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Relationship between H. pylori infection and microalbuminuria in type 2 diabetic patients

Hassan Abd El Hady (MD)¹, Yassin Salah Yassin (MD) ¹, Hany Said El Barbary (MD) ¹ and Shimaa Hamato Ibrahim El Badawy (MBBCh) ²

¹Department of Internal Medicine, Faculty of Medicine, Menoufia University, Egypt.

²Resident of Internal Medicine, Benha Educational Hospital, Egypt.

mlselbadawy@gmail.com

Abstract: Objective: The aim of this study was to investigate the relationship between helicobacter infection and occurrence of microalbuminuria (a marker of diabetic nephropathy) in type 2 diabetic patients. Background: The incidence and prevalence of type 2 diabetes mellitus is one of the most critical problems in the healthcare system. Diabetes is a fast-growing health problem in Egypt with a significant impact on morbidity, mortality, and health care resources. Currently, the prevalence of type 2 diabetes (T2D) in Egypt is around 15.6% of all adults aged 20 to 79. Patients and Methods: Cross sectional study was conducted on50 type-2 diabetic patients that invited to Group I: Included 25 patients of type 2 diabetes mellitus with microalbuminuria, and Group II: Included 25 patients of type 2 diabetes mellitus without microalbuminuria attending to Banha Educational Hospital-EGYPT for diabetic care. In addition, Twenty healthy individuals as control group. The study was done during the period from January 2015 to December 2015. Subjects were submitted to the history taking, physical examination as well as routine and special investigations. Results: no significant difference between case and control groups regarding age and BMI (p value> 0.05). On contrast, there was high significant difference regarding hypertension, SBP /mmhg and DBP /mmhg and all studied laboratory characteristics except Urea and Creatinine. There was significant relation between group I and group II regarding age, BMI and all studied laboratory except Creatinine (mg/dl). no significant correlation (p value > 0.05) between microalbuminuria with clinical data and all studied laboratory characteristics except 24h urinary ptn (mg/d). Results indicated that non-significant correlation (p value >0.05) was observed between CIMT and studied microalbuminuric patients with positive HPIgG. Conclusions: Results of concluded that H.P. infection is significantly prevalent in type 2 diabetes patients with microalbuminuria (64%) compared to non-microalbuminuric diabetic patients (28%). In H.P. IgG positive diabetic patients with microalbuminuria (16/25%), microalbuminuria is not significantly correlated with the studied clinical, CIMT and laboratory data except with 24 hrs urinary patients (r=1, p=0.00). moreover, the validity of microalbuminuria for detection of H.P. IgG in the studied type 2 diabetes patients is weak at cut off level of 95.0 (sensitivity 56.2, specificity, 44.4, p value = 0.699).

[Hassan Abd El Hady, Yassin Salah Yassin, Hany Said El Barbary and Shimaa Hamato Ibrahim El Badawy. Relationship between H. pylori infection and microalbuminuria in type 2 diabetic patients. Stem Cell 2017;8(4):1-7]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 1. doi:10.7537/marsscj080417.01.

Key words: Type 2 diabetes, Cross Sectional, H. pylori, Microalbuminuria

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Intrafamilial spread of Hepatitis C Virus in high socioeconomic population, in Menoufia Governorate

Prof. Dr. Ibrahim Mohamed Boghdadi, Prof. Dr. Tarek El Mahdey Korah, Prof. Dr. Ehab Ahmed Abd El Atty and Mohammed El Shahat Abel Rahman El Kalawy

Department of Internal Medicine, Faculty of Medicine, Menoufia University, Egypt.

midodrone@gmail.com

Abstract: Objective: This study was done to study the intrafamilial spread of HCV in high socioeconomic population, and to determine the prevalence of anti-HCV antibodies among household contacts of HCV seropositive index patients and to identify the possible risk factors for HCV transmission among families. Background: HCV is a major public health problem world wide. Persistent HCV infection is a leading cause of serious liver disease including cirrhosis and hepatocellullar carcinoma. Patients and Methods: This study included 100 HCV positive cases of high socioeconomic population and their family members; they were selected from different areas in Menoufia Governorate. All participants were subjected to thorough history taking, clinical assessment, and detection of HCV antibodies by one-step test device. Results: our study reaveld that Prevalence of HCV in family members of HCV positive patient was 8.24% Conclusion: intrafamilial contact is an important factor in the transmission of HCV. Transmission might occur during family contact, sexual behavior, and the shared use of personal items. A wide scale national study is needed to clarify this important entity.

[Ibrahim Mohamed Boghdadi, Tarek El Mahdey Korah, Ehab Ahmed Abd El Atty and Mohammed El Shahat Abel Rahman El Kalawy. Intrafamilial spread of Hepatitis C Virus in high socioeconomic population, in Menoufia Governorate. Stem Cell 2017;8(4):8-14]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 2. doi:10.7537/marsscj080417.02.

Key words: Hepatitis c virus, Intrafamilial transmission

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Lysyl Oxidase Like -2 in the pathogenesis of psoriasis

Mohamed Abd El-Moneim Shoeib MD¹, Ola Ahmed Amin MD ¹, Dalia Rifaat Alsharaky MD ², and Takia Fouad Mursi El Ezbawy M. B., B. Ch¹.

¹ Department of Dermatology, Andrology and STDs, Faculty of Medicine-Menoufia University, Egypt

² Department of Medical pathology, Faculty of Medicine-Menoufiya University, Egypt

tiger1234565@yahoo.com

Abstract: Objectives: to investigate the role of Lysyl Oxidase Like -2 (LOXL2) in the pathogenesis of psoriasis. Background: LOXL2 has been involved in gene transcription, cell motility/migration and adhesion, angiogenesis and differentiation, demonstrating their ability to affect both extra and intracellular cell functions.

Patients and Methods: twenty patients with psoriasis and ten healthy subjectsas a control group were included in this study. All patients were subjected to the following: History taking & clinical examination and dermatological examination and Punch biopsies were taken. each specimen was cut on routine slides for Hematoxylin and Eosin staining and immuno-staining with LOXL2. Results: Fifteen cases of psoriasis showed positive LOXL2 Immunoreactivity (75%).15 cases (100%) had cytoplasmic pattern. Comparing LOXL2 immunoreactivity in psoriasis versus normal epidermis showed downregulation of LOXL2 in psoriasis (75%) compared normal skin (100%). Conclusion: Downregulation of LOXL2 expression in psoriasis compared with normal skin. We identified novel LOXL2 roles in tissue homeostasis and support it as a target for pathogenesis of psoriasis.

[Mohamed Abd El-Moneim Shoeib, Ola Ahmed Amin, Dalia Rifaat Alsharaky, and Takia Fouad Mursi El Ezbawy. Lysyl Oxidase Like -2 in the pathogenesis of psoriasis. Stem Cell 2017;8(4):15-20]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 3. doi:10.7537/marsscj080417.03.

Keywords: homeostasis, Lysyl Oxidase Like -2, Notch1, psoriasis pathogenesis, psoriasis.

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Knowledge of stroke risk factors and warning signs among population in Shebin Al-Kom District, Menoufia Governorate, Egypt

Badr SA. MD ¹, El-Esrigy FA. MD ², Galhom MA. MBBCH ²

¹ Community Medicine Department, Faculty of Medicine, Menoufia University, Egypt

² Family Medicine Departments, Faculty of Medicine, Menoufia University, Egypt

Mariam.galhom@gmail.com

Abstract: Objectives: The aim of this study was to assess the knowledge level of the general population about risk factors and warning signs of stroke. Background: Both reduction the risk of stroke and increase in the speed of hospital presentation after the onset of stroke depend on the level of knowledge of stroke among general population. Participants and methods: This cross-sectional study was conducted in the context of time frame of 15 months (starting from first January 2016 to the end of March 2017) and included 400 participants of both genders, aged from 18 to 80 years old who were all attendants at two different family health centers in the context of time frame of three months. A closed-ended questionnaire was used to assess the awareness about stroke among population of Shebin Al Kom District. Results: The total stroke knowledge score was higher among participants with previous history of stroke attack and who with family history of stroke. The most identified risk factor for stroke by respondents was uncontrolled hypertension 271 (67.75%). The most recognized stroke symptom was severe headache 231(57.75%). Conclusion: There was a serious lack in knowledge about stroke; so educational programs about stroke can help to reduce stroke burdens in Egypt.

[Badr SA. MD, El-Esrigy FA. MD, Galhom MA. Knowledge of stroke risk factors and warning signs among populationin Shebin Al-Kom District, Menoufia Governorate, Egypt. Stem Cell 2017;8(4):21-25]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 4. doi:10.7537/marsscj080417.04.

Keywords: Knowledge, stroke, population

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Dermatophytosis among Basic School Children in Menoufia Governorate (Epidemiological Study)

Mostafa Ahmed Hammam MD¹; Azza Gaber Antar Farag MD^1; Reda Abdel Latif Ibrahem MD² and

Rehab Reda Elsayed Tolba¹

¹Dermatology Department, Faculty of Medicine, Menoufia University, Egypt

²Public Health and community Medicine Department Faculty of Medicine, Menoufia University

rehabtolba@gmail.com

Abstract: Back ground: Most superficial mycotic infections of human skin are due to dermatophytes. Children are mostly affected due to different predisposing factors especially overcrowding in classrooms. Meanwhile its transmissibility can be controlled through simple school-health measures. Objectives: This study was performed to estimate the prevalence of dermatophytes infections and their related risk factors among the primary and preparatory school pupils. Methods: In Menoufia governorate, Egypt, by using multistage random sampling technique, six public primary and preparatory schools were selected with a total number of 3464 pupils. The selected pupils were subjected to a predesigned questionnaire covering personal data and suspected risk factors for superficial dermatophyte infection, clinical examination to detect superficial dermatophyte infection with taking samples from the suspected lesions for mycological examination. Results: Among the studied pupils with age ranged from 6 – 14 years, the prevalence of clinically suspected dermatophytes infection was (1.41%) meanwhile the prevalence of culture confirmed cases was (0.98%). The most common clinical type was tinea capitis with specific prevalence (1.01%) followed by tinea pedis, tinea corporis and Onichomycosis. Microsporum canis was the only isolated organism on culturing the suspicious samples with positivity rate (69.4%). A statistically significant higher prevalence was observed among males, those with low socio economic level and with the presence of positive family history. Dealing with pits, common use of towels and sharing caps among pupils were significant risk factors of these infections. Conclusion: Dermatophytes infection is still prevalent among basic school children in Egypt. It was simply controlled as it was related mostly to preventable risk factors, so, health education program and regular screening should be advised for schools authorities.

[Mostafa Ahmed Hammam; Azza Gaber Antar Farag^; Reda Abdel Latif Ibrahem; Rehab Reda Elsayed Tolba. Dermatophytosis among Basic School Children in Menoufia Governorate (Epidemiological Study). Stem Cell 2017;8(4):26-32]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 5. doi:10.7537/marsscj080417.05.

Key words: epidemiology – dermatophyte infection – Tinea capitis

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A study of the effect of tramadol on testicular functions in adult males

Mohammad A Basha¹, Azza G Farag¹, Safaa A Amin², Seham A Khodair³ and Mariam Mohammad Taha¹

¹Department of Dermatology, Andrology and S.T.Ds, Faculty of Medicine, Menoufia University, Menoufia, Egypt

²Department of Forensice Medicine and Medical Toxicology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

³ Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

m_maaty_te_eg@yahoo.com

Abstract: Objective: The aim of the study was toelucidate the effects of tramadol addiction on testicular functions of adult males. Background: Tramadol is centerally acting atypical opiod analgesic with additional serotonine-norepinephrine reuptake inhibiting effects. Tramadol is used primarily to treat moderate to severe pain. Also, tramadol is used in other uses as post herpetic neuralgia, diabetic neuropathy, antidepressant, acute opioid withdrawal management, obsessive compulsive disorder and premature ejaculation. Long term use of high doses of tramadol may be associated with physical dependence and withdrawal symptoms including numbness, tingling, paresthesia and tinnitus. Many studies were performed on rats for assessment of the effect of tramadol on testis but no studies were performed on humans till now. Patients and methods: This study was conducted on 60 patients taking tramadol daily and 30 age matched control. Serum hormones (FSH, LH, prolactine and testosterone) were measured. Semen samples of 30 addicts were analysed. Results: Tramadol significantly reduce all measured hormones in comparison to the control groups. Also, tramadol significantly affect the sperm vitality and motility in comparison to the control group. High pus cell in semen of tramadol addicts in comparison to the control group. Conclusion: Tramadol affect the hormonal and reproductive functions of the testis.

[Mohammad A Basha, Azza G Farag, Safaa A Amin, Seham A Khodair and Mariam Mohammad Taha. A study of the effect of tramadol on testicular functions in adult males. Stem Cell 2017;8(4):33-37]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 6. doi:10.7537/marsscj080417.06.

Key words: Tramadol, Semen analysis, Hormonal profile

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Correlation between Adenoid Volume and Intratympanic Pressure Level and Degree of Mastiod Air Cell Pneumatization in Children at Pre-School Age

ELhosyni E. Shreef (MD)^1; Essam A. Behairy (MD)¹; Ayman A. Abd El Fattah (MD)¹ and Mohammed F. Sahaly (MBBCH)²

¹Department of Otorhinolaryngology, Faculty of Medicine, Menoufia University, Egypt

²Resident of ENT, Gamal Abdel Naser Hospital, General Authority for Health Insurance, Alexandria, Egypt

m.sahalyent@yahoo.com

Abstract: Objective: Studying correlation between adenoid volume and intratympanic pressure level and the degree of mastoid air cells pneumatization, clinically, audiologically and radiologically in children between (3-6^th) years. Background: Adenoid Hypertrophy and Eustachian tube dysfunction are considered causal factor for intratymanic pressure level changes. There are many methods to measure the size of adenoid aslateral soft tissue X-ray of nasopharynx and measuring the adenoid volume physically. Materials and method: This study was made as a prospective study performed on 40 children with adenoid hyperatrophy, that was diagnosed clinically, radiologically by lateral soft tissue x-ray of neck and physically. Intratympanic pressure level was measured audiologcally. Mastoid air cells pneumatization was assessed radiologically by computerized tomography of temporal bone from May 2014 till September 2016. Results: 57.5 % males and 42.5 % females with adenoid volume were estimated in ranges between 4-7 ml in all cases with mean ±SD 5.47±0.96. We found that 35 cases with mean adenoid volume "5.48±0.94" have well mastoid air cell pneumatization, and 5 cases with adenoid volume "5.40±1.19" have poorely air cell pneumatization, also we found 42 ears with mean adenoid volume "5.80±0.87" their tympanogram was type B and, 10 ears with mean adenoid volume "6.05±0.85" their tympanogram type c, 24 ears with mean adenoid volume "4.69±o.69" with tympanogram type A and 4 ears with mean adenoid volume "5.18±0.35" with tympanogram type As. p value was < 0.001. Conclusion: There is a significant correlation between increasing adenoid volume and changes in intratympanic pressure level, and there is no significant relation between mastoid air cells pneumatization and Adenoid volume.

[ELhosyni E. Shreef; Essam A. Behairy; Ayman A. Abd El Fattah and Mohammed F. Sahaly. Correlation between Adenoid Volume and Intratympanic Pressure Level and Degree of Mastiod Air Cell Pneumatization in Children at Pre-School Age. Stem Cell 2017;8(4):38-43]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 7. doi:10.7537/marsscj080417.07.

Keywords: Adenoid hypertrophy, mastoid, middle ear pressure level, middle ear ventilation and tympanometry

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Factors Affecting Axillary Lymph Node Involvement in Breast Cancer

Ayman A. Albatanony, (MD)¹; Asem F. Moustafa, (MD) ¹ and Ali G. Hydara, MBBCh²

¹General Surgery Department, Faculty of Medicine, Menoufiya University, Egypt.

²General Surgery Department, Tanta Cancer Center, Tanta, Egypt.

alihydara69@yahoo.com

Abstract: Objectives: to detect factors affecting axillary lymph node (LN) metastasis in breast cancer. Background: Surgical dissection is the accepted mode of staging the axilla in breast cancer. However, the associated morbidity has led researchers to look at less invasive options so Proper prediction of factors influencing axillary lymph node positivity is very important to detect proper surgical interference Methods: This study is a prospective, comparative, randomized and descriptive study it includes 40 patients Certain factors related to the primary tumor recorded including: (tumor size, lymphovascular invasion, body mass index (BMI), family history, histologic type, tumor grade and positivity or negativity for estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor 2 HER2neu ) and relation between these factors and percentage of positive axillary lymph nodes recorded. Results: there are factors that are highly predicator of axillary lymph node metastasis in breast cancer as age of patient of (p value 0.048) tumors larger than 2cm (p value 0.048). With positive lymphovasularinvasion (p value 0.036). Her 2neu positive tumors (p value 0.011) at upper outer quadrant (p value 0.008) obese patient (p value 0.046). Tumorhistopathology. Conclusion: young patients with tumors larger than 2cm with positive lymphovasular invasion Her 2neu positive tumors at upper outer quadrant obese patient tumor lobular carcinoma and mixed ductal and lobular have higher incidence of positive axillary lymph nodes so these factors should be considered in treatment.

[Ayman A. Albatanony, Asem F. Moustafa and Ali G. Hydara. Factors Affecting Axillary Lymph Node Involvement in Breast Cancer. Stem Cell 2017;8(4):44-49]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 8. doi:10.7537/marsscj080417.08.

Key words: Axilla, axillary node clearance, Breast cancer, Lymph nodes, Palpation.

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A Perspective of Immunologists in Thrombotic Microangiopathies

Sabry Abd-Allah Shoeib MD, PhD¹, Alaa Efat Abdel-Hamid MD¹, Emad Mohammad El-Shibeni MD¹ and Amira Abdel-Monem Noureldeen M.B.B.CH ².

¹ Department of Internal Medicine, Faculty of Medicine, Menoufia University, Egypt.

² Resident Doctor of Internal Medicine, 10^th of Ramadan hospital, HIO, Egypt.

amiranoureddin@hotmail.com

Abstract: Objectives: Aim of this work To understand the immunological bases of Thrombotic microangiopathy syndromes and their implications in diagnosis and therapy. Data Sources: Medline databases (PubMed, Medscape, Science Direct) and all materials available in the Internet from 2009 to 2017. Article Selection: The article studied. if the articles did not fulfill the inclusion criteria they were excluded. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, adequate information and defined assessment measures. Data Synthesis: Short reviews were made on thrombotic microangiopathy Syndromes. Findings: In total 63 potentially relevant publications were included, 37 were about immnuo-pathogenesis of thrombotic microangiopathy.26 were about immune –based diagnosis and therapy of thrombotic microangiopathy. Conclusion: The immune system plays an important role in the pathogenesis of thrombotic Microangiopathies, either through aberrant complement activation, or through autoantidodies formation. In thrombotic thrombocytopenic purpura, Complement can be activated through anti-ADAMTS13 antibodies immune complexes, or infected or damaged cells. New ADAMTS13 autoantibody testing has prognostic values and also differentiates acquired TTP from rare cases of hereditary TTP. Plasma exchange replenish ADAMTS-13 and remove the ultra-large Von Wellibrand Factor and ADAMTS-13 autoantibodies. Adjunctive immunosuppressive therapy as humanized anti-CD20 monoclonal antibody (Rituximab) with plasma exchange produced good response in patients with refractory or relapsing acquired TTP, also Adjuvant treatment with intravenous immunoglobulin (IVIG) potentiate remission. In Shiga-toxin-induced HUS, it is thought that complement is activated via p-selectin, The atypial Hemolytic Ueramic Syndrome results from aberrant complement alternative pathway activation secondary to mutation in CFH, CFI, CD46, THBD, CFB and C3 genes or anti-FH antibodies. A recent study has confirmed C3 reduction in severe cases of shigatoxin Ecoli-HUS, also Low levels of C4 have also been observed. Eculizumab ( anti-C5) is recommended for cases of aHUS.

[Sabry Abd-Allah Shoeib, Alaa Efat Abdel-Hamid, Emad Mohammad El-Shibeni and Amira Abdel-Monem Noureldeen. A Perspective of Immunologists in Thrombotic Microangiopathies. Stem Cell 2017;8(4):50-53]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 9. doi:10.7537/marsscj080417.09.

Key words: thrombotic Microangiopathy, acquired TTP, HUS, complement activation, ADAMST13 autoantibodies

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Modeling of Iron Catalyst Deactivation and the Impact of Different Promoters on this Model

Hossein Atashi^1,*, Maliheh Ghofranpakdel¹, Ramin Kamali², Nazanin Nikbakht², Maryam Haji³, Siroos Shojaei²

¹ Department of Chemical Engineering, Faculty of Engineering, University of Sistan and Baluchestan, Zahedan, Iran.

²Department of Chemistry, Faculty of Sciences, University of Sistan and Baluchestan, Zahedan, Iran.

³Department of Chemistry, K. N. Toosi University of Technology, Tehran, Iran.

Telephone: +989121193366； E-mail: H.Ateshi@hamoon.usb.ac.ir

Abstract: The synthesis of Fischer Tropsch is a catalytic process converting synthesis gas to liquid fuels. Iron catalytic activity changed due to the increase in metals as a promoter. The catalyst was determined at a temperature of 280° and the ratio of H2/CO = 2/1, and the metals were added to the catalyst including Mn, Cr, Mo, Ta, V and Zr. The rate of the catalyst deactivation was investigated and specified. The catalyst deactivation model followed the first order GPLE model and the catalyst FeZr is deactivated earlier than other catalysts.

[Department of Chemical Engineering, Faculty of Engineering, University of Sistan and Baluchestan, Zahedan, Iran. Modeling of Iron Catalyst Deactivation and the Impact of Different Promoters on this Model. Stem Cell 2017;8(4):54-58]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 10. doi:10.7537/marsscj080417.10.

Keywords: Agglomeration, Promoter, Fischer-Tropsch synthesis, Iron Catalyst Deactivation

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Serum Lipoprotein-A in Patients with Aortic Valve Sclerosis as A Predictor for Severity of Coronary Artery Disease

Prof. Dr. Walaa Farid Mousa, Dr. Wessam EL Din Hadad EL Shafey and Remon Saleh Adly Abdallah

Department of Cardiology, Faculty of Medicine, Menoufia University, Egypt. remonsaleh@yahoo.com.

Abstract: Objective: The aim of this study was to assess the association of serum level of lipoprotein (a) [Lp (a)] with severity of coronary artery disease (CAD) in aortic valve sclerosis (AVS) patients. Background: The relation between AVS on one hand and severity of CAD and complexity of coronary lesions on the other hand, was not clearly established by previous investigators. Also the correlation between Lp (a) and severity of CAD in AVS using SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score was not tested before. Methods: In this study, a total of 50 eligible patients with AVS were divided into 2 groups: high and normal Lp (a) with cut off level (30 mg /dl). We included assessment of all major cardiovascular risk factors, transthoracic echocardiography and coronary lesion characteristics by angiography. SYNTAX scoring was used. Results: There was significant relation between severity and number of diseased coronaries on one hand and Lp (a) levels on the other hand in AVS patients. Conclusions: Serum Lp (a) is an independent predictor for severity of coronary lesions among AVS patients.

[Walaa Farid Mousa, Wessam EL Din Hadad EL Shafey and Remon Saleh Adly Abdallah. Serum Lipoprotein-A in Patients with Aortic Valve Sclerosis as A Predictor for Severity of Coronary Artery Disease. Stem Cell 2017;8(4):59-63]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 11. doi:10.7537/marsscj080417.11.

Keywords: Aortic valve sclerosis, coronary artery disease, lipoprotein-a.

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Antiplatelet Therapy in the Perioperative Period (Systematic review)

Ashraf Mohamed Mohamed Moustafa (MD)¹, Essam Abd El-Hamid Ismael Ghoniem (MD)¹, Hala Mohamed Koptan (MD)¹, Mohamed Mahdy Abdel-Alim Shaheen (MBBch)².

¹Anesthesia, Intensive care and Pain management Department, Faculty of Medicine, Menoufia University, Egypt.

² Resident of Anesthesia at Ministry of Health, Egypt.

drmohamedmahdy9@gmail.com

Abstract: Objectives: The goal of our work is to discuss different strategies for preoperative management of antiplatelet therapy and the new anti-platelets drugs types. Background: cardiovascular events represent the major cause of morbidity and mortality. A key role in the pathogenesis of these events is played by platelets. The activated platelet plays not only an important role in the initiation and progression of atherosclerotic disease ⁽¹⁾. Data sources: Medline, articles in Medscape, Science Direct, and PubMed were searched. The search was performed on January 2016 and included all articles with no language restriction. Study selection: The initial search presented 98 articles. The articles stuԁieԁ antiplatelet therapy in the periоperative periоd. Data extraction: Data from each study were independently abstracted to capture information on study characteristics and interventions. Data synthesis: Significant data were collected. Thus, a structured review was performed. Finding: Antiplatelet agents represent a particular challenge for the anaesthesiologist when regional anaesthetic techniques are considered. New antiplatelet agents have been developed for patients at high risk of thrombosis, their benefits in terms of mortality and major cardiovascular events have been demonstrated. Conclusion: Platelets are essential for primary hemostasis and repair of the endothelium, but they also play a key role in the development of acute coronary syndromes and contribute to cerebrovascular events. Several antiplatelet drugs are available for use in clinical practice and several antiplatelet are under investigation. Antiplatelet and anticoagulants are be useful in the treatment and prophylaxis of arterial thrombotic conditions.

[Ashraf Mohamed Mohamed Moustafa, Essam Abd El-Hamid Ismael Ghoniem, Hala Mohamed Koptan, Mohamed Mahdy Abdel-Alim Shaheen. Antiplatelet Therapy in the Perioperative Period (Systematic review). Stem Cell 2017;8(4):64-66]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 12. doi:10.7537/marsscj080417.12.

Keywords: Platelets, Antiplatelets, Anticoagulants, Hemostasis, Aspirin, Coronary

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Epigenetics meets Rheumatology: Beyond DNA

Sabry A. Shoeib (MD)¹, Alaa E. Abd El Hamid (MD) ¹, Emad M. El Shebeiny (MD) ¹ and Sameh Y. El Hallab (MBBCH) ²

¹Internal Medicine Department, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt

² Resident of Internal Medicine Department, Samanoud Hospital, Gharbeya Governorate, Egypt

samehusif@yahoo.com

Abstract: Objectives: The aim of this work was to illustrate the relation between the epigenetics and rheumatic diseases and the novel epigenetic therapies. Data Sources: Data sources were obtained from the Medline databases (Pub Med, Science Direct, and Medscape). Article Selection: This article studied the epigenetics role in rheumatic diseases and the recent epigenetic therapies. Data Synthesis: Short reviews were performed in the pathophysiology of the rheumatic disorders in association with epigenetic modifications. Conclusion: Despite the epigenetic mechanisms are involved in many rheumatic diseases, yet enhanced understanding of the reversible epigenetic alterations that change gene expression could help in paving the way for prospective treatments of several rheumatic diseases.

[Sabry A. Shoeib, Alaa E. Abd El Hamid, Emad M. El Shebeiny and Sameh Y. El Hallab. Epigenetics meets Rheumatology: Beyond DNA. Stem Cell 2017;8(4):67-77]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 13. doi:10.7537/marsscj080417.13.

Key words: epigenetics, genetics, rheumatology.

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Effect of early assessment and management of emergency physician on time and mortality of pediatric poly trauma patients

Magdi Ahmed Abd El Fattah Lolah, Nagwan Yousery Saleh, and Eman Mahmoud Hegazy

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

Pediatrics Department, Faculty of Medicine, Menoufia University, Egypt

Emergency Medicine Department, Faculty of Medicine, Menoufia University, Egypt

Emamhmoud5@yahoo.co.uk

Abstract: Objective: to study the effect of early assessment and management of emergency physician on time and mortality in pediatric poly-trauma patients. Methods: A prospective study included 100 poly traumatized patients aged less than 16 years presented to emergency department at Menoufiya University Hospitals. Every patient was subjected to: triage, Primary survey (Airway, Breathing, Circulation, Disabilities and Exposure/Environmental control), Resuscitation: all life threatening conditions detected in primary survey were managed as guidelines in the pediatric advanced life support and advanced trauma life support, Secondary survey: a complete history and head to toe physical examination including reassessment of all vital signs were done and Reevaluation and monitoring. Results: delayed grade in revised trauma score took 23.9±6.1 minutes in primary survey and 87.8±39.2 minutes in Time of image, while dead grade took 88±52 minutes of Mean ± SD in primary survey. The basic management took 24.7±6.5 minutes in primary survey and 83.7+37.2 minutes in Time of image and the advanced management took 86.7±32.2 minutes in primary survey and 35.3+13.86 minutes in Time of image. 100% patients in delayed grade of revised trauma score were alive while 100% patients in dead grade were dead. 100% dead patients had advanced management and in regarding to alive patients: 29.1% patients had advanced management and 70.9% patients had basic management. Conclusion: there is effect of early assessment and management of emergency physician on mortality in pediatric poly-trauma patients.

[Magdi Ahmed Abd El Fattah Lolah, Nagwan Yousery Saleh, and Eman Mahmoud Hegazy. Effect of early assessment and management of emergency physician on time and mortality of pediatric poly trauma patients. Stem Cell 2017;8(4):78-82]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 14. doi:10.7537/marsscj080417.14.

Keywords: assessment; management; emergency; physician; mortality; pediatric; poly trauma; patient

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Transthoracic echocardiography as predictor of fluid responsiveness in circulatory failure patients

Nagwa Mohamed Doha ¹(MD), Walid Abdou Hamed ² (MD), Rabab Mohamed Habeeb¹ (MD) and Islam Mohamed Abd Elkarim Shatla³ (M.B.B.ch)

¹Department of Anesthesiology, Intensive care, and Pain Management, Faculty of Medicine, Menoufia University, Egypt.

² Department of Cardiology, Faculty of Medicine, Menoufia University, Egypt.

³ Teaching assistant of Critical care medicine, Faculty of Medicine, Menoufia University, Egypt.

islam_moahmmed101@yahoo.com

Abstract: Objectives: To evaluate role of tranthoracic echocardiography in prediction of fluid responsiveness in cirulatory failure patients. Data Sources: a literature search using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for prospective studies with no restrictions. All materials accessible from these database to 2016 were included. Study Selection: a special search was conducted with the key words transthoracic echocardiography, fluid responsiveness & circulatory failure. Only full text articles in indexed journals were included. Data Extraction: The initial investigation exhibited 3138 articles of which 8 met the incorporation criteria. The articles discussed the role of Echocardiography in predicting fluid responsiveness. Data Synthesis: the main result of the review. Each study was reviewed independently; the data obtained were rebuilt in a new language according to the need of the researcher and arranged into topics through the article. Results: The predictive power of diagnostic accuracy of transthoracic echocardiography parameters changes with the respiratory cycle or passive leg raising in mechanically ventilated patients was strong throughout the articles reviewed. Conclusion: Transthoracic echocardiographic techniques accurately predict fluid responsiveness in critically ill patients who develop circulatory failure.

[Nagwa Mohamed Doha, Walid Abdou Hamed, Rabab Mohamed Habeeb and Islam Mohamed Abd Elkarim Shatla. Transthoracic echocardiography as predictor of fluid responsiveness in circulatory failure patients. Stem Cell 2017;8(4):83-89]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 15. doi:10.7537/marsscj080417.15.

Key words: Transthoracic echocardiography, fluid responsiveness & circulatory failure

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Prognostic Value of Albumin/Creatinine Ratio in Urine in Septic Patients

Nagwa Mohammed Daha (MD) ¹, Elham Mohammed El-Feky (MD) ¹, Ayman Mohamed Azzam (MD)¹, Mahmoud Mohammed Abdul-Aleem El-Badawy (MBBCh)²

¹Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Menoufia University.

²Resident of critical care at Ministry of Health, Shebin El-Kom Fever H., Menoufia governorate, Egypt

drbadawy80@yahoo.com

Abstract: Objective: A review of Prognostic Value of Albumin/Creatinine Ratio in Urine in Septic Patients. Data Sources: Medical text books, medical journals, and medical websites that have updated researches with key words (Albumin/Creatinine Ratio in sepsis) in the title of the paper. Study Selection: Systematic reviews that addressed Albumin/Creatinine Ratio and studies that addressed Sepsis and septic shock. Data Extraction: A special search was conducted at midline with the key words (Albumin/Creatinine Ratio in sepsis) in the title of the paper; extraction was performed, including the assessment of the quality and the validity of the papers that met with the prior criteria that describe the review. Data Synthesis: The main result of the review. Each study was reviewed independently; the data obtained were rebuilt in a new language according to the need of the researcher and arranged into topics through the article. Recent Findings: Urinary albumin/creatinine ratio may be used as a simple, rapid, noninvasive, inexpensive, easy to perform and interpret test for early prognosis and prediction of mortality in septic patients, this early risk stratification is of particular significance in the intensive care environment where it allows clinicians to make more rational therapeutic decisions to ensure that the hospital resources are used efficiently and appropriately. Thus, together with conventional illness severity scores, the measurement of ACR on entry to the ICU, and 24 hours later, can provide additional information on patient outcome. Conclusions: Urinary albumin/creatinine ratio would be an interesting prognostic tool to study septic patients.

[Nagwa Mohammed Daha, Elham Mohammed El-Feky, Ayman mohamed Azzam, Mahmoud Mohammed Abdul-Aleem El-Badawy. Prognostic Value of Albumin/Creatinine Ratio in Urine in Septic Patients. Stem Cell 2017;8(4):90-97]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 16. doi:10.7537/marsscj080417.16.

Key words: Urinary albumin/creatinine ratio, Sepsis, Septic shock

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Upper Airway Collapse Evaluation in Sleep Disorderd Breathing with Drug Induced Sleep Endoscopy

Mohamed k. El-Sharnouby (MD)¹, Essam A. Behairy (MD)¹, Ayman A. Abdel-fattah (MD)¹, Tarek A. Abdl-Hafez (MD)¹, Mohamed A. Eldeeb (MBBCh)²

¹ Otorhinolaryngology Department, Faculty of Medicine, Menofia University, Egypt

²Resident Of Otorhinolaryngology at Ministry of Health, Samannoud General Hospital, Gharbeya, Egypt.

Aboeyad77100@gmail.com

Abstract Objective: to assess value of using drug induced sleep endoscopy (DISE) in evaluation of upper airway (UA) collapse in obstructive sleep apnea (OSA) patients and comparing its results with that of traditional evaluation techniques. Background: to obtain a better insight into the complex pathophysiology of airway collapse and upgrade treatment success rates while prospectively selecting the most suitable therapeutic option for the individual patient. Airway appreciation in sleep disordered breathing (SDB) patients is often restricted by the fact that the evaluation is static and/or performed during wakefulness, possibly not representing the actual dynamics of airway collapsibility during sleep. Patient and Methods:46 patients who were referred for sleep endoscopy and were diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) diagnosed by overnight polysomnography. Full ear, nose and throat (ENT) examination was conducted including Muller maneuver (MM), and then DISE was performed by using the flexible rhinopharyngolaryngoscope. Results: DISE results are significantly different from MM in diagnosing the level and degree of collapse of upper airway collapse especially in higher degrees of obstruction at the level of oropharynx and hypopharynx, and by using chi square this difference was statistically significant (P value =0.040). Conclusion: Most of patients with OSA had upper airway collapse, with different level, degree and pattern of obstruction. DISE is a reliable and an accurate tool of UA assessment during sleep and can give us the best treatment recommendations for OSA patients.

[Mohamed k. El-Sharnouby, Essam A. Behairy, Ayman A. Abdel-fattah, Tarek A. Abdl-Hafez, Mohamed A. Eldeeb. Upper Airway Collapse Evaluation in Sleep Disorderd Breathing with Drug Induced Sleep Endoscopy. Stem Cell 2017;8(4):98-102]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 17. doi:10.7537/marsscj080417.17.

Key Words: Drug induced sleep endoscopy, Muller maneuver, Obstructive sleep apnea, Upper airway.

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The Effects of Eicosapentaenoic acid Supplementation in The Patients with Type II Diabetes Mellitus: Study protocol for a randomized controlled trial

Mohammad Hassan Golzari¹, Saeed Hosseini², Fariba Koohdani³, Seyde Ali Keshavarz⁴, Mahmoud Djalali⁵

¹MSc, Ph.D Candidate, Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

²MD, Ph.D. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

³Ph.D. Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

⁴Ph.D. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

⁵Ph.D. Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Abstract: Background: Diabetes mellitus is one of the most common endocrine disorders in the world, and as a public health challenge due to the substantial financial and economic burden related to this disease and its chronic complication on the individuals, families, society, and healthcare system of the country. Cardiovascular disease is the most important cause of death among these patients, and ω-3 fatty acids have the antioxidant properties and improving the antioxidant status and the serum levels of HDL-c. Meanwhile, the antioxidants result in an increase in the gene expression and serum activity of PON1. Methods: The present study is a randomized, double-blind, and placebo-controlled clinical trial. Thirty six patients with type 2 diabetes mellitus will be selected. They will give written; informed consent, will randomly be allocated to the supplement and placebo groups. Blood sample for measurement of the biochemical parameters and gene expression of PON2 will be given. Discussion: EPA could be has the antioxidant, antiinflammatory, antithrombotic and antiarteriosclerotic effects, and PON family has antioxidant and antiinflammatory roles in the context of atherosclerosis. We expect that EPA supplementation has been desirable effects on the serum levels of sVCAM-1, sE-selectin, HDL-c and its subfractions, apoB-100, apoA-I, Malondialdehyde, Hcy, and FBS, and increases the antioxidant activities of serum PON1 and HCTLase, as well as up-regulate the gene expression of PON2.

[Mohammad Hassan Golzari, Saeed Hosseini, Fariba Koohdani, Seyde Ali Keshavarz, Mahmoud Djalali . The Effects of Eicosapentaenoic acid Supplementation in The Patients with Type II Diabetes Mellitus: Study protocol for a randomized controlled trial. Stem Cell 2017;8(4):103-111]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 18. doi:10.7537/marsscj080417.18.

Keywords: Eicosapentaenoic acid, Fasting blood sugar, Paraoxonase-1, Paraoxonase-2, Homocysteine thiolactonase, HDL-c, HDL2-c, HDL3-c, apoB-100, apoA-I, Homocysteine, Malondialdehyde, sVCAM-1, sE-selectin, Type II diabetes mellitus.

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Saprolegnia in Fish and Methods of Treatment (Review)

Mona S. Zaki¹; Olfat M. Fawzy²; Nabila El-Batraway³ and Samy Shalaby⁴

¹Deptartment of Hydrobiology, National Research Center, Cairo, Egypt

² Deptartment of Biochemistry, National Research Center, Cairo, Egypt

³Animal Reproduction Institute Al Haram, Egypt

⁴Deptartment of Animal Reproduction, National Research Center, Cairo, Egypt

dr_mona_zaki@yahoo.co.uk

Abstract: Saprolegnia, the fungus appears as focal white to brownish cotton-like patches on the surface of the skin and/ or gills. Early lesions consist of pale foci with peripheral areas of erythema and a central zone of lifted scales which frequently becomes ulcerated, expos- ing underlying musculature. Systemic infections are characterized by mycelia masses in the gut and surrounding viscera causing peritonitis with extensive hemor-rhage, necrosis and adhesions. In smaller juvenile fish external signs of bloating caused by gut obstruction may progress to perforation of the abdominal wall. In the present review we focus how to treat Saprolegnia.

[Mona S. Zaki ; Olfat M. Fawzy ; Nabila El-Batraway and Samy Shalaby. Saprolegnia in Fish and Methods of Treatment (Review). Stem Cell 2017;8(4):112-115]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 19. doi:10.7537/marsscj080417.19.

Keywords: Saprolegnia; Fish; Method; Treatment

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A Clinicopathological Study Comparing the Treatment Effect of Stem Cell Transplantation and Antivascular Endothelial Growth Factor (Bevacizumab) on Adjuvant Induced Rheumatoid Arthritis in Rats Joints

Shaymaa Ali¹, Somaia Ahmed Saad El-Din², Hebt Alla El Chamy¹, Takwa Badr¹, Faten Ghazal², Hanaa Amer³, Fatma A.Abu Zahra⁴, Nadia Kamel and Ahmed Abdalla⁵

¹Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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

³Department of Clinical Pathology, Faculty of Medicine, Ain Shams University

⁴Department of Biochemistry, Medical Research Center, Ain Shams University

⁵Veterinary Department, Medical Research Center, Ain Shams University

drsomaia2005@gmail.com

Abstract: Background: Methotrexate is effective in rheumatoid arthritis treatment but with no regeneration of the damage tissue. Efforts to discover new target therapies are still needed. AIM: The present work studied the therapeutic and regenerative effect of stem cell transplantation as well as combined bevacizumab with methotrexate on the joints of animal model of rheumatoid arthritis compared to the standard methotrexate treatment by clinical, laboratory and histopathological examination. Material and methods: This study was carried out on 32 rats. Systemic arthritis was induced then clinical arthritis score was assessed. Anti-cyclic citrullinated peptides (CCP) level was measured. Two rats were sacrificed to determine their joint histopathological score. The remaining 30 rats were divided into three groups: (A):10 rats were injected with stem cells, (B):10 rats were injected with methotrexate, and (C):10 rats were injected with methotrexate and bevacizumab. After treatment, animals were clinically scored and measured for anti-CCP level. Then animals were sacrificed for histopathological analysis of their joints. Results: Improvement with the three modalities of treatment was found by clinical, laboratory and histopathological examination. Group (A) was the best regarding clinical and anti-CCP results while group (C) was the best regarding the histopathological vascular changes. Conclusion: Both bevacizumab and stem cells are promising therapies in the treatment of rheumatoid arthritis.

[Shaymaa Ali, Somaia Ahmed Saad El-Din, Hebt Alla El Chamy, Takwa Badr, Faten Ghazal, Hanaa Amer, Fatma A.Abu Zahra, Nadia Kamel and Ahmed Abdalla A Clinicopathological Study Comparing the Treatment Effect of Stem Cell Transplantation and Antivascular Endothelial Growth Factor (Bevacizumab) on Adjuvant Induced Rheumatoid Arthritis in Rats Joints. Stem Cell 2017;8(4):116-124]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 20. doi:10.7537/marsscj080417.20.

Key words: Rheumatoid arthritis, methotrexate, mesenchymal stem cell, bevacizumab.

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New trends in diagnosis of parasitic infections in marine fishes

Hussien A.M. Osman and Mona S. Zaki

Hydrobiology Department, National Research Center, Dokki, Giza, Egypt.

drmonazaki@yahoo.com

Abstract: Parasitic diseases of fish are very important in aquaculture as it was the basis for all outbreaks of fish. It is very important to defiantly diagnose and control of the parasitic diseases of fish to avoid great economical losses in aquaculture. So it is very important to discover new techniques for diagnosis of fish parasitic infections. So that the aim of the present review was to throw light on the new trends of diagnosis of the parasitic diseases of marine fishes. Recent methods for diagnosis illustrated in the present review are immunodiagnostic techniques depends on antigen –antibody reaction, the methods includes; agar gel precipicitation test, Agglutination test, ELISA, Dot ELISA, fluorescent antibody technique and immunohistochemistry. Developments in molecular biology have led to a rapid growth in new methods for diagnosing fish parasitic infections. Techniques of major significance include polymerase chain reaction (PCR) for specific accurate diagnosis of fish parasites. In addition, scanning and transmission electron microscope which considered developed method for identification of fish parasites depending on computerized digital image analysis.

[Hussien A.M. Osman and Mona S. Zaki. New trends in diagnosis of parasitic infections in marine fishes. Stem Cell 2017;8(4):125-133]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 21. doi:10.7537/marsscj080417.21.

Key words: diagnosis, parasitic diseases, marine fishes, immunodiagnostic, PCR, Scan electron microscope.

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Comparative studies on some red rice biotypes and cultivate rice on morphological and yield bases under Egyptian condition

Aboyousef I. M. ¹, F. A. Sorour², A. A. Mohammed², and M. Salem¹

¹ Rice Research Section, FCRI, ARC, Egypt

²Agronomy Department, Fac. of Agric., Kafr EL Sheikh Univ., Egypt.

‫ srour21@yahoo.com

Abstract: This experiment was conducted at experimental farm of Rice Research Section, Sakha Agric. Research Station, Kafrelsheikh, Egypt during 2015 and 2016 seasons, the study to characterize of some red rice biotypes and ten cultivated rice on germination, growth and yield characters. The study included ten cultivated rice varieties with two biotypes of red rice were planted in randomized complete block design with three replications. The date of sowing was on the May^1st during the two seasons; packages of recommendation were applied as recommended by RRTC. The data were collected on seed viability, seedling, physiomorphological, yield and its components characters. The obtained results could be summarized as follow: seed viability of red rice biotypes were higher than the cultivated varieties especially after 15 days of heading, the red rice biotypes were early heading and taller than the cultivated varieties. Also, it gave were higher chlorophyll content than the biotypes of red rice, indicated that to could be distinguish between the biotype of red rice and cultivated varieties in early growth stages and could be removed from seed production plots before heading to avoid the out crossing or apply alternative system for late maturity variety after early maturing variety.

[Aboyousef I. M., F. A. Sorour, A. A. Mohammed, and M. Salem. Comparative studies on some red rice biotypes and cultivate rice on morphological and yield bases under Egyptian condition. Stem Cell 2017;8(4):134-137]. ISSN: 1945-4570 (print); ISSN: 1945-4732 (online). http://www.sciencepub.net/stem. 22. doi:10.7537/marsscj080417.22.

Keywords: Comparative study; red rice; biotype; cultivate rice; morphological; yield; base; Egyptian

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