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Science Journal

 

Nature and Science
(Nat Sci
ISSN 1545-0740 (print); ISSN 2375-7167 (online); doi:10.7537, Monthly
Volume 15 - Number 8 (Cumulated No. 125), 25, 2017
Cover Page (jpg), Cover  Page (pdf) , Introduction, Contents, Call for Papers, nsj1508

 

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CONTENTS   

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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 10th 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

 

Elham Ramazani1, Rezgar Salimi2 (Corresponding author)

 

1. MSc of Architecture, Islamic Azad University, Ayatollh Amoli Branch, Mazandaran, Iran

2. BSc in Architecture, Shomal Unversity, Amol, Mazandaran, Iran

Salami.rezgar70@gmail.com

 

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.

[Elham Ramazani, Rezgar Salimi. 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 1st versus 2nd 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 g/kg/h in the range of 0.2-0.7 g/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 M vs. 0.19 M, 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 5315. 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 > 38C or < 36C. 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. N Y Sci J 2017;10(8):129-132]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 20. doi:10.7537/marsnys100817.20.

 

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

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The manuscripts in this issue are presented as online first for peer-review starting from May 23, 2017.

 All comments are welcome: editor@sciencepub.net or contact with author(s) directly.

For back issues of the Nature and Science, click here.

Emails: editor@sciencepub.net; sciencepub@gmail.com; naturesciencej@gmail.com

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2017 Marsland Press