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Bicanalicular Intubation versus Monocanalicular Intubation in Management of Congenital Nasolacrimal Duct Obstruction

Prof. Dr. Abd-El Moez Haddad Ahmed, Prof. Dr. Ahmed Ismail M. Kamel, Prof. Dr. Abdallah Elhosainy Shaleel, Hala Salim Hagag

Ophthalmology Department, Faculty of Medicine Al-Azhar University, Egypt

haythamabdou@yahoo.com

Abstract: Congenital nasolacrimal duct obstruction occurs in approximately 5% of normal newborn infants. However, not all the neonates have symptoms because the obstruction usually resolves spontaneously before lacrimal secretion begins. The characteristic presentation of CNLDO obstruction is watering (epiphora) and mucopurulent discharge observed from the first month of life. This usually affects only one eye, although both eyes may be affected in up to 20% of cases. There is an extensive literature advocating treatments for CNLDO, Opinions have diverged as to the appropriate treatment regarding nature and timing. Probing has traditionally been advocated as a first-line management of CNLDO. Recently, however, some authors prefer to stent all patients at initial probing, regardless of complexity as it is thought to be associated with a high success and a low complication rate. In the present study assessment of the role of the newly designed monocanalicular intubation (Monoka) versus bicanalicular intubation in treatment of congenital nasolacrimal obstruction was evaluated. The study included 60 eyes of 54 patients with CNLDO their age was between 1.2-4.4 years, 30 eyes had monocanalicular intubation with Monoka tube and 30 eyes had bicanalicular intubation. The overall success rate in monocanalicular intubation (Monoka) group was 76.7% while in bicanalicular intubation group was 80.0%. However the difference in the success rates between the two groups was not statistically significant (P value of 0.936). Monocanalicular intubation proved to be a simple method for nasolacrimal intubation with a fast learning curve and few complication. Both types of intubation are effective in primary management of congenital nasolacrimal duct obstruction. Our results raise the question of whether this ease and effectiveness of the tube could be weighed against the extra higher cost compared to bicanalicular intubation as there was no statistical difference between the two procedures.

[Abd-El Moez Haddad Ahmed, Ahmed Ismail,. Kamelm, Abdallah Elhosainy Shaleel, Hala Salim Hagag. Bicanalicular Intubation versus Monocanalicular Intubation in Management of Congenital Nasolacrimal Duct Obstruction. Nat Sci 2019;17(3):1-9]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj170319.01.

Keywords: Bicanalicular Intubation versus Monocanalicular Intubation, Management of Congenital Nasolacrimal Duct Obstruction

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Arthroscopically Assisted Anterior Cruciate Ligament Anatomic Reconstruction Using Quadruple Semitendinosus and Gracilis Graft

Salah El-din Youssef, Fathy H. Salama, Mohamed A. Hassan and Mohammed S. Zahra

Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University (Damietta), Egypt

dr_samy1111@yahoo.com

Abstract: Background: If complete anterior cruciate tear is diagnosed, surgical treatment mandatory to reconstruct ACL after a period of rehabilitation to regain muscular activity and to avoid its atrophy, this facilitates early return to work after surgery. Object: To reconstruct the torn ACL by Semitendinosus and Gracilis tendons using Arthroscopically assisted Anatomic Quadruple Bundle Technique. Methodology: The study comprises 30 patients who underwent single bundle anterior cruciate ligament reconstruction using quadrupled hamstring graft in Al-Azhar university hospital Damietta, followed up for average period of 12 month. All patients were operated for anterior cruciate ligament reconstruction using endobutton on the femoral side using trans-portal technique (accessory antero-medial) and interference screw on the tibial side. Results: In surgical management of cases which had chronic anterior cruciate ligament tear, we had the choice to do arthroscopically assisted anatomic ACL reconstruction using quadrupled Gracilis and semitendinosus tendon graft, fixing it through bony tunnels, from above in femoral tunnel by endobutton and from below in tibial tunnel by biodegradable interference screw, this unique technique offered us good results as it allow early incorporation of the graft in the bones, as well as it done through small incision to attain long powerful tendon graft had great intensity, this lower risk of joint stiffness or other complications, while increases the strength and stability of the knee, following this method we had attained good satisfactory results. Conclusion: The goals of ACL reconstruction are to restore stability of the knee, allow the patient to return to normal activities, including sports, and to delay the onset of osteoarthritis with associated recurrent injuries to the articular cartilage and loss of meniscal functions. During the past decades arthroscopically assisted techniques have been an accepted method of reconstructing the ACL.

[Salah El-din Youssef, Fathy H. Salama, Mohamed A. Hassan and Mohammed S. Zahra. Arthroscopically Assisted Anterior Cruciate Ligament Anatomic Reconstruction Using Quadruple Semitendinosus and Gracilis Graft. Nat Sci 2019;17(3):10-17]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj170319.02.

Keywords: ACL, Quadruple Semitendinosus, Gracilis

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Virulence and Resistance genes of Gram Negative Bacteria Escherichia coli and Pseudomonas aeruginosa in Poultry Products and Edible Egg

Asharaf A. Abd El-Tawab¹, Fatma. I. El-Hofy¹, Khalid I. Alekhnawy² and Doaa M. Sharaf³

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

²Animal Health Research Institute, Dokki, Giza, Egypt.

³Animal Health Research Institute, Tanta Branch, Egypt

mohammedebrahim3988@gmail.com

Abstract: This work was performed for determination of virulence and resistance genes of E coli and Pseudomonas aureginosa isolated from poultry products and edible eggs. A total of 150 poultry products represented as chicken fillet, chicken liver, smoked chicken products (50 for each) and 90 red egg samples were analyzed bacteriologically by classical cultural methods. All isolated bacteria were identified using standard microbiological identification technique. The antimicrobial susceptibility profile of the isolates was determined by Kirby –Baur disk diffusion technique. Virulence and resistance genes were determined by using PCR technique. Overall samples, E coli was detected in poultry products in chicken fillet (14) 28% chicken liver (5) 10% smoked chicken (0) 0% and red egg (8) 26.6%. Pseudomonas spp was detected as follow from poultry fillet (6) 12% and from egg samples (4) 13.3%. Shiga toxins (stx1, stx2) were not detected in this study but eae A gene was detected in all isolated E coli strains while bla_Tem and tetA were detected in only one strain of E coli while ermB gene failed to be detected. For pseudomonas confirmed by using 16srRNA gene and detection of virulence genes as lasB, toxA and resistance genes as mexR genes were detected in all tested isolates while bla vim not detected in the examined isolates.

[Asharaf A. Abd El-Tawab, Fatma. I. El-Hofy, Khalid I. Alekhnawy and Doaa M. Sharaf. Virulence and Resistance genes of Gram Negative Bacteria Escherichia coli and Pseudomonas aeruginosa in Poultry Products and Edible Egg. Nat Sci 2019;17(3):18-24]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj170319.03.

Key words: E. coli, P aeruginosa, Poultry products, Virulence, Resistance genes

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Case Report: Incontinentia Pigmenti Associated with Oculocutaneous Albinism

Okasha M G^1,2, Seitz B¹, and Käsmann-Kellner B¹

¹Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany

²Department of Ophthalmology, Al – Azhar University, Cairo, Egypt

berthold.seitz@uks.eu; kaesmann@gmail.com

Abstract: Aim: To describe unusual ocular presentation associated with incontinentia pigmenti (IP) and theorize a protective effect for this association. Setting: Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany. Methods: 18-month-old girl already diagnosed with IP had complete clinical ophthalmological examination, orthoptic assessment as well as genetic analysis. Results: Clinical diagnosis of oculocutaneous albinism (OCA) was confirmed in our IP patient along with ocular associations with IP. Genetic analysis revealed11,7 kb deletion in exons 4-10 of IKBKG gene. The chance is 25% for the next child of the family for IP. Conclusions: This paper reports a case of a premature girl of a twin pregnancy with IP associated with OCA and theorize whether OCA hypopigmentation would protect her from melanin associated complications of IP.

[Okasha M G, Seitz B, and Käsmann-Kellner B. Case Report: Incontinentia Pigmenti Associated with Oculocutaneous Albinism. Nat Sci 2019;17(3):25-27]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj170319.04.

Keywords: incontinentia pigmenti, oculocutaneous albinism, case report

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Placental Location, Postpartum Hemorrhage and Retained Placenta in Women with a Previous Cesarean Section Delivery: A Prospective Cohort Study

Ahmed A. Abbas, Hossam Al-Din H. Kamel, Elsayed A. Eldesouky, Abd Elhalim Mohammed and Mohammed H. Amin

Department of Obstetrics and Gynaecology, Faculty of Medicine – Al-Azhar University, Cairo, Egypt

drmohammedhamdi@hotmail.com

Abstract: Objective: The objective of this study was to determine if placental location increased the risk of PPH and retained placenta in women previously giving birth with cesarean section. Design Prospective cohort study. Setting: Edfu general hospital –Edfu-Aswan and Elsayed Galal Hospitals. Patients and methods We performed a prospective cohort study on 100 women with cesarean section delivery in a previous pregnancy. Ultrasound examinations were performed at gestational week 28–30, and placental location, placental thickness, Data on maternal age, parity, BMI,, gestational week at delivery, induction, delivery mode, oxytocin, preeclampsia, PPH, retained placenta, and birth weight were obtained for all women. Outcome measures were PPH (≥1,000 mL) and retained placenta. Main outcome. Anterior and posterior previa location of placenta increase risk of postpartum and retained placenta. Results The overall incidence of PPH was 9.3% and of retained placenta 9.3%. two women (2.1%) with anterior previa, two women (2.1%) with posterior previa, two women (2.1%) with low anterior, two women (2.1%) with low posterior placenta had PPH compared to 89 (90.7%) with anterior, posterior or fundal locations. There was significant increase risk of retained placenta in women with anterior previa, posterior previa, and low anterior and low posterior placenta. Conclusions The overall risk of PPH and retained placenta was high for women with previous cesarean section. anterior previa, posterior previa, low anterior and low posterior placentae location of the placenta in such women tended to impose an increased risk for PPH and risk increase of retained placenta.

[Ahmed A. Abbas, Hossam Al-Din H. Kamel, Elsayed A. Eldesouky, Abd Elhalim Mohammed and Mohammed H. Amin. Placental Location, Postpartum Hemorrhage and Retained Placenta in Women with a Previous Cesarean Section Delivery: A Prospective Cohort Study. Nat Sci 2019;17(3):28-34]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj170319.05.

Keywords: Postpartum hemorrhage, placental location, previous cesarean section, retained placenta and ultrasound

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State of The Art Positron Emission Tomography and Computed Tomography (PET/CT) in Pancreatic Cancer

Rawhia Taha Hasan, Huda Fathy El said and Rehab Saber Mahmoud

Department of Radiology, Faculty of Medicine-Al-Azhar University, Egypt

fagr553@hotmail.com

Abstract: Background: The purpose of this study is the evaluation of the role PET/CT in the detection & follow up of pancreatic cancer. Is it has emerged as a promising diagnostic tool for pancreatic cancer. Material and Methods: A retrospective analysis of 60 patients, presenting with pathology proved or clinically suspected pancreatic lesions of pancreas, where collected from two centers (national cancer institute and Naser hospital) during the period of October 2013 till May 2017, all patients were referred for abdominal 18F-FDG PET/CT for localization of tumor. Patients fasted for 4 - 6 h before PET scanning. Each patient was injected with 0.14 mCi/kg of body weight with F-18 FDG. PET images were acquired 45-60 min after intravenous injection of FDG. At first low dose contrast CT was performed prior to PET. Five millimeter thick sections are obtained at 80 mA and 120 kVp from the xiphisternum to symphis pupis, sometimes from the skull base till the feet and in some patients late images were obtained. For PET/CT fusion images were also reconstructed transverse, coronal and sagittal slices in two sets with and without attenuation correction. Results: This study was performed in the Radio diagnosis & nuclear medicine departments in national cancer institute and Nasser institute hospital. The study was prospectively carried on 60 patients with pancreatic lesions. In this study, mean age at diagnosis of 57 years, with 41 male patients & 19 female patients, mean weight 76kg, mean height 162, (mean Blood sugar at diagnosis of 116. Study revealed local pancreatic lesions in 23 patients local invasion in 3 patients (about 6.7%), LNS_METS in15 patients (about. 25%), osseous deposits in 5 patients (about 8.6%) while perionteal deposite in 6 patients (about 10%) this study. Conclusion: FDG-PET/CT is a useful modality for detection of pancreatic cancer and monitoring metabolic response.

[Rawhia Taha Hasan, Huda Fathy El said and Rehab Saber Mahmoud. State of The Art Positron Emission Tomography and Computed Tomography (PET/CT) in Pancreatic Cancer. Nat Sci 2019;17(3):35-37]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj170319.06.

Keywords: pancreatic cancer, Fused positron emission tomography (PET)/computed tomography (CT).

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Maintenance Tocolysis with Nifidipine versus β-sympathomimeticsin Established Preterm Labour on Pregnancy Elongation

Abd El Sattar Farhan¹, El Sayed El-Desouky¹, Ashraf Elshahat¹, Abdel Halim Mohammed² and Ezz El-Din Salama Abd El-Aty El-Sayed³

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

²Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assuit

³Department of Obstetrics and Gynecology, El-Galaa Maternity Teaching Hospital, Cairo.

ezzwerway@gmail.com

Abstract: Background: This study aimed to compare the efficacy of Nifedipine versus β-sympathomimetic as tocolytic agents and effect of tocolysis on pregnancy elongation. Methods: This clinical trial was conducted at El Galaa Maternity Teaching Hospital and El Sayed Galal university hospital for women with preterm labour pain, intact membrane and singleton pregnancy between 28 weeks to 34 weeks. on 100 women divided in two groups each group 50 womens (1^st group nifedipine-2^nd group ritodrine). Results: There was significant difference between two groups regarding preterm labor after 48 hours. also there was significant difference between both groups regarding delivery after 1 week & regarding delivery at 37th weeks, there was significant difference between two groups regarding labor GA (weeks), episodes of recurrent preterm labor were statistically significant in ritodrine group compared to nifedipine group, vaginal delivery was more statistically significant in nifedipine group than in ritodrine group (88%,-70% respectively). Conclusion: The Use of Nifedipine as a maintenance tocolytic therapy in preterm birth is better than ritodrine. Also, Nifedipine was associated with less side effects than Ritodrine.

[Abd El Sattar Farhan, El Sayed El-Desouky, Ashraf Elshahat, Abdel Halim Mohammed and Ezz El-Din Salama Abd El-Aty El-Sayed. Maintenance Tocolysis with Nifidipine versus β-sympathomimeticsin Established Preterm Labour on Pregnancy Elongation. Nat Sci 2019;17(3):38-42]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj170319.07.

Keywords: Nifedipine, β-sympathomimetics, Preterm labor

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Sublingual Versus Vaginal Misoprostol For Induction Of Labour At Term

Dr. Ahmed Taha Abdelfattah, Prof. Dr. Abdelfattah Mohammed Elsenity, Dr. Ahmed Osama Abdelmotaal, Ahmed Mohammed Abdelaziz Selim

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

a_selim4004@yahoo.com

Abstract: Introduction: Induction of labor implies the artificial initiation of uterine activity to affect labor and delivery. The indications for induction have been steadily widened in recent years. The aim of successful induction is to achieve vaginal delivery with a safe maternal and perinatal outcome and to eliminate any anticipated adverse outcome associated with continuation of pregnancy. It should bring about adequate uterine activity sufficient for cervical changes and fetal descent to occur without causing hyperstimulation or fetal compromise. The objective of pharmacological induction is to mimic the natural process as closely as possible. Aim of the work: The aim of this study is to assess the effectiveness and safety of sublingual Misoprostol (25 microgram), compared with the same dose administered vaginally every 4 hours for cervical ripening and labour induction in women with a viable term pregnancy. Patients and methods: This randomized controlled study was conducted on 100 women who were admitted at Department of Obstetrics and Gynecology, Matareya Teaching Hospital (MTH) in Cairo, in the period between January 2018 to August 2018. All these cases were admitted for induction of labor by Misoprostol either sublingually or vaginally. These cases were randomized into Group A and Group B. Group A included sublingual group. Group B included vaginal group. Results: In group A, there were 36 cases delivered vaginally, versus 34 cases in group B. The difference between the two groups was statistically non significant. The number of cases delivered by C.S. was 14 cases in group A and 16 cases in group B, with no statistically significant difference between both groups. The mean misoprostol dose was higher in group B in comparison to group A with statistically significant difference between both groups. (P=0.015). There was statistically significant difference between two groups as regards induction-delivery interval and which was shorter in group A in comparison to group B. (P=0.045). In group A, 8 cases delivered by C.S. because of fetal distress, 4 cases were due to failed progress of labor, 2 cases were due to failed induction. In group B, there were 9 cases due to fetal distress, 6 cases due to failed progress of labor, 1 case due to failed induction. There was no statistically significant difference between two groups as regards the indication of delivery by C.S. There was no statistically significant difference between two groups as regards 1 and 5 minutes Apgar Score and NICU admission. There was no statistically significant difference between two groups as regards misoprostol side effects.

[Ahmed Taha Abdelfattah, Abdelfattah Mohammed Elsenity, Ahmed Osama Abdelmotaal, Ahmed Mohammed Abdelaziz Selim. Sublingual Versus Vaginal Misoprostol For Induction Of Labour At Term. Nat Sci 2019;17(3):43-51]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj170319.08.

Keyword: Sublingual; Versus; Vaginal; Misoprostol; Induction; Labour; Term

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Comparative Study between 3D / 4D Ultrasound an Hysteroscopy in Evaluation of Cases of Recurrent Abortion

Abdel Samee Hassan Khalifa¹, Mohamed Mohamed Ibrahim Farahat¹ and Yusuf Haggag Abdo Mohamed²

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

²Department of Obstetrics and Gynecology, El- Matarya Teaching Hospital, Cairo, Egypt

dr.joe01148904361@gmail.com

Abstract: Background: This study aimed to compare between 3D / 4D Ultrasound an Hysteroscopy in Evaluation of Cases of Recurrent Abortion. Methods: This clinical trial was conducted at Al-Azhar University hospitals (Hussien & Said Galal) for women with recurrent pregnancy loss on 100 on 100 women divided in two groups each group 50 womens. Results: There was significant difference between two groups regarding to 3D and Hysteroscopy, but 4D and hysteroscopy there was non significance difference value. Conclusion: 3D and 4D TVS is both sensitive and specific in diagnosing uterine polyps and submucus fibroids, but with a low PPV, both in first trimester and second trimester RPL groups with hysteroscopy taken as a reference. However, 3D and 4D TVS has a moderate sensitivity in the diagnosis of a double-cavity uterus in the first trimester RPL group, and a low sensitivity in the diagnosis of the same condition in the second trimester RPL group. Hysteroscopy is a minimally invasive, highly accurate and efficient diagnostic method in the detection of uterine anomalies.

[Abdel Samee Hassan Khalifa, Mohamed Mohamed Ibrahim Farahat and Yusuf Haggag Abdo Mohamed. Comparative Study between 3D / 4D Ultrasound an Hysteroscopy in Evaluation of Cases of Recurrent Abortion. Nat Sci 2019;17(3):52-57]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj170319.09.

Keywords: 3D and 4D – Hysteroscopy – Recurrent abortion.

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Significance of Angiogenesis in Management and Prognosis of Breast Cancer

Hoda El-Sayed Hosny Khodair¹; Hamed Ahmed Abdel Hamed Elbadawy¹; Laila Abd El-Samea El-Sayed Mousa²; Bosat Elwany Bosat Kassy¹

¹Department of General Surgery, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.

²Department of Pathology, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.

Email: hodakhodair@gmail.com

Abstract: Introduction: Tumor angiogenesis is the main process responsible for the formation of new blood vessels that promote tumor growth and metastasis. The evaluation of both CD₃₄- CD₁₀₅ showed the role of angiogenesis in the cancer proliferation and local spread, the angiogenesis level being maintained high even in the advanced stages of the disease. There was observed difference between the MVD assessed by (CD₃₄) and the MVD assessed by (CD₁₀₅), the study of this difference possibly leading to a better assessment of prognosis and adjusted therapies in the future. Patients and Methods: Endothelial cells are highlighted using a variety of endothelial markers. One of the best known marker is CD₃₄, pan endothelial marker; surface antigen. The most used immunohistochemical marker for identification of activated endothelial cells is CD105. Our study included 46 patients with breast cancer between 2010- 2013 who underwent breast surgery (CBS/ MRM) at Al- Zahraa University hospital department of surgery, Faculty of medicine, Cairo, Egypt. We used MVD quantification by highlighting the tumor bleed vessels with two different endothelial markers using the immune histochemical protocols. Results: The CD34 evaluation of MVD was 10 patients (approx.; 22.2%) with low vascular density and 36 patients (77.8) with high vascular density. In the same patients MVD for CD₁₀₅ (endoglin); staining the intratumoral active endothelial cells was 16 patients (app 35.6%) showed low vascular density and 29 patients (approx. 64.4%) with high vascular density. There was a statistical significant correlation between high vascular density and the number of positive axillary lymph node (P= 0.054 for CD₁₀₅ and P= 0.037 for CD₃₄), tumor size (P= 0.050 for CD₁₀₅) Mitotic index (MI) (p= 0.003 for CD₃₄; P= 0.002 for CD₁₀₅); ER and PR negativity (P= 0.014 for CD₁₀₅); and Her -2 neu overexpression (P= 0.026 for CD₁₀₅).

[Hoda El-Sayed Hosny Khodair; Hamed Ahmed Abdel Hamed Elbadawy; Laila Abd El-Samea El-Sayed Mousa; Bosat Elwany Bosat Kassy. Significance of Angiogenesis in Management and Prognosis of Breast Cancer. Nat Sci 2019;17(3):58-65]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj170319.10.

Keyword: CD34, CD105, endoglin, breast cancer, Pan-endothelial marker, angiogenesis, ER, PR, Her- 2 neu, MI

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Hysteroscopic Evaluation of Uterine Cavity after Septoplasty either By Scissor or Bipolar Resectoscope

Rashed Mohamed Rashed¹, Waled Ahmed Ayad¹ and Somaia Mostafa Hamed Balbola²

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

²Department of Obstetrics and Gynecology, Damietta Specialized Hospital, Egypt

Somaiamostafa43@gmail.com, saeed2007201018@gmail.com

Abstract: Background: Septate uterus is a commonly encountered congenital malformation of the uterus characterized by abnormal resorption of the Mullerian canal during embryogenesis. It has been associated with poor reproductive outcomes, such as abortion and preterm births. Objective: The present study was designed to evaluate the uterine cavity after hystroscopic metroplasty either by scissors or bipolar resectoscope. Patients and Methods: This is a prospective study which was conducted on women after septoplasty from the outpatient clinic of AL-Azhar University hospital (New Damietta) during the period from December 2017 to last of December 2018. This study include two groups; Group I: 25 women underwent septoplasty by scissor and group II: 25 women underwent septoplasty by bipolar resectoscope. Results: As regard to group I, the mean operative time is 10.9min, fluid deficit is 525ml, the mean of pain score is 3 with incidence of residual part of septum 12%, intra-uterine adhesion is 8%, and as regard to group II, the mean operative time is 11 min, fluid deficit is 515 ml, the mean of pain score is 5 with incidence of residual part of septum 4%, intra uterine adhesion is 12%. Conclusion: women underwent septoplasty by bipolar resectoscope had pain score less than women underwent septoplasty by scissor.

[Rashed Mohamed Rashed, Waled Ahmed Ayad and Somaia Mostafa Hamed Balbola. Hysteroscopic Evaluation of Uterine Cavity after Septoplasty either By Scissor or Bipolar Resectoscope. Nat Sci 2019;17(3):66-72]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj170319.11.

Keywords: Hysteroscopy, Septoplasty, Resectoscope.

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Role of MRI in the Evaluation of Soft Tissue Masses

Prof. Dr. Naaila Abd-Ellatif Abo Madyan¹, Prof. Dr. Hoda Mahmoud Abd-Elwahab¹, Dr. Mohammed Samy Saied El-Azab² and Eman Taha Soliman Nashy¹

¹Radiodiagnosis department, Faculty of Medicine, Al-Azhar University, Egypt

²Radiodiagnosis department, National Cancer Institute, Cairo University, Egypt

nashy_et@yahoo.com

Abstract: Introduction: Magnetic Resonance Imaging (MRI) is a major radiologic method for evaluation of soft tissue masses due to superior contrast resolution, Multi-planar imaging and lack of ionizing radiation. Diffusion weighted imaging (DWI) provides the functional information required. The addition of quantitative ADC values plays an important role in more accurate diagnosis. Aim: This thesis aimed at evaluation the role of MRI, especially Diffusion weighted sequence and ADC mapping in the initial characterization of soft tissue masses. Methodology: This study enrolled 50 patients. Their ages range from 1 to 90 years. All patients present with clinical symptoms of soft tissue mass, according to its site. All were subjected to conventional MRI (T1, T2, and STIR) sequences. DW images were obtained, with calculation of ADC map from them. Gadolinium contrast was administered using automatic injector. Provisional radiological diagnosis was compared to the histo-pathological diagnosis. Results: 22 of our lesions were benign and 28 were malignant. Soft tissue masses with well-defined margin are benign (P=0.049). Addition of DW imaging with ADC mapping to the conventional MRI evaluation of soft tissue masses shows sensitivity (100%) and specificity (90.9%). Conclusion: MRI is the method of choice for evaluation and characterization of soft tissue masses. The parameter favoring benignity is well-defined margin. Adding DW-MRI with ADC mapping to the routine MRI protocol for soft tissue masses improves diagnostic accuracy and differentiation between benign and malignant masses.

[Naaila Abd-Ellatif Abo Madyan, Hoda Mahmoud Abd-Elwahab, Mohammed Samy Saied El-Azab and Eman Taha Soliman Nashy. Role of MRI in the Evaluation of Soft Tissue Masses. Nat Sci 2019;17(3):73-80]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj170319.12.

Keywords: Soft tissue masses-MRI-DW imaging-ADC mapping

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The Association between Vitamin D and Frequency of Streptococcal pharyngitis among School Students

Mohamed A. Fareid^1,2

Basic Science Dept., Health Colleges, H’ail University, Saudi Kingdom¹.

Botany and Microbiology Dept., Faculty of Science, Al-Azhar University, Nasr City, Cairo, Egypt².

mohamedfareid73@yahoo.com

Abstract: The aim of the present study was to assessment the relationship between Vitamin D deficiency and Streptococcal pharyngitis among school students. Our study showed that, the proportion of vitamin D deficiency in females was significantly higher than the prevalence in males. It recorded 122 (64.89%) and 66 (35.10%), respectively. The frequency of Group A Streptococcal (GAS) isolate recorded the most higher percentage between enrolled students which have deficient vitamin D level in compared to sufficient vitamin D level. It recorded 115 (73.24%) and 31 (49.20%), respectively. Statistically, there is a higher significant different between vitamin D deficiency and frequency of GAS isolates, p-value < 0.05. Also, our data showed a higher significant positive correlation between vitamin D levels and the frequency of GAS (r = 1.000**, p-value = 0.001).

[Mohamed A. Fareid. The Association between Vitamin D and Frequency of Streptococcal pharyngitis among School Students. Nat Sci 2019;17(3):81-91]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj170319.13.

Keywords: Association, Vitamin D, Frequency, Streptococcal pharyngitis

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CD4+CD25-Foxp3+T Cells as a Novel Biomarker for Lupus Nephritis

Soha Abdel Fattah Shalaby¹, Nesreen Ahmed Kotb ¹, Gamal Fathy Elnagar¹, Hala Mohamed Nagy ², Eiman Adel Hasby ³

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

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

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

soha.shalaby@med.tanta.edu.eg, dr_soha_shalaby@yahoo.com

Abstract: Background: Systemic lupus erythematous is a prototypic autoimmune disease that is known to affect virtually every organ system in the body. One of the striking manifestations of SLE is renal affection which may lead to end stage renal disease with marked affection of quality of life of many young patients primarily targeted by such disease. Objective: The aim of this study is to analyze the presence of CD4+CD25-Foxp3+ T cells in systemic lupus erythematous patients with and without nephritis. Materials and Methods: Our case control study aimed at quantitatively analyzing proportions and absolute cell numbers of CD4⁺CD25^-Foxp3⁺Treg cells by flow cytometry and the correlation between results, renal disease and systemic lupus erythematous disease activity index score was documented. Eighty patients were enrolled; of which 30 patients underwent renal biopsy for suspected lupus nephritis and peripheral blood samples were taken at the time of the biopsy and analyzed for proportions and absolute cell numbers of CD4⁺CD25^-Foxp3⁺ Tregcells in a standardized way. The activity of lupus nephritis was classified according to the renal histology. Thirty SLE patients without nephritis and twenty healthy volunteers were investigated for comparative purpose. Results: Increased proportions of CD4+CD25-Foxp3+ T cells in SLE patients with renal involvement. The sensitivity of proportions of CD4+CD25-Foxp3+ T cells was 100% and the specificity was 60%, and the predictive values for renal disease were 71.43% and 100% for positive and negative predictive values respectively with a predictive accuracy of 80.00%. The proportions of CD4+CD25-Foxp3+ T cells were highest in patients with class IV lupus nephritis. Conclusions: Comparative analysis of CD4+CD25-Foxp3+ T cells in SLE patients revealed a significant association of this cell population with active nephritis. Therefore CD4+CD25-Foxp3+ T cells may be used to monitor and follow activity of lupus nephritis patients.

[Soha Abdel Fattah Shalaby, Nesreen Ahmed Kotb, Gamal Fathy Elnagar, Hala Mohamed Nagy, Eiman Adel Hasby. CD4+CD25-Foxp3+T Cells as a Novel Biomarker for Lupus Nephritis. Nat Sci 2019;17(3):92-105]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj170319.14.

Keywords: Biomarker, lupus, nephritis, T cells

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Neutrophil CD64 as A Diagnostic Marker in Neonatal Sepsis

Nashwa Mamdouh Samra¹; Mohamad Ezzat Al Ghwass¹; Sayed Ali Amin¹; Fadwa Abd El Reheem Mohammad² and Shaimaa Madkour Abd El-wahed¹.

¹ Pediatric Department, Faculty of Medicine, Fayoum University, Egypt.

²Clinical and Chemical Pathology Department, Faculty of Medicine, Fayoum University, Egypt.

shaimaamadkour84@gmail.com

Abstract: Background: Sepsis in neonates hospitalized in the neonatal intensive care unit is a global problem and is a significant contributor to morbidity and mortality. Although treatment of sepsis has evolved in the last decades with newer therapeutic options, little has changed to improve diagnosis or therapeutic monitoring. Objective: This case control study aimed to evaluate the diagnostic utilities of neutrophil CD64 (nCD64) expression for the diagnosis of neonatal sepsis. Subjects and methods: The study was performed on 41 neonates with evidence of sepsis admitted in the Neonatal Intensive Care Unit (NICU) of Fayoum University Hospitals as a case group and 19 healthy neonates as a control group. Detailed history and meticulous general & systemic examinations were done. Complete blood count, C-reactive protein (CRP), blood culture and CD64 index were done simultaneously at time of evaluation. Neutrophil CD64 was analyzed by flow cytometry. Results: Neutrophil CD64% showed moderate sensitivity (70.7%) and moderate specificity (73.7%) with cut off value 17.8 in diagnosis of neonatal sepsis. Conclusion: There was a significant difference in the percentage of neutrophils expressing CD64 between the case and control groups so nCD64 can be considered a useful marker in diagnosis of neonatal sepsis.

[Nashwa Mamdouh Samra; Mohamad Ezzat Al Ghwass; Sayed Ali Amin; Fadwa Abd El Reheem Mohammad and Shaimaa Madkour Abd El-wahed. Neutrophil CD64 as A Diagnostic Marker in Neonatal Sepsis. Nat Sci 2019;17(3):106-112]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj170319.15.

Key words: neonatal sepsis, neutrophils, CD64, Flow cytometry.

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Impact of religion in work place

Alasmari Nouf Abdulrahman

Affixation Occupation teacher international school

Email. noufa7797@gmail.com

Abstract: Studies on the impact of religion in management of organizations are rarely done. In addition, most organizations do not allow such studies to be conducted on their premises. Most respondents also fear participating in the research because they fear being victimized. However, most organizations still suffer from challenges of religious believes that their employees subscribe to. On the other hand, some employees also resist some of the policies that organizations put in place because they may contradict the teachings of their religion. To find out the impact of religion, a research was conducted on the Salvation Army. The research involved conducting interviews on a number of stakeholders working within the organization. Salvation Army is a Christian based charitable organization with its base in Minnesota. The organization was chosen because; it is founded on the teachings of the Salvation Army church. The beneficiaries of the charitable activities are both Christians and non-Christians. It also employees employs of diverse religious faiths. The research was carried out in December 2013 at a time that the organization was at the peak of their annual charitable activities. Of the 1000 thousand volunteers working with the organization, 100 took part in the interview. We also interviewed 1500 beneficiaries out of the 15000 beneficiaries of the program. The research also involved interviewing the management of the organization. From the analysis, it is evident that the research interviewed ten percent of the total population of employees and beneficiaries respectively. Based on the findings of the research, the paper proposes the incorporation of religious teachings in management of organizations dealing in provision of human services. The paper also proposes peaceful ways of solving conflicts that occur as a result of religious misunderstanding. The paper also seeks to see the application of religious teachings in the promotion of organization ethics and moral standards.

[Alasmari Nouf Abdulrahman. Impact of religion in work place. Nat Sci 2019;17(3):113-117]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj170319.16.

Keywords: Impact; religion; work; place

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Comparative Study between Haloperidol and Quetiapine as Antipsycotic in Management of Delirium in Criticaly ill Patients

Nahed Effat Yossef Salama; Sahar Mohamed Kamal Mahmoud; Rania Hassan Abd El Hafiez Mohamed, Ahmed Mohamed Ali Nasef

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

dr.nasef888@gmail.com

Abstract: Delirium is an independent predictor of increased length of ICU stay, mortality, and treatment costs in critical care department. Its incidence may be underestimated or overestimated if delirium is assessed by using subjective clinical impression alone rather than an objective instrument. Different antipsychotics; either typical or atypical, are used for control of delirium in critically ill patients. In this comoarative study between haloperidol and quetiapine among adults critically ill patients using biological equivalent doses haloperidol and quetiapine are equally effective and safe in the treatment of delirium in the critically ill patients.

[Nahed Effat Yossef Salama; Sahar Mohamed Kamal Mahmoud; Rania Hassan Abd El Hafiez Mohamed, Ahmed Mohamed Ali Nasef. Comparative Study between Haloperidol and Quetiapine as Antipsycotic in Management of Delirium in Criticaly ill Patients. Nat Sci 2019;17(3):118-121]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj170319.17.

Key Words: Antipsychotics - Critically Ill Patient – Delirium

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