy Outcome in Women Aged Forty Years Old

Mohammed Sameer Fouad¹, Mohammed M. Al-Khouly¹, Osama Salah El-Taher², Mohammed El-Sayed Awaga²

¹Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

²El-Galaa Maternity Teaching Hospital, Cairo, Egypt

muhammed.3awaga@gmail.com

Abstract: The changing life pattern for women in our current society includes education. Entering work force and developing a career outside of the home accompanying this, is often a postponement of childbearing. Furthermore, failure of proper contraceptive practice among elderly women may result in an unplanned pregnancy at an older age. Age was considered for many years a reproductive risk factor on both mother and child. The aim of this study is to predict the influence of maternal age on the pregnancy outcome, and if there are more complications either fetal or maternal associated with pregnancy in the fifth decade of life. This is a cross- sectional study which will be conducted at EL-Galaa Maternity Teaching Hospital Cairo, Egypt. About 23.92% of the studied women were complicated by hypertensive disorders of antepartum hemorrhage was 34% in elderly study group. For women aged 40 years or older, pregnancy carries a higher maternal as well as fetal an neonatal risks. The high rate abdominal deliveries may increase the risk of maternal mortality and morbidity at that age group.

[Mohammed Sameer Fouad, Mohammed M. Al-Khouly, Osama Salah El-Taher, Mohammed El-Sayed Awaga. Pregnancy Outcome in Women Aged Forty Years Old. Nat Sci 2017;15(8):61-66]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj150817.11.

Keywords: High risk pregnancy, women aged forty, aged less than40, hypertensive disorder, g estational diabetes, Down syndrome, molar pregnancy

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Mangment of Late post-operative complications in patients with Hirschsprung’s disease

Ahmed Elsayed Abdul-Hamed; Gamal El-Sayed El-Maadawy; Mohamed Mohamed Shahin

General Surgery Department, Faculty of Medicine, Al-Azhar University, Egypt

Drdodo54321@gmail.com

Abstract: Background: Postoperative complications following Hirschsprung’s disease surgery is a challenging health problem. Its proper timing and disgnosis of such complicaitons is of utmost importance. Objective: to evaluate the post-operative complications in patients with Hirschsprung’s Disease after unsuccessful initial surgery and its management. Patients and methods: the study included 30 children from dameitta and Al-Hussin Unviersity hospitals (Al-Azhar University). All were reviewed for history taking, clinical examination and surgical intervention, complications and its treatment. Results: The most common initial clinical presentations were constipation and abdominal distension in all studied children. The most common surgical procedure was Soave (50.0%), then trans-anal-endo-rectal pull through (20.0%), myomectomy (16.7%), LAEPT (6.7%) and each of TAAPT and Swenson (3.3%). Late postoperative complications were in the form of constipation (26.7%), anastomic stricture (20.0%), enterocolitis, fecal incontinence and increased stool freuquncy, each (13.3%), rectal prolapse (10.0%) and fecal fistula (6.7%). Treatment before redo operation, (46.7%) underwent anal dilation, (40.0%) bowel management and (13.3%) medical treatment. Redo procedures were in the form of Soave (20.0%), strictureroplasty (6.7%), Duhamel (3.3%); Swenson (10.0%), resection anastomosis (10.0%) and each of trans-anal pull through and myomectomy, (3.3%). Conclusion: postoperatrive complications after HD surgery still represent a surgical problem. Proper diagnosis and selection of initial surgical intervention and timing of this intervention may reduce the occurrence of postoperative complicaitons.

[Ahmed Elsayed Abdul-Hamed; Gamal El-Sayed El-Maadawy; Mohamed Mohamed Shahin. Mangment of Late post-operative complications in patients with Hirschsprung’s disease. Nat Sci 2017;15(8):67-73]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj150817.12.

Keywords: Hirschsprung disease, complications, surgical intervention

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Comparative Study between Dexmedetomidine and Propofol as Sedatives after Cardiac Surgery

Ahmed Mohamed Shawky¹, Ahmed Mohamed Abd-Alrahman Tahoun², Ahmed Said Abd-Alrahman¹, Usama Ibrahim Abd-Alkarim¹, Ahmed Mosaad Ahmed El-Naggar¹

¹Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Egypt

² Department of clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

ett883@yahoo.com

Abstract: Background: Sedation in mechanically ventilated cardiac patients presents a unique therapeutic dilemma in which the provider must balance patient comfort with the potentially negative consequences of drug exposure. The aim of this study was to compare dexmedetomidine topropofol in the provision of sedation and analgesia, time to extubation, their effects on hemodynamic and respiratory parameters and early post-operative complication after cardiac surgery and Investigators overall assessment of the sedative agent. Materials and Methods: A prospective, randomized single-blinded trial was conducted on 60 cardiac surgery patients in the ICU. Patients were assigned into equal propofol and dexmedetomidine groups. At start of skin closure, with no loading dose Infusion rate was at 3mg /kg /h in the range of 1-6 mg/kg/h for propofol and 0.4 µg/kg/h in the range of 0.2-0.7 µg/kg/h for dexmedetomidine and for both groups morphine was the only rescue analgesic. Riker sedation-agitation scale and Critical care pain observation tool were used. Results: Patients sedated with dexmedetomidine required significantly lower dose of morphine compared to propofol [total morphine 4.19 mg ± 0.96 and 9.15 ± 2.19 respectively, p <0.001*]. Mean heart rate and mean blood pressure, time to wean and time to extubation were also significantly lower in dexmedetomidine group compared to propofol group. Incidence of shivering in dexmedetomidine was significantly lower than propofol 33.3% and 7.1% p=0.015*. However There was no significant difference between groups as regard percentage of time spent at (SAS4) in relation to the total sedation time, it was 54.12 % ± 18.61 for propofol and 47.12 % ± 16.37, p=0.144. Also there were no significant differences in the other parameters between the two groups. Discussion and Conclusions: Dexmedetomidine is comparable to propofol in the provision of sedation, and its effect on hemodynamics and respiratory parameters. However it has added advantages in the provision of analgesia, and a significant reduction in heart rate and decrease time to wean and time to extubate without causing significant complication.

[Ahmed Mohamed Shawky, Ahmed Mohamed Abd-Alrahman Tahoun, Ahmed Said Abd-Alrahman, Usama Ibrahim Abd-Alkarim Ahmed Mosaad Ahmed El-Naggar. Comparative Study between Dexmedetomidine and Propofol as Sedatives after Cardiac Surgery. Nat Sci 2017;15(8):74-88]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj150817.13.

Keywords: cardiothoracic surgery, cardiac surgery, cardiovascular anesthesia, fast-track, post-operative sedation, dexmedetomidine, propofol, time to extubation

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Honey As A Therapeutic Agent

Atsede Gebreyohanes, Melkamu Bezie and Askale Abrhaley

College of Veterinary Medicine and Animal Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia

e-mail: atsedegebreyohanes@gmail.com

Abstract： The use of honey for prophylactic medicinal purpose is an ancient idea recently becoming an alternative approach to modern medicine with least possible side effects. Potent antibacterial activities of honey make it effective in preventing and clearing wound infections. The beneficial role of honey which attributed to its antibacterial property is due to its high osmolarity, acidity and content of hydrogen peroxide (H₂O₂) and non-peroxide components like the presence of phytochemical components. Honey may also possess properties like ant-inflammatory, deodresing and debriding of wound and stimulation of new tissue growth. Honey can be indicated in wound infection even in deep surgical wounds with infections that do not respond to the conventional therapy. Therefore, therapeutic use of honey should be a standard procedure in human and veterinary health care services.

[Atsede Gebreyohanes, Melkamu Bezie and Askale Abrhaley. Honey As A Therapeutic Agent. Nat Sci 2017;15(8):89-97]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj150817.14.

Keywords: Antimicrobial, Honey, therapeutic, wound healing

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Effect of Diabetes, Hyperlipidemia and Atherosclerosis on Human Plasma Coenzyme Q10 Concentration

Noha Sulaimani ¹, Samar Damiati ², and Samir Khoja ² *

¹ Department of Food and Nutrition, Faculty of Home Economics, King Abdulaziz University, Jeddah, Saudi Arabia

² Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia

* Corresponding Author: skhoja@kau.edu.sa

Abstract: Coenzyme Q10 (CoQ10) is a powerful lipid-soluble antioxidant, which is considered as an important cofactor in the mitochondrial electron transfer pathway. There is a possible relationship between CoQ10 and the pathogenesis of type 2 diabetes, hyperlipidemia, and atherosclerosis. This study aimed to assess the effects of these diseases on human plasma CoQ10 concentration. A total of 200 human male and female subjects with ages of 20-70 years were divided into four groups: normal control subjects, diabetic type 2 patients, hyperlipidemic patients and patients with atherosclerosis. The samples of each group were comprised of 25 males and 25 females. The mean concentration of plasma coenzyme Q10 was close to each other in male and female healthy subjects (0.21 µM vs. 0.19 µM, respectively). It was found that the concentration of plasma CoQ10 was decreased in both male and female patients as compared with the control subjects. These changes could be attributed to the increased production of reactive oxygen species and decreased antioxidant concentrations. There is significant correlation between low CoQ10 levels and diabetes, hyperlipidemia and atherosclerosis, this correlation does not necessarily indicate a causal relationship.

[Sulaimani N, Damiati S, Khoja S. Effect of Diabetes, Hyperlipidemia and Atherosclerosis on Human Plasma Coenzyme Q10 Concentration. Nat Sci 2017;15(8):98-104]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj150817.15.

Keywords: Anti-oxidant, Biochemical Analytes, HDL (High, Density Lipoprotein), LDL (Low Density Lipoprotein), Metabolic Disorders, Reactive Oxygen Species.

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Evaluation of the Protective Role of Proximal Diverting Stoma in Low Anterior Resection for Rectal Cancer

Ahmed Samy Fahmy, Hazem Mohamed Sobieh, Mohammad Samy Kharob, Abd Elghany Abd Elghaffar Abd Elkader

General Surgery Department, Faculty of Medicine, Benha University, Egypt

Dawdedo80@gmail.com

Abstract: Background:-Low anterior resection (LAR) with or without diverting stoma is a complete surgical removal with adequate safety margins, with the attempt of achieving a cure. This can either be done by laparotomy or laparoscopy plus importance of proximal diverting stoma to minimize rate of complications. Purpose:-Evaluation of protective role of proximal diverting stoma in low anterior resection against the anastomotic leakage in cases of rectal carcinoma. Patients and methods:-In this study, Fifty patients had are sectable, non- obstructed cancer rectum and not less than 6 cm from anal verge underwent low anterior resection. These patients subdivided into two groups -Group A, underwent low anterior resection (LAR) had proximal protective stoma. Group B, underwent (LAR) without proximal stoma. Results:-The study included 50 patients coming for LAR. They were 25 females and 25 males. The age of the patients ranged from 26 years to eighty years (average 53 years). The anastomotic leakage rate diminished in group A than group B because diverting stoma protect against leakage At group B there is32 patients admitted to LAR without any stoma 3 patients complicated by leakage i.e.9.4% and P value was (0.180). Evaluation of the outcome in patients underwent (LAR) and follow up in the outpatient clinic for 3 months according this parameter: Hospital staying days-Post-operative anastomtic leakage - Surgical site infections and Functional complications-Stomal complications (regarding to the first group). Conclusion:-Proximal diverting stoma play an important role in reducing the incidence of anastomotic leak also low anterior resection (LAR) still the standard treatment of mid and high rectal carcinoma, despite of different modalities of treatment of cancer rectum, there are other important factors that influence the outcome of LAR as the surgeon's experience, general condition of the patient, pre-operative colonic preparation as well as the meticulous technique of anastomosis. All this factors have greater impact on the post-operative squeal after LAR.

[Ahmed Samy Fahmy, Hazem Mohamed Sobieh, Mohammad Samy Kharob, Abd Elghany Abd Elghaffar Abd Elkader. Evaluation of the Protective Role of Proximal Diverting Stoma in Low Anterior Resection for Rectal Cancer. Nat Sci 2017;15(8):105-110]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj150817.16.

Keywords: Diverting stoma, Low anterior resection, early management of cancer rectum.

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Comparative Study between Heparin and Prednisone in Women with Repeated Early Pregnancy Loss

Samia M Eid, Abd El Raouf M Oun, and Eman T Elsayed

Department of Obstetrics and Gynecology, Al-Azhar University, Damietta, Egypt

Eman.tolba@hotmail.com

Abstract: Objective: To compare the effect of Heparin versus Prednisone in treatment of women suffering repeated early pregnancy loss. Design: Prospective matched pair study. Setting: Outpatient clinic of Al-Azhar University. Subjects: 100 pregnant women (median age 26) with history of repeated early pregnancy loss (2 or more consecutive miscarriages in the first trimester without anatomic, hormonal and infectious pathology). Intervention: 50 women on 5000U of unfractionated heparin subcutaneously 12 hourly. The other 50 women on prednisone (5mg 12 hourly). Two groups matched for age, body mass index and number of previous miscarriages. Main outcome measures: fate of pregnancy at the end of first trimester and therapy related side effects. Results: In heparin group 84% pass first trimester and 16% had missed abortions while in prednisone group, 80% pass first trimester and 20% had missed abortions. There was no significant difference between two studied groups as regard to fate of pregnancy at the end of first trimester (P- value=0.603). Conclusion: There was no significant difference between heparin and prednisone in treatment of women with repeated early pregnancy loss.

[Samia M Eid, Abd El Raouf M Oun, and Eman T Elsayed. Comparative Study between Heparin and Prednisone in Women with Repeated Early Pregnancy Loss. Nat Sci 2017;15(8):111-114]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj150817.17.

Keywords: Heparin, Prednisone in Women, Pregnancy Loss.

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Comparison of the Efficacy of Progesterone and Nifedipine in Inhibiting Threatened Preterm Labor a Randomized Comparative Study

Dr. Kaled Zakaria El Shikka, Dr. Osama Kamal Hewy Raslan, Ahmed Mohamed Moussad Farh

Obstetrics and Gynaecology Department, Faculty of Medicine Al-Azhar University, Egypt

dr.ahmad_farh@yahoo.com

Abstract: Preterm laboris a common obstetric problem. It is any birth that occurs before 37 completed weeks of gestation. The incidenceis between 5% and 10% in most developed nations. In 2009, 13 million babies were born preterm, 11 million in Africa and Asia and 500, 000 in the USA; the highest rates of preterm birth are in Africa (11.9%) and North American (10.6%). Aim of our study is to evaluate the efficacy of progesterone and nifedipine in treatment of threatened preterm labor, considering any fetal or maternal drawbacks caused by these medications. In our study, nifedipine was successful to inhibit contractions in threatened preterm labor about 78% (39/50 cases) but oral progesterone was successful to inhibit contractions in threatened preterm labor by 10% (5/50 cases) only. There was highly statistical significance in both groups with P value (0.001).

[Kaled Zakaria El Shikka, Osama Kamal Hewy Raslan, Ahmed Mohamed Moussad Farh. Comparison of the Efficacy of Progesterone and Nifedipine in Inhibiting Threatened Preterm Labor a Randomized Comparative Study. Nat Sci 2017;15(8):115-117]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 18. doi:10.7537/marsnsj150817.18.

Keywords: Comparison; Efficacy; Progesterone; Nifedipine; Preterm Labor; Randomize

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The effect of Antibacterial Activity of Streptomyces avermilitis, SK60-8, against pathogenic bacteria isolates from follicular fluidof Inferitility Egyptian Women

Enayat Mahmoud Deskouy¹, Wael Refaat Hablus², Ahmed Mohamed Ramah³ Nermine Nasr Al-Din Abed¹, and Eman Abdullah Elhusseiny³

¹Botany and Microbiology Department, Faculty of Science (Girls), Al-Azhar University-Cairo-Egypt.

²Clinical Pathology Department, Faculty of Medicine, Al-Azhar University-Cairo-Egypt.

³Assited and Reproductive Unit, International Islamic Center for Population Studies and Research (IICPSR), Al-Azhar University-Cairo-Egypt.

nermineabed67@gmail.com   zizo.maadi@gmail.com

Abstract: In previous study reported bacteria in human follicular fluid. The objective of this study was to test human follicular fluid for the presence of bacteria and in vitro treatment with antibacterial agent isolated from some Actinomycetes. In this study,200 follicular fluids and vaginal swabs were collected from women undergoing Intracytoplasmic Sperm Injection (ICSI) cycles, with various causes for infertility, attending the fertility clinic at International Islamic Center for Population Studies and Research (IICPSR), Al-Azhar University, Cairo, Egypt. Bacteria isolated from follicular fluids were classified as: (1) ‘Colonizers’ if bacteria was detected within the follicular fluid, but not within the vaginal swab (at the time of Oocyte retrieval); or (2) ‘Contaminants’ if bacteria detected in the vagina at the time of Oocyte retrieval were also detected within the follicular fluid. A variety of eleven pathogenic bacterial species were isolated; Escherichia coli ES-1, Staphylococcus aureus ES-2, Propionibacterium ES-3, Lactobacillusacidophilus ES-4, Lactobacillus plantarum ES-5, Lactobacillusruminis ES-6, Lactobacillusparacasei ES-7, Streptococcus agalactiae ES-8, Enterococcus faecalis ES-9, Enterococcushirae ES-10 & Proteus mirabilis ES-11. The obtained bacterial species were subjected for antibacterial activity of different Actinomycete cultures isolated from different localities of Egypt, it was found that an Actinomycete culture SK60-8isolated from Soil sample collected from Kilo 60, Suez governorate, Egypt to be active against the isolated bacterial pathogens. Identification of this isolate was performed according to spore morphology and cell wall chemo-type, which suggested that this strain is a Streptomycete. Further cultural, physiological characteristics and phylogenetic analysis of 16S rRNA gene indicated that this strain is identical to Streptomyces avermilitis and then designated Streptomyces avermilitis, SK60-8. In its culture supernatant, this organism could produce one major bioactive compound belonging to B-Lactam antibiotics group exhibited strong antibacterial activity against the isolated bacteria-pathogens.

[Enayat Mahmoud Deskouy, Wael Refaat Hablus, Ahmed Mohamed Ramah Nermine Nasr Al-Din Abed, and Eman Abdullah Elhusseiny. The effect of Antibacterial Activity of Streptomyces avermilitis, SK60-8, against pathogenic bacteria isolates from follicular fluidof Inferitility Egyptian Women. Nat Sci 2017;15(8):118-128]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 19. doi:10.7537/marsnsj150817.19.

Keywords: Follicular fluid, Streptomyces avermilitis SK60-8, antibacterial, phenotypic and phylogentic identification.

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Evaluation of Left Atrial Diameter and Volume as Prognostic Factor In Sepsis

Ayman Fattoh, Moamed Bader, Mohamed Nab

Cardiology Department, National Heart Institute, Giza, Egypt

Ama_fattoh@hotmail.com

Abstract: Cardiovascular changes are important in septic shock; peripheral vascular dysfunction, which can result in heterogeneous microcirculatory flow, can frequently induce myocardial depression. In this population, cardiovascular collapse can increase the risk of death in sepsis as much as two times and myocardial depression occurs in almost 40% of septic patients. Myocardial depression is characterized by a cardiac output that fails to meet metabolic demands. Objective: The aim of this study is to detect the need for anticoagulation therapy during the transseptal left sided Accessory Pathway (AP) ablation, and to determine at which stage of RF procedure antithrombotic drugs should be administered. The biochemical markers used in this study is direct measures of fibrinolysis (d-dimer, DD). Patients and Methods: It was a prospective study involving forty patients (18 females and 22 males) with sepsis admitted to the intensive care unit in Theodor Bilharz Research Institute (TBRI), this study was approved from the local ethical committee. The mean patients age is 53±15. An informed consent was obtained from every patient or his next to kin if he is unable to give the consent before being included in the study. Inclusion criteria: Patients with: 1-Sepsis Documented or suspected infection (considered as pathologic process caused by invasion of normally sterile tissue, fluid or cavity by pathogenic or potentially pathogenic microorganisms) associated with Systemic inflammatory response syndrome (SIRS) when two or more of the following criteria are met: A. Body temperature > 38°C or < 36°C. B. Tachycardia >90/minute. C. Hyperventilation: respiratory rate >20/minute or arterial hypocapnia < 32 mmHg. D. White blood cell count > 12,000/dL or <4,000/dL o immature forms > 10% 2-Severe Sepsisb Sepsis associated with organ dysfunction. 3-Septic shock Sepsis associated with circulatory failure characterized by persistent arterial hypotension (decrease of systolic blood pressure below 90 mmHg or ≥ 40 mmHg from baseline, or mean arterial pressure < 60 mmHg despite adequate fluid resuscitation) unexplained by other causes. All patients included in the study were subjected to: Full history taking, Full clinical assessment. Laboratory tests on admission and follow up including urea, creatinine, sodium, potassium, random blood sugar, complete blood count, coagulation profile, liver function tests. Transthoracic echocardiography (TTE): All echocardiographic measurements of left atrium were performed according to the recommendations of the American Society of Echocardiography (5). M-mode, Two dimensional echocardiography and Doppler ultrasound studies were made using a high resolution. Exclusion criteria: Exclusion criteria: 1- Patients with history of ischemic heart disease. 2- Patients with history of congestive cardiac failure. 3- Patients with history of rheumatic heart disease. 4- Terminally ill patients due to causes other than current sepsis. 5-patients with AF. Results: We studied 40 patients: 17 had sepsis, 14 had severe sepsis and 9 had septic shock during the study. We used the criteria of the 2016 SCCM international sepsis definitions conference to define and classify the patients. In our study 17 patients didn’t survive while 23 patients survived. There was no statistically significant difference between the two groups concerning the age and the gender. The two compared groups were homogenous. There was no statistically significant difference between survivors and non survivors regarding LAD and LAV neither on the first nor the third day. Conclusion: Left atrial diameter and volume seem of limited value as indicators of mortality in sepsis. It was apparent there is no statistically significant difference between survivors and non-survivors regarding LAD and LAV neither on the first nor the third day.

[Ayman Fattoh, Moamed Bader, Mohamed Nab. Evaluation of Left Atrial Diameter and Volume as Prognostic Factor In Sepsis. Nat Sci 2017;15(8):129-132]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 20. doi:10.7537/marsnsj150817.20.

Keywords: Evaluation; Left Atrial; Diameter; Prognostic Factor; Sepsis

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Ultrasonographic assessment of Cesarean Section Scar defect during Pregnancy

Prof. Dr. Khatab Abd Elhalim Omar, Dr. Mahmoud Salah Mahmoud and Marwa Mohamed Hamed

Obstetrics and Gynecology Department, Faculty of Medicine, AL-Azhar University (New Damietta), Egypt

Dr.marwasmeda@gmail.com

Abstract: Objective: The objective of the study is to assess the value of ultrasonographic assessment of the cesarean section scar defect during pregnancy starting from first trimester till term hoping to reach cut off value for prediction of the scar dehiscence by measuring the niche parameters and the scar thickness. Conclusion: (1) The niche dimensions changes over the course of pregnancy in the majority of women. (2) The depth of the niche decrease over the course of pregnancy, RMT and LUS thickness get thinner over the course of pregnancy. (3) The greater the depth of the niche the smaller the RMT and the greater the risk of CS scar dehiscence. (4) The risk of CS scar dehiscence increase, when the thickness of LUS is less than 2.45mm and RMT less than 1.55mm. (5) Myometrial thickness is more accurate than full thickness in prediction of CS scar dehiscence, as dehiscence may occur with thick full thickness and thin myometrium.

[Khatab Abd Elhalim Omar, Mahmoud Salah Mahmoud and Marwa Mohamed Hamed. Ultrasonographic assessment of Cesarean Section Scar defect during Pregnancy. Nat Sci 2017;15(8):133-145]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 21. doi:10.7537/marsnsj150817.21.

Keyword: Ultrasonographic; assessment; Cesarean; Section; Scar; defect; Pregnancy

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The Efficacy of Plate Construct Augmentation versus Cage Alone in Anterior Cervical Fusion

Abdel Kafi Shraf El Din, Maamoon Abo Shosha, Mohamed S. Abdul Aziz and Mohamed W. Abd-Allah*

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

* surgeon.neurospine@gmail.com

Abstract: Aim: to compare and analyze the radiologic and clinical outcomes of anterior cervical discectomy and fusion (ACDF) using cages alone or cages and anterior plating for the surgical treatment of multilevel degenerative cervical disk disease to evaluate short-term efficacy of metal plate augmentation. Material and Methods: A retrospective randomized controlled study on 20 cervical disc disease patients. Results: The patients were classified into group I using cages alone (ACDF-CA) and group II with cages and plate construct (ACDF-CPC). There were no complications related to the surgical approach. All patients achieved good overall pain and disability improvement within the first 3-month follow-up. This shows that carefully selected patients can achieve the desired levels of pain relief and functional improvement. Conclusion: Although plate method was superior to cage alone method in terms of preserving alignment and disc height achievement, Short-term outcome were almost the same.

[Abdel Kafi Shraf El Din, Maamoon Abo Shosha, Mohamed S. Abdul Aziz and Mohamed W. Abd-Allah. The Efficacy of Plate Construct Augmentation versus Cage Alone in Anterior Cervical Fusion. Nat Sci 2017;15(8):146-149]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 22. doi:10.7537/marsnsj150817.22.

Key words: Cervical plating, Neck pain, Radiculopathy, Stand-alone PEEK cage

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The Use of Multiplex PCR for Identification of Mycobacterium Bovis Isolates in Egypt

Ashraf, A. Abd El Tawwab ¹, Ahmed, M. Ammar ², Essam, A. Nasr ³, Aisha, R. Ali ⁴, Fatma, I. El Hofy ¹ and Mohammed, E. E. Sayed Ahmed ⁵

¹ Bacteriology, Immunology and Mycology Dep., Fac. of Vet. Med., Benha Univ., Egypt.

² Bacteriology, Mycology and Immunology Dep., Fac. of Vet. Med., Zagazig Univ., Egypt.

³ Veterinary Serum and Vaccine Research Institute, Abbasia. Egypt.

⁴ Serology Unit -Animal Health Research Institute, Dokki – Giza, Egypt.

⁵ Animal Health Research Institute (Mansoura branch) Dokki – Giza, Egypt.

dr_mohamedebrahim3988@yahoo.com

Abstract: The cause of bovine tuberculosis in cattle mainly is Mycobacterium bovis which is pathogenic for a large number of other animals, and its transmission to human constitutes a public health problem. The control and eradication of Mycobacterium bovis in Egypt depend on developing rapid and accurate detection techniques. Control of bovine tuberculosis in Egypt is mainly depending on test and slaughter policy which consume the economy and yet there is no evidence of reducing the prevalence of tuberculosis. We need rapid and accurate method for identification of M.bovis. The aim of this study, establishment of multiplex PCR for Identification of Mycobacterium bovis isolates in Egypt and comparing it with the Conventional gold standard mycobacterial culture techniques. Ten samples, collected from different areas of Egypt, were positive using conventional Mycobacterial culture technique, were subjected to multiplex PCR by using two sets of primers. The primer set one amplified 123bp DNA segment located within insertion element IS6110 characteristic of Mycobacterium tuberculosis complex (MTBC). The primer set two, amplified 470bp fragment which species-specific for M.bovis. The results of multiplex PCR showed that seven samples gave two specific PCR product (123 and 470 bp) indicating that they were positive for M.bovis. While two samples identified as MTBC gave only one 123 bp DNA band. Only one sample gave negative result. Multiplex PCR results were in concordance to the conventional culturing techniques results with high sensitivity and specificity (100%). It can be done with one day work in comparison with routine culture methods which take several weeks (6-8 weeks) by using culture methods.

[Ashraf, A. Abd El Tawwab, Ahmed, M. Ammar, Essam, A. Nasr, Aisha, R. Ali, Fatma, I. El Hofy and Mohammed, E. E. Sayed Ahmed. The Use of Multiplex PCR for Identification of Mycobacterium Bovis Isolates in Egypt. Nat Sci 2017;15(8):150-154]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 23. doi:10.7537/marsnsj150817.23.

Keywords: Bovine tuberculosis, Mycobacterial culture, Multiplex PCR, Mycobacterium bovis.

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A Comparative Study on Oncological Outcome between Laparoscopic and open Anterior Resection Cancer Rectum

Ramadan Hasan Elfar MD, Ahmad M. Salamah MD, Mohammad Yousri Abdou MSc.

General Surgery Department, Faculty of Medicine, AL-Azhar University, Egypt.

mohyousri@gmail.com

Abstract: Colorectal cancer is a major cause of morbidity and mortality throughout the world. It accounts for over 9% of all cancer incidences. It is the third most common cancer worldwide and the fourth most common cause of death. It affects men and women almost equally. Worldwide, colorectal cancer represents 9.4% of all incident cancer in men and 10.1% in women. The aim of the work is to compare laparoscopic and conventional open low anterior resection with total mesorectal excision for managing patients with rectal cancer from the oncological radicality point of view. The study will be a prospective randomized controlled clinical trial involving 40 patients with cancer rectum in whom anterior Resection with total mesorectal excision is indicated. There was no statistical significant difference in mean of distal margin in the studied groups. The mean distal margin in group A was 2.8 ± 0.59cm, while in group B the mean length of the distal margin was 3.0 ± 0.62cm, p value was 0.9. The mean number of harvested lymph nodes in group A was 11.55 ± 1.9, while in group B it was 10.7 ± 2.23, p value 0.2, with no statistical significant difference in mean of number of harvested lymph nodes in the studied groups. The number of affected lymph nodes in our study shows no significant difference between the two groups with the number of affected nodes in group A was 0.0 – 6.0 with mean number 2.1 ± 1.59, while in group B the mean number was 2.6 ± 3.1, with p value 0.5 with no significant differences between the two groups. All cases had negative circumferential margins. Laparoscopic anterior resection have provided optimism for the oncologic safety and have showed advantages of minimally invasive surgery. Thus, laparoscopic procedures may become the most effective treatments for colorectal cancer in the future.

[Ramadan Hasan Elfar, Ahmad M. Salamah, Mohammad Yousri Abdou. A Comparative Study on Oncological Outcome between Laparoscopic and open Anterior Resection Cancer Rectum. Nat Sci 2017;15(8):155-159]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 24. doi:10.7537/marsnsj150817.24.

Keywords: Oncology, Laparoscopic, Cancer Rectum

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Saline infusion sonohysterography versus laparoscopy for the assessment of tubal patency

Yehia Abd El Salam Wafa¹, Mohamed El Sayed Hammour¹, Reda Talaat Hussein Mosly²

¹Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Egypt

²Obstetrics and Gynecology Department, Damanhour Teaching Hospital, Egypt

Abstract: Background: The aim of the present study is to evaluate the accuracy of saline infusion sonohysterography in assessment of tubal patency in 20 infertile women in comparison to laparoscopy. Methods: Women with infertility and fulfilling Inclusion criteria will undergo saline infusion sonohysterography and its results will be compared with the results of laparoscopy. Results: The results of this study showed that the accuracy of saline sonohysterography in diagnosis of bilateral tubal patency in the infertile patients was sensitivity of 62.0%, a specificity of 52.0%, a PPV of 50%, an NPV of 60%, an FPR of 10% and an FNR of 0.0%. Saline sonohysterography was diagnostic of bilateral tubal patency with a sensitivity of 68.0%, a specificity of 50%, a PPV of 65.0%, an NPV of 45.0%, an FPR of 50% and an FNR of 5.0%. Conclusion: In conclusion of our study we found that saline infusion sonohysterography offer much less invasive method than laparoscope for the diagnosis of tubal patency. Saline infusion sonohysterography also can be performed initially to infertile patients. It is simple, fast, safe, well tolerated, inexpensive procedure avoiding anesthesia complications and associated with rare adverse effects. Laparoscopy with chromopertubation is widely accepted as the gold standard method for evaluating of internal pelvic organs and tubal patency. It has the ability to simultaneously evaluate the abdominal cavity and other pelvic structures for an enhanced diagnostic evaluation of other etiologies of sub fertility. On the other hand it has operative risks, expensive, more time consuming and the patient needs a period of postoperative recovery.

[Yehia Abd El Salam Wafa, Mohamed El Sayed Hammour, Reda Talaat Hussein Mosly. Saline infusion sonohysterography versus laparoscopy for the assessment of tubal patency. Nat Sci 2017;15(8):160-167]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 25. doi:10.7537/marsnsj150817.25.

Keywords: Saline; infusion; sonohysterography; laparoscopy; assessment; tubal patency

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Maternal and Fetal Outcome of Eclampsia Using Different Management protocols

Yehia Abd El Salam Wafa¹, Mohamed El Sayed Hammour¹, Mohamed Abd El Hameid Mohamed Gamal El Dein Dabeis²

¹Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Egypt

²Obstetrics and Gynecology Department, Damanhour teaching Hospital, Egypt

mohamed.dabees@gmail.com

Abstract: Background: The objective is to evaluate the outcome of 50 cases of eclampsia managed in Damanhour teaching hospital. Main outcome measures include maternal and perinatal morbidity and mortality using different management protocols. Methods: This work is a case series report (descriptive study) dealing with 50 cases of eclampsia will be admitted and managed at Damanhour teaching hospital. Eclamptic patients are those with new onset seizures in women with pre-eclampsia, either admitted with eclampsia or developed seizures in the hospital. Data sources will include interview from patients and their attendants, obstetric record charts of the patients, referral letter in case of those who will be referred from any health facility. Results: As regard our study magnesium sulphate was effective in 88% of cases. The other management protocol using (magnesium sulphate+diazepam) was found to be effective in controlling 100% of fits yet it associated with higher rate of respiratory depression, hypoventilation and maternal mortality. Conclusion: The seriousness of eclampsia and the high maternal and fetal complication rate encountered necessitates the management of patients with eclampsia in tertiary care, Centers with both maternal and neonatal ICU facilities. Magnesium sulphate is the drug of choice in cases with eclampsia, yet using other protocols such as (Mg sulphate+Diazepam) may be beneficial regarding cases with recurrent fits or fits not controlled by Mg sulpahte alone.

[Yehia Abd El Salam Wafa, Mohamed El Sayed Hammour, Mohamed Abd El Hameid Mohamed Gamal El Dein Dabeis. Maternal and Fetal Outcome of Eclampsia Using Different Management protocols. Nat Sci 2017;15(8):168-176]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 26. doi:10.7537/marsnsj150817.26.

Keywords: Maternal; Fetal; Outcome; Eclampsia; Management; protocol

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Relation between Adipokines and Radiological Changes in Patients with Knee Osteoarthritis

Hesham Abd Elwahab¹, Tarek M. Emran ², Ashraf Abd Elsalam³, Elsayed M. Abd Elhamid⁴, Mona M. Alsaeed⁵

¹Professor and Head of Department of Physical Medicine, Rheumatology and Rehabilitation Damietta Faculty of Medicine - Al-Azhar University, Egypt

²Assistant professor of Clinical pathology, Damietta Faculty of Medicine - Al-Azhar University, Egypt

³Lecturer of Physical Medicine, Rheumatology and Rehabilitation, Damietta Faculty of Medicine - Al-Azhar University, Egypt

⁴Lecturer of Radiodiagnosis, Damietta Faculty of Medicine - Al-Azhar University, Egypt

⁵Resident of Physical Medicine, Rheumatology and Rehabilitation, Talkha Hospital, Egypt

Corresponding email: Arheumatology@yahoo.com mona.alsaeed11@yahoo.com

Abstract: Background: Osteoarthritis (OA) is the most common degenerative articular disease caused by joint degeneration, weight-bearing joints, and the knee is most frequently involved. Since the mechanical factors can’t explain incidence of osteoarthritis (OA), attention had been shifted to an obesity-related systemic factor as a link between obesity and OA. Adipokines (ADK) were proposed as a predictor markers and potential systemic factor, which links obesity to OA. Objective: to investigate the association of ADK with OA and their potential to be used as biomarkers for OA activity and its relation with radiological grading. Subjects and Methods: Serum levels of adipokines (adiponectin (ADP), leptin (LEP), visfatin and resistin) were determined in 40 patients with primary knee OA who had evidence of radiological changes in the knee by plain x-ray. Results: serum ADP, LEP, visfatin and resistin were significantly higher in the patients KOA compared to the controls (P=0.008, 0.002, <0.001, and <0.001, respectively) BMI is significantly correlated with serum ADP, LEP, visfatin and resistin. In addition, serum levels of the ADP, LEP, resistin and visfatin were significantly correlated with clinical and radiological markers indicating the severity of the KOA as well as with OA activity. Conclusion: Serum ADP, LEP, visfatin and resistin can be used as a marker for KOA activity and severity. These findings strongly suggest that ADK is involved in the pathogenesis of joint inflammation and cartilage damage in OA and may form the link between obesity and development of OA and therefore, may be a target for disease-modifying drug development.

[Hesham Abd Elwahab, Tarek M. Emran, Ashraf Abd Elsalam, Elsayed M. Abd Elhamid, Mona M. Alsaeed. Relation between Adipokines and Radiological Changes in Patients with Knee Osteoarthritis. Nat Sci 2017;15(8):177-184]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 27. doi:10.7537/marsnsj150817.27.

Keywords: knee osteoarthritis, adiponectin, leptin, visfatin, resistin

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Evaluation of the Effect of Intra-Articular Injection of Platelet Rich Plasma in Treatment of Primary Knee Osteoarthritis

Hesham Abd Elwahab¹, Saad M. El Zokm¹, Hesham S. Abd El-Samee², Rasha M. Badr¹

¹Rheumatology, Physical medicine and Rehabilitation Department, Faculty of Medicine, Al-Azhar University, Egypt.

²Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Egypt.

hamadazina19842017@gmail.com

Abstract: Two hundred consecutive patients with symptomatic primary knee osteoarthritis ( KOA) were included in this study. All patients met the European League against Rheumatism (EULAR) 2010 criteria for diagnosis of primary KOA.100 patients received treatment withintra articular injection of platelet retched plasma (PRP) and 100 patients received treatment with NSAIDs as control group. Clinical data were collected at baseline and after three months of treatment with (PRP) or NSAIDs. To assess results some measures were used, the VAS-pain score, tenderness score, the IKDC score, KL-grade, and the synovial vascularity using plain X ray and musculoskeletal ultrasound. The study revealed that, there were no significant differences between the two groups at baseline, after 3 months of treatment there were significant differences between the two groups. The VAS-pain score was significantly lower in the PRP-treated group than in the control group (4.2 ±1.6 versus 4.7 ±1.5 respectively, p=0.025). The tenderness score in the PRP-treated group was 1.9 ±0.8 vs. 2.3 ±0.6 in the control group (p<0.001). The IKDC was significantly higher in the PRP-treated group compared to the control group (73.9 ±11.4 versus 63.6 ±12.3 respectively, p<0.001). In addition, the average KL grade of the control group was significantly higher than that of the PRP-treated group (1.64 ±0.61 versus 1.48 ±0.52 respectively, p=0.048). So, treatment were significantly better in the PRP-treated group in comparison to the control group.

[Hesham Abd Elwahab, Saad M. El Zokm, Hesham S. Abd El-Samee, Rasha M. Badr. Evaluation of the Effect of Intra-Articular Injection of Platelet Rich Plasma in Treatment of Primary Knee Osteoarthritis. Nat Sci 2017;15(8):185-190]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 28. doi:10.7537/marsnsj150817.28.

Keywords: Evaluation; Effect; Intra-Articular; Injection; Platelet Rich Plasma; Treatment; Primary Knee Osteoarthritis

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Prognostic Value of Day 3 Luteinising Hormone (LH) in the prediction of Ovarian Response in Patients with Polycystic Ovary syndrome

Mohammed Samir Fouad¹; Mohammed Said El-Shorbagy², Mohammed Mohammed Farahat¹, Mostafa Ahmed Abd El-Hamed¹

¹Obstetrics and Gynecology Department, Faculty of Medicine - Al-Azhar University, Egypt

² Clinical Pathology Department, Faculty of Medicine - Al-Azhar University, Egypt

Mostafaelq2d@gmal.com

Abstract: Background: The aim of this study was to test the prognostic value of day 3 LH in predicting the success of ovarian response in patients with polycystic ovary syndrome. Methods: A prospective observational study was conducted at Infertility outpatient clinic, Sohag Teaching Hospital. Patients were sixity PCOS women who underwent induction of ovulation. All women had serum basal LH measured before induction of ovulation. The main outcome measured was ovarian response using folliculometry and serum progesterone. Results: PCOS women with LH < 8 mIU/ml had higher incidence of ovulation than those with LH>8 mIU/ml using both folliculometry and serum progesterone (44.73% vs 10.52%, P=0.01 ), also PCOS women with LH/FSH ratio <2 had higher incidence of ovulation than those with LH/FSH ratio>2 (40.9 % vs 7.69 %, P=0.026). Conclusions: Basal serum LH and LH/FSH ratio may has useful prognostic value in the prediction of ovarian response in patients with PCOS.

[Mohammed Samir Fouad; Mohammed Said El-Shorbagy, Mohammed Mohammed Farahat, Mostafa Ahmed Abd El-Hamed. Prognostic Value of Day 3 Luteinising Hormone (LH) in the prediction of Ovarian Response in Patients with Polycystic Ovary syndrome. Nat Sci 2017;15(8):191-196]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 29. doi:10.7537/marsnsj150817.29.

Key words: LH/ LH/FSH ratio / ovarian response/ Polycystic Ovary Syndrome/ Folliculometry / Serum Progesterone.

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Addition of Sofosbuvir to the Standard Pegylated Interferon-Ribavirin Therapy in Treatment-naive & -experienced Patients with Chronic Hepatitis C Infection

Mostafa Soliman El-Kady¹; Mohamed Hatem Wali²; Hatem Samir Abd El Raouf¹; Hany Ragheb Elkholy¹; Mohamed Morsi Sheta¹

¹Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Banha University, Banha, Egypt.

²Community and Occupational Medicine Department, Faculty of Medicine, Banha University, Banha, Egypt. Email: drmorsy77@hotmail.com.

Abstract: Background and study aim: Hepatitis C virus (HCV) is a major cause of liver diseases including chronic hepatitis‚ liver cirrhosis and hepatocellular carcinoma. Egypt has the highest worldwide prevalence of HCV with more than 90% of HCV isolates are genotype 4 variants. To avoid progression of the disease and its complications, antiviral treatment is needed. Genotype-1 infected patients achieved a SVR ranging from 41-52% after 48 weeks of peginterferon-ribavirin with slight higher rates in genotype 4. This study was designed to evaluate the efficacy and safety of adding sofosbuvir to this standard combination therapy in naive patients with chronic hepatitis c and those previously experienced. Patients and methods: Ninety patients with chronic hepatitis c were included in this study. Forty five patients were treatment- naïve while the other 45 patients was failed previous course of pegylated IFN and ribavirin. All patients were evaluated by history, clinical examination, imaging and laboratory investigations. Sofosbuvir was added to the standard combination therapy. Side effects during therapy were observed in patients of both groups to assess safety. Real time quantitative PCR was repeated after 12 weeks from the end of treatment to evaluate sustained virological response (SVR) of patients in both groups to assess efficacy. Results: The overall SVR in all patients was 72.2%. It was achieved in (35/45) patients in the treatment-naïve group (77.8%) while in the experienced one, it was achieved in (30/45) patients (66.7%) with non-significant difference between both groups (p=0.239). In the treatment-experienced group, patients with breakthrough on old regimen (27/45) patients achieved SVR in a significantly lower rate than those in patients with history of relapse (51.9% vs 88.9 % respectively) (p=0.010). The main side effects developed were headache (84.4 & 55.6%), fever (64.4 & 51.1%), bone aches (57.8 & 40%) and asthenia (53.3 & 37.8%) in naïve and experienced groups respectively. headache was significantly more frequent in the treatment-naïve group (p=0.003). Conclusion: Adding sofosbuvir to standard combination therapy (peginterferon-ribavirin) is associated with increased SVR in both treatment-naïve and those experienced with high safety profile in both groups.

[Mostafa Soliman El-Kady; Mohamed Hatem Wali; Hatem Samir Abd El Raouf; Hany Ragheb Elkholy; Mohamed Morsi Sheta. Addition of Sofosbuvir to the Standard Pegylated Interferon-Ribavirin Therapy in Treatment-naive & -experienced Patients with Chronic Hepatitis C Infection. Nat Sci 2017;15(8):197-202]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 30. doi:10.7537/marsnsj150817.30.

Keywords: Addition; Sofosbuvir; Standard; Pegylated; Interferon-Ribavirin; Therapy; Treatment-naive & -experienced Patient; Chronic Hepatitis C Infection

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Short and Longfeed Starvation-Refeeding Regime in Polyculture Ponds of Oreochromis niloticus and Mugilcephalus

Marwa F. Abd El-Kader ¹, Eman M. M. Moustafa²* and Tarek M. Mousa-Balabel³

¹Fish Health Department, Sakha, Aquaculture Research Unit, Central Lab. For Aquaculture Research, Abbasa, Sharkia- ARC.

² Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Kafr El-Sheikh University, Kafr El-Sheikh governorate, Postal code: 33516, Egypt.

³ Department of Hygiene and Preventive Medicine, Faculty of Veterinary Medicine, Kafr El-Sheikh University, Kafr El-Sheikh governorate, Postal code: 33516, Egypt

emantarek2002@yahoo.com

Abstract: The current study was conducted in a private fish farm at Dakahlia governorate, in polyculture earthen pond containing Oreochromis niloticus and Mugilcephalus. The aim of the study (i) access the impact of different periods of starvation followed by refeeding regimes in polyculture ponds containing Oreochromis niloticus and Mugilcephalus, and to (ii) evaluate the effect of starvation on fish growth performance and hematological parameters; in a trial to reduce the economic costs needed for the fish farm. Starvation of fish was performed for different periods; 7, 14, 21 days followed by refeeding on commercial fish ration (25%protein) at least 4 weeks. Fish growth parameters and hematological investigations were recorded for the starved fish and control group (kept without starvation) along the period of experiment. It was observed that starvation of fish for up to 14 day (Group 2) followed by refeeding did not have a significant negative effect on both growth and hematological parameters. Growth parameters of fish starved for 14 days were the best because they exceeded control levels. This could be of an economic profit because the final outcome of both starvation- refeeding regime and feeding without food restrictions will be equal. That is why the total expenses of feedstuff costs of the daily fish feeding will be reduced.

[Marwa F. Abd El-Kader, Eman M. M. Moustafa and Tarek M. Mousa-Balabel. Short and Longfeed Starvation-Refeeding Regime in Polyculture Ponds of Oreochromis niloticus and Mugilcephalus. Nat Sci 2017;15(8):203-208]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 31. doi:10.7537/marsnsj150817.31.

Keywords: Hematology, Mugilcephalus, Oreochromisniloticus, Polyculture, Refeeding, Starvtion.

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Ultrasound Evaluation of Recent Uterine Wound after Cesarean Section

Samia M Eid, Rashed M Rashed, Randa M El-mahdy

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University (Damietta), Egypt.

randahala1981@gmail.com

Abstract: Objective: We evaluate the uterine wound thickness after cesarean section by repeated ultrasound and correlate the finding according to the various factors that may cause uterine scar defect. Design: Prospective cohort study. Methods: Ultrasonographic follow-up of the uterine scar thickness was performed at 1 week, 6 weeks, 3 months, and 6 months post c.s for measuring the thickness of residual myometrium and presence of defects. The patient’s criteria were scrutinized and correlated according to the state of scar whether intact or not. Results: Scar defects were found in 48 patients (24%). The mean age of the patients was 27.21±4.77, 14 patients had DM, 7 patients had collagen diseases (chronic steroid treatment during pregnancy), and 19 patients developed wound infection.8 patients (17%) had RVF uterus. Conclusion: Factors that were associated with deficient scars: increase maternal age, history of DM, chronic steroid treatment during pregnancy, wound infection, uterine retro-flexion.

[Samia M Eid, Rashed M Rashed, Randa M El-mahdy. Ultrasound Evaluation of Recent Uterine Wound after Cesarean Section. Nat Sci 2017;15(8):209-214]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 32. doi:10.7537/marsnsj150817.32.

Key words. CS scar defect – Transvaginal US.

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Assessment of Normal Hepatosplenic Span Using Ultrasound in Egyptian Population

Osama F. Ahmed

Department of anatomy, Faculty of Medicine, Benha University, Egypt

osamafouad20@yahoo.com

Abstract: Background: he human liver and spleen are organs demanding constant attention from the anatomical, immunological and clinical point of view. Enlargement of liver and spleen is associated with different hepatic and systemic diseases. Racial differences in hepatic and splenic lengths could result in incorrect interpretation of their sizes. So, population specific spleen and liver normograms would provide more accurate standards. Purpose: This study was designed to set baseline data for sonographic values of liver and spleen spans for Egyptians in Qualiobia and to identify their relationship with anthropometric variables. Materials and methods: The study included randomly selected 337 patients attended Al-Fouad radiology scan and laboratory center who were referred for different radiologic examinations not related to the liver or the spleen, the subjects involved were assayed with complete blood count (CBC), hepatic and renal functions tests, The age, body weight, height and the body mass index were calculated for each subject as well as sonographic evaluation of hepatosplenic spans were done. Subjects were divided into three groups according to their age. Results: Our results showed significant difference of BMI and liver size between males and females and there was statistically significant positive correlation of BMI with liver span while no statistically significant correlation with spleen span. Also there was statistically significant negative correlation between the hepatosplenic spans and age of the oldest group. Conclusion: The present study was an attempt to determine the normal range of the hepatosplenic spans which correlated variably with different anthropometric parameters.

[Osama F. Ahmed . Assessment of Normal Hepatosplenic Span Using Ultrasound in Egyptian Population. Nat Sci 2017;15(8):215-219]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 33. doi:10.7537/marsnsj150817.33.

Key words: Liver, spleen, normal size, Egyptians, anthropometric measures

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