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Assessment of best combination of soil amendment and different irrigation regimes to improve yield of sugarcane.

Aimen Ali¹, Zulqarnain Aslam², Misha Iqbal¹, Meh Gul¹, Iqra Aslam¹, Faiza Bano¹, M. Umair Gulzar³

¹Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan.

²Department of Plant Breeding and Genetics, University of Agriculture Faisalabad.

³Department of Entomology, University of Agriculture, Faisalabad, Pakistan.

Abstract: The studies related to effect of irrigation levels and soil amendments practices on sugarcane was conducted on a loamy soil under field conditions at Agronomic/Research/Farm area, University/of Agriculture, Faisalabad/(Latitude 31.26°N, Longitude 73,06° E and Altitude 184 m) Pakistan during growing season 2016- 17. The experiment was laid out in Randomized Complete Block Design (RCBD) with split plot arrangement and three replications with a net plot size of 4.8 m x 10.0 m. Planting was sown in 120 cm wide trenches using two eyed cane setts in dual rows @ 75,000 setts ha^-1 by hand placement. Sugarcane variety CPF-249 was planted on Last week of March 2016. All agronomic operations were kept uniform except (N) nitrogen and (P) phosphorus fertilizers and time of irrigations. In experiment, potash @112 kg ha'1 was applied in trenches at the time of planting while Nitrogen and phosphorus fertilizer was applied as per treatment plan from organic and inorganic sources with irrigation combinations viz. I₀T₀ = 100% of Recommended Irrigation (16 Irrigations) + Control, I₀T₁ = 100% of Recommended Irrigation (16 Irrigations) + Press-mud, I₀T₂ = 100% of Recommended Irrigation (16 Irrigations) + Polymer Coated SSP, I₀T₃ = 100% of Recommended Irrigation (16 Irrigations) 50% Cane Trash boiler ash+50% SOP, I₁T₀ = 75% of Recommended Irrigation (12 Irrigations) + Control, I₁T₁ = 75% of Recommended Irrigation (12 Irrigations) + Press-mud, I₁T₂ = 75% of Recommended Irrigation (12 Irrigations) + Polymer Coated SSP, I₁T₃ = 75% of Recommended Irrigation (12 Irrigations) + 50% Cane Trash boiler ash+50% SOP, I₂T₀ = 50% of Recommended Irrigation (08 Irrigations) + Control, I₂T₁ = 50% of Recommended Irrigation (08 Irrigations) + Press-mud, I₂T₂ = 50% of Recommended Irrigation (08 Irrigations) + Polymer Coated SSP, I₂T₃ = 50% of Recommended Irrigation (08 Irrigations) ₊ 50% Cane Trash boiler ash+50% SOP. Effect of irrigation levels and soil amendments techniques on trash weight (t ha'1) and harvest index remained non- significant. The highest number of tillers m^-2 (15.63) was recorded at I₀T₂ (100% of recommended irrigation + polymer coated SSP) and minimum m^-2 (11) at I₁F₁ (75% of recommended irrigation + pressmud). The maximum cane girth (2.00 cm) was recorded at I₀T₂ (100% of recommended irrigation + polymer coated SSP), cane length (220.00 cm) at I₀T₂ (75% of recommended irrigation + polymer coated SSP), weight per stripped cane (1.09 kg) at I₀T₂ (100% of recommended irrigation + polymer coated SSP). While minimum cane girth (1.5 cm) was recorded at I₂F₀ (50% of recommended irrigation + control), cane length (157 cm) at I₂T₀ (50% of recommended irrigation + control), weight per stripped cane (0.51 kg).

[Aimen Ali, Zulqarnain Aslam, Misha Iqbal, Meh Gul, Iqra Aslam, Faiza Bano, M. Umair Gulza. Assessment of best combination of soil amendment and different irrigation regimes to improve yield of sugarcane. Nat Sci 2019;17(9):1-8]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj170919.01.

Key words: Sugarcane, yield, irrigation, soil amendments

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Isolation, Identification and Pathogenicity of Anthracnose of Grapevine and its Management by different chemicals

Moez Ullah Khan^1*, Manzoor Ali Abro¹, M. Qasim Kakar², Habibullah Kakar², Hassan Akhtar¹, Abid Saeed³, Zubair Khan⁴

¹Department of Plant Pathology, Sindh Agriculture University Tandojam, Pakistan

²Department of Agriculture & Cooperative, Research Wing, Balochistan, Pakistan

³Department of Agriculture & Cooperative, Extention Wing, Balochistan, Pakistan

⁴Department of Plant Pathology, Balochistan Agriculture College Quetta, Pakistan

*Corresponding author’s email: moeez.ghilzai@gmail.com

Abstract: Grape (Vitis venifera) is the most remunerative and economically important fruit crop and has a lot of uses. It is commonly attacked by a wide range of fungus species in which the most prominent is Elsinoe ampelina which cause anthracnose disease of grapevine. An in vitro trial was conducted in the Labotory of Mycology, Department of Plant Pathology, Sindh Agricultural University Tandojam, sindh, Pakistan, during 2017-2018 in order to properly manage Anthracnose disease of grape with systemic fungicides. Five systemic fungicides namely Diniconazole, Thiophanate-methyl, Myclobutanil, Difenoconazole and Hexaconazole were tested at 50 ppm, 100 ppm and 200 ppm in order to check their efficacy against percent growth inhibition of Elsinoe ampelina. Hexaconazole and Myclobutanil at 200 ppm inhibited 88.33% and 86.42% radial growth respectively and found to be significantly superior to Diniconazol and Thiophanate-methyle at 200 ppm. Difenoconazol was significantly inferior against Elsinoe ampelina. Another field experiment was also conducted in which Diniconazole, Thiophanate methyl, Myclobutanil, Difenoconazole and Hexaconazole were further evaluated under greenhouse condition, among the five tested fungicides, Hexaconazole was found to be the most effective fungicide in controlling the disease incidence, for which the disease incidence was recorded very low (40.93%) followed by Myclobutanil and Diniconazole, while Difenoconazole was found to be less effective in controlling the disease incidence.

[Moez Ullah Khan, Manzoor Ali Abro, M. Qasim Kakar, Habibullah Kakar, Hassan Akhtar, Abid Saeed, Zubair Kha. Isolation, Identification and Pathogenicity of Anthracnose of Grapevine and its Management by different chemicals. Nat Sci 2019;17(9):9-21]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj170919.02.

Keywords: Isolation; Identification; Pathogenicity; Anthracnose; Grapevine; Management; chemical

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Effect of natural and synthetic soil supplements on qualitative parameters of sugarcane under water scarcity

M. Hamza Ishaq Rao¹, Abuzar Ghafoor^2*, Ayesha Liaquat³, Amir Manzoor⁴, H.M Umair Waqas⁵, M. Saqib Riaz⁴

¹Center of Agricultural Biochemistry and Biotechnology, University of Agriculture, Faisalabad, Pakistan.

²Agricultural college of Sichuan Agricultural University, 211 Huimin Street, Wenjiang District, Chengdu 611130, China.

³Department of Botany, University of Agriculture, Faisalabad, Pakistan.

⁴Department of Agronomy, PMAS Arid Agriculture University, Rawalpindi, Pakistan.

⁵Department of Plant Breeding and Genetics, University of Agriculture, Faisalabad, Pakistan.

*Corresponding author’s email: abuzarghafoor2974@outlook.com

Abstract: The present study was performed to check the effect of irrigation levels and soil amendments practices on sugarcane under field conditions at Agronomic/Research/Farm area, University/of Agriculture, Faisalabad Pakistan during growing season 2017- 18. The experiment was performed under RCBD with split plot arrangement and three replications. Planting was sown in 120 cm wide trenches using two eyed cane setts in dual rows @ 75,000 setts ha^-1 by hand placement. Sugarcane variety CPF-249 was planted on Last week of March 2017. All agronomic practices were performed uniformly except (N) nitrogen and (P) phosphorus fertilizers and time of irrigations. In experiment, potash @112 kg ha'1 was applied in trenches at the time of planting while Nitrogen and phosphorus fertilizer was applied as per treatment plan from organic and inorganic sources with irrigation combinations viz. I₀T₀ = 100% of Recommended Irrigation (16 Irrigations) + Control, I₀T₁ = 100% of Recommended Irrigation (16 Irrigations) + Press-mud, I₀T₂ = 100% of Recommended Irrigation (16 Irrigations) + Polymer Coated SSP, I₀T₃ = 100% of Recommended Irrigation (16 Irrigations) 50% Cane Trash boiler ash+50% SOP, I₁T₀ = 75% of Recommended Irrigation (12 Irrigations) + Control, I₁T₁ = 75% of Recommended Irrigation (12 Irrigations) + Press-mud, I₁T₂ = 75% of Recommended Irrigation (12 Irrigations) + Polymer Coated SSP, I₁T₃ = 75% of Recommended Irrigation (12 Irrigations) + 50% Cane Trash boiler ash+50% SOP, I₂T₀ = 50% of Recommended Irrigation (08 Irrigations) + Control, I₂T₁ = 50% of Recommended Irrigation (08 Irrigations) + Press-mud, I₂T₂ = 50% of Recommended Irrigation (08 Irrigations) + Polymer Coated SSP, I₂T₃ = 50% of Recommended Irrigation (08 Irrigations) ₊ 50% Cane Trash boiler ash+50% SOP. All quality parameters like Brix (%), Sucrose content in juice (%), cane juice purity (%), and cane fiber (%) exposed non-significant effect of irrigation levels and soil amendments techniques in spring planted sugarcane. Maximum commercial cane sugar (CCS) (15.00 %) and cane sugar recovery (14.53 %) was recorded at I₀T₂ (100% of recommended irrigation + polymer coated SSP).

[M. Hamza Ishaq Rao, Abuzar Ghafoor, Ayesha Liaquat, Amir Manzoor, H.M Umair Waqas, M. Saqib Ria. Effect of natural and synthetic soil supplements on qualitative parameters of sugarcane under water scarcity. Nat Sci 2019;17(9):22-28]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj170919.03.

Key words: Sugarcane, qualitative parameters, irrigation

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Role of serum miRNA-500 as a biomarker of hepatocellular carcinoma (HCC) progression with hepatitis C virus infection

Alaa W. Elmetwalli¹, Ahmed Esmael² and Mahmoud M. Amer²

¹Department of Clinical trial Research, Egyptian liver Research Institute and Hospital, Mansoura, Dakhliah, Egypt.

² Microbiology Department, Faculty of Science, Benha University, 13511, Egypt.

E-mail: Dr.prof2011@gmail.com

Abstract: Hepatitis C virus (HCV) infection is a significant health challenge affecting over 185 million individuals globally. Egypt has the highest rate for chronic HCV infection globally. Unresolved chronic HCV infection could progress to more deteriorating conditions such as cirrhosis and/or hepatocellular carcinoma (HCC). The latter is one of the most common malignant tumor in the world. Current conventional HCC biomarkers lack both sensitivity and specificity. Discovering novel and reliable biomarkers that are sensitive, specific and non-invasive is very decisive for early diagnosis and rapid intervention for HCV related liver HCC. Recently, miRNA have drawn great attention as promising non-invasive biomarkers for various diseases.

[Alaa W. Elmetwalli, Ahmed Esmaeland Mahmoud M. Ame. Role of serum miRNA-500 as a biomarker of hepatocellular carcinoma (HCC) progression with hepatitis C virus infection. Nat Sci 2019;17(9):29-36]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj170919.04.

Keywords: Hepatocellular carcinoma, early diagnosis, Biological marker miRNA.

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Nat Sci 2019;17(9):37-48. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5.

Withdrawn

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Scientific Based evidence of the effects of combined Makka soil and zamzam water (Mud therapy MMT) in treating head and nervous system injuries: (Two case reports ) and head cap invention

Manal Galal Abd El Wahab¹ and Salwa Sager²

¹ Department of Anatomy, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt

(YAJ) Members of Yousef Abdul Latif Jameel Scientific Chair of Prophetic Medicine Applications, Faculty of Medicine, King Abdulaziz University (KAU) Jeddah Kingdom of Saudi Kingdom of Saudi Arabia.

²Certified nurse, Ministry of health Taif Hospital. KSA

(YAJ) * Members of Yousef Abdul Latif Jameel Scientific Chair of Prophetic Medicine Applications, Faculty of Medicine, King Abdulaziz University (KAU) Jeddah Kingdom of Saudi Arabia.

profdrmanal2018@gmail.com

Abstract: Aim: Evidence based effects of combined Makka Mud therapy (MMT) in treating nervous system injuries. Material and methods: Preraration of Makka Mud (MM) was from Makka soil from AL sail way –Al kaekea area- Jazan Road - KSA. ( MM) was chemically analyzed, It was full of elements, ions and heavy metals which included CO3, HCO3, SO4, Cl-, iron Fe, cobalt, Ni, copper Cu and zinc Zn, Na+, K+, Cd, Mn, Pb. MMT was applied on two cases: one female 14 years old suffered from head injury after car accident that caused UMNL and hemiplegic. The other case was a new born infant aged 8months with hydrocephaye. Results: Combined (MMT) lead to improvement of body function, decreased pain, improvement of nervous system AND reflexes, fine movements in two cases of head trauma and hydrocele. Conclusion: combined. (MMT) could be adjuvant complementary management for head and nervous system traumas. Further controlled studies are needed.

[Manal Galal Abd El Wahab and Salwa Sager. Scientific Based evidence of the effects of combined Makka soil and zamzam water (Mud therapy MMT) in treating head and nervous system injuries: (Two case reports ) and head cap invention. Nat Sci 2019;17(9):49-59]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj170919.06.

Key words: Makka Mud Therapy- Nervous System - Reflexes - Head Trauma –Hydrocephaly.

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Risk factors predicting prognosis in upper gastrointestinal bleeding

Esraa Hamdy Nassar¹, Mohammed Mohammed El Bedewy², Khalil Mohammed Abbas³, Khaled Mohammed Zaghloul Darwish²

¹ Emergency Medicine Department, Faculty of Medicine, Tanta University, Egypt

²Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt

³ Public Health & Occupational Medicine Department, Faculty of Medicine, Tanta University, Egypt

dr_esrhome2010@yahoo.com

Abstract: Background: Upper gastrointestinal bleeding is a disastrous problem worldwide and particularly in Egypt and considered the most prevalent gastrointestinal emergency. Like other common medical conditions, risk scores have been developed to try and identify those at lower or higher risk of poor outcome. Numerous prognostic factors have been described in literature to be associated with a lethal outcome; however, to date, it remains unclear whether a single or a combination of these factors is associated with poor outcome of the patient with upper GI bleeding. Aim: This prospective study evaluates the role of various risk factors in predicting the prognosis of patients with upper gastrointestinal bleeding. Patients and Methods: Data was obtained at the time of presentation in the Emergency Department. The following were noted: history: (Demographic, personal, occupational, present, past medical, habits & drug history). Complete clinical examination includes ABCDE priorities of advanced life support “ALS” protocol was done. The presence of hematemesis and its appearance (coffee grounds or fresh blood), melena and hematochezia were also noted. Blood pressure was measured at presentation, as well as heart rate and then close monitoring of all these data was carried out. Laboratory investigations including Hemoglobin level, Platelet count, Prothrombin time and international normalized ratio, Urea and creatinine. Patients underwent ultrasound examination Esophagogastroduodenoscopy (EGD) was performed in all patients by expert endoscopist. Results: Two hundred (200) patients were included in this study. One hundred thirty-one patients were males (65.5%). The age of our patients ranged from 18 to 85 years with a mean (+SD) of 58.46+12.15 years (Median age 58.5). 168 patients (84%) had associated comorbidities (e.g. chronic kidney disease, cardiac diseases, liver diseases, etc) Hypotension was present in the initial presentation of sixty seven (67) patients (33.5%) while abdominal examinations of eighty three (83) patients (41.5%) revealed ascites. The hemoglobin level of our patients ranged from 3 to 16 g/dl with a mean (+SD) of 8.54+2.20 (Median 8.35) while INR ranged from 1 to 7 with a mean (+SD) of 1.50+1.02 (Median 1.2). Endoscopic examination in one hundred nine (109) patients (54.5%) showed variceal lesions; other seventy two (73) patients (36.5%) were non-variceal while nine (9) patients (4.5%) showed both variceal and non variceal lesions. Endoscopic examination of another nine (9) patients (4.5%) was normal. Favorable outcome (Improvement) was present in one hundred and fourteen (114) patients (57%); Unfavorable outcome (Recurrence, Need for surgery & Death) was present in seventy six (76) patients (38%) while ten (10) patients (5%) were missed. Conclusion: Age, associated comorbidities as hepatic diseases, initial pulse, initial blood pressure, initial investigations as urea, hemoglobin & INR, ultrasonography findings and endoscoping timing can be used effectively to predict prognosis in upper gastrointestinal bleeding.

[Esraa Hamdy Nassar, Mohammed Mohammed El Bedewy, Khalil Mohammed Abbas, Khaled Mohammed Zaghloul Darwis. Risk factors predicting prognosis in upper gastrointestinal bleeding. Nat Sci 2019;17(9):60-66]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj170919.07.

Keywords: Risk; factor; predicting; prognosis; upper; gastrointestinal; bleeding

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Role of Hysteroscopy in Anticipation of Endometrial Pathology in Women with Postmenopausal Bleeding

Asmaa Fateh EL Bab, Fayza Ahmed Abdel Hakam  and , Amal Mahmoud Abdel Ghani .
 Obstetrics and Gynecology department, Faculty of Medicine Al-Azhar University for Girls, Egypt.

drfaizafouad@icloud.com

Abstract: Background: Post-menopausal bleeding (PMB) occurs in approximately 5% -10% of post menopausal women. Postmenopausal abnormal bleeding is concomitant with carcinoma in about 10% of women in the endometrium, where, (PMB) is initially due to endometrial neoplasea until confirmatory tests to confirm the actual causes of PMB. The suitable method for assessment of the uterine cavity in women showing thickening in the endometrium or not showing any signs is the hysteroscopy. The advantages of hysteroscopy is the direct view of the endometrium, possible biopsies, which confirm the diagnosis of lesion, specially focal lesions. Objective: The goal from this work was to anticipate the possible endometrial pathology by hysteroscopy which will be assessed and confirmed by pathological examination of the curettage. Patients and Methods: The study was done in 40 patient complaining of postmenopausal bleeding and TV U/S show thickened pathology  was suggesting endometrial polyps in 18%(50%) of cases the sensitivity of hysteroscopy in detection of endometrial polyps was 95% and the specificity was 95%, the  PPV 95% and the NPP 95%. Results: endometrial hyperplasia was suggested in 16 (40%) of cases with sensitivity 88.23% and specificity 95.65% PPV 93.75% and NPP 91.66%.Atrophic and normal endometrium were suggested in 2 cases (5%) of cases. Conclusions: the results revealed that the hysteroscopy is a safe and dependable diagnostic technique for assessing lesions of endometrium.  Diagnostic hysteroscopy is recommended with endometrial biopsy in women suffering from postmenopausal bleeding and 5 mm or more the thickening of endometrium (double-layer) estimated by transvaginal ultrasound even if the hysteroscopy not recording any abnormalities in the uterine cavity .

[Asmaa Fateh EL Bab, Fayza Ahmed Abdel Hakamand,  Amal Mahmoud Abdel Ghani. Role of Hysteroscopy in Anticipation of Endometrial Pathology in Women with Postmenopausal Bleeding. Nat Sci 2019;17(9):67-73]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj170919.08.

Key words: hysteroscopy, postmenopausal bleeding, endometrial pathology

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Retinopathy of Prematurity among the Risky Neonates in Port-Said Governorate

Prof. Dr. Mohammad Mohammad El-Mazahy¹, Prof. Dr. Ehab Mahmoud Ghoneim², Marwa Nassim Hassan Eliwa¹

¹Pediatrics Department, Faculty of Medicine - Al-Azhar University (Damietta), Egypt

²Ophthalmology Department, Faculty of Medicine – Port Said University, Egypt

hysgerr2020@gmail.com

Abstract: background and objectives: Preterm birth is defined as delivery prior to 37 weeks of gestation. Preterm birth is associated with a high risk of neonatal morbidity and mortality, one of them is retinopathy of prematurity (ROP). ROP is a vaso-proliferative disease affecting the retina of premature infants. The manifestations of the disease range from a mild defect with no visual disorders to severe defects with new vessel formation that may progress to retinal detachment and blindness. This study aimed to detect the association between the preterm associated risk factors and occurrence of ROP and estimate the prevalence of ROP among pre-term infants at the NICUs in Port Said governorate within the period from October 2017 to September 2018. Methods: this study is a retrospective study with prospective ROP screening using binocular indirect ophthalmoscopy. Results: the prevalence of ROP is 6.9% of the (58) infants included in this study. The results also showed that there is association between many preterm associated risk factors and ROP.

[Mohammad Mohammad El-Mazahy, Ehab Mahmoud Ghoneim, Marwa Nassim Hassan Eliwa. Retinopathy of Prematurity among the Risky Neonates in Port-Said Governorate. Nat Sci 2019;17(9):74-76]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj170919.09.

Keywords: Retinopathy; Prematurity; Risky; Neonates; Port-Said Governorate

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Molecular detection of virulence and resistance genes of Enterococci spp isolated from milk and milk products in Egypt.

Ashraf A. Abd El-Tawab¹, Sahar R. Mohamed² and Mohamed A. M. Kotb³

¹Bacteriology, Immunology and Mycology Department, Faculty of Veterinary Medicine, Benha University. Egypt

² Animal Health Research Institute, Dokki, Giza, Egypt

³ Animal Health Research Institute, Tanta Branch, Egypt

ashrafabdeltwab@yahoo.com, saharroshdy12@yahoo.com, mohamedabdelhady923@yahoo.com

Abstract: In this study, two hundred random milk and milk products samples including raw milk, mastitic milk, karish cheese, feta cheese, yoghurt and ice cream were collected from different sources in El– Gharbia governorate, Egypt. Enterococcus spp were detected in milk and milk products with a total incidence 60%. Enterococcus isolates were identified and further tested for antimicrobial susceptibility.92% of tested Enterococci isolates were resistant to cefotaxime, 78% to ampicillin, 66% to rifampin, 58% to erthomycin, 54% to gentamicin, 18% to vancomycin, 18% to ciprofloxacin and 14% to doxycycline. Polymerase chain reaction (PCR) was applied for detection of enterococcal virulence genes (esp, gelE, asa1 and ace) and resistance genes (vanA, ermB and tetM). Enterococcus isolates were positive mainly forasa1(91.7%), ace (83.3%) and esp (66.7%) while gelE was detected in 6(50%) isolates only. vanAwas detected in three isolates (25%), while ermB was detected in 6 isolates (50%). All tested isolates were negative for tetM.

[Ashraf A. Abd El-Tawab, Sahar R. Mohamed and Mohamed A. M. Kot. Molecular detection of virulence and resistance genes of Enterococci spp isolated from milk and milk products in Egypt. Nat Sci 2019;17(9):77-83]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj170919.10.

Keywords: Enterococci, PCR, Milk products.

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Total intravenous anaesthesia with Propofol for laparoscopic gastric bypass surgery: dexmedetomidine versus fentany l.

Alaa Mohammad Fathi Abohagar, Mohammad Ibrahem Okab, Sabry Mohammad Amen, Sameh Abdelkhalik Ahmed.

Department of Anaesthesiology, Surgical ICU and Pain Medicine, Faculty of Medicine, Tanta University, Egypt.

Email: alaaabohagar@yahoo.com

Abstract: Background: To compare the efficacy of dexmedetomidine versus fentanyl infusion during general anesthesia using total intravenous anesthesia with Propofol in laparoscopic bariatric surgeries. The primary outcome was to compare the recovery profile between dexmedetomidine and opioids (fentanyl), while recording any adverse outcome was the secondary outcome. Patients and methods: Prospective randomized study was carried out on sixty-four patients scheduled for elective laparoscopic bariatric surgeries divided to Group I (Dexmedetomidine group) which received loading dose of dexmedetomidine (0.5 ug/kg) intravenously over 10 minutes before induction of anesthesia followed by continuous infusion at a rate of (0.5 ug/ kg/ hr) after intubation and group ii (fentanyl group) which received fentanyl (1 ug/kg) was given intravenously over 10 minutes before induction of anesthesia as loading dose followed by continuous infusion at a rate of (1ug/kg/hr) after intubation. Demographic data, MAP and HR were recorded at baseline, before induction, before intubation, after tracheal intubation, at skin incision, at every 30 minutes until the end of surgery. BIS was recorded every 30 minutes, the total amount of Propofol used, urine output, postoperative pain and incidence of adverse effects, the time from reversal of anesthesia to spontaneous eye opening, follow simple commands, tracheal extubation, time of first analgesic requirement, postoperative O₂ saturation were assessed. Results: There was statistically significant decrease in HR in group I compared to group II at all times of measurement except before induction of anesthesia and at 150 minutes. On the other hands, MAP was significantly decrease after tracheal intubation, at skin incision, at 30 minutes, 60 min, 90 min and 120 min in group I compared to group II. There was statistically significant decrease in time to spontaneous eye opening, time to follow simple commands and time to tracheal extubation in group I compared to group II with statistically significant decrease in additional amount of Propofol (mg) required to control the blood pressure and maintain BIS < 60 in group I as compared to group II. Comparison between both groups revealed significant decrease in VAS at 2 hours postoperative in group I compared to group II and the time of the first request for rescue analgesia was statistically significant prolonged in group I in comparison to group II with statistically significant decrease of the total dose of Morphine consumption as rescue analgesia in group I compared to group II postoperative. Conclusion: The dexmedetomidine can be used with advantage instead of fentanyl for facilitation of anesthesia in patients receiving total intravenous anesthesia (TIVA) for laparoscopic bariatric surgeries.

[Alaa Mohammad Fathi Abohagar, Mohammad Ibrahem Okab, Sabry Mohammad Amen, Sameh Abdelkhalik Ahmed. Total intravenous anaesthesia with Propofol for laparoscopic gastric bypass surgery: dexmedetomidine versus fentany l. Nat Sci 2019;17(9):84-93]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj170919.11.

Keywords: Bariatric surgery, Dexmedetomidine, Fentanyl, Pain, Propofol

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Reduction of Accelerated Sea Level Rise Problem by Using Global Desalination of Sea Water as a Mitigation Measure

Reda M. A. Hassan

Ph.D., Professor Assistant, Coastal Research Institute, National Water Research Center, Egypt

E-mail: doctor_reda2010@yahoo.com

Abstract: Sea level rise (SLR) causes high threats and can deteriorate the coastal area ecosystem. Many studies had been carried out to alleviate SLR problem, but the problem still exist. This present study assesses the possibility of using engineering mitigation measures, like desalination plants, as a possible solution for the SLR problems. It presents a vision for decision makers; using globally the desalination of sea water to balance the expected increase in sea level. The aim of this paper also is to demonstrate the average rate of global sea level rise (GSLR) and the expected values in 2050, and 2100. For achieving the goals of this research, the global surface water area of seas and oceans, the rate of change of global desalinated water, the expected global sea level, and the expected global desalinated water should be calculated. Data from 128 sea level gauge stations all over the world, for more than 75 years for each station were collected. Also the sea level data from gauge stations in Egypt, at Nile Delta (Port Said, Rosetta, Burullus, Alexandria and Damietta) had been collected, for years from 1925 to 2017. Two scenarios for SLR in accordance with intergovernmental panel on climate change (IPCC), 1.0 m and 1.8 m rise in sea level, were taken as comparison values, for the calculated average rate of change in SLR of the present study values. The data of global desalination and global surface area of water had been collected also. The average rate of GSLR for more than 75 years are 0.58 mm/year for the actual present measured data, for 95% confidence interval (CI) of sea level rise is 0.05 mm/year to 1.11 mm/year. Analysis of data and calculations of the acceleration of driving force which affect sea level at different local stations showed that for Port Said, Burullus, Damietta, and Alexandria gauge stations, for long time until 2100, the accelerations are 0.031 mm yr^-2, 0.01 mm yr-², and 0.441 mm yr^-2 and 0.027 mm yr^-2, respectively. Comparing the present accelerations of local gauge stations at Port Said, Burullus, Damietta, and Alexandria for expected accelerations to drive sea level to be 1000 mm and 1800 mm above present mean sea level, the accelerations are 2.57 times the present to reach 1000 mm, and 5.16 to reach 1800 mm for Port Said gauge station, but for Burullus, Damietta, and Alexandria gauge stations the accelerations are (8.946), (0.17), and (3.19) times the present acceleration to reach 1000 mm, and (5.158) for Port Said, and (16.94) for Burullus, but for Damietta, and Alexandria are (0.36), and (6.14) times the present acceleration to reach 1800 mm. For short term, the results of data analysis showed deceleration for Burullus gauge station, and small acceleration for Rosetta gauge station. Analysis of data showed that, increasing of desalinated water, could contribute in reduction of SLR by (16.17 %, 24.25 %, and 48.5%) for year 2050, if the rate of change is (1.50, 1.0, and 0.5 mm/year). The contribution in reduction of the increase in GSLR and reducing level using desalination are (31.22 %, 46.83 %, and 93.65%) for year 2100, if the rate of change is (1.50, 1.0, and 0.5 mm/year). It is recommended that increasing desalination plants for production of seawater can be viable as a possible solution for sea level rise problems.

[Reda M. A. Hassan. Reduction of Accelerated Sea Level Rise Problem by Using Global Desalination of Sea Water as a Mitigation Measure. Nat Sci 2019;17(9):94-109]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj170919.12.

Keywords: Global Desalination – Sea Level Rise –Engineering Mitigation Measure

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The mutual effect of irrigation water requirements and anti-respirations type on peanut plants grown on sandy soils

Heba Abd A. El Shehawy Ahmed E. El-Sherbieny¹, Adel A. Sheha¹ and Nader R. Habashy²

¹ Zagazig University, Faculty of Agriculture, Egypt.

² Soils, water and Environment Research Institute, ARC, Egypt.

Email: habashy@yandex.com

Abstract: Two field experiments were carried out on a newly reclaimed sand soil under drip irrigation system at El Ismailia Agricultural Research Station, El Ismailia Governorate, Egypt located between Latitude 30° 35' 30" N, Longitude 32° 14' 50" E and Elevation 3 meters, and cultivate with peanut plants as summer season (Arachishypogaea, Giza 5 c.v) during the agricultural growing season of 2016 and 2017 to evaluate foliar application of anti-respiration abscisic acid and chitosan at rate of 0.0, 5.0,10.0 and 0.0, 15.0, 20.0 mg l⁻¹, respectively at different water requirements 100 and 75% (1125 and 884 m³acre^-1)on soil nutritional status, some growth characteristics, seeds productivity, oil seed quantity and quality, increase water use efficiency, taking a full advantage of available water and net benefit of return and create ways to improve drought tolerance of peanut plant under sandy soil conditions. Data obtained showed that: 1- From the data obtained, it is clear that nutritional status as soil content can be influenced considerably by soil type, water irrigation system as well as types of hydro-gel at different rate of soil application under study. Revealed highly significant on macro-nutrients (N, P and K) and micro-nutrients (Fe, Mn and Zn) content in soil throughout the irrigation water 100% applied at drip irrigation system; 2- Regard to interaction between treatments under study data illustrated that higher effect on peanut all plant growth characteristics under study when applied the irrigation water at high rate 100% (1152 m³acre^-1) accompanied with spray chitosan at low rate of 5 mg l^-1 and abssic acid at 10 mg l^-1; 3- Concerning 100 peanut seeds and yield the application of two anti-respiration (chitosan and abcissic acid) combined with 100 and 75% irrigation water at 2% application rate of hydro-gel resulted was in a significant increases; 4- Regard to peanut seed quality, however, the highest value of irrigation water, 1125 m³acre^-1, was associated with the combined effect of 100% irrigation quantity and 5mg l^-1 of chitosan as anti-respiration increase oil seed content and crude protein with both oleic acid and iodine value than other treatments under study; 5- The results obtained of macro-nutrients (N, P and K) and micro-nutrias (Fe, Mn and Zn) content of peanut plants, data showed that irrigating peanut plants by 1125 m³acre^-1 and application of hydro-gel at rate of 2% with foliar spray of 5 mg l^-1 chitosan and 15 mg l^-1abcissic macro-nutrients (N, P and K) acid micronutrients (Fe, Mn and Zn) content of peanut resulted in remarkable increases. Nerveless, decreasing the amount of irrigation water from 1125 to 884 m³acre^-1 decreased the micro nutrients content; 6-Fromthe above mentioned could be conclude that the application irrigation water at 100% (1125 m³acre^-1) accompanied with anti-respiration chitosan or abcissic acid both of each at low rates were more effect than that obtained in term of water use efficiency is sandy soil condition grown with peanut plants.

[Heba Abd A. El Shehawy Ahmed E. El-Sherbieny, Adel A. Sheha and Nader R. Habash. The mutual effect of irrigation water requirements and anti-respirations type on peanut plants grown on sandy soils. Nat Sci 2019;17(9):110-118]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj170919.13.

Key word: Irrigation water, anti-respirations, drip irrigation system, peanut plants and sandy soils

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Different Surgical Modalities for Reconstruction of Soft Tissue Defects in Diabetic Foot Ulcers; A Metaanalysis: A Systematic Review/Meta-Analysis

Mahmoud A. Elshafei¹, Hisham M. Omran¹, Khaled A. Reyad², Ahmed A. Abd Elalim²

¹ Department of General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

²Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Pacemaker.amer@gmail.com

Abstract: Background: Foot ulceration is a very common complication in diabetic patients. It is well established that about 25% of people with diabetes develop a foot ulcer during their lifetime and 20% of all diabetic patients who enter the hospital are admitted for foot problems. Aim of the Work: This study aimed at comparing different surgical modalities used for soft tissue coverage of the diabetic foot wounds highlighting the success rates, postoperative mortality and morbidity. Patients and Methods: Twenty one clinical trials or case series studies that discuss different reconstructive surgical techniques for coverage of diabetic foot ulcers from 1998 to 2018and fulfilled the inclusion and exclusion criteria and were included in the review. Results: The pooled average success rate was 92%for free tissue transfer, 90% for regional flaps, 95% for intrinsic muscle flaps, 96.7% for local random fasciocutaneous flaps and 74% for STSG. The minor complications rate such as wound infection, marginal flap necrosis/ graft loss, haematoma, successfully revised arterial/venous anastomosis failure and dehisence pooled across the studies was 13.5%. A more detailed description reveals the rate being highest with local intrinsic muscle flaps and local random flaps (19.6% and 19.3% respectively) and lowest with STSG (7.5%) whilst the rate is 18.5% with regional flaps and 14% with free tissue transfer. The major complications rate e.g. major flap necrosis/graft loss and amputations (TMA, below knee and above knee amputation) was 13.1% (9.2-16.7, CI 95%). A deeper review shows that skin grafting was associated with the highest incidence rate of major complications (26%), specifically major graft loss (24% of all operated cases) requiring additional reconstructive procedure, while the lowest incidence of major complications was associated with local random and intrinsic muscle flaps (3.2% and 3.9% respectively). Finally, Incidence rate of major complications following regional flaps and free tissue transfer was 8.6% and 7.2% respectively. In-hospital mortality was reported in 4 studies only. In all of these studies, free tissue transfer was the reconstructive modality utilized. 30-day mortality was 2.9%. No postoperative mortality was reported in the remaining studies where other surgical modalities were used. Taken in consideration the preoperative associated comorbidities in the diabetic patients e.g. ischemic heart disease or uremia which commonly complicate the disease, and are significantly higher among patient underwent free flap reconstruction of the foot wound, the postoperative mortality rate must be cautiously interpreted as these comorbidities contribute to the risk of postoperative mortality. Conclusion: Reconstruction of the diabetic foot ulcers should be based on the patient’s overall medical status and local wound condition.

[Mahmoud A. Elshafei, Hisham M. Omran, Khaled A. Reyad, Ahmed A. Abd Elali. Different Surgical Modalities for Reconstruction of Soft Tissue Defects in Diabetic Foot Ulcers; A Metaanalysis: A Systematic Review/Meta-Analysis. Nat Sci 2019;17(9):119-128]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj170919.14.

Key words: Surgical modalities, reconstruction, soft tissue defects, diabetic foot ulcers

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Role of Ghrelin Hormone in Physical and Sexual Maturation in Children with Beta Thalassemia

Eman M Elaskary¹, Shebl S Shebl¹, Adel A Hagag¹, Mona M Watany ²

¹Pediatrics Department, Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt

²Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt

Abstract: Background: Thalassemia is a common genetic blood disorder associated with multiple endocrine disorders due to iron overload secondary to chronic hemolysis and recurrent blood transfusion. Ghrelin hormone regulates a lot of functions including growth hormone secretion, food intake and energy balance. This study aimed to assess serum ghrelin and its role in growth and puberty in children with β thalassemia and its correlation with iron overload. Patients and Methods: This cross sectional study was carried out on 60 children with β-thalassemia major including 32 males and 28 females with their age range 11 - 18 years and mean age value of 13.608 ± 1.880 years and 60 healthy children as control group including 28 males and 32 females with their age range 11 - 17 years and mean age value of 13.933 ± 1.780 years. For all patients the following were done: complete clinical evaluation including anthropometric data and Tanner staging, complete blood count, assessment of serum iron status, thyroid function, insulin like growth factor 1 (IGF-1), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (males), estrogen (females) and ghrelin hormone. Results: There were significantly lower weight, Z score of weight, height, Z score of height and body mass index in patients compared with controls. There was delayed puberty in patients compared with controls as evidenced by more Tanner stage I and II in patients versus more Tanner stage IV and V in controls. Serum ghrelin level was significantly higher in patients compared with controls (mean serum ghrelin was 2220.333 ± 1818.194 in patients versus. 1413.733 ± 1040.498 in controls with P value of 0.027 ). FSH, LH, testosterone, estrogen and IGF-1 levels were significantly lower in patients compared to controls (mean FSH level was 1.44 ± 1.15 mIU/ml in patients versus 5.727 ± 2.349 mIU/ml in controls with p value <0.001, mean LH level was 1.286 ± 1.319 mIU/ml in patients versus 6.47 ± 2.55 mIU /ml in controls with p value <0.001, mean testosterone level was 1.304 ± 0.973 ng/ml in male patients versus 4.664 ± 2.246 ng/ml in controls with p value <0.001, mean estrogen level was 27.361 ± 11.015 pg/ml in female patients versus 213.813 ±87.762 pg/ml in controls with p value <0.001, mean IGF-1 level was 96.378 ± 46.673 ng/ml in patients versus 411.900 ± 131.937 ng/ml in controls with p value <0.001). There were significantly higher serum ferritin and iron and significantly lower TIBC in patients than controls, (mean serum ferritin was 3825.933 ± 1959.174 ng/ml in patients versus 85.367 ± 16.994 ng/ml in controls with p value <0.001, mean serum iron was 490.133 ± 171.445 ug/dl in patients versus 107.333 ± 19.505 ug/dl in controls with p value <0.001, mean serum total iron binding capacity was 117.083 ± 51.541 ug/dl in patients versus 270.533± 16.827 ug/dl in controls with p value <0.001. There were significant negative correlations between serum ghrelin and BMI, FSH, LH, testosterone and estrogen (r = -0.288 and p value of 0.026 for BMI and serum ghrelin, r = -0.302 and p value of 0.019 for FSH and serum ghrelin, r = -0.275 and p value of 0.033 for LH and serum ghrelin, r = -0.380 and p value of 0.032 for testosterone and serum ghrelin and r = -0.478 and p value of p 0.010 for estrogen and serum ghrelin. There were non significant negative correlations between serum ghrelin level and weight, height and serum ferritin of studied patients. Conclusions: Significant negative correlations between serum ghrelin level and BMI and sex hormones of studied patients may arouse our attention to the role of ghrelin in physical and sexual maturation in thalassemic patients. Recommendations: Extensive multicenter studies on thalassemic children to find the link between delayed puberty, growth retardation and increased serum ghrelin level. Children with thalassemia must undergo regular assessment by a team work of multi-specialties including hematology, endocrinology, nutrition and cardiology.

[Eman M Elaskary, Shebl S Shebl, Adel A Hagag, Mona M Watany. Role of Ghrelin Hormone in Physical and Sexual Maturation in Children with Beta Thalassemia. Nat Sci 2019;17(9):129-140]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj170919.15.

Keywords: β-Thalassemia, iron overload, endocrine dysfunction, ghrelin hormone

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Using Prophylactic Prolene Mesh to Reduce the Incidence of Incisional Hernia at the Site of Stoma Closure

Prof. Dr. Hassan Sayed Tantawy, Ass. Prof, Dr. Mohamed Mahfouz Mohamed, Dr. Ahmed Yasser Abdel Halim and Mostafa Mohamed Abdel Aziz

General Surgery Department, Faculty of Medicine, Ain Shams University, Egypt.

mostafa.mohamed.abdelaziz1992@gmail.com

Abstract: Background: Incisional hernias at stoma sites are not an infrequent problem, occurring in up to 30% of cases and it also varied in a range of studies from 0-48%. Objectives: This is a prospective study to detect the feasibility of application of prolene mesh at the site of stoma closure in reducing the rate of post stomal incisional.

[Hassan Sayed Tantawy, Mohamed Mahfouz Mohamed, Ahmed Yasser Abdel Halim and Mostafa Mohamed Abdel Aziz. Using Prophylactic Prolene Mesh to Reduce the Incidence of Incisional Hernia at the Site of Stoma Closure. Nat Sci 2019;17(9):141-146]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj170919.16.

Keywords: Prophylactic; Prolene; Mesh; Reduce; Incidence; Incisional Hernia; Stoma Closure

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Effect of Sildenafil Citrate on Peripheral Natural Killer Cells in women with Recurrent Pregnancy Loss

Prof Dr. Ahmed Khairy Makled¹, Dr Haytham Abdelmohsen Sabaa¹, Dr Mona Ahmed Esmail², Sarah Abdel Tawfik Ibrahim Aboelmagd¹

¹ Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

² Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

sarahadel111287@outlook.com

Abstract: Back ground Researchers’ defined recurrent miscarriage as three or more pregnancy losses, the available research data denotes that the risk of abortion is 30% and 33% after two miscarriages and three miscarriages, consecutively. Sildenafil citrate (a type 5-specific phosphodiesterase inhibitor, augments the vasodilatory effects of NO. Vagina sildenafil augments the vasodilatory effects of NO.NK cytotoxicity has been reported to be predictive of subsequent pregnancy loss in women who had recurrent spontaneous abortions (RSA). Aim: Is to investigate whether sildenafil citrate affect peripheral natural killer cells successful in women with history of recurrent pregnancy loss. Methodology: An interventional research study, with one arm clinical trial: one group of study subjects were administered the sildenafil citrate without comparative placebo effect, conducted at the Obstetrics and Gynecology Outpatient clinic at Ain Shams University hospital throughout 2017-2018. The sample size consists of 77 women within the reproductive age (from 18 to 35 years old) having a history of recurrent pregnancy loss. Results: There was a statistical significant reduction in peripheral blood natural killer cell activity after having vaginal sildenafil. (p value <0.001), there was no statistical significant correlation between peripheral blood natural killer cell activity (%) and other demographic characteristics (age, BMI, parity, miscarriages, time from last miscarriage, p values before = 0.204, 0.929, 0.416, 0.302, 0.627, consecutively, p values after intervention =0.133, 0.709, 0.380, 0.410, 0.559, consecutively, p values of reduction =0.794, 0.458, 0.687, 0.181, 0.944, consecutively). Conclusions: The current research reveals and displays that vaginal sildenafil citrate is a potentially promising agent in managing cases with recurrent miscarriage and it reduces the natural killer cell activity levels.

[Ahmed Khairy Makled, Haytham Abdelmohsen Sabaa, Mona Ahmed Esmail, Sarah Abdel Tawfik Ibrahim Aboelmagd. Effect of Sildenafil Citrate on Peripheral Natural Killer Cells in women with Recurrent Pregnancy Loss. Nat Sci 2019;17(9):147-152]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj170919.17.

Keywords: Effect; Sildenafil; Citrate; Peripheral; Natural; Killer; Cell; women; Recurrent Pregnancy Loss

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Enhanced Recovery after Colo-Rectal Surgeries (ERAS) V.S Conventional Care A systematic review and meta-analysis

Hanna Habib Hanna¹, Sherif Abdelhalim¹, Aboelatta Khairy², Rihaj Mohammed Abdulfattah Al-Abbasi¹

¹Department of General Surgery, Faculty of Medicine - Ain Shams University, Egypt

²Department of General Surgery, Faculty of Medicine, Misr University of Science and Technology, Egypt

Email: rihaj.alabasi@gmail.com

Abstract: Background: ERAS programs are not only used in abdominal surgeries, they are also used in cardiothoracic, gynecology, urology, orthopedic, and neurosurgery. Many authors and surgeons worldwide have been adapting this program, also trying to modify it due to its promising outcomes and it’s low damage toit’s continence. Objective: To present an updated assessment of perioperative care in colorectal surgery from the available evidence and Enhanced Recovery After Surgery (ERAS) group recommendations. Patients and Methods: We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. An electronic search was conducted from the inception till March 2019 in the following bibliographic databases: Medline via PubMed, SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Google Scholar to identify relevant articles. We used different combinations of the following queries: ("Colorectal Surgery"[Mesh]) AND ("Enhanced recovery" OR "conventional care"). The search have been done with no limit regarding the year publication or language. Results: In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar from their inception till March 2019. The search retrieved 2861 unique records. We then retained 41 potentially eligible records for full-texts screening. Finally, 28 reports of 25 RCTs were included in the present systematic review and meta-analysis. Conclusion: ERAS was proven to be feasible, minimally invasive, cheap, relatively easy, which is safe and effective at the same time. This program can be ideal for patients undergoing elective colo-rectal surgery, yet more studies should be conducted in Egypt to compare results regarding different approaches of this program with longer follow up and randomization of patients.

[Hanna Habib Hanna, Sherif Abdelhalim, Aboelatta Khairy, Rihaj Mohammed Abdulfattah Al-Abbas. Enhanced Recovery after Colo-Rectal Surgeries (ERAS) V.S Conventional Care A systematic review and meta-analysis. Nat Sci 2019;17(9):153-163]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 18. doi:10.7537/marsnsj170919.18.

Keywords: Enhanced recovery after surgery, conventional care

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Comparison between Lidocaine, Magnesium Sulphate and Verapamil for Attenuating Stress Response of Intubation during Induction of General Anesthesia

Prof. Dr. Mohamed Ali Zaghloul, Assis. Prof. Dr. Ehab Hamed Abd El Salam, Dr. Mohamed Moien Mohamed, Enas Soliman Abd El-Hamid Fahmy

Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University, Egypt. enassoliman90@gmail.com

Abstract: Background: Endotracheal intubation is one of most common procedure occurring every day in operating room. One of major concern is the stress response that occur during endotracheal intubation. Stress response appears in form of hypertension and tachycardia. Many trials had been established to control that stress response. Pharmacological additives to anesthetic drugs had been used like lidocaine, magnesium, calcium channel blockers and others. Objectives: To evaluate the effects of introducing intravenous lidocaine (1.5mg/kg) versus magnesium sulphate (30mg/kg) versus verapamil (0.1mg/kg) 3 minutes before intubation on patient hemodynamics for attenuating the stress response. Patients and Methods: In our study, we compared the effect of lidocaine, magnesium sulphate and verapamil to control the stress response. Patients were randomly allocated in three equal groups (25 each). Group I received 1.5 mg/kg lidocaine. Group II received 30mg/kg magnesium sulphate. Group III received 0.1mg/kg verapamil. All groups received medication 3 minutes before intubation. Blood pressure and heart rate has been recorded in pre-induction, pre-intubation, immediate post intubation and 5 minute post intubation. Results: The three drugs could be used as stress inhibitors as the change in blood pressure and heart rate between the basal reading and other readings is less that 20%. There is no significance difference between the groups regarding blood pressure. Magnesium sulphate couldn’t control heart rate like other groups significally. Conclusion: We conclude that any of three drugs could be used to control the stress response of intubation. Adding small dose of opioids to magnesium will help to abolish the reflex tachycardia that occur during intubation.

[Mohamed Ali Zaghloul, Ehab Hamed Abd El Salam, Mohamed Moien Mohamed, Enas Soliman Abd El-Hamid Fahmy. Comparison between Lidocaine, Magnesium Sulphate and Verapamil for Attenuating Stress Response of Intubation during Induction of General Anesthesia. Nat Sci 2019;17(9):164-171]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 19. doi:10.7537/marsnsj170919.19.

Keywords: Lidocaine, Magnesium Sulphate, Verapamil, Stress Response, Intubation

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Shapes: Powerful Energy Transformation Tools

Sofia Z. Hejaz

Department of Design (Industrial Design), Faculty of Fine Art, Yarmouk University, Irbid 21163, Jordan

sofia@yu.edu.jo

Abstract: From simple shapes to complex three dimensional forms, we as designers, engineers, and users, we all come in contact with such arrays on a daily basis, and as designers we are responsible for their creation. However, the subtle, hidden but significant physical power shapes and forms can have on all who view or come in close proximity with them, is often underestimated. This article aims to show that the shapes and forms we design, must undergo careful consideration of what impact they may exert energetically on the surrounding and users. To better understand this shape-energy connection, and how to formulate shapes and forms, to exhibit outcomes we intend, and limit secondary damaging effects to humans and the environment, we will review current research into shape-energy, to direct us towards a possible future path, that could help us create healthier designs through incorporating and integrating this knowledge in all design fields. Current limitations and prospects of integrating shape-energy science into the design education will be briefly discussed.

[Hejaz S. Shapes: Powerful Energy Transformation Tools. Nat Sci 2019;17(9):172-179]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 20. doi:10.7537/marsnsj170919.20.

Keywords: Interdisciplinary, Design, Shapes, Energy, Physics, Biogeometry

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Value of Hormone Receptor Status in Patients with Locally Advanced Breast Cancer as Regard the Response to Neoadjuvant Chemotherapy

Samy Ahmed Abdel Rahman¹, Sherif Morad Gerges², Sherif Hasaanien Ahmed³ and Omnia Mohammed Mohammed Essawy⁴

¹Professor of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

² Lecturer of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

³ Lecturer of Oncology Nuclear Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

⁴ Oncosurgery resident, Dar Al-Salam Cancer Center, Cairo, Egypt

Abstract: Background: To investigate the value of hormone receipt or expression status in patients with locally advanced breast cancer as regard the response to neoadjuvant chemotherapy. Methods: 72 stage II-III breast cancer patients treated with neoadjuvant chemotherapy were prospectively studied. Data of patients is divided into two groups based on the hormone receptor expression status: Group A, patients with HR-positive; Group B, patients with HR negative. Results: Among over all 72 patients received NAC; their age ranged from 31-68ys, and 42.86% were postmenopausal. Complete response (CR) was achieved in 12 patients (16.7%), it reached 23% in HR -ve patients and 13% of HR +ve patients. Most of patients underwent MRM; 69.57%, and 61.54% in HR +ve and HR –ve group respectively. In group A (46 patients), 32 patients underwent MRM (69.57%), 14 patients underwent CBS (30.43%) and pCR was achieved in 4 patients (8.6%). While, in group B (26 patients), 16 patients underwent MRM (61.54%), 10 patients underwent CBS (38.46%) and pCR was achieved in 5 patients (19.2%). Conclusions: patients with hormone receptor negative breast cancer have a better response to neoadjuvant chemotherapy and more liable to achieve complete response (CR) than patients with HR +ve breast cancer.

[Samy Ahmed Abdel Rahman, Sherif Morad Gerges, Sherif Hasaanien Ahmed and Omnia Mohammed Mohammed Essawy. Value of Hormone Receptor Status in Patients with Locally Advanced Breast Cancer as Regard the Response to Neoadjuvant Chemotherapy. Nat Sci 2019;17(9):180-185]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 21. doi:10.7537/marsnsj170919.21.

Keywords: Breast cancer, neoadjuvant chemotherapy, hormone receptor, pathological complete response

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[Nat Sci 2019;17(9):186-189]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 22.

withdrawn

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Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures

Ahmed Mohamed Morsi, Tameem Mohamed Shafik, Ahmed Kamal Mohamed Hassan

Department of Orthopedic Surgery, Faculty of Medicine - Ain Shams University, Cairo, Egypt

Email: kimo_raddevils@yahoo.com

Abstract: Background: During the last two decades, our understanding of fracture healing has evolved rapidly. Bone is one of the few body tissues that can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The complex cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures and their role in fracture healing. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the Accident and Emergency Department of Trauma Surgery, El Zaitoun specialized hospital within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained elevated in high energy group than low energy group. Conclusion: Serial monitoring of these physiological markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.

[Ahmed Mohamed Morsi, Tameem Mohamed Shafik, Ahmed Kamal Mohamed Hassan. Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. Nat Sci 2019;17(9):190-195]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 23. doi:10.7537/marsnsj170919.23.

Keywords: Alkaline phosphatase, parathyroid hormone, distal radioulnar joint

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Incidence Rate & Risk Factors of Anastomotic Leakage after Gastrointestinal Surgeries in Al Matariya Teaching Hospital

Ahmed Alaa Eldeen Salman, Rania Al Ahmady, Samar Emado-ddien Hasan

Department of General Surgery, Faculty of Medicine Ain Shams University Cairo, Egypt

Samar.emadoddien@gmail.com

Abstract: Background: Intestinal anastomosis is one of the most commonly performed surgical procedures, both in the emergency and elective settings. Anastomotic leak after gastrointestinal anastomosis is one of the important postoperative complication that leads to significant morbidity, length of hospital stay and unfortunately mortality. Objective: To define the incidence & risk factors of anastomotic leakage in Al Matariya Teaching Hospital as an example of tertiary care centres in Egypt. Methods: Retrospective data collection regarding patients who underwent small or large bowel resection and anastomosis without fecal diversion in the surgical department in Al Matariya Teaching Hospital in the period between July 2017 and January 2019. Demographic details of the patients as well as preoperative, intraoperative and postoperative data were recorded. Leak found or not and on which postoperative day leak found. How it was identified (clinical or radiological) and how it was managed. Outcome of patients was recorded. Results: There were 33 male (64.7%) and 18 female (35.3%) patients. Age ranged from 16 to 65 years, with a median of 40.5 years. Anastomotic leak was occurred in 13 patients (25.4 %), while there was no leak in 38 patients (74.5%). The mean postoperative period for diagnosis of anastomotic leakage was 9 days range (5-16) days. Certain factors associated with occurrence of leak seemed to be significant in this study (P<0.05) such as: preoperative anemia, hypoalbuminemia, emergent conditions without adequate bowel preparation, intraoperative hypotension, and postoperative ICU. Other factors were not significant in our study for their impact on the anastomotic leak (P>0.05) they include gender and age of the patients, previous medical history, level of anastomosis, underlying pathology and intraoperative blood transfusion. Mortality rate was (23.1%) 3/13 in group I, while it was (2.6%) 1/38 in group II. Conclusion: Postoperative gastrointestinal anastomotic leak is a very serious complication that has great clinical impact on patients. There is multiple risk and predictive factors associated with occurrence of leak were suspected in this study such as: preoperative anemia, hypoalbuminemia, surgery performed in an emergency setting, without adequate bowel preparation, intraoperative blood loss and hypotension. Many other factors remain unclear. Death after leak is most often a substitute for a critically ill patients and was infrequently the actual cause of deaths.

[Ahmed Alaa Eldeen Salman, Rania Al Ahmady, Samar Emado-ddien Hasan. Incidence Rate & Risk Factors of Anastomotic Leakage after Gastrointestinal Surgeries in Al Matariya Teaching Hospital. Nat Sci 2019;17(9):196-202]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 24. doi:10.7537/marsnsj170919.24.

Key Words: Anastomotic leakage, gastrointestinal surgery, risk factors.

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