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Comparative study of serum E2, P and E2/P ratio on ovulation induction day as a predictor of success of ICSI outcome

Hanaa Mohammed Shalabi, Yehia Abdelsalam Wafa, Mona Al-Sayed El-Kafrawy, Ayaelrahman Salaheldin Mahmoud

Department in Obstetrics and Gynecology, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt

ayatelrahmansalah781@gmail.com

Abstract: Background: Since infertility represents a major physiological and psychological problem to a growing proportion of the population, governments worldwide are investing heavily in assisted reproductive technology (ART), which has led to significant improvements in our understanding of male/female reproductive systems, gamete preservation and gamete manipulation. ART now accounts for 7% of all births in some developed countries. Worldwide, ~1 million ART treatments are performed each year and over 8 million ART babies have been born worldwide. Objective: To evaluate the effect of high serum estrogen (E2), progesterone (P4) levels and E2/P ratio on the day of human chorionic gonadotropin (hCG) administration on outcome of ICSI cycles. Patients and Methods: This study was conducted from June 2017 till May 2018 on 150 patients attending for IVF/ICSI programs in private IVF centers. It was a prospective observational study that included 150 patients accessed for eligibility, after examination and exclusion of patients with uterine and ovarian abnormalities only 120 patients underwent IVF as a treatment of infertility. Results: The results of our study analysis as regard demographic data of females; mean age, parity and BMI was (28.12, 0.5 and 24.3) respectively, and mean duration of infertility was (6±3.9) years.70% show primary infertility versus 30% had a secondary fertility, and 34% of females did previous ART. Mean of basal hormonal profile in day 2 among the studied group; FSH, LH, estrogen, PRL and TSH was (5.5±2), (4.8±2.5), (47.1±17.4), (20.2±11.2) and (2.3±0.93) respectively. Conclusion: We concluded that an increase in serum progesterone levels on the day of hCG administration in GnRH agonist protocol was detrimental to IVF pregnancy outcome more than P/E2 ratio by reducing clinical pregnancy. In the case of estradiol, our results showed no association was found between estradiol levels on the day of hCG administration and pregnancy achievement.

[Hanaa Mohammed Shalabi, Yehia Abdelsalam Wafa, Mona Al-Sayed El-Kafrawy, Ayaelrahman Salaheldin Mahmoud. Comparative Study of Serum E2, P And E2/P Ratio on Ovulation Induction Day As A Predictor of Success of ICSI Outcome. Nat Sci 2019;17(11):1-13]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj171119.01.

Keywords: Estradiol, antral follicle concentration, chronic endometritis

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A technical and economic study for the effect of irrigation water scheduling on cotton yield productivity

Ibrahim M. Abdel-Fattah¹, Amal A. abd-Elmotaal² and Howida. E. Hassan²

¹Soils, Water and Environment Research Institute (SWERI), ARC, Egypt

²Agricultural Economic Research Institute (AERI), ARC, Egypt

dr.howida.elsayed@gmail.com

Abstract: To find out the impact of different scenarios of irrigation scheduling i.e. when to irrigate and how much water should be applied using the CropWat computer model which reflects the response of yield to water, particularly under the water deficit status. The aim of the present work was to improve the productivity of each unit of water and land for cotton crop (Gossypium barbadence L) in Kafr El-Sheikh Governorate, which represents the circumstances and conditions of North Nile Delta region. That governorate has the largest cotton cultivated acreage in Egypt. So, in this regard, twenty different scenarios of irrigation scheduling were tested using CropWat model during the two successive cotton growing seasons of 2016 and 2017. Four different irrigation intervals of 8, 12, 16 and 20 days were the selected intervals, while 20, 30, 40, 50, and 60 mm were the net applied irrigation water under each investigated irrigation timing. Therefore, by using CropWat model in evaluating the impact of different scenarios of irrigation scheduling on the economic return of water and land in North Nile Delta region, following are the main findings: (1) Ripening growth stage or said the last season stage is the most sensitive stage regarding water deficit, increasing water applied and/or shortening the irrigation interval during the second half of the growing cotton season becomes recommended. (2) Under each irrigation interval, reduction in percentages of  QUOTE  , CWP and economic return of water unit are decreased with increasing net irrigation. On the other hand, cotton yield and net revenue are increased. (3) By elongating irrigation interval from 8, 12, 16 and 20 days under each net irrigation, percentage reduction in Et and cotton yield, CWP but return of water unit are increased. (4) Further studies using CropWat computer model should be done to find out the impact of different scenarios of irrigation scheduling on crop water productivity for different crops.

[Ibrahim M. Abdel-Fattah, Amal A. abd-Elmotaal and Howida. E. Hassa. A technical and economic study for the effect of irrigation water scheduling on cotton yield productivity. Nat Sci 2019;17(11):14-23]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj171119.02.

Keywords: irrigation scheduling, CropWat, Cotton crop, water deficit, crop water use ( QUOTE  ),  QUOTE  , Net revenue, Economic efficiency, Economic return of land unit and Economic return of water unit.

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Evaluation of the usefulness of sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation III (APACHE III) scoring systems in outcomes prediction of critically ill cirrhotic patients

Mervat Mohamed Marzouk¹; Mervat Mohamed Eldmarawy²; Sameh Salem Hefny¹; Rania Mahrous Aly¹; Ahmed Nasser Abdel Fattah Mahmoud¹

¹Anesthesia, Intensive Care and Pain Management Department; Faculty of Medicine Ain Shams University, Cairo, Egypt

²Professor of Intensive Care, Theodor Bilharz Research Institute, Cairo, Egypt

ahmednasser14120@yahoo.com

Abstract: Background: The ability to objectively estimate patient risk for mortality or other important outcomes is a new undertaking for clinical research. Empirically based risk assessments for important clinical events have been extremely useful in evaluating new therapies, in monitoring resource utilization, and in improving quality assessment. Attempts at prediction, however, have been much less successful in forecasting individual patient risk or in reducing the uncertainty of daily clinical decision making. Objective risk estimates are particularly important in the high-cost, emotional, and technologically demanding environments of intensive care units (ICUs). Because of the high costs of ICUs, precise quality assurance and utilization management strategies are essential. Knowledge of the risk faced by a patient on the day of ICU admission could provide an empiric basis for quality assurance and utilization activities. Estimates during the course of therapy could be useful in investigating the optimal time for discharge or in deciding how long to continue therapy. Objective: The aim of our study was to evaluate the usefulness of sequential organ failure assessment (SOFA) and acute physiology, age, chronic health evaluation III (APACHE III) scoring systems obtained on the first day of intensive care unit (ICU) admission in predicting hospital mortality in critically ill cirrhotic patients. Methods: The study enrolled 60 cirrhotic patients consecutively admitted to ICU of TBRI from October 2018 to July2019. Clinical and laboratory variables were analyzed as predicators of survival. Information considered necessary to calculate the SOFA and APACHE III scores on the first day of ICU admission was also gathered. Results: The score-matched analytical data showed that the predictive accuracy of SOFA is superior to that of APACHE III in evaluating critically ill patients with cirrhosis. SOFA score has cut of point ≤9, Sensitivity=96.67. Specificity=96.67, PPV=96.7 and NPV =96.7. APACHEIII score has cut of point ≤85, Sensitivity=96.67, Specificity=80, PPV=82.9 and NPV =96.0. Conclusion: Our results provide additional evidence that SOFA scores differ significantly in outcome prediction of patients with cirrhosis matched according to APACHE III score. The score-matched analytical data showed that the predictive accuracy of SOFA is superior to that of APACHE III in evaluating critically ill patients with cirrhosis. When considering cost-effectiveness and ease of implementation, the SOFA score is recommended for evaluating long-term prognosis in critically ill patients with cirrhosis.

[Mervat Mohamed Marzouk; Mervat Mohamed Eldmarawy; Sameh Salem Hefny; Rania Mahrous Aly; Ahmed Nasser Abdel Fattah Mahmou. Evaluation of the usefulness of sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation III (APACHE III) scoring systems in outcomes prediction of critically ill cirrhotic patients. Nat Sci 2019;17(11):24-30]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj171119.03.

Keywords: Evaluation; sequential organ failure assessment (SOFA); acute physiology and chronic health evaluation III (APACHE III); cirrhotic patient

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Incidence of Malignant Breast Tumors in Cases of Bleeding Per Nipples Thesis

Emad El-den Farid, Shabaan Mohamed Abd-Elmeged, Ahmed Serag-Elden Hussain, Samr Foly Ahmed

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

Email: rooz88_2010@hotmail.com

Abstract: Background: Nipple discharge (ND) is an important presenting complaint in women attending breast clinics worldwide. It is the third most common breast complaint after breast pain and breast mass, with a prevalence of 4.8% to 7.4%, and accounts for 5% of all breast symptoms. At least 80% of women will experience at least 1 episode of nipple discharge during their reproductive years. Objective: To determine the incidence of malignant tumors among the patients presented with bleeding per nipples. Patients and Methods: It is Prospective study, that was carried out in the period from July 2017 to January 2019 in Ain Shams University hospitals. The patients were collected from breast clinics of Ain Shams university and El Minia University hospitals under supervision of supervisors. This study included 90 patients presented with bleeding per nipple, the research was performed according to the standards of the ethical committee of the faculty of medicine, Ain shams University and informed consent was obtained from every patient. Results: According to the incidence of malignancy that detected in our patients we found that 25 patients (27.7%) had a malignant lesions 10 patients in each group B & C and 5 patients in group A. Conclusion: Traditional treatment is surgical excision of the involved ductal system from which the discharge emanates. Ductal excision has been the only reliable procedure in establishing a certain diagnosis and in controlling the bloody discharge. The early success reported with image-guided excision of papilloma and duct endoscopy promises a significant improvement in diagnostic accuracy from minimally invasive emerging technology.

[Emad El-den Farid, Shabaan Mohamed Abd-Elmeged, Ahmed Serag-Elden Hussain, Samr Foly Ahmed. Incidence of Malignant Breast Tumors in Cases of Bleeding Per Nipples Thesis. Nat Sci 2019;17(11):31-37]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj171119.04.

Keywords: Incidence; Malignant; Breast; Tumor; Case; Bleeding; Nipple; Thesis

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Evaluation of Early vs Late Latissimus Dorsi Flap Reconstruction for Breast Cancer Patients in Egypt

Prof. Dr. Mohamed Helmy Shehab, Dr. Amr Hamed Afifi and Ahmed Abdel Hakim Hassan Abdel Al*

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

E-mail: abdelal.ahmed@gmail.com

Abstract: Background: Breast cancer remains the leading type of cancer affecting females in Egypt. More and more patients and surgeons are opting for breast reconstruction after radical surgery for breast cancer, partly due to more heightened awareness of the matter and partly due to more innovation in the techniques used. Aim of the Study: To compare the outcomes between early and late latissimus dorsi myocutaneous flap reconstruction as regards cosmetic outcome, complication rate and recurrence rate for female breast cancer patients in Egypt. Methodology: This is a retrospective analysis study. This study included 60 patients who underwent Latissimus-Dorsi Flap reconstructions for breast cancer in Nasser Institute Hospital and Ain Shams University Hospitals between January 2013 and December 2016. Results: This study found that, overall patients᾽ age ranged from 23 to 48 years with a mean of 35.38 years. The majority of patients (93.3%) had invasive ductal carcinoma while (6.7%) had invasive lobular carcinoma, with a cancer stage of I (36.7%) or II (48.3%). None of patients had silicone or other co-morbid conditions. About 73% of patients underwent Modified Radical Mastectomy (MRM), while 27% underwent Conservative Breast Surgery (CBS) for their breast cancer. All patients have received adjuvant CTH while 68.3% have received the adjuvant RTH. No statistically significant difference between the two groups regarding the age of the patients or the receipt of adjuvant RTH. Conclusion: Plastic surgery plays an important role in the treatment of patients with breast cancer. Breast reconstruction with LDMF is widely applicable and can correct almost all post-mastectomy defects.

[Mohamed Helmy Shehab, Amr Hamed Afifi and Ahmed Abdel Hakim Hassan Abdel Al. Evaluation of Early vs Late Latissimus Dorsi Flap Reconstruction for Breast Cancer Patients in Egypt. Nat Sci 2019;17(11):38-44]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj171119.05.

Keywords: Breast Cancer - Dorsi Flap Reconstruction – Early and Late Latissimus

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The use of cyanobacteria as partial nitrogen source for maize (Zea mays L.) in presence of different mineral nitrogen rates

Hala A.M. El-Sayed¹ and Ghazal, F. M. A.²

¹ Agric. Sciences, Dept., Higher Institute for Agricultural Co-Operation, Qalubia, Egypt

²Agric. Microbiol. Dept., Soils, Water and Environ. Res. Inst., Agric. Res. Centre, (ARC), Giza, Egypt

ghazalfekry@gmail.com

Abstract: A field experiment was executed at EL-Nubaria Agricultural Research Station, Agricultural Research Centre (Latitude 30ᵒ 54′ 48.220″ N and Longitude 29ᵒ 51′ 50.834″ E), EL- Behera Governorate, Egypt, in two summer seasons of 2017 & 2018 to explore the influence of cyanobacteria (cyano) inoculation either as dry or liquid inoculum under the effect of different mineral nitrogen fertilizer rates on maize yield (variety single hybrid Giza 10) and yield components as well as, their impact on maize rhizosphere soil biological activity. Results revealed that in season 2018 early days to 50% tasseling (Dtt _50%) and days to 50% silking (Dts _50%) had recorded significant differences due to the cyanobacteria treatment of dry + foliar spray in the same season. However, in the opposite cyanobacteria inoculation did not affect Dtt _50% and Dts _50% in 2017 season. On the other hand, the cyano-seed coating + dry cyano + foliar spray recorded the tallest plants and the highest values of ear heights. While, the shortest plant heights and the lowest ear heights values were due to using cyano-seed coating + foliar spray treatment. Also, the treatment of cyano-seed coating + dry cyano + foliar spray recorded the highest maize grain yield in both tested seasons. The treatment of cyano-seed coating + foliar spray gave the highest values for ear length (EL) and ear diameter (Ed). Cyanobacteria inoculation affected significantly the number of kernels row^-1 (NK Row^-1) in 2017 and 2018 seasons. Tasseling and silking processes had positively affected by using mineral nitrogen fertilizer. Increasing nitrogen rates from ¹/₂, ³/₄ up to full recommended rate gradually increased the values of plant and ear heights. Grain yield increases were correlated to the increase of nitrogen rate. Same trend, in grain yield was true with the maize yield component attributes. Moreover, using cyanobacteria along with different mineral nitrogen fertilizer rates increased the maize rhizosphere soil biological activity in as expressed by dehydrogenase and nitrogenase enzyme activities and carbon dioxide amount. Almost, cyanobacteria may save 25% from mineral nitrogen fertilizer necessary for maize production.

[Hala A.M. El-Sayed and Ghazal, F. M. A. The use of cyanobacteria as partial nitrogen source for maize (Zea mays L.) in presence of different mineral nitrogen rates. Nat Sci 2019;17(11):45-52]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj171119.06.

Keywords: Cyanobacteria, nitrogen fertilizer rates, maize yield and its component, maize rhizosphere soil. 1hectare = 2.4 feddan.

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The effect of hypophosphatemia on critically ill patient with acute exacerbation of chronic obstructive pulmonary disease (COPD)

Mohamed H. Shokeir, Nevein G. Fahmy, Reham M. Hashim, Hossam A. Abdel Raoof

Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Egypt

Abstract: Background: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease with some significant extra-pulmonary effects that may contribute to the severity in individual patients. Aim of the Work: evaluate the effect of hypophosphatemia on patients with acute exacerbation of COPD. Patients and Methods: This study was performed on 50 patients with AECOPD admitted at chest department and respiratory ICU in Tanta university hospital in the period between July 2018 and January 2019., serum of phosphorus was measured on admission, hypophosphatemia is considered if serum phosphorus is below 2.5mg/dl. Results: Combination between hyponatremia and hypophosphatemia significantly increased the need for ventilation, duration of ventilation and associated with poor outcome (p value < 0.01), while hyponatremia alone not significantly affect the need for ventilation, duration of ventilation and outcome (p value > 0.05). Conclusion: Hypophosphatemia may increase the severity of COPD exacerbation, need for ventilation, duration of ventilation, weaning failure and so increases the rate of mortality. Combination between hypophosphatemia and hypokalemia or hyponatremia increased the need for ventilation, duration of ventilation and affected outcome badly.

[Mohamed H. Shokeir, Nevein G. Fahmy, Reham M. Hashim, Hossam A. Abdel Raoof. The effect of hypophosphatemia on critically ill patient with acute exacerbation of chronic obstructive pulmonary disease (COPD). Nat Sci 2019;17(11):53-61]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj171119.07.

Key words: Hypophosphatemia critically ill patient, acute exacerbation, chronic obstructive pulmonary disease

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MELD Score in Critical Cirrhotic and Non Cirrhotic Patients

Hazem Mohamed Fawzi¹, Amna Ahmed Metwaly², Eman Mohamed Kamal¹, Riham Fathy Galal¹, Mahmoud Ibrahim Eldosoky Mahmoud²

¹Department of Anesthesiology, Intensive Care and Pain Medicine, Faculty of Medicine, Ain Shams University, Egypt

²Department of Intensive Care, Theodor Bilharz Research Institute, Egypt

Email: adamkasper61@gmail.com

Abstract: Background: Patients admitted to the intensive care unit (ICU) who have multi-organ failure, showed a very poor outcome. The use of prognostic models for patients admitted to ICU is of great importance, since they provide an objective evaluation for a group of patients with potentially high mortality rates and cost. The advanced stage of liver failure and presence of cirrhotic complications contribute to poor prognosis of cirrhotic patients admitted to ICU. Objective: To comparing MELD score in critical cirrhotic and critical non cirrhotic patients for mortality and discharge from ICU. Patients and Methods: This a cross section prospective and retrospective thesis study was conducted on 120 patients (60 cirrhotic,60 non cirrhotic (heart failure, hepatorenal Syndrome et al.) who were admitted to ICU of Theodor Belhars Research Institute Hospital which is related to the Ministry of Higher Education and Scientific Research Hospitals. Signed consent was taken from the patients or the 1^st degree relatives. Results: Model for End Stage Liver Disease (MELD) highly statistically significant with outcome of cirrhotic patients. MELD is non statistically significant with outcome of critical ill non cirrhotic patients. But SOFA and APACHE II significant in both cirrhotic and non cirrhotic according to outcome. Conclusion: MELD, SOFA, APACHE II score are good prognostic factors and have a high mortality prediction in liver cirrhosis patients who were admitted to ICU. Although SOFA, APACHE II score are good predictor for mortality in critical non cirrhotic patients MELD score does not act as a good predictor for them.

[Hazem Mohamed Fawzi, Amna Ahmed Metwaly, Eman Mohamed Kamal, Riham Fathy Galal, Mahmoud Ibrahim Eldosoky Mahmou. MELD Score in Critical Cirrhotic and Non Cirrhotic Patients. Nat Sci 2019;17(11):62-70]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj171119.08.

Keywords: Model for end stage liver disease, acute physiology and chronic health evaluation, sequential organ failure assessment

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 Effect of Process Factors on the Physical and Combustion Properties of Briquette Produced from Saw Dust

Ejikeme, Patrick C. N., Ejikeme, Ebere M., Enemuo, Sergius, M.

Chemical Engineering Department, Enugu State University of Science and Technology, Enugu, Nigeria

ebemoca@yahoo.com

Abstract- The quest for an alternative source of renewable energy has prompted the researchers to investigate the potential of using saw dust for briquette production. Effect of process factors on the physical and combustion properties of the briquette was studied as a guide to the optimum conditions that will be employed for the production. The briquettes were produced mechanically with a hydraulic operated briquette machine using cassava starch as a binder. Effect of binder ratio, compaction pressure and dwelling time on the porosity index, compressed density, durability index, relaxed density, water resistance and water absorption capacities of the briquette was studied. FTIR analysis of the uncarbonized saw dust, carbonized saw dust and saw dust briquette was studied. The result showed that all the process factors had effect on the properties of the produced briquette. It was observed that increase in compaction pressure, binder ratio and dwelling time increased the percentage resistance of the briquette to water penetration and lowered the porosity index. Increase on the three process factors increased the compression and relaxed densities and decreased the water absorption capacity. Increase on the three process factor equally increased the calorific value to a point that further increase on the process factors decreased the calorific value. The low nitrogen content of the briquette shows that there will be minimal release of nitrogen oxide into the atmosphere and is an indication that the produced briquette will not pollute the environment.

[Ejikeme, Patrick C. N., Ejikeme, Ebere M., Enemuo, Sergius, M. Effect of Process Factors on the Physical and Combustion Properties of Briquette Produced from Saw Dust. Nat Sci 2019;17(11):71-78]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj171119.09.

Keywords: Briquette, Calorific value, Cassava starch, Saw dust

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Outcome of Management of Blunt Liver Trauma

Khaled Zaky Mansour, Hany Rafeek Wakeem, Kamal Mamdouh Kamal, Mohamed Elshahat Arafaa

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

Email: surgmhmd@gmail.com

Abstract: Background: Liver is a solid organ with the highest injury rate in abdominal injury. Approximately 15% e 20% of abdominal injuries refer to hepatic trauma. Hepatic injury takes the third place in abdominal injury and 80% e 90% of hepatic injuries are blunt ones. In 2013, a study using ultra sonography to evaluate the intraperitoneal trauma showed that liver was the mostly affected organ and younger people were more vulnerable to hepatic and pancreatic injury. Objective: To assess the safety and efficacy as well as advantages and disadvantages in management of patients with liver blunt trauma so as to put conclusion and recommendation about what results arrive in management of patients with blunt liver trauma. Patients and Methods: The study was conducted at Emergency departments in Ain shams University Hospitals and Al-Ahrar Teaching Hospital in Al- zagazig and included 20 patients of both sexes with blunt liver trauma from May 2018 to May 2019. All patients presented to emergency department with blunt abdominal trauma and were diagnosed by focused abdominal Sonography for trauma (FAST) to have liver trauma. Results: This study was conducted on twenty patients with blunt liver trauma, their ages ranged from 18 to 60 years with Mean ± SD 38.13 ± 5.17, 4 patients (20%) were females, while 16 patients (80%) were males. There were two patients of grade IV liver injury one managed surgically and the other managed conservatively. Conclusion: The Patients who underwent conservative treatment with high-grade liver injuries should be closely monitored in the intensive care unit for the indication of failure of NOM which can be treated with operative management. NOM could be successful even in high graded injuries with low morbidity and mortality.

[Khaled Zaky Mansour, Hany Rafeek Wakeem, Kamal Mamdouh Kamal, Mohamed Elshahat Arafaa. Outcome of Management of Blunt Liver Trauma. Nat Sci 2019;17(11):79-85]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj171119.10.

Keywords: Blunt abdominal trauma, focused assessment by ultrasound for trauma, American association for the surgery of trauma

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Relationship between Helicobacter Pylori Infection and Preterm Labor: A Case-Control Study

Mohammed Sayed Ali,^*,1 Ahmed Mahmoud Hussein,¹ Walid Abdelhady Ahmed,² and Ahmed Eid Zidan¹

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

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

*E-mail: Ahmedeidzidan@gmail.com

Abstract: Helicobacter pylori (H. pylori), a Gram-negative bacteria and spiral-shaped bacterium occurring in the stomach, is proposed to be directly connected to various gastrointestinal diseases, such as gastric mucosal-associated lymphoid tissue lymphoma, gastric adenocarcinoma, and peptic ulcer disease. Moreover, preterm labor is the main reason of neonatal death and disabilities like deafness, blindness, cerebral palsy, and chronic lung complications. Herein, we established a case study aiming to investigate the relationship between helicobacter pylori infection and preterm labor. The study was carried out on one hundred pregnant women and took place at Ain Shams University Hospital. Finally, data analysis was performed using Statistical Package of Social Science (SPSS) software.

[Mohammed Sayed Ali, Ahmed Mahmoud Hussein, Walid Abdelhady Ahmed, and Ahmed Eid Zida. Relationship between Helicobacter Pylori Infection and Preterm Labor: A Case-Control Study. Nat Sci 2019;17(11):86-89]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj171119.11.

Keywords: Helicobacter pylori, Preterm labor, Gram-negative bacteria, Spiral-shaped bacteria

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In vivo mobilization of bone marrow stem cells versus injection of stem cells on experimentally induced diabetes in adult albino rats

Ashraf Mahmoud Moustafa¹, Salama Sayed Said¹, Ayman Fathy Elshaarawy¹, Rania Galhom² and Ibrahim Mohammed Fayed¹

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

²Department of Anatomy and Embryology, Faculty of Medicine, Seuz Canal University, Egypt.

ebrahimfayed@gmail.com

Abstract: Background: diabetes mellitus is a major health problem affecting more than 200 million of adult populations worldwide and is expected to affect at least 5 % of global population by the year 2025. Objective: this work was planned to evaluate the role of StemEnhance in mobilizing naturally occurring bone marrow stem cells in addition to the effect of this mobilization in improving streptozotocin-induced diabetes mellitus in rats in comparison with injection of stem cells in the adult albino rats. Histological techniques were applied in this study. Materials and Methods: Streptozotocin (STZ): is an antibiotic and it was purchased from Sigma Company (St. Louis, Mo, USA) in the form of powder. StemEnhance: capsules were purchased from STEM Tech Health Sciences (San Clemente, CA, USA) in the form of a bottle contained 50 capsules each contained 500 mg of L-selectin ligand enriched fractions of Aphanizomenon flos-aquae (AFA). This study included forty four adult male albino rats (160-200 g). Results: the mean values of blood glucose level of diabetic (GII), diabetic-StemEnhance (GIV) and stem cells treated group (GV) were significantly increased in comparison with the control (Gs I & III). However it was increased in group GV in comparison with group GIV. This decrease may be related to insulin secreted by the newly differentiated β cells from the mobilized HSCs. However, blood glucose level decreased after StemEnhance administration. Conclusion: StemEnhance and endogenous injection of stem cells mobilized BM stem cells were differentiated into pancreatic islet β cells who ever its more occur in exogenous injection in comparison with endogenous mobilization.

[Ashraf Mahmoud Moustafa, Salama Sayed Said, Ayman Fathy Elshaarawy, Rania Galhom and Ibrahim Mohammed Faye. In vivo mobilization of bone marrow stem cells versus injection of stem cells on experimentally induced diabetes in adult albino rats. Nat Sci 2019;17(11):90-96]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj171119.12.

Keywords: diabetes, Streptozotocin, Albino rats

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Comparative study between laparoscopic tubal disconnection, ultrasound guided tubal aspiration and hysteroscopic tubal occlusion in management of hydrosalpinx prior to ICSI

Prof. Asem Anwar Abdo Moussa, Prof. Mohamed Ali Mohamed, Mohamed Mohamed Abdalsalam

Obstetrics and Gynecology Department, Faculty of Medicine, Al Azher University, Cairo, Egypt

mohamedabdalsalam997@gmail.com

Abstract: Patients with hydrosalpinges have significantly lower implantation and pregnancy rates than patients with other tubal pathologies. An increased risk for early pregnancy loss and increased risk for ectopic pregnancies was reported, and many studies confirmed that the presence of hydrosalpinx significantly impairs in vitro fertilization (IVF) outcome as well. The lowered efficacy of IVF led to the concept that fallopian tube surgery prior to IVF might improve results. In the current study we investigated the treatment efficacy of three options for the management of hydrosalpinx prior to ICSI cycles. The study is designed as an equivalence clinical trial assuming that the three techniques are almost equally effective. The ultimate goal of the trial is to reach multiple alternatives in this context, with comparable success rate of ICSI cycles. Three options for hydrosalpinx treatment were tested; laparoscopic disconnection of the hydrosalpinx, hysteroscopic occlusion of the cornual end of the affected tube and hydrosalpinx aspiration. The study involved 60 women with tubal factor of infertility in the form of unilateral or bilateral hydrosalpinx divided into three equal groups. All women were prepared for ICSI cycles with controlled ovarian hyperstimulation (COH) using hMG. There was no significant difference between the three groups regarding the response to COH, endometrial thickness, total number of retrieved oocytes, the number of MII oocytes, and the embryo number or grade. The three treatment options resulted in comparable pregnancy rates (p = 0.765). However, aspiration group had the lowest rate of clinical pregnancy (40%) compared to 50% in laparoscopic disconnection group and hysteroscopic occlusion groups with no significant difference. This confirms the assumption of this equivalence trial giving a chance to adapt the way of management according to the circumstances of each individual case. In conclusion, surgical treatment of hydrosalpinx prior to ICSI cycles can be done through laparoscopic disconnection of the hydrosalpinx, hysteroscopic occlusion of the cornual end of the affected tube or hydrosalpinx aspiration. The three techniques are generally safe with comparable outcome regarding clinical pregnancy rate. The management can be individualized according to the patient’s general condition and status of the abdominal wall and pelvis pelvic regarding adhesions and complications of previous surgery.

[Asem Anwar Abdo Moussa, Mohamed Ali Mohamed, Mohamed Mohamed Abdalsalam. Comparative study between laparoscopic tubal disconnection, ultrasound guided tubal aspiration and hysteroscopic tubal occlusion in management of hydrosalpinx prior to ICSI. Nat Sci 2019;17(11):97-108]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj171119.13.

Keywords: Comparative; study; laparoscopic tubal disconnection; ultrasound guided tubal aspiration; hysteroscopic tubal occlusion; management; hydrosalpinx

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Serum Eotaxin as a marker in Prediction of Atherosclerosis in Obese Patients with NAFLD

Shireen Ali Elhoseny^*1, Mervat Abd El-Hamed ELkhateb¹, Wael Farrag Mohamed Farrag¹, Manal Abdel-Wahed Eid²

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

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

ashrafaboreda@gmail.com 

Abstract: Background: Atherosclerosis and its clinical manifestations in coronary heart disease, stroke, and peripheral artery disease are the leading cause of morbidity and mortality worldwide. Atherosclerosis is considered to be a chronic inflammatory disease and scientific interest has focused on the role of cytokines as possible predictor agents for early atherosclerosis and as a therapeutic target for atherosclerosis. As obese patients with nonalcoholic fatty liver disease (NAFLD) are vulnerable to many risk factors for atherosclerosis that related to metabolic syndrome and NASH prevalence in those patients. Objective: The aim of this study is to study the role of serum Eotaxin, in early prediction of atherosclerosis in obese patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods: The study included 90 participants 60 of them were obese with NAFLD (cases) recruited from Tanta University Hospitals The patients were subdivided into 3 groups 30 obese patients with NAFLD without vascular ischaemic complications, 30 obese patients with NAFLD with vascular ischaemic complications. Serum Eotaxin level, hsCRP, Interleukin 1β(IL-1β) and Vascular endothelial growth factor (VEGF) were measured. Abdominal ultrasound, Muscle ultrasound and Duplex on common carotid, the carotid bulb, and the near and far wall segments of the internal carotid to measure CIMT and evaluate early atherosclerosis also were done. Results: There was significant increase of serum Eotaxin levels in ischaemic obese patients than non ischaemic obese patients and it was positively correlated with HOMA for insulin resistance, IL1β (proatherogenic cytokine) and VEGF (angiogenic factor) Also, there was positive correlation between CIMT and serum Eotaxin. CIMT was predicted by serum Eotaxin level. Also, it was significantly higher in obese patients with MetS than obese patients without MetS. ROC curve showed that it has higher sensitivity and specificity in detection and prediction of atherosclerosis in obese patients. Conclusions: From this study, it is concluded that despite few studies investigated the role of serum Eotaxin in the pathogenesis of atherosclerosis, it was significantly higher in ischaemic obese patients than non ischaemic obese and its levels in obese patients are positively correlated with subclinical atherosclerosis.

[Shireen Ali Elhoseny, Mervat Abd El-Hamed ELkhateb, Wael Farrag Mohamed Farrag, Manal Abdel-Wahed Eid. Serum Eotaxin as a marker in Prediction of Atherosclerosis in Obese Patients with NAFLD. Nat Sci 2019;17(11):109-119]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj171119.14.

Keywords: Eotaxin, atherosclerosis, obesity, NAFLD

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Serum Procalcitonine level in diabetic foot patients

Sama Fathy Mohamed *¹, Nashwa Mohamed Aboalnasr¹, Loai Mohamed El-Ahwal¹, Mamdouh Radwan El-Nahas², Saharmohey El-Din Hazzaa³

¹Department of internal medicine, Tanta University, Faculty of Medicine, Egypt.

² Department of internal medicine, Port said University, Faculty of Medicine, Egypt.

³Department of Clinical Pathology, Tanta University, Faculty of Medicine, Egypt.

dr.samamostafa@gmail.com

Abstract: Background: Diabetes represents an emerging global epidemic and one of the leading causes of morbidity and mortality. Although many serious complications, such as kidney failure or blindness, can affect individuals with diabetes, it is the complications of foot that take the greatest toll. Currently it can be estimated that millions of people are or will be affected by diabetic foot. Up to 66% of the persons admitted to the hospital with a diabetic foot infection have osteomyelitis. Its presence increases morbidity, risk of amputation and mortality. Charcot neuro-osteoarthropathy is another devastating complication of diabetic peripheral neuropathy which can be another important cause of amputation. In spite differentiation between CN and OM is often obvious, but it still difficult in many cases. Aim of the work: we aimed to assess the value of Procalcitonine (PCT) to distinguish acute osteomyelitis from acute Charcot arthropathy. Patients and methods: Our study included 90 patients, acute Charcot group (30 patients) and acute osteomyelitis group (30 patients). 30 diabetic patients, all were recruited from Tanta and Mansoura university Hospital (diabetic foot clinic, diabetes outpatient clinics and inpatient wards); All patients were subjected to thorough full history taking, complete clinical examination, and laboratory investigation including FBG, HbA1c, CBC, serum creatinine, liver function tests, ESR and CRP as well as serum levels of Procalcitonine. We studied the role of the inflammatory markers (ESR, CRP, TLC and PCT) in the differentiation between the Charcot group and osteomyelitis group. Result: We found that TLC showed non-significant difference between study groups (P = 0.144) as it was of limited sensitivity for the diagnosis of osteomyelitis. ESR levels were significantly higher in the OM group in comparison to the Charcot and control group (P= 0.000) and the cut-off value of ESR to diagnose OM was 22.50 mm/hr. CRP levels were significantly higher in the OM group in comparison to the Charcot and control group (P= 0.000), Cut-off value of CRP to diagnose acute OM was 19.5 mg/l.PCT levels were significantly higher in the OM group in comparison to the Charcot and control group (P= 0.000), and the best cut-off value of PCT to diagnose a case of acute OM was 0.2 ng/ml that of a sensitivity and specificity (86.7% and 96.7%) respectively. There was a non-significant correlation between PCT levels and age, BMI, DM duration, HBAIC and HB%.ESR and CRP levels were positively correlated with PCT (r=0.727**, P=0.000) and (r=0.678 **, P=0.000) respectively. ESR levels were positively correlated with CRP (r=0.697**, P=0.000). Conclusion: PCT at a cut - off value 0.2 ng/ml is a sensitive and specific marker that can be used in the differentiation between Charcot arthropathy and OM. TLC count may be of limited value in differentiating OM and CN. The incorporation between PCT, ESR, CRP and MRI finding can help in differentiation between CN and OM.

[Sama Fathy Mohamed, Nashwa Mohamed Aboalnasr, Loai Mohamed El-Ahwal, Mamdouh Radwan El-Nahas, Saharmohey El-Din Hazza. Serum Procalcitonine level in diabetic foot patients. Nat Sci 2019;17(11):120-131]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj171119.15.

Keyword: Diabetes, Charcot arthropathy (CN), osteomyelitis (OM), Procalcitonine (PCT)

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Parathyroid Gland Injuries Post Total Thyroidectomy

Hossam El Din Hassan El Azzazy, Hisham Mohamed Omran, Ramy Mikhael Nageeb, Yehia Mahfouz Abd El Menem

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

Email: yehiahassanin333@gmail.com

Abstract: Background: Postoperative hypocalcaemia is observed in total thyroidectomy patients and it is the most common complication. It is usually transient, and the incidence of permanent hyperparathyroidism is 3% or less. Despite being self-limiting in most patients, symptomatic hypocalcaemia is of particular concern because of a delay in its manifestation and the consequent need for prolonged patient hospitalization or readmission. Objective: The aim is to evaluate the risk of hypocalcaemia (transient or permanent) after total thyroidectomy for goiter, the frequency and impact of unintentional parathyroidectomy. Patient and Methods: In this randomized prospective study, we surveyed 50 patients who were admitted in the General Surgery Department, Ain-shams University Hospital, during the period from December 2017 and December 2018 with benign thyroid diseases such as simple multinodular goiter, secondary toxic goiter, diffuse toxic goiter relapsing after full medical treatment, selected cases of thyroiditis (Hashimoto's thyroiditis) and thyroid cancer. Results: We found ten cases with transient hypocalcaemia with multinodulargoiter, secondary toxic goiter and papillary carcinoma, whereas no selected cases of permenant hypocalcemia. The typical signs and symptoms associated with hypocalcaemia are neuromuscular irritability, including perioral or acralparesthesia, muscle cramps that may progress to carpopedal spasm, laryngospasm, bronchospasm or even tetany. Treatment is based on the severity of symptoms. Symptomatic hypocalcemic patients were treated with IV calcium supplementations intravenous calcium (10 ml 10% calcium gluconate in 100 ml of normal saline IV over 10 min) till the patients become asymptomatic followed with maintenance therapy of 1-3 mg of calcium gluconate/kg/h usually over the first 24 to 48 h postoperatively and shift to oral calcium (1.5 gm / day) and Vit D (Calcitriol 1.5 ug/day) supplements, the infusion rate is titrated to keep the serum calcium level in the low normal range. Conclusion: Transient hypocalcemia is a frequent complication of total thyroidectomy despite careful and meticulous surgical technique. Unintentional parathyroidectomy is uncommon complication of total thyroidectomy and there is no significant relation between histopathological nature of thyroid and unintentional parathyroidectomy and no statistical relation between unintentional parathyroidectomy and transient hypocalcemia.

[Hossam El Din Hassan El Azzazy, Hisham Mohamed Omran, Ramy Mikhael Nageeb, Yehia Mahfouz Abd El Menem. Parathyroid Gland Injuries Post Total Thyroidectomy. Nat Sci 2019;17(11):132-138]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj171119.16.

Keywords: Unintentional parathyroidectomy, hypocalcemia, Total thyroidectomy.

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Clinical Significance Of Genomic Deep Sequencing In Egyptian Patients With Diffuse Large B-Cell Lymphoma

Raghda Gabr Farid Mashaal^*1, Sahar Saad El-Din Zaki Bessa¹, Said Mohamed Hammad Abdou², Nashwa Mohamed Nor El-Din¹, Amr Abd El Aziz Ghannam³

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

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

³ Department of Medical Oncology, Tanta University Faculty of Medicine, Tanta, Egypt

¹raghdmeshaal@med.tanta.edu.eg, raghda_mashaal@yahoo.com

Abstract: Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. It has heterogeneous clinical features and varies markedly in response to treatment and prognosis. Distinctive molecular and genetic abnormalities have been identified in DLBCL. Next-generation sequencing (NGS) has detailed the genomic characterization of DLBCL by identifying recurrent somatic mutations. This study aimed to identify genetic alterations and rearrangements in DLBCL and to examine their association with clinical features, response to therapy and final outcome. Objective: The aim of the present work was to identify genetic alterations and rearrangements in diffuse large B-cell lymphoma and to examine their association with clinical features, response to therapy and final outcome. Materials and Methods: This study included 40 subjects; 30 patients with diffuse large B-cell lymphoma and 10 normal subjects as a control group. The Ann Arbor classification system was used to determine the stage of the patients. The patients were evaluated according to age, sex, stage, B symptoms, lactate dehydrogenase level, response to treatment and overall survival. Target sequencing was performed on lymph node or bone marrow biopsy samples from patients with DLBCL and on peripheral blood samples from healthy subjects for detection of some genetic mutations, including BCL 10, GNA13, MEF2B, PRDM1, BCL6, BCL2, CARD11, PIM1 and TBX21. Results: This study revealed that only 4 genetic mutations were detected (BCL2, CARD11, PRDM1 and TBX21) in 12 out of 30 patients. 11 patients had BCL2 mutation with 34 variants, 2 patients had CARD11 mutation with 3 variants, one patient had PRDM1 mutation with 2 variants and 4 patients had TBX21 mutation with 6 variants. BCL2 was the most frequent gene affected representing 75.6% with statistically significant increased frequency as compared to other genes (p <0.001). Moreover, C-T was the most frequent variant affected representing 62.2% with statistically significant increased frequency as compared to other variants (p < 0.001). There was statistically significant difference between the stage of the disease and genetic variants (P = 0.048), however, no significant difference was observed between the response to treatment and genetic variants. Patientswho didn’t have identified variants had slight superiority in overall survival than those who had identified variants, with no statistically significant difference between both patient groups. No any genetic mutation was detected in control group. Conclusions: BCL2 gene mutation can be regarded as a potential genetic risk factor in Egyptian patients with DLBCL, however it has no significant impact on the clinical outcome. The prognostic significance of genetic alterations and rearrangements in DLBCL should be evaluated in the context of molecular subtypes in future studies. Clearly, further well-designed prospective studies to clarify the exact role of genetic mutations as prognostic factors, predictors of outcome and emerging therapeutic targets in DLBCL would be warranted.

[Raghda Gabr Farid Mashaal, Sahar Saad El-Din Zaki Bessa, Said Mohamed Hammad Abdou, Nashwa Mohamed Nor El-Din, Amr Abd El Aziz Ghanna. Clinical Significance Of Genomic Deep Sequencing In Egyptian Patients With Diffuse Large B-Cell Lymphoma. Nat Sci 2019;17(11):139-153]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj171119.17.

Keywords: Genomic sequencing- DLBCL - BCL2 - Egyptian.

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Role of 3D / 4D Ultrasound in Assessment of Fetal CNS Congenital Anomalies

Fatma Salah El-Dein Mohammed, Wafaa Raafat Abdel Hamid, Ahmed Bassiony Bassiony Elsayed

Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Egypt.

Dr_ahmedbassiony@yahoo.com

Abstract: Background: Congenital abnormalities account for 20-25% of perinatal deaths. Central nervous system anomalies are often severe and are the most common indications for therapeutic abortions. Objectives: The aim of this study is to verify the role of 3D, 4D ultrasonography in prenatal assessment of anatomical structure of central nervous system and early diagnosis of the CNS congenital anomalies. Patients and Methods: From January 2018 to April 2019, 30 pregnant women range from 18 to 40 years old which suspected to have CNS congenital anomalies during routine prenatal obstetric examination, then referred to do 3D / 4D detailed ultrasonography after an initial detailed diagnostic 2D ultrasonography to confirm the diagnosis. 30 pregnant women had undergone detailed anomaly scan in an outpatient private clinics and Ghamra hospital using Chison i3 ultrasound machine and Voluson p8 with both curvilinear 3.5 MHz 60-mm curved probe and 3D real time volumetric 4.5 MHz probe. Results: CNS anomalies occur in significant frequency and some of them are incompatible with life whereas others are life limiting. Ultrasound is an effective investigation for in-utero screening for anomalies including CNS. Ultrasound imaging in antenatal period practically gives an anatomical record of the developing fetus. Confirmation of the anomalies by 3D / 4D ultrasonography definitely helps in increasing accuracy of diagnosis and better counseling of the patient. Additionally, it provides very useful educational information. This also provides psychological benefits for some patients by confirming the reality of fetal anomalies. Conclusion: Three dimensional ultrasonography play an important role in detection and diagnosis of some fetal central nervous system anomalies which may be difficult to be detected by two dimensional ultrasonography due to position of the fetus. For example, the acquisition of the median plane may be impossible with 2D transabdominal ultrasound and require special expertise in transvaginal-transfontanelle scanning, as well as prolonged examination time.

[Fatma Salah El-Dein Mohammed, Wafaa Raafat Abdel Hamid, Ahmed Bassiony Bassiony Elsayed. Role of 3D / 4D Ultrasound in Assessment of Fetal CNS Congenital Anomalies. Nat Sci 2019;17(11):154-157]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 18. doi:10.7537/marsnsj171119.18.

Keywords: 3D / 4D Ultrasound, Fetal CNS Congenital Anomalies

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Meta-Analysis of the Effects of Preoperative Embolization on the Outcomes of Carotid Body Tumor Surgery

Mohamed Magdy Samir, Tamer Abd ElWahab Abo Elezz, Peter Milad Mikahail and Mohamed Khaled Shafeek Bassam

Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Egypt

dr0mohamed0khaled@gmail.com

Abstract: Background: Carotid body tumors (CBTs) are situated at the bifurcation of the common carotid artery within the adventitia, and are reported to be the most common head and neck paragangliomas. Surgery is the gold standard for curative treatment of respectable CBTs and is recommended in otherwise healthy patients because of the risk of local complications related to tumor size and a small but definite risk of malignancy. Preoperative embolization has been shown to reduce potential intraoperative blood loss and provide the surgeon with greater ease and safety in excising the tumor, thus reducing the operation time and morbidity. However, other physicians have stated that although blood loss may be reduced after preoperative embolization, transfusion requirements are not affected, and that the embolization procedure adds a significant risk for stroke. Therefore, the purpose of the current study was to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization. Aim: To evaluate the need for preoperative embolization for the treatment of carotid body tumour. Methodology: A meta-analysis study is done to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization. Results: Our meta-analysis for evaluation of the effects of preoperative embolization on the outcomes of carotid body tumour surgery, included (14) studies with a total number of patients (n=477). The results of these studies showed no statistically significant difference between preoperative embolization group and non embolization group in carotid body surgery for (blood loss & operation time). Preoperative embolization did not reduce risk of postoperative complications. Conclusion: Preoperative embolization shows no statistically significant reducing in blood loss and operation time, also embolization does not decrease incidence of postoperative complications.

[Mohamed Magdy Samir, Tamer Abd ElWahab Abo Elezz, Peter Milad Mikahail and Mohamed Khaled Shafeek Bassam. Meta-Analysis of the Effects of Preoperative Embolization on the Outcomes of Carotid Body Tumor Surgery. Nat Sci 2019;17(11):158-163]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 19. doi:10.7537/marsnsj171119.19.

Keywords: Carotid Body Tumor, Preoperative Embolization, Vascular Tumors Management, Carotid Body Tumor Surgery, Carotid Body Tumor Radiotherapy

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Comparison between Cartilage Cutting and Cartilage Sparing In Correction of Prominent Ear

Prof. Dr. Samia Ahmed fawaz, Dr. Mohamed Saad Hassaballah, Dr. Ossama Mostafa Mady and Mahmoud Mohamed Morshed

Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Egypt

E-mail: johncarter023.jc@gmail.com

Abstract: Background: Protruding ears are the most common congenital ear deformity, with a frequency of 13.5% and a well-known hereditary component. Such a deformity can lead to serious psychosocial disturbances from childhood onward. Aim of the Study: To compare the success rates of cartilage cutting and cartilage sparing technique of otoplasty as regard outcomes, complications and recurrence rates through a systematic review study. Patients and Methods: Our study included all the studies of cartilage cutting technique and cartilage sparing technique for correction of prominent ear published in PubMed and MEDLINE with using terms (cartilage cutting, cartilage sparing, prominent ear). Our study included (25) studies, (14) studies about cartilage cutting techniques with total number of patients (n=2034) and (11) studies about cartilage sparing techniques with total number of patients (n=933) with only two studies comparing the two techniques at the same time. Results: There is no significant difference between cartilage cutting techniques and cartilage sparing techniques in term of recurrence (8% and 7%, respectively), bleeding (3% and 4%, respectively) and infection (2% and 1%, respectively). Cartilage cutting techniques have higher percent of hematoma (3%) while cartilage sparing techniques have higher percent of suture extrusion (7%). Conclusion: No difference between cartilage cutting and sparing in term of recurrence, infection and bleeding. however, Cartilage cutting techniques have higher percent of hematoma while cartilage sparing techniques have higher percent of suture extrusion.

[Samia Ahmed fawaz, Mohamed Saad Hassaballah, Ossama Mostafa Mady and Mahmoud Mohamed Morshed. Comparison between Cartilage Cutting and Cartilage Sparing In Correction of Prominent Ear. Nat Sci 2019;17(11):164-172]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 20. doi:10.7537/marsnsj171119.20.

Keywords: Cartilage Cutting - Cartilage Sparing - Prominent Ear-complication.

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A Comparative Study between Fistulectomy and Fistulotomy with Marsupialization In Management of Simple Anal Fistula

Prof. Dr. Ahmed Mohamed Khalifa Nafei, Prof. Dr. Hanna Habib Hanna, Dr. Mohammed Abd Almegeed Alsayed, and Badr Eldeen Mamdouh Badr Eldeen Hegazy

General and Colorectal Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

drbadrhegazy2019@gmail.com

Abstract: Anal fistula is a common disease that has long challenged surgeons’ skills Perianal fistula, if not treated properly will result in one of two terrible complications, recurrence or incontinence. Despite many preoperative investigations that can help to identify the correct anatomy of the fistula, one might face difficult or unexpected intraoperative findings that require wise decisions. Appropriate decisions in such circumstances have a significant impact on the outcome of surgery and the patient's quality of life. The present study is a retrospective clinical trial study including twenty five (25) patients who presented with simple perianal fistula to surgical outpatient clinic at Ain Shams University Hospitals in Egypt. The patients were divided in to two groups: A. Group A: patients who underwent fistulectomy. B. Group B: patients who underwent fistulotomy with marsupialization. Fistulotomy with marsupialization is a simple, easy, and effective method for the treatment of simple perianal fistula, as it has shorter operating time with less postoperative pain and less time needed for wound healing than fistulectomy with the same incidence of postoperative complications, recurrence, and incontinence as fistulectomy.

[Prof. Dr. Ahmed Mohamed Khalifa Nafei, Prof. Dr. Hanna Habib Hanna, Dr. Mohammed Abd Almegeed Alsayed, and Badr Eldeen Mamdouh Badr Eldeen Hegazy. A Comparative Study between Fistulectomy and Fistulotomy with Marsupialization In Management of Simple Anal Fistula. Nat Sci 2019;17(11):173-180]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 21. doi:10.7537/marsnsj171119.21.

Keywords: Comparative; Study; Fistulectomy; Fistulotomy; Marsupialization; Management

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Comparison between Stented and Non Stented TIP Urethroplasty for Distal Hypospadius

Prof. Dr. Ayman Ahmed Albaghdady¹, Prof. Dr. Yasser Mohamed Abdel Samee², Dr. Ayman Moustafa Allam¹ and Mohamed Sherif Samy²*

¹Pediatric Surgery Department, Faculty of Medicine, Ain Shams University

²General Surgery Department, Faculty of Medicine, Ain Shams University

E-mail: mohamedsherif_2010@hotmail.co.uk

Abstract: Background: Hypospadias is a condition where the meatus is situated along the underside of the penis instead of the normal position at its tip. Aim of the Work: To compare the outcome of stented versus non stented repair in TIP urethroplasty operation for distal hypospadius as regards cosmetic outcome and complications rate e.g. fistula, disruption and infection. Patients and Methods: This is a randomized control study to assess the outcome of TIP repair of distal hypospadias with or without stents as regarding surgical outcomes. This study was conducted at (pediatric surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and informed consent from all participants were obtained. This study was conducted over a period of 6 months. Results: This study is an effort to find out the effects of urethral stenting on complication rate in distal hypospadias repair but it was seen that there was no difference in post-operative fistula rates in unstented and stented patients in distal hypospadias surgery, but at the same time there was no difference in post-operative stay between the two groups. Conclusion: Repair with stents or without stents did not affect the outcome of hypospadias repair in terms of fistula formation or postoperative stay.

[Ayman Ahmed Albaghdady, Yasser Mohamed Abdel Samee, Ayman Moustafa Allam and Mohamed Sherif Samy. Comparison between Stented and Non Stented TIP Urethroplasty for Distal Hypospadius. Nat Sci 2019;17(11):181-186]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 22. doi:10.7537/marsnsj171119.22.

Keywords: Distal Hypospadius - Stented and Non Stented TIP Urethroplasty

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Leakage after Single Anastomotic Gastric Bypass Surgery

Khaled Aly Gawdat; Basem Helmy El-Shayeb; Abdallah Basha El-Raey

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

Abdallahelar3y@gmail.com

Abstract: Background: Morbid obesity is one of the major health problems of the 21st century which has a steadily increasing incidence, representing approximately 10% of the world‘s population and considered as the second leading cause of preventable death after smoking. Annually, obesity-related diseases account for 400,000 of premature deaths. Objective: The aim of the present study is to evaluate causes, diagnosis and different lines of management of anastomotic leakage after gastric bypass surgery. Methods: This is a prospective study carried on 10 patients with morbid obesity. All patients consented to participate in this study. They have single anastomotic gastric bypass surgery and those cases are attendants of bariatric surgery department at Ain shams university hospitals and some other private hospitals. Results: In our study, there was no significant difference between patients concerning sex and its role in developing leakage with 40 % female and 60% male patients. Also, there was significant role for increasing age and BMI of the patients participated in the study. Patients with more co-morbidities are more reliable to incidence of leakage post lap mini gastric bypass. Most of the patients had intra operative complications like bleeding from anastomotic line (20%), intra operative leakage (20%), miss firing (10%) and thus increase percentage of leaking post operation, so surgeons experience and skills are so important in operation and management. Leakage happened in the 1^st and 2^nd days post operation. However, some authors reported that leakage may happened later on. Most of the patients had re exploration and refashioning of anastomotic line (60%), conservative treatment and close observation was done to (30%) of the cases and conversion to other operation was done to (10%) of the cases. Conclusion: Advanced laparoscopic skills, including two handed technique and laparoscopic stapling and suturing, are required. Both fundamentals of bariatric surgery and advanced laparoscopic surgery should be mastered before performing laparoscopic surgery, several intraoperative techniques have been implanted to prevent the anastomosis leak. These interventions include intraoperative pneumatic testing, the use of linear staplers with shorter stapler height, over sewing of staple line, use of omental wrap, and measures designed to reinforce staple line, such as fibrin glue, peristrips, seamguard, bovine pericardium and various other staple line reinforcement material.

[Khaled Aly Gawdat; Basem Helmy El-Shayeb; Abdallah Basha El-Raey. Leakage after Single Anastomotic Gastric Bypass Surgery. Nat Sci 2019;17(11):187-192]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 23. doi:10.7537/marsnsj171119.23.

Keywords: Leakage; Single Anastomotic Gastric Bypass

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Different routes of Misoprostol for same-day cervical priming prior to hysteroscopy a randomized controlled single blind trial

Mohamed Salah-Edin Hassanin, MD.¹, Abdelrahman Mostafa Anbar, MD.¹, Elsayed Mohamed Tah, MD.¹, Mohamed Shaban Abdel-Hamed Hawata.²

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

²Department of Obstetrics and Gynecology Mataria Teaching Hospital

drmohamedhawata@gmail.com

Abstract: Introduction: Hysteroscopic surgery, with prior cervical ripening by misoprostol (a synthetic prostaglandin E1 analogue, PGE1), has been widely used to treat gynecological diseases including submucosal myoma, endometrial polyps and uterine synechia in non-pregnant women. The route of administration of misoprostol for cervical dilatation can be oral, vaginal or sublingual. Aims: The aim of the present study was to evaluate the efficacy 400 µg misoprostol administered orally, vaginally or sublingually on cervical ripening before hysteroscopy. Methodology: Study setting: Sayed Galal Hospital. Study duration: April 2017 to April 2018. Number of patients: Included 300 patients. Study Design: A prospective randomized controlled single blind trial. Non-pregnant women scheduled for hysteroscopy were divided randomly into four groups using sealed opaque envelopes to receive 400 mg of misoprostol, administered either orally (n =75) or vaginally (n =75) 6–8 h prior to surgery or 400 mg sublingually (n =75) 2–4 h prior to surgery or control group (n =75) received nothing. The primary outcome in this study was the preoperative cervical width as measured by the largest number of Hegar dilators. The duration of cervical dilatation was also recorded along with side effects related to misoprostol and complications during surgery for each group. Results: The mean ±SD cervical widths for the oral, sublingual, vaginal, and control groups were 7.60 ± 1.76 mm, 7.56 ±1.64 mm, 7.57 ± 2.06 mm, and 5.65 ±2.17 mm, respectively, which was statistically significant. Time to cervical dilatation was also significantly longer in the control group than in the other three groups. Misoprostol-related adverse effects and hysteroscopy-related complications were comparable among the four study groups. Conclusion: All routes (oral, sublingual, vaginal) of administrations of misoprostol are equally effective in inducing proper cervical priming before hysteroscopy compared to the control group.

[Mohamed salah-Edin Hassanin, Abdelrahman Mostafa Anbar, Elsayed Mohamed Tah, Mohamed Shaban Abdel-hamed Hawata. Different routes of Misoprostol for same-day cervical priming prior to hysteroscopy a randomized controlled single blind trial. Nat Sci 2019;17(11):193-200]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 24. doi:10.7537/marsnsj171119.24.

Keywords: Misoprostol, Hysteroscopy, cervical priming, cervical ripening

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Comparison between the Role of Transabdominal Ultrasound versus Transvaginal Ultrasound in Evaluation of Placental Invasion in Cases of placenta Previa Anterior wall with previous Uterine Scar

Elsayed Eldesouky and Ashraf Elshahat

Department Of Obstetrics and Gynecology Faculty of Medicine Alazhar University, Cairo, Egypt

elsayedeldesouky@yahoo.com

Abstract: Background: Accurate antenatal diagnosis of an abnormally invasive placenta (AIP), allowing multidisciplinary management at the time of delivery, has been shown to improve maternal and fetal outcomes. Placenta previa and previous cesarean section are the two most important known risk factors for AIP. To compare between the role of Transabdominal ultrasound versus Transvaginal ultrasound in evaluation of placental invasion in cases of placenta previa anterior wall with previous uterine scar applying the unified ultrasonographic descriptors suggested by the European working group on abnormally invasive placenta "EW-AIP'. Methods: Fifty pregnant women with persistent placenta previa (after 28 weeks’ gestation) were prospectively enrolled into this study. Both transabdominal and transvaginal ultrasound were performed by two different operators who were blinded to the results of each other. The placenta was studied as regarding the exact localization and the unified descriptors were applied and evaluated by TAS and TVS. The ultrasound findings were analyzed with reference to the final diagnosis made during Cesarean delivery and histopathological examination. Results: Abnormally invasive placenta and its variants was found in 43 patients at the time of Cesarean delivery, and was later confirmed by histopathological evaluation. As regards Grey-scale criteria; the accuracy of detection of the loss of the retroplacental clear zone was 76% by TVS and 54% by TAS, While that of the abnormal placental lacunae was 92 % by TVS and 88% by TAS, Myometrial Thinning detection accuracy was 66% by TVS and 72% by TAS. While the Doppler assessment showed that the accuracy of detection of the uterovesical hypervascularity was 84% by TVS and 88% by TAS. While the detection of bridging vessels was 76% by TVS and 75% by TAS. the overall accuracy of detection of TAS was 91% whereas that of TVS was about 97.1%, putting in mind the difference in the level of experience of the operators Conclusion: Both transabdominal and trasnvaginal ultrasound are found to be complementary to each other with an upper hand to transvaginal ultrasound, with the safety of TVS being confirmed also the unified describtors were found to be reliable in accurate diagnosis.

[Elsayed Eldesouky, Ashraf Elshahat. Comparison between the Role of Transabdominal Ultrasound versus Transvaginal Ultrasound in Evaluation of Placental Invasion in Cases of placenta Previa Anterior wall with previous Uterine Scar. Nat Sci 2019;17(11):201-208]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 25. doi:10.7537/marsnsj171119.25.

Keywords: Transabdominal, transvaginal ultrasound, placental invasion, Previa anterior wall, uterine Scar

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Theme: Foundation Of Aydar-Arnasay Lakes System And Their Effects On The Environmental Landscape

Gudalov Mirkomil Ravshanovich

Jizzakh State Pedagogical Institute

Abstract: In this article you can find the history of the Aydar-Arnasay lakes system and changes in the volume of lake water that have learned from the environmental effects of landscapes.

[Gudalov Mirkomil Ravshanovich. Theme: Foundation Of Aydar-Arnasay Lakes System And Their Effects On The Environmental Landscape. Nat Sci 2019;17(11):209-211]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 26. doi:10.7537/marsnsj171119.26.

Key words: Aydar-Arnasay lakes system, salt marshe, marshy, landscape, morphometric indication, levels of water, swing.

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Laparoscopic versus Open appendectomy in young female patients

Awad Hassan El Kayal, Amr Mohamed Mahmoud El Hefny, Ahmed Yasser El Rifa and Mohamed Salah Ezzat Said

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

Email: midosalahsaid@yahoo.com

Abstract: Background: Appendectomy is the most common surgical procedure performed in general surgery. For almost a century, open appendectomy, first described by Charles Mc Burney in 1889, has remained the gold standard treatment for acute appendicitis. The introduction of laparoscopic surgery has dramatically changed the field of surgery and laparoscopic surgery has been widely used as a minimally invasive surgery. Objective: Comparative evaluation of modified laparoscopic versus open appendectomy for the treatment of acute appendicitis. As regard surgical technique, operative time, hospital stay, post-operative morbidity and cost of both techniques in young females. Patients and Methods: This study was conducted in Ain Shams faculty of medicine, Ain Shams university hospitals, general surgery department from October 2018 to May 2019. The study was conducted on 40 female patients diagnosed with acute appendicitis. Results: The overall post-operative complications were different in the 2 group. The incidence of wound infection was less in laparoscopic group (5 % versus 10 %). The mean hospital stay was shorter in laparoscopic patients than open appendectomy patients (1.25 days versus 2.10 days). The post-operative analgesia was less in laparoscopic than open group. The mean time to return to normal activities was shorter in laparoscopic appendectomy patients (6.05 days versus 10.80 days). Conclusion: Laparoscopic appendectomy is safe and feasible. Despite that the operating time for laparoscopic appendectomy is still higher than that for open procedure, laparoscopic approach had several advantages over open appendectomy in that, it has lesser incidence of wound infection, shorter hospital stay, less need for post-operative analgesia and faster return of patients to normal activities. Moreover, it is very useful in reaching an exact diagnosis in equivocal cases in females during their childbearing period. We must convert laparoscopic procedure to open surgery when indicated for the safety of the patient. A larger further study to evaluate the cost, benefit of laparoscopic appendectomy is recommended.

[Awad Hassan El Kayal, Amr Mohamed Mahmoud El Hefny, Ahmed Yasser El Rifa and Mohamed Salah Ezzat Said. Laparoscopic versus Open appendectomy in young female patients. Nat Sci 2019;17(11):212-221]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 27. doi:10.7537/marsnsj171119.27.

Keywords: Laparoscopic appendectomy, open appendectomy, right lower quadrant

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Comparative Study between Invasive and Non-invasive Mechanical Ventilation in Management of Patients with Mild Acute Respiratory Distress Syndrome

Sahar K. Abo Elela, Noha M. Elsharnouby, Mohamed M. Abd-Elfatah, Amr M. Mohamed

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt

amrmahfouzicu87@gmail.com

Abstract: Background: Acute respiratory distress syndrome (ARDS) is a major cause of acute respiratory failure and it is associated with high mortality and morbidity. Aim of the Work: To evaluate whether using noninvasive mechanical ventilation can achieve a good improvement in patients with mild (ARDS) compared to those treated with endotracheal intubation and invasive mechanical ventilation. Patients and Methods: This prospective randomized control clinical trial was conducted on 40 males (66.6 %) and 20 females (33.3%) admitted to ICU units of Abu-Qir specialized hospital for Six months. Group 1 included 18 males (60%) and 12 females (40%), and group 2 included 22 males (73.3%) and 8 females (26.7%). Results: There was a significant difference between the two groups according to the outcome with success rate of ( 93.3 %) for group 1 versus success rate of (73.3%) for group 2 with (p =0.038). In group (1) the PH ranged from (7.01-7.56) and in group (2) the PH ranged from (7.20-7.59) and the only significant difference between the two groups was during the zero hour. There were 8 cases who failed to improve in group 2, four of them had metabolic acidosis with PH ≤7.30 and other 2 cases had compensated metabolic acidosis. Also in our current study we found that younger ages have higher response to treatment and success rate in both groups compared to older ages, as the mean age for patients who failed to improve in group 1 was 69 which was higher than those who improved in the same group where the mean age was 56, also the mean age of patients who failed to improve in group 2 was 66 which was higher than the mean age (45) of patients who improved in the same group. Till the present day it is well established that invasive mechanical ventilation remains the standard treatment option in management of ARDS especially in moderate to severe cases, however, non-invasive mechanical ventilation may play a significant role in management of selected mild cases in addition to avoidance of endotracheal intubation with its usual problems and risks. Conclusion: Noninvasive mechanical ventilation can be a treatment option for patients with mild (ARDS) and may even be the first choice of treatment provided that patients are closely monitored for signs of improvement during the first few hours. However, patients with mild (ARDS) who are older or with metabolic acidosis respond much less to (NIV). No doubt that further studies are needed for more evaluation with larger sample size and longer follow up.

[Sahar K. Abo Elela, Noha M. Elsharnouby, Mohamed M. Abd-Elfatah, Amr M. Mohamed. Comparative Study between Invasive and Non-invasive Mechanical Ventilation in Management of Patients with Mild Acute Respiratory Distress Syndrome. Nat Sci 2019;17(11):222-229]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 28. doi:10.7537/marsnsj171119.28.

Key words: mechanical ventilation, mild Acute respiratory distress syndrome

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Minimally invasive techniques in treatment of fracture calcaneus

Mohamed Bissar¹, Faisal Hasan Yousef Zayed¹, Ahmed Mohamed Mostafa Ahmed ²

¹Professor at Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

²Resident Doctor at Department of Orthopaedic Surgery, El-Fayoum General Hospital, Egypt

Email: a2magdo@gmail.com

Abstract: Calcaneum fractures accounts for about 2% of all body fractures. Minimally invasive fixation for displaced intra-articuler calcaneal fracutres was mainly used to overcome associated complications with open techniques such as infection and skin problems. Patient and method: the study was performed on twelve patients (6 male and 6 females) with displaced intra-articuler calcaneus fractures managed by lateral sinus tarsi approach and k wires fixation. the most common cause of injury was fall from height specially with heavy work. post operative follow up was performed for one year. Results: the mean Maryland score among cases was (86.8± 5.6) ranged between 75 and 96. Four patients were excellent representing 33.3% and eight patints were good representing 66.6%. the average time for k wire removal was 8 weeks (91.7%) and average time for full weight bearing in 11 cases was 12 weeks or less (91.7). Conclusion: minimal invasive fixation of displaced intra articular calcaneal fracures is an effective method with a low rate of complications if compared to open techniques.

[Mohamed Bissar, Faisal Hasan Yousef Zayed, Ahmed Mohamed Mostafa Ahme. Minimally invasive techniques in treatment of fracture calcaneus. Nat Sci 2019;17(11):230-233]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 29. doi:10.7537/marsnsj171119.29.

Key words: Calcaneal fracture, minimal invasive, percutaneous fixation

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Femtosecond LASIK Versus Microkeratome LASIK, A Comparative Study Of The Effect On Tear Film Stability

Prof. Dr. Mohamed Yasser Sayed Saif, Dr. Hazem Effat Haroun, Dr. Mohammed Othman Abdel Khalek, Mahmod Mohammad Gouda

Ophthalmology Department, Faculty of medicine; Beni Suef University, Egypt

 Mahmodmg1400@gmail.com

Abstract: LASIK is the most common procedure used to correct refractive errors. Conventional LASIK depends on a microkeratome to create the corneal flap. Femto Lasik uses femtosecond laser to create that flap. Those procedures may cause tear film instability, therefore patients often complain of dryness. Dry eye disease can be problematic for some individuals, as it can affect their daily activities. Different tests are used to assess tear film stability and dry eye. One of the most recent tests is measurement of tear film stability by anterior segment Optical Coherence Tomography. 80 eyes of 40 patients were examined to compare between Femto LASIK and mechanical LASIK. Tear film stability was assessed by Tear Break-up Time Test, Schirmer's Test and basically in our study by Anterior Segment Optical Coherence Tomography. The data revealed decrease in tear film stability in the early postoperative period. The parameters measured were stabilized to near normal levels 3 months postoperatively. A slight difference was noticed between mechanical LASIK patients and Femto LASIK, although the difference was insignificant.

[Mohamed Yasser Sayed Saif, Hazem Effat Haroun, Mohammed Othman Abdel Khalek, Mahmod Mohammad Gouda. Femtosecond LASIK Versus Microkeratome LASIK, A Comparative Study Of The Effect On Tear Film Stability. Nat Sci 2019;17(11):234-241]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 30. doi:10.7537/marsnsj171119.30.

Keywords: LASIK and Femtolasik; Tear film stability; Anterior segment OCT

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Effect of diazepam on the growth rate of Chrysomya albiceps (Fabricius) (Diptera: Calliphoridae) for the forensic entomology purposes

Layla Al-Shareef and Ohoud Alazwari

Department of Biology, College of Science, University of Jeddah, Jeddah, Saudi Arabia

E-Email: layladr@hotmail.com

Abstract: This study was conducted to examine the effect of diazepam on the development rate of Chrysomya albiceps. Larvae grew on the rabbit carcasses treated with lethal dosage of diazepam. Development rate of larvae and pupae were estimated by means of length, width and weight, whereas in adult flies length of costal vein in wing and tibia in hind leg as well as weight of the body were estimated. Results indicated that length of the larvae during most times 48, 72, 96 hours in treated group were significantly longer than untreated, but during 120, 168 hours, there were no significant differences. There were significant differences between larval lengths during different times. For each of larval width and weight treatment with diazepam did not affect significantly, whereas time had a significant effect. Treated with diazepam increased length and width of pupae significantly, but did not effect on the weight. For adult stage, costal vein length in treated group was longer than untreated significantly. The length of tibia in treated group was significantly longer than untreated. But, treatment with diazepam did not affect significantly. It was concluded that the presence of malathion altered the development rate of C. megacephala and thus disrupted normal postmortem intervalestimation.

[Layla Al-Shareef and Ohoud Alazwari. Effect of diazepam on the growth rate of Chrysomya albiceps (Fabricius) (Diptera: Calliphoridae) for the forensic entomology purposes. Nat Sci 2019;17(11):242-249]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 31. doi:10.7537/marsnsj171119.31.

Keywords: Effect; diazepam; growth; rate; Chrysomya albiceps; Fabricius; forensic; entomology; purpose

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Drinking water quality at the urban and rural area in Makkah 2018.

Khalid Abdullah Almasaodi¹, Fadhel Ahmad Trabulsi¹, Ali Hammad Alzahrani¹_, Mamdouh Mohammed Allehyani², Maher Mohammed Allehyani², Waleed Abdulwahed Alharbi², Hani Abdualmuti Allugmani³, Khaled Hassan Tumayhi⁴, Mohmmad Hassan ALfadhli⁵

¹Family Medicine Consultant, Makkah Public Health, Ministry of Health, Saudi Arabia.

² Health Services, Management Specialist, Makkah Public Health, Ministry of Health, Saudi Arabia.

³Social Worker, Makkah Public Health, Ministry of Health, Saudi Arabia.

⁴Epidemiology Technician, Makkah Public Health, Ministry of Health, Saudi Arabia.

⁵Nursing technician, Makkah Public Health, Ministry of Health, Saudi Arabia.

Email: dr.khalidphc@gmail.com

Abstract. Water is the most important substance in our daily life. Without it, life would not have been possible. Drinking water from different water resources such as wells and tankers should be free from contamination with waterborne pathogens including bacteria, fungi, viruses and parasites. Potable water is essential to humans and other life forms, as water is important to the mechanics of biological metabolisms in the body. Water is unsafe for human consumption when it contains pathogenic or disease-causing microorganisms. In addition, water transferring techniques may contaminate the drinking water. Aim of the study: To assess Drinking water quality at the urban and rural area during 2018 in Makkah and understanding the differences between these areas in water quality to improve the situation. Method: Cross-sectional design was adopted in the present study. Environmental Health Administration - Makkah Health Affairs. Self-administered Secondary data collection from Environmental Health Administration Files. All water samples results (319) in EHD during 2018 will be taken. Results: In our study, showed that the majority of TDS test the reference result is (1000) were Mean ± SD was 194.48±507.62 and Range (2-7890) put the PH test the references result is (6.5-8.5) were Mean ± SD was 7.11±0.40 and Range (5.40-8.55). And the Turbidity test the references is (5) were Mean ± SD was 0.59±0.93 and Range (0.11-14.30). Also showed that there is a significant relation between place and final results p-value <0.001. the majority test place from Urban used potable water (75.6%) while not potable is 38.6% on the other hand in Rural the potable water (24.4%) while not potable is (61.4%) were the Chi-square (22.724). Conclusion: The best way to make sure drinking water supplies are kept clean, safe and reliable is to take a preventive risk management approach. This means understanding each water supply from its beginning in nature to where it reaches you, the consumer. This understanding--about the water's characteristics, the ways it could become contaminated, and the type of treatment it needs--comes from collecting and studying data. Recommendations: ensuring the safety of a drinking-water supply. The use of a comprehensive risk assessment and risk management approach that encompasses all steps in the water supply from catchment to consumer. In these Guidelines, such approaches are termed water safety applied to drinking-water and to ensure the applicability of these practices to the management of drinking-water quality assessments that include and encompass the whole of the water supply system and its operation.

[Khalid Abdullah Almasaodi, Fadhel Ahmad Trabulsi, Ali Hammad Alzahrani_, Mamdouh Mohammed Allehyani, Maher Mohammed Allehyani, Waleed Abdulwahed Alharbi, Hani Abdualmuti Allugmani, Khaled Hassan Tumayhi, Mohmmad Hassan ALfadhl. Drinking water quality at the urban and rural area in Makkah 2018. Nat Sci 2019;17(11):250-257]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 32. doi:10.7537/marsnsj171119.32.

Keywords: Drinking water, quality of water, governmental, private facilities

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The Benefit Roles of Micro- and Macro-Algae in Probiotic

Hanan H Omar^1,2*, Kholoud A Dighriri¹, Rukaia M Gashgary¹

¹Department of Biological Science, Faculty of Science, University of Jeddah, Jeddah, Saudi Arabia.

²Department of Botany and Microbiology, Faculty of Science, Tanta University, Tanta, Egypt

* Corresponding Author: hananomar1@yahoo.com

Abstract: The present review deals with the probiotics and effect of micro- and macro-algae supplementation on fermented dairy products. Today the world’s attention has drawn on the health advantages of using probiotics in human consumption. Probiotics are living bacteria and yeasts that are good for Human beings. Probiotics are fermented foods contain microorganisms which have beneficial impacts on the host. The utilization of probiotic microorganisms delivers a protective impact on the gut flora. Probiotics have beneficial concerns for microbial disorder of the gut. Some indication has come to light about the beneficial effects, either for the host or the gut microbiota, of some foods and food ingredients. The most promising seem to be polysaccharides or their derivatives, and they include the dietary fibers. The polysaccharides from marine micro- and macro-algae act as prebiotics. The prebiotics have the possibility of using to modulate the microbiome, and, consequently, prevent certain human diseases. If prebiotics combined with probiotics they will form what is termed as synbiotics. A synbiotic activates the growth and the metabolism of one or a limited number of health promoting bacteria. On the other side, algae are emerging as dietary supplements. Researcher thought about the combination of algae in fermented dairy products as medium. Their effort was to enhance the functionality of food quality with addition of algae into it. Algae are rich source of proteins, vitamins, minerals and used mainly as a health supplements. Algae contain plenty of gut-supporting nutrition and produce beneficial bacteria when it undergoes fermentation helps in digestion. Addition of algae enhanced the viability of probiotic bacteria, acidity of food, and storage quality. There was more viability during storage to deliver more probiotics to human at time of their consumption. In the future, the possibility of using algae to modulate the microbiome, and, consequently, prevent certain human diseases is expected.

[Hanan H Omar, Kholoud A Dighriri, Rukaia M Gashgary. The Benefit Roles of Micro- and Macro-Algae in Probiotic-A Review. Nat Sci 2019;17(11):258-279]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 33. doi:10.7537/marsnsj171119.33.

Keywords: probiotics, prebiotics, synbiotics, microalgae, macroalgae

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The Influence of Methionine and Vitamin E on the Morphological Picture of Pancreas of Albino Rats Intoxicated With Sodium Fluoride

Naglaa A.S. Sarg and Kamal M. Kamal

Anatomy & Embryology Department Faculty of Medicine, Benha University, Egypt

kamal01225756395@gmail.com

Abstract: Background: Sodium Fluoridehas protective effects on dental health. Excessive ingestion of fluoride may cause toxic and harmful effects. Chronic toxicity with fluoride is more common than acute toxicity. Methionine is a potential natural antioxidant. Vitamin E is a fat-soluble vitamin which acts as an antioxidant. It protects cells from free radical damage. It also enhances the immune function. Aim of the work: This work aims at evaluation of the protective role of Methionine, and Methionine in combination with vitamin E, on the pancreas of Albino rats intoxicated with Sodium Fluoride. Materials and Methods: This study included 24 adult male Albino rats which were divided into four equal groups: Group I (Control group): Each rat received 1 ml distilled water orally. Group II (Fluoride- treated group): Each rat received 10 mg NaF/kg b.w., once daily for 35 days. The prepared dose was given orally by a gastric tube. Group III (Fluoride and Methionine - treated group): Each rat received 10 mg NaF/kg b.w. orally by gastric tube once daily in addition to 2 mg methionine/rat/day using a syringe connected to gastric tube for 35 days. Group IV: Each rat received 10 mg NaF/kg b.w. orally by a gastric tube once daily in addition to 2 mg Methionine/rat/day orally by a gastric tube & vitamin E in a dose of 3mg/rat/day using a syringe connected to gastric tube for 35 days. Pancreatic samples were prepared for histopathological and Immunohistochemical study. Results: Heamatoxilen and Eosin study of sections of the pancreas of Albino rats from Sodium Fluoride-treated rats (group II) showed disturbance of the normal architecture of the pancreas in the form of variable degrees of cellular degeneration. There was an increase of interlobular connective tissue with dilated congested blood vessels and massive infiltration of inflammatory cells. Areas of highly vacuolated acini were also noticed. There was an obvious increase in the connective tissue by Masson’s Trichrome stain. These group showed strong positive immunoreactions to PCNA in acinar cell and islets of Langrhans. Sections of the pancreas of Albino rat from group III that received sodium fluoride and Methionine showed an improvement of islets of Langerhans but with congested blood vessels and were surrounded by normal exocrine acinar cells of pancreatic tissues. Degeneration of few acini were also noted. Mild to moderate amount of connective tissue in between the pancreatic acini was seen by Masson’s Trichrome. moderate positive immunoreaction to PCNA in acinar cell and islets of Langerhans was also noticed. As regards rats of group IV, most pancreatic specimens showed preserved normal pancreatic architecture, with most acinar cells; their nuclei appeared more or less similar to those in the control group. Normal appearance of islets of Langerhans with very mild infiltration with inflammatory cells was also observed. By Masson’s Trichrome minimal amount of connective tissue was seen. Specimens also showed mild positive immunoreaction to PCNA in acinar and in islets of Langerhans. Morphometric results: Group III showed a significant (P<0.01) decrease in collagen fibers deposition when compared with group II and a significant (P<0.01) increase when compared with group I. Group IV showed a significant (P<0.01) decrease in collagen fibers deposition compared with group II and group III while it showed an insignificant (P<0.01) increase when compared with group I. Group III showed a significant (P<0.01) decreased PCNA immunoreaction compared with group II but a significant (P<0.01) increase when compared with group I. Group IV showed a significant (P<0.01) decreased PCNA immunoreaction compared with group II and group III but an insignificant (P<0.01) increase when compared with group I. Conclusion: These results indicate that Sodium Fluoride may cause pancreatic histological and immunohistochemical changes which may lead to a series of pathological abnormalities. Concurrent administration of NaF and vit. E in combination with Methionine alleviate the adverse effects of Fluoride.

[Naglaa A.S. Sarg and Kamal M. Kamal. The Influence of Methionine and Vitamin E on the Morphological Picture of Pancreas of Albino Rats Intoxicated With Sodium Fluoride. Nat Sci 2019;17(11):283-291]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 34. doi:10.7537/marsnsj171119.34.

Keywords: Influence; Methionine; Vitamin E; Morphological; Picture; Pancreas; Rat; Intoxicate; Sodium Fluoride

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