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Comparative study between endoscopic myringoplasty and microscopic myringoplasty in tubotympanic chronic suppurative otitis media

Mohamed A. Aldabaa, Mohammed H. Abdel-Azim and Basuni A. Abdeltwab

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

dr.baat2017 @gmail.com

Abstract: Background: The use of the rigid endoscope in the management of dry central perforation of the drum represented a significant advance in middle ear surgery. It replaces the operating microscope in observation and surgery of the tympanic membrane perforation. It provides an extremely sharp image with high resolution. Aim: Comparative study between endoscopic myringoplasty and microscopic myringoplasty in tubotympanic chronic suppurative otitis media. Methods: 30 patients (30 ears) with tympanic membrane perforation safe type under went Type1 Tympanoplasty (myringoplasty) met the inclusion criteria; Patients with traumatic perforation, Patients with mucosal chronic otitis media associated with central perforation that is dry for at least 3 months, Patients more than 12 years old and younger than 50 years old. Results: This study shows that no significant difference between the endoscopic and microscopic technique in myringoplasty with the superiority to the endoscopic for being better visualizing the field especially the anterior perforations and less traumatic. Conclusion: Success rate was found equal for both endoscopic and microscopic techniques. Endoscopic technique has a panoramic, wide angle, and magnified view as well as ability to easily negotiate through external auditory canal and provide uninterrupted picture that overcomes most of the disadvantages of microscope.

[Mohamed A. Aldabaa, Mohammed H. Abdel-Azimand Basuni A. Abdeltwab. Comparative study between endoscopic myringoplasty and microscopic myringoplasty in tubotympanic chronic suppurative otitis media. Nat Sci 2019;17(5):1-4]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj170519.01.

Keywords endoscopic myringoplasty; microscopic myringoplasty; tubotympanic chronic suppurative otitis media

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Efficacy of Epidural Analgesia versus Ultrasound guided Femoral Nerve Block in Postoperative Pain Relief in case of Total Knee Surgery.

Dr. Gehan Fouad Kamel, Dr. Manal Mohamed Kamal, Dr. John Nader Nasief and Saad Fayez Kaldas

Anaesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

saadkaldas81@gmail.com

Abstract: Surgeries of the knee are associated with moderate to severe postoperative pain. Uncontrolled postoperative pain has an adverse sequel of delayed resumption of normal pulmonary function, restriction of mobility, nausea and vomiting, increase in the systemic vascular resistance, cardiac work, and myocardial oxygen consumption. So these procedures are better to be done under regional anesthetic techniques which reduce neuroendocrinal stress responses, central sensitization of the nervous system and muscle spasms which occur in response to painful stimuli. Recently, among these regional anesthetic techniques PNB are gaining popularity because they reduce the possibility of complications and side effects associated with the central blocks. Femoral block provide effective analgesia with potentially fewer complications and side effects than epidural blocks. The purpose of this study was to compare between epidural analgesia and femoral nerve block in adult patients undergoing total knee replacement including comparison of analgesic efficacy, side-effects, and complications. The study was performed upon 40 patients, aging 40-70 years, and randomly distributed among two groups: Group A: 20 patients received lumbar epidural analgesia. Group B: 20 patients received femoral nerve block. For each patient, the following data were collected: age, sex, weight, height, ASA, duration of surgery, hemodynamic changes, incidence of postoperative complications, pain scores. The results showed that performing femoral nerve block provided effective analgesia, equivalent rehabilitation and duration of hospital stay in addition to fewer complications in comparison to epidural analgesia such as hypotension, postoperative vomiting and urinary retention.

[Dr. Gehan Fouad Kamel, Dr. Manal Mohamed Kamal, Dr. John Nader Nasief and Saad Fayez Kaldas. Efficacy of Epidural Analgesia versus Ultrasound guided Femoral Nerve Block in Postoperative Pain Relief in case of Total Knee Surgery. Nat Sci 2019;17(5):5-14]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj170519.02.

Keywords: Efficacy; Epidural; Analgesia; versus; Ultrasound; Femoral Nerve; Block; Postoperative; Pain Relief; Surgery

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Role of laparoscopy in abdominal Trauma Patients

Ashraf O. Ali M.D ¹, Mohamed A. Rizk M.D², Mina R. Tawfeek¹

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

²Department of Vascular and General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Email: minaromanymedical1989@gmail.com

Abstract: Background: Trauma is the main cause of morbidity and mortality worldwide and is still the most frequent cause of death in the first four decades of life. Moreover, it remains a major public health problem among all countries, regardless of the socioeconomic status. Aim of the Work: to evaluate the role of laparoscopy in minimizing the complications of exploratory laparotomy, especially when the results of laparotomy comes negative. Patients and Methods: This prospective cohort clinical study was conducted on 25 patients who presented to emergency unit with abdominal trauma (either blunt or penetrating) during the period between December 2017 and May 2018. Results: 7 cases (28%) had no detected intra-abdominal injuries and considered negative, the other 18 cases (72%) showed variety of intra-abdominal injuries and considered positive. Between the 18 positive cases 11 of them (61.1%) were dealt with laparoscopically and the other 7 cases (38.9%) required conversion to laparotomy. The use of laparoscopy in abdominal trauma patients appears as a safer alternative for exploratory laparotomy with 100% sensitivity in detecting intra-abdominal injuries, less complications rate and less post-op. hospital stay. In the hands of an experienced laparoscopic surgeon it can be safely used to repair those injuries laparoscopically. Conclusion: In a hemodynamically stable patient presented with abdominal trauma (either penetrating or blunt), Laparoscopy has both a diagnostic and therapeutic roles.

[Ashraf O. Ali, Mohamed A. Rizk, Mina R. Tawfeek. Role of laparoscopy in abdominal Trauma Patients. Nat Sci 2019;17(5):15-21]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj170519.03.

Key words: laparoscopy, abdominal Trauma Patients

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Comparative Study between Dexmedetomidine versus Nalbuphine as an Adjuvant to Bupivacaine in Caudal Anesthesia in Children undergoing Inguinal Hernia Repair Surgery

Prof. Dr. Magdy Mohamed Hussein Nafie, Assis. Prof. Dr. Dalia Mahmoud Ahmed El-Fawy, Dr. Hany Magdy Fahim Hanna, Hossam Salah El-Sayed Ibrahim*

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

E-mail: hsalah173@yahoo.com

Abstract: Background: Anesthesia primarily aims to relief patient's pain, agony and discomfort associated with the surgical procedure. Postoperative pain control is a cornerstone in management of anesthesia, various methods are used to control postoperative pain in children, one of the most reliable, popular and safe techniques is the caudal block which provides proper analgesia for lower abdominal surgical procedures with one disadvantage which is the short lived duration of action of the single shot caudal block. Objectives: The aim of this the study is to compare the efficacy of adding dexmedetomidine versus nalbuphine to local anesthetic in children undergoing inguinal hernia repair surgery. Patients and methods: After obtaining informed written consent from parents or guardian, and obtaining approval from Research Ethics Committee of anesthesiology department, the study was conducted in Nasser institute for research and treatment hospital. This prospective randomized controlled, double blind clinical trial was conducted on 60 patients were randomly divided into 2 study groups as simple randomization by computer-generated random numbers. Each group contains 30 patients: Group D (Dexmedetomidine group): Bupivacaine+ Dexmedetomidine, group N (Nalbuphine group): Bupivacaine + Nalbuphine. Results: There was no significant difference in the two groups with regard to age and sex. The mean age was 4.23±1.50 years in Group N and 4.17±1.53 years in Group D. In both the groups’ males were more, this could be due to inclusion of surgery. Regarding heart rate and blood pressure, all the patients were monitored at regular intervals. The mean baseline heart rate was similar in both groups before the administration of caudal block. The mean baseline rate was 124.10±3.5 beats per minute in Group N and 123.90±3.4 beats per minute in Group D. There was significant fall in heart rate after caudal by 20 minutes which showed 114.60±2.62 beats per minute in Group N and 112.30±3.58 beats per minute in Group D. This fall in heart rate continued until end of surgery without clinical significance. Conclusion: The results of this clinical trial had demonstrated that addition of dexmedetomidine to caudal local anesthetic bupivacaine produced longer duration of postoperative analgesia in pediatric patients undergoing inguinal hernia repair surgery than in nalbuphine group with no side effects.

[Prof. Dr. Magdy Mohamed Hussein Nafie, Assis. Prof. Dr. Dalia Mahmoud Ahmed El-Fawy, Dr. Hany Magdy Fahim Hanna, Hossam Salah El-Sayed Ibrahim. Comparative Study between Dexmedetomidine versus Nalbuphine as an Adjuvant to Bupivacaine in Caudal Anesthesia in Children undergoing Inguinal Hernia Repair Surgery. Nat Sci 2019;17(5):22-32]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj170519.04.

Keywords: Dexmedetomidine, Nalbuphine, Bupivacaine, Caudal Anesthesia, Inguinal Hernia Repair Surgery

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Investigation of heavy metals pollution in water, sediment and fish tissues at Upper Egypt

Abd-Elatief shaker, Ashraf gonhiem, Fayzasadeek and Amira M Abdellhaa

Depart. of Forensic Medicine & Toxicology, Faculty of Vet. Medicine, South vally University, Egypt

amirahasanin84@yahoo.com

Abstract: The present study was aimed to investigate heavy metals pollution in water, sediment and fish tissues at different sites of water (Elhawaweesh, Elahaywa, Dar-Elsalam, Belsofora and Elnemsawy) at two seasons autumn and spring. Heavy metal residues (zinc, copper, lead, manganese and iron) were determined in water, sediment and fish. The study revealed that concentration of Fe, Pb and Mn in water was higher than the permissible limit of WHO, EPA, EC and USEPA except Cu and Zn. It is the same for fish tissue. The levels of all the metals in the sediment were found to be higher than the values in water and fish. This affirmation with most of the research findings of other workers that sediments usually serve as sink for heavy metals. However the average heavy metal concentrations in sediment samples were below the permissible limits (except Mn) compared to the permissible limit. This study discovers seasonal variation in metal accumulations.

[Abd-Elatief shaker, Ashraf gonhiem, Fayzasadeek and Amira M Abdellhaa. Investigation of heavy metals pollution in water, sediment and fish tissues at Upper Egypt. Nat Sci 2019;17(5):33-38]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj170519.05.

Keywords: Water, sediment, fish tissue, heavy metals

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Histological study on the effect of different doses of tramadol administration on adult male albino rat cerebellum

Gamal M Hagras, Magda A Mansour, Nagwa S Ghoneim and Haitham M Sewilam

Histology Department, Faculty of Medicine, Menoufiya University, Egypt.

Haitham.sewilam@gmail.com

Abstract: Background: Tramadol hydrochloride is a centrally acting synthetic analgesic drug used to treat moderate to severe pain. Long-term use of high doses of tramadol may be associated with physical dependence and a withdrawal syndrome. Objective: This study was designed to demonstrate the histological changes and immunohistochemical findings in the cerebellum of the adult male albino rats induced by different doses of tramadol administration. Materials and methods: 50 adult male albino rats were divided into two main groups: control group (Group I), received a balanced diet for 2 weeks and experimental group (Group II), divided into two subgroups; IIA, divided into IIA₁, injected with 0.7 mg as a single daily dose of tramadol solution for 2 weeks and IIA₂, injected with 0.7 mg as a single daily dose of tramadol solution for 2 weeks, then left for another 2 weeks without injection for recovery and IIB, divided into two subgroups IIB_1, injected with 1.8 mg as a single daily dose of tramadol solution for 2 weeks and IIB₂, injected with 1.8 mg as a single daily dose of tramadol solution for 2 weeks, then left for another 2 weeks without injection for recovery. At the end of the experiment, the rats were sacrificed and decapitated. The cerebellum was removed and prepared for histological and immunohistochemical studies. Results: Group II A₁ showed mild congested blood capillary. It also showed degenerated Purkinje cells characterized by deformity in the nuclear membrane appeared as finger projections. Group II A₂showed mild restoration of the normal histomorphological structures. It also showed degenerated Purkinje cell with projections of its nuclear membrane and remnants of electron dense bodies. Group II B₁ showed congested blood vessels with empty spaces in the Purkinje layer with disarrangement of Purkinje cells. It also showed an irregular-shaped, necrotic Purkinje cells. Group II B₂showed mild congested blood vessels with still presence of some apoptotic Purkinje cells and mild degenerated nerve axons with some disarrangement of myelin sheath. Conclusion: The results of this study provided evidence that tramadol intake exerts a neurotoxic effect on the cerebellar structure in an ascending manner according to the dose administered.

[Gamal M Hagras, Magda A Mansour, Nagwa S Ghoneim and Haitham M Sewilam. Histological study on the effect of different doses of tramadol administration on adult male albino rat cerebellum. Nat Sci 2019;17(5):39-53]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj170519.06.

Keywords: Tramadol, Cerebellum, Histology and TEM.

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Mineralogy, Radioactivity and Geochemistry of the altered granite of Gabal Nikeiba area, South Eastern Desert, Egypt

Wafaa. H. Saleh

Nuclear Materials Authority, Cairo, Egypt. 530.P.O. El Maadi, Cairo, Egypt.

drwafaahosny@live.com

Abstract: The rock types in Gabal Nikeiba area are dominantly metavolcanics (lithic tuffs and crystal tuffs), tonalite, post orgonic (younger) granitic rocks, post granite dykes, veins and tertiary sediments. The young granites range in composition from monzogranite, syenogranite to alkali feldspar granite. They are the most favorable host rocks for uranium and thorium mineralization, especially in altered facies. Uranium and thorium concentrations of the studied altered granites range between 1031 and 2944, 4028 and 4030 ppm, respectively suggesting that the altered granites belong to high thorium, high uranium granites. Th/U and ²³⁴U/²³⁸U ratio indicate that the presence of more than one stage of uranium mineralization. Radioactive mineralized zone show average activity concentration of the ²³⁸U (24516 BqKg^-1), ²³⁴U (11937 BqKg^-1), ²³²Th (15153.67 BqKg^-1), ⁴⁰K (1558.5 BqKg^-1) and ²³⁵U (1101.83 BqKg^-1). The first is uranium accumulation in the studied altered granites clarified from Th/U ratio, followed by later uranium leaching from altered granites to the surrounding rocks as indicated by ²³⁴U/²³⁸U ratio. High uranium and thorium contents are mainly attributed to the presence of uranothorite, thorite, kasolite, fergusonite, ferrocolumbite and zircon in the studied altered granites. Other mineralization are also recorded such as gold, galena and fluorite. Geochemical investigations show that the studied altered granites are subjected to desilicification, albitization and silicification, several processes of alterations in the uraniferous granites, sodic or potassic metasomatism, serictization is the most common process associating with other processes of alteration. Chemical compositional variation in minerals is referred to two solid solution types, the first type when ion of higher charge substitutes for two lower charged ions to maintain charge balance. In this study, the EDX analysis indicate enrichment of Ca²⁺ (14.14%) on the account of Na⁺¹ and K⁺¹. The second type is the interstitial solid solution, where some sites in the crystal structure are vacant (M- site) occupied by the other ions especially the trace elements such as Nb, Zr, Hf, REE and uranium, while the temperature range increase from 750⁰C to 1000⁰C. The studied highly radioactive granite zone revealed that the chondrite normalized REE patterns are different from the normal M- and W-type of tetrad effects and has complex characteristics of the two types. The first four elements (La, Ce, Pr, Nd) and the third set (Gd, Tb, Dy, Ho) exhibit a clear convex curve (M-type) while the fourth (Er, Tm, Yb, Lu) define distinct concave curves (W-type), on chondrite-normalized plots. The convex (M-type) T₁ and T₃ accompanying with concave (W-type) T₄ may be related to the physico-chemical conditions that prevailed during the alteration processes. The unusual MW-type tetrad effect could be considered as geochemical exploration method for Au mineralization of reworked plutons.

[Wafaa. H. Saleh. Mineralogy, Radioactivity and Geochemistry of the altered granite of Gabal Nikeiba area, South Eastern Desert, Egypt. Nat Sci 2019;17(5):54-67]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj170519.07.

Key words: Mineralogy, Radioactivity, Geochemistry, Gabal Nikeiba area, South Eastern Desert

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Correlation between the Level of Serum C-Reactive Protein and The Fetal Ultrasonic Prediction of Threatened Abortion

Galal Alkholy; Ayman Shedid; Mohamed Ibrahim; Bassam Gaber Mohamed

Obstetrics and Gynecology Department; Faculty of Medicine - Benha University

Dr_bassam012@yahoo.com

Abstract: Background: Spontaneous miscarriage is the involuntary termination of pregnancy before 20 weeks of gestation or spontaneous expulsion of fetus below a fetal weight of 500 g. The definition varies in duration of gestational age according to the countries and available facilities. Spontaneous miscarriage accounts for about 15% of pregnancies. 1% of it is recurrent. Several studies have been established using ultrasound parameters and biochemical markers, aiming to predict the outcome of pregnancy. Objective: This study aimed to predict abortion using blood C reactive protein and some ultrasonographic measurements at the 7^th week of gestation. Methods: This prospective study was conducted on two hundreds pregnant women on the 7^th week of gestation, evaluating the relation between C- reactive protein serum level and fetal heart rate in prediction of spontaneous abortion in women presenting with live pregnancies complicated by vaginal bleeding at 5–12 weeks’ gestation with or without abdominal pain at the period from May 2015 to May 2018. The 200 women will be included in this study have singleton pregnancy between 5th and 12th week of gestational age calculated on the basis of the last menstrual period and confirmed by ultrasound examination. Results: The current study found that the use of MSD, MSD-CRL ratio and FHR is significant in predicting pregnancy outcome and low abortion risk. Conclusion: This study found that the use of MSD, MSD-CRL ratio and FHR is significant in predicting pregnancy outcome. But CRL is not significant.

[Galal Alkholy; Ayman Shedid; Mohamed Ibrahim; Bassam Gaber Mohamed. Correlation between the Level of Serum C-Reactive Protein and The Fetal Ultrasonic Prediction of Threatened Abortion. Nat Sci 2019;17(5):68-77]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj170519.08.

Keywords: Serum C-Reactive Protein; Fetal Ultrasonic Prediction; Threatened Abortion

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Monitoring the Effect of Mannitol 20% Solution on Brain Midline Shift Using Transcranial Ultrasonography in Severe Traumatic Brain Injury

Prof. Dr. Mohamed Anwer Elshafey, Assist. Prof. Dr. Ghada Mohamed Samir, Dr. Riham Fathy Galal, and Ahmed Metwally Mahmoud ElAtrash

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

A_metwally2001@yahoo.com

Abstract: Brain midline shift (MLS) in traumatic brain injury is a life-threatening condition that requires urgent diagnosis and treatment. The early detection of a MLS in severe traumatic brain injury patients is thus very important because it allows starting an appropriate treatment plan. Head CT is considered to be the gold standard to diagnose MLS. Transcranial B-mode sonography (TCS) is a bedside neuroimaging technique which is safe, painless, and accurate. The aim of the present study is to monitor the effect of mannitol 20% solutions on brain mid line shift by using transcranial ultrasonography in severe traumatic brain injury. The current study is a prospective observational study conducted on 30 adult male and female admitted to the Critical Care Medicine Departments in Ain Shams University Hospital with the diagnosis of severe traumatic brain injury. In the current study, there was a positive correlation between APACHE II and ICU stay and mortality. We also found that brain edema, midline shift, Glasgow coma score and FOUR score were improved after the use of mannitol 20% solution. The most important finding in this study was that transcranial ultrasonography can detect and monitor MLS with only a small difference in comparison to CT brain so it provide a cheap accurate noninvasive and bedside tool for diagnosis and monitoring MLS.

[Mohamed Anwer Elshafey, Ghada Mohamed Samir, Riham Fathy Galal, and Ahmed Metwally Mahmoud ElAtrash. Monitoring the Effect of Mannitol 20% Solution on Brain Midline Shift Using Transcranial Ultrasonography in Severe Traumatic Brain Injury. Nat Sci 2019;17(5):78-88]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj170519.09.

Keywords: Monitoring; Effect; Mannitol; Solution; Brain; Midline; Shift; Transcranial; Ultrasonography; Traumatic Brain Injury

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Comparative thesis study between Lipoabdominoplasty Versus Traditional Abdominoplast

Prof. Dr. Hassan Sayed Tantawy ¹, Dr. Mohamed Ibrahim Hassan ¹, Dr. Riham Zakaria Ahmed Lashin ², Laith Mokhtar Mohamed ¹

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

² Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Egypt

laith.mokhtar@gmail.com

Abstract: Background: Abdominoplasty is one of the most common aesthetic procedures that have developed significantly over the past several years. Objectives: The purpose of this study is to evaluate the safety of abdominoplasty with concurrent abdominal liposuction. Patients and Methods: Proper patient selection and education are critical factors to ensure long-term success of the procedure. Patients requiring abdominoplasty must have realistic expectations and should be committed to healthy lifestyle, a well-balanced diet and regular exercises. Between February of 2017 and January of 2019, in sheikh zayed specialized hospital, (32 patients) seeking abdominal contouring were evaluated and be operated. Data were taken from charts of patients with mean follow-up of 10 months postoperatively. Results: Concerning Infection, the total wound infection rate in our study in both of the groups was (3 patients 12.5%). In abdominoplasty group of patients (one patient 6.25%) got wound infection, Also, in lipoabdominoplasty group of patients’ (one patient 6.25%) got infection. All cases required treatment with intravenous antibiotics for two weeks and healing with no further complications. Conclusion: Lipoabdominoplasty is a very effective tool to perfect body shape. This study showed that it wasn’t associated with higher rates of complications than traditional abdominoplasty.

[Hassan Sayed Tantawy, Mohamed Ibrahim Hassan, Riham Zakaria Ahmed Lashin, Laith Mokhtar Mohamed. Comparative thesis study between Lipoabdominoplasty Versus Traditional Abdominoplast. Nat Sci 2019;17(5):89-94]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj170519.10.

Keywords: Lipoabdominoplasty, Traditional Abdominoplasty

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Relationship between hematological parameters and myocardial perfusion in patients with acute anterior myocardial infarction managed by primary percutaneous coronary intervention

Ahmed EL Missiri MD, Ehab Mohamed Elfekky MD, Sameh Mosaad MD, Mahmoud Hamad Salama MBBCh

Department of Cardiovascular, Faculty of medicine, Ain shams university

mahmoudhamad01115227426@gmail.com 

Abstract: Background: Elevated white blood cell count and neutrophils to lymphocyte ratio consider a good Predictor in risk stratification in chronic stable coronary arteries disease and prognostic marker In long and short term cardiovascular mortality. Objective: To evaluate relationship between total leukocyte count TLC, neutrophills to lymphocyte NLR and myocardial perfusion in patient with acute anterior ST segment elevation myocardial infarction managed by primary PCI. Patients and Methods: This study is a prospective observational study. It was conducted at Ain Shams University and October 6 university hospitals from 15/11/2017 to 15/5/2018. The study was conducted on 60 patients diagnosed as acute anterior ST segment elevation myocardial infarction who underwent primary percutaneous coronary intervention within 6 hour from onset of symptoms with mean age 58.45 ± 10.61 Eighty percent of subjects were males. Results:. We found that the TLC and NLR was significantly associated with MBG and TIMI grades, patients with MBG 0-1 had significantly higher TLC & NLR than patients with MBG 2-3. patient with MBG (2 & 3) had significantly lower peak CKMB than patients with MBG 0 & 1, there is excess rate of morbidity and mortality in patient with impaired myocardial perfusion. Conclusion: The present study shows that higher TLC and NLR at admission were significantly correlated with poor perfusion outcomes, morbidity, low ejection fraction and mortality.

[Ahmed EL Missiri, Ehab Mohamed Elfekky, Sameh Mosaad, Mahmoud Hamad Salama. Relationship between hematological parameters and myocardial perfusion in patients with acute anterior myocardial infarction managed by primary percutaneous coronary intervention. Nat Sci 2019;17(5):95-103]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj170519.11.

Keywords: Acute myocardial infarction, neutrophil-to-lymphocyte ratio, myocardial blush grade

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Fatigue Levels among Patients with Chronic Hepatitis C Undergoing Antiviral Therapy

Sabah Elgendi¹, Mohga Sliem², Amany Shebl³, Wafaa Ismaeil⁴, Faye A. Gary⁵

¹Assistant lecturer of Medical Surgical Nursing Department, Faculty of Nursing, Kafr El Sheikh University, Egypt

²Professor of Medical Surgical Nursing Department, Faculty of Nursing, Kafr El Sheikh University, Egypt

³Professor of Medical Surgical Nursing Department, Faculty of Nursing, Mansours University, Egypt

⁴Professor of Medical Surgical Nursing Department, Faculty of Nursing, Mansours University, Egypt

⁵Professor of Psychiatry and mental health, Frances Payne Bolton School of Nursing, Case Western Reserve University, USA

sabah_zein@yahoo.com

Abstract: The objectives of this study are: to assess fatigue levels among patients infected with the hepatitis C virus (HCV) and undergoing 24 weeks of daily antiviral therapy with Sofosbuvir (SOF) and ribavirin (RBV). Design and sample: A descriptive study was conducted on a convenience sample of 100 patients with chronic Hepatitis C undergoing antiviral therapy in outpatient clinics in Egypt. Fatigue was assessed using the Fatigue Severity Scale (FSS). Results: Among all participants (n=100), 66 percent reported having severe fatigue levels while 32 percent reported having moderate fatigue levels. Conclusion: our study confirms that fatigue was the most common side-effect among patients with chronic HCV and undergoing antiviral therapy. Nurses can use these findings to develop programs to decrease fatigue levels among patients infected with HCV patients.

[Sabah Elgendi, Mohga Sliem, Amany Shebl, Wafaa Ismaeil, Faye A. Gar. Fatigue Levels among Patients with Chronic Hepatitis C Undergoing Antiviral Therapy. Nat Sci 2019;17(5):104-109]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj170519.12.

Keywords: Fatigue Severity Scale, chronic Hepatitis C virus, Sofosbuvir, Ribavirin

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A comparative study between the effect of continuous positive air way pressure ventilation and standard oxygen therapy in acute cardiogenic pulmonary edema patients

Prof. Dr. Hoda Omar Mahmoud, Dr. Ashraf Nabil Saleh, Dr. Mohammed Moien Mohamed, and Dr. Ahmed Abdelkawy Elsaed Aborya

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

ahmed_aboria2a@yahoo.com

Abstract: Background: Acute cardiogenic pulmonary edema (ACPE) is one of the most common conditions presenting to the emergency department which require rapid assessment and intervention. It is associated with mortality rates of 10-20% (1). Acute cardiogenic pulmonary edema is a common cause of acute respiratory distress among patients presenting to the emergency departments and intensive care units. Hypoxemia, sometimes associated with hypercapnia, is a common feature in the clinical presentation of acute cardiogenic pulmonary edema. The use of noninvasive ventilation (NIV) in the acute care setting in general has been fueled by the desire to avoid the complications associated with intubation and invasive ventilation, (4) including trauma to the larynx, pharynx, and trachea, arrhythmia, hypotension, aspiration of gastric contents, sinusitis, pneumonia, and loss of the ability to eat and communicate verbally (5). Objectives: The aim of this study is to determine the clinical outcome with continuous positive pressure ventilation in adults with acute cardiogenic pulmonary edema compared to standard oxygen therapy. Patient and methods: This was a prospective, randomized, comparative clinical study to evaluate the clinical outcome with continuous positive pressure ventilation (CPAP) in adults with acute cardiogenic pulmonary edema (ACPE) compared to standard oxygen therapy. After approval of the ethical committee and obtaining a written informed consent from patient guardians, this prospective, randomized, comparative clinical study conducted in Ain Shams University hospitals on (20) adult patients aged more than 20 years, presenting to ICU of Ain Shams University hospitals with acute cardiogenic pulmonary edema. Results: Comparative studies between control and CPAP showed that highly significant decrease in average follow up HR and RR and highly significant increase in O₂ saturation; in CPAP group compared to control group; with highly significant statistical difference (p < 0.001 respectively). Combined paired and un-paired comparative studies showed that: After analysis of all 20 (control and CPAP) patients according to the 5 serial (baseline and follow up) vital and ABG data; with entering a dichotomous grouping factor (control – CPAP). Factorial ANOVA studies showed that; CPAP group had a higher average decline in HR and RR; and a higher average increase in O₂ saturation compared to control group; during serial 5 (baseline and follow up) vital data measurements (especially at 24-hours); with highly significant statistical difference (p < 0.001 respectively). Factorial ANOVA studies showed that; CPAP group had a higher average increase in PaO₂ compared to control group; during serial 5 (baseline and follow up) ABG measurements (especially at 24-hours); with highly significant statistical difference (p < 0.001). Conclusion: Based on our findings and those previously published, we conclude that CPAP should be considered especially in patients with respiratory failure due to ACPE. Also, PaCO₂ levels should be monitored closely in order to assess the response to treatment. Non-Invasive Ventilation has been shown to be effective in acute respiratory failure of various etiologies in different health care systems and ward settings. It should be seen as complementary to invasive ventilation and primarily as a mean of preventing some patients from deteriorating to the point at which intubation is needed.

[Hoda omar Mahmoud, Ashraf Nabil Saleh, Mohammed Moien Mohamed, and Ahmed Abdelkawy Elsaed Aborya. A comparative study between the effect of continuous positive air way pressure ventilation and standard oxygen therapy in acute cardiogenic pulmonary edema patients. Nat Sci 2019;17(5):110-118]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj170519.13.

Keywords: comparative; study; effect; continuous positive air; pressure; ventilation; standard; oxygen; therapy; acute cardiogenic pulmonary edema patient

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Diagnostic Accuracy of Core Needle Biopsy of Breast Lesions at Al-Demerdash University Hospital, Ain Shams University

Nihal Hisham Menessi, Lobna S. Shash, Eman Abdel-Salam Ibrahim, Faten Wagdi Ragheb

Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Drnihal92@gmail.com

Abstract: Background: Once a breast lesion is suspected on basis of clinical and radiological impression, pathological evaluation is fundamental to establish its definitive diagnosis. Core needle biopsy (CNB) is a far less invasive procedure than excisional biopsy and clearly more reliable than fine needle cytology. As such CNB represents the diagnostic tool of choice to complement the pre-management tertiary assessment. Nonetheless, technical errors as well as inherent restrictions of limited biopsy samples might ameliorate the diagnostic efficiency of CNB. Objectives: To evaluate the concordance of CNB and excisional biopsy results of breast lesions in Al-Demerdash hospital and spot light on potential causes of non-concordance when present. Methods: Comparison of CNB and excision biopsy results to investigate rate of disconcordance and delineate potential underlying causes for CNB incompetency in these cases. CNB results were categorized as B1, B2, B3, B4 and B5 for objective analysis. Final diagnosis of excisional and/or the open surgical biopsy results were used as the gold standard for evaluation of the diagnostic accuracy of CNB. Correlation with available pre-biopsy clinical and sonomamographic data was also applied. Results: 126 cases of CNB specimens were included in this study with conclusive diagnosis of a benign lesion in (7.9%) as compared to 17.5% in final diagnosis and conclusive diagnosis of a malignant lesion in (69.8%) as compared to 84.6% in final diagnosis, thus accuracy of CNB as a diagnostic tool mounted to an absolute sensitivity of 84.6%, and full Specificity 68.1%. The non-conclusive CNB result comprised (18.2%) of cases was attributed to inadequacy of sample material in (82.6%) and diagnostic pitfalls in (17.3%). Diagnostic pitfalls were encountered in B3 category (6.3%) and B4 category (3.9%). Conclusions: Core needle biopsy is an accurate, sensitive and specific method for pre-management evaluation of breast lesions. CNB proved to be a single independent predictive factor as compared to other pre-management clinical and radiological background data.

[Nihal Hisham Menessi, Lobna S. Shash, Eman Abdel-Salam Ibrahim, Faten Wagdi Ragheb. Diagnostic Accuracy of Core Needle Biopsy of Breast Lesions at Al-Demerdash University Hospital, Ain Shams University. Nat Sci 2019;17(5):119-125]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj170519.14.

Key words: Core Needle Biopsy, Breast Cancer, Diagnosis.

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Role of ‘14_3_3 Eta Protein’ in Rheumatoid Arthritis

Prof. Dr. Mohammed Ragaey El-Helw, Prof. Dr. Henaz Faroukd Khaled, Dr. Howaida Farouk Zidan, Sahar Samir Ragab

Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

dr-susita28@hotmail.com

Abstract: Background: Rheumatoid arthritis (RA) is a common, chronic, inflammatory, autoimmune disease of unknown etiology, associated with articular, extra-articular and systemic effects. It is affecting approximately 1% of the world population Objectives: This study is designed to measure the serum levels of 14_3_3 eta protein in patient with rheumatoid arthritis in order to detect its value as a diagnostic and disease severity marker. Patients and Methods: We conducted our study on 30 RA patients, and 30 normal healthy individuals served as a control group. The patient and control groups were subjected to full history taking, thorough clinical examination, laboratory investigations, and plain x-ray of the clinically affected joints. Results: Significantly higher plasma levels of 14_3_3 eta protein in patients compared to the controls. Statistically significant difference between groups according to ESR and CRP. Positive correlation and significant between marker 14-3-3 Eta protein with ESR, CRP, RF, Anti CCP, Modified DAS score and Larsen Radiological score. RF, AntiCCP and 14-3-3eta indices were significant predictors with sensitivity of (73.3%, 76.6% and 86.67% respectively) this makes 14-3-3 eta protein being the most significant predictor. Conclusion: Serum levels of 14_3_3 eta protein was measured in all patients and controls using ELISA technique.

[Mohammed Ragaey El-Helw, Henaz Faroukd Khaled, Howaida Farouk Zidan, Sahar Samir Ragab. Role of ‘14_3_3 Eta Protein’ in Rheumatoid Arthritis. Nat Sci 2019;17(5):126-131]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj170519.15.

Keywords: 14_3_3 Eta Protein, Rheumatoid, Arthritis

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Developed Heat Transfer Fluid Containing Nanoparticles

Reda I. Afify¹ S.F. Mansour², Khairy F. Megalaa³, and M. Saad Mostafa⁴

¹Faculty of Engineering at Shoubra, Mech. Department, Benha University, Cairo, Egypt.

²Faculty of Science at Zagazig, Zagazig University, Elsharqia, Egypt.

³Faculty of Engineering at El Mataria, Mech. Department, Helwan University, Cairo, Egypt.

⁴ Higher Technological Institute, Tenth of Ramadan city, Egypt.

Eng.muhammad.saad@gmail.com

Abstract: The monitoring increase of world population and living standards accomplished with the massive demand of limited fossil fuel and dangerous nuclear fission emphasizes the global energy crisis. Solar power offers a viable option for solving the uprising energy crisis. Furthermore, there is a strong motivation to explore the possibility of harnessing solar thermal energy around the world, especially in locations with relatively high temperature (i.e Egypt). In the present work, the enhancement of both of thermal energy transfer and storage in a concentrated solar power (CSP) system was developed. The enhancement criteria stand on improving the thermal properties of the base fluid by adding nanoparticles (i.e alumina). Innovative eutectic halide salt (used in the current work) was chosen as a base heat transfer fluid for three main aspects which are i.) relatively high heat capacity, ii) wide working temperature range up to 850^oC, and iii) low cost compared to similar solutions. The Alumina (Al₂O₃) nanoparticles (prepared by citrate nitrate auto combustion technique "Pechini method") with 0.5%, 1%, 1.5%, 2% concentrations by weight were mixed with ternary halide eutectic salt composed of 13.4 wt.% NaCl, 33.7 wt.% KCl and 52.9 wt.% ZnCl₂ by the aid of a magnetic stirrer. The thermal properties of pure eutectic halide salt were investigated before and after adding nanoparticles (nanofluid). The main concerned parameters are the specific heat capacity, melting point, phase change temperature difference, heat of fusion and weight stability percentage. The experimental results show that specific heat capacity of the nanocomposites increased by increasing nanoparticle concentration. The observed enhancement in specific heat capacity was found to be 1.0416, 1.095, 1.196, 1.109 and 1.115 (J/g.^oC) respectively for various concentrations of 0.0%, 0.5 wt.%, 1.0 wt.%, 1.5 wt.% and 2.0 wt.% respectively. Consequently, the heat of fusion was to be 96.34, 71.64, 76.923, 71.98 and 70.67 for concentrations 0.0%, 0. 5 wt.%, 1.0 wt.%, 1.5 wt.% and 2.0 wt.% respectively. While, the stability of nanocompositions in liquid phase increased by increasing the concentrations of NPs.

[Reda I. Afify S.F. Mansour, Khairy F. Megalaa, and M. Saad Mostaf. Developed Heat Transfer Fluid Containing Nanoparticles. Nat Sci 2019;17(5):132-142]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj170519.16.

Key words: Concentrated solar power (CSP), Renewable Energy (RE), Alumina (Al₂O₃) Nanoparticles, Eutectic halide salt, Pechini method).

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