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Fibrinogen Level as an indicator for aggravation of Primary Post Partum Hemorrhage

Elsayed Eldesouky, Elsayed Aly Farag, Mohammed Mahmoud¹ and Mahmoud Hashish²

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

²Departmentof Clinical Pathology Faculty of Medicine Al Aazhar University, Cairo, Egypt

elsayedeldesouky@yahoo.com

Abstract: Background: postpartum hemorrhage is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. Though some women are at greater risk for postpartum hemorrhage compared to others, the most common cause is poor contraction of the uterus following childbirth. Objective:  study the role of serum fibrinogen as a predictor for the severity of postpartum hemorrhage. Patients and Methods: this prospective multicenter study was conducted from February 2019 to October 2019 at Department of Obstetrics and Gynecology, al azhar university hospitals. included 100 patients ,characteristics (age, parity, medical history, labour, and delivery) were recorded in both groups (group I (non-severe )and GROUP II (severe PPH) as were their laboratory results (hemoglobin, coagulation data, platelet count, and fibrinogen concentration) and the time blood samples were obtained, to calculate the time relative to hemorrhage diagnosis. Results: there was    a high significant difference between both group  as regard the mean serum fibrinogen levels in group I was 4.2 ± 1.2 SD, in group II it was3.4 ±0.9 SD with p value equal 0.002. PPH was severe for 43 of the 100 (43%) women included group I, but not for 75 (57%) group II. Among the women with severe hemorrhage, no women required embolization, 12 required ligation of the uterine arteries, and 7 hysterectomy; 7 were transferred to intensive care, 37 received transfusions, and 42 had a postpartum hemoglobin level that decreased more than 4 g liter .Conclusion: high fibrinogen level  in  PPH  was associated with subsequent aggravaation to severe PPH.serum fibrinogen level indicator for alert to clinicians.

[Elsayed Eldesouky, Elsayed Aly Farag, Mohammed Mahmoud and Mahmoud Hashish. Fibrinogen Level as an indicator for aggravation of Primary Post Partum Hemorrhage. Nat Sci 2020;18(2):1-5]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj180220.01..

Keywords: Fibrinogen, post partum Hemorrhage

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Gastric Bypass versus Sleeve Gastrectomy in Morbid Obesity Management

Khaled A. Gawdat, Basem H. El Shayeb, Kerolos R. Naguib

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

Keroloselwa7sh@gmail.com

Abstract: Background: Obesity is caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications, or psychiatric illness. The main aim of obesity therapy is weight loss and maintenance by dietary interventions and increased physical activity. Aim of the Work: To review two of the most commonly performed modalities of weight loss namely Sleeve Gastrectomy, Gastric Bypass, and to study their early post-operative complications, outcomes, effects regarding excess body weight loss (EBWL), life style changes and sustainability. Patients and Methods: This is a prospective comparative randomize study included 40 patients presented with morbid obesity with BMI range between (40 to 60 kg/m²) were treated 20 cases by laparoscopic sleeve Gastrectomy and 20 cases by laparoscopic Gastric Bypass (15 cases one anastomosis gastric bypass – 5 cases Roux-en-Y bypass) in Ain Shams Hospital during the period from October 2017 till May 2018. Cases were followed up monthly for 6 months and after 1 year. Results: Laparoscopic sleeve gastrectomy has higher incidence of complications (15%) than the incidence of complications of Laparoscopic Gastric Bypass (5%). Conclusion: Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Bypass are both safe and effective procedures for the surgical management of morbid obesity. Laparoscopic Gastric Bypass has slightly higher mean of (EBWL%) than Laparoscopic sleeve gastrectomy at 6 months, and a higher mean of (EBWL%) than Laparoscopic sleeve gastrectomy at 1 year follow up.

[Khaled A. Gawdat, Basem H. El Shayeb, Kerolos R. Naguib. Gastric Bypass versus Sleeve Gastrectomy in Morbid Obesity Management. Nat Sci 2020;18(2):6-12]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj180220.02.

Key words: Gastric bypass, sleeve gastrectomy, morbid obesity

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Role of Fluorine 18 Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in Detection of Thyroid cancer Recurrence with positive thyroid tumor markers and negative thyroid scan.

Emam Abo Seif, Aliaa Elnagar, Yahia Mohammed Abdelaal

Department of Radiodiagnosis, Faculty of Medicine (for Girls) Al-Azhar University, Egypt

dr_yahia.nayel@yahoo.com

Abstract: Background: Thyroid cancer is the 6^th common cancer in women and accounts for approximately 1% of all cancer cases. Thyroid cancer is generally characterized by long term survival, good prognosis and low aggressiveness. Its prognosis is related to the age at diagnosis, tumor dimension, extra capsular extension and presence of distant metastases. Distant metastases is relatively rare with incidence ranging from 4- 27%. Combination between positron emission tomography (PET) and computed tomography (CT) allow anatomic, functional & molecular information. Aim of the Study: Role of Fluorine 18 fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) / Computed Tomography (CT) in detection of post-thyroidectomy recurrence in thyroid cancer patients with negative iodine radioisotope scan (I-131WBS) and elevated serum thyroglobulin (TG) level. Patients and Methods: this study will be performed on 30 patients presenting with pathologically proven recurrence differentiated thyroid carcinoma after total thyroidectomy with positive thyroid tumor markers and negative thyroid scan. Results: There was a high frequency of papillary carcinoma found in 22 patients (73.3%) while (16.6%) and (10%) patients had follicular carcinoma and Hurthle cell tumor respectively. Conclusion: The sensitivity & accuracy of PET & PET/CT (100%) were significantly better than those of the CT alone (85.7% and 44.5%, respectively), Co-registered 18F-FDG PET/CT provide precise anatomical localization of recurrent and/or metastatic thyroid carcinoma, leading to improved diagnostic accuracy.

[Emam Abo Seif, Aliaa Elnagar, Yahia Mohammed Abdelaal. Role of Fluorine 18 Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in Detection of Thyroid cancer Recurrence with positive thyroid tumor markers and negative thyroid scan. Nat Sci 2020;18(2):13-15]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj180220.03.

Keywords: Fluorodeoxyglucose, Post-Thyroidectomy, Thyroid Cancer, Radiodiagnsis

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Assessment of phyto-filtration and biosorption treatment on the removal of contaminant form wastewater

Reham K. Badawy¹, Sherine M. Shehata² and Yasmin I. E. Aboulsoud¹

¹Desert Research Center, Plant Ecology and Range Management Department, Cairo, Egypt

²Desert Research Center, Soil Chemistry and Physics Department, Cairo, Egypt

Abstract: Nowadays, the environmental pollution resulting from natural resources acquisition is one of the most severe problems. Biosorption is an environmentally friendly and economically attractive technique using low-cost biomasses for contaminants removal. The study on the performance of low-cost biosorbents, such as dried biomasses of Neem leaves (Azadirachta indica A. Juss.) and Azolla pinnata, in the removal of Ni, Al, Cu, Pb, Fe and Cd ions from aqueous solutions was performed. The optimum concluded conditions were pH: 7 for Ni; 3 for Al; 5 for Cu; 5 for Pb; 3 for Fe and 5 for Cd, contact time: 1 hour, S/L ratio: 1/500 g/ml, shaking rate: 300 rpm and initial metals concentration: 100 mg/l. The higher biosorption capacities were achieved using Azolla pinnata biomass that reached 28.22, 28.46, 39.67, 41.27, 35.64 and 21.70 mg/g; whereas, neem leaves achieved lower capacities reached to 14.75, 12.65, 19.60, 35.86, 21.00 and 11.67 mg/g for Ni, Al, Cu, Pb, Fe and Cd, respectively. The biosorption process obeyed the 2^nd order kinetic modeling. The isotherm modeling indicated that the biosorption onto Azolla pinnata was a multilayer coverage; meanwhile, it was monolayer coverage onto neem leaves. The concluded optimum conditions from batch experiments were applied to treat actual contaminated wastewater samples from Bahr El-Baqar drain. The removal percentage for Al, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, V and Zn reached 94.76, 96.66, 90.40, 95.26, 75.51, 86.51, 47.98, 89.10, 93.44 and 88.63 %, respectively using Azolla pinnata biomass; whereas, neem leaves achieved removal percentage of 93.60, 98.06, 89.27, 90.95, 60.47, 79.61, 68.91, 36.70, 86.88, 72.03 % and 59.76, respectively. However, neem leaves biomass was mightily recommended to be used in water treatment process because of Mn release from Azolla pinnata biomass during water treatment process.

[Reham K. Badawy, Sherine M. Shehata and Yasmin I. E. Aboulsou. Assessment of phyto-filtration and biosorption treatment on the removal of contaminant form wastewater. Nat Sci 2020;18(2):16-26]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj180220.04.

Keywords: Biosorption, Neem, Azolla pinnata, Heavy metals, Langmuir and Freundlich isotherm models, Kinetic modeling, Reusability.

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Investigation of elements of the water regime phases of rivers belonging to the middle part of Zeravshan river basin

Rakhmat Ziyayev¹, Narzikul Erlapasov², Fazliddin Khikmatov³

^1.Department of Hydrology, National University of Uzbekistan, 100174

Email: z-rahmat@mail.ru

Abstract: in the article, in the result of analysis of the mean long-term discharge values of the rivers belonging to the middle part of Zeravshan river basin there were selected the years of characteristic water availability. The quantitative changes of the flood elements were determined for the years of characteristic water availability.

[Rakhmat Ziyayev, Narzikul Erlapasov, Fazliddin Khikmatov. Investigation of elements of the water regime phases of rivers belonging to the middle part of Zeravshan river basin. Nat Sci 2020;18(2):27-31]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj180220.05.

Key words: rivers, river basin, discharge, phases of water regime, high-water, low-water, characteristic years, high-water years, medium-water years, low-water years, elements of phases of water regime

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Change Of Statistical Characteristics Of Flow With Prolongation Of Observation Series

Sagdeev N.Z., Khamzaeva J.Т., Khakimova Z.F.

Department of Hydrology, National University of Uzbekistan, 100174

Email: nailsagd@mail.ru

Abstract: in the article the changes of statistical characteristics of the river flow in Chirchik and Kashkadarya hydrological regions are considered in the case of lengthening of observation series.

[Sagdeev N.Z., Khamzaeva J.Т., Khakimova Z.F. Change Of Statistical Characteristics Of Flow With Prolongation Of Observation Series. Nat Sci 2020;18(2):32-35]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj180220.06.

Key words: river flow, long observation series, short observation series, mean long-term discharge, root-mean-square deviation, coefficient of variation, coefficient of skewness.

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Characters of the Bladder Cancer in Urology Department of Tanta University Hospitals

Mohamed M. Elzoghby, M.Sc.; Mohamed H. Radwan, M.D.; Mohamed A. Elbendary, M.D. and Ayman A. Hassan, M.D.

Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt

E-mail: muhammad.elzoghby@gmail.com

Abstract: Background: Bladder cancer is a highly prevalent disease and is associated with substantial morbidity, mortality and cost. Aim of the study: to study characters of bladder cancer using the new registry system in urology department of Tanta University. Material and Methods: The study included 229 patients with recently diagnosed bladder cancer who presented to urology department from June 2018 to June 2019. Secondary bladder masses or metastatic tumors were excluded. All data were collected from the registry system of Tanta urology department. All patients were subjected to routine perioperative evaluation then underwent TURBT and all resected pieces of masses were sent to histopathological examination. Outcomes: Measurement of histopathological patterns of bladder cancer. Results and limitations: In this cross-sectional study, 62.4% of newly diagnosed patients had NMIBC. The main limitation is a good registry system that includes demographical data, perioperative information and histopathological picture. Conclusion: Bladder cancer attained the developed world characters with smoking and urbanization being the most important risk factors.

[Mohamed M. Elzoghby, M.Sc.; Mohamed H. Radwan, M.D.; Mohamed A. Elbendary, M.D. and Ayman A. Hassan, M.D. Characters of the Bladder Cancer in Urology Department of Tanta University Hospitals. Nat Sci 2020;18(2):36-39]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj180220.07.

Keywords: NMIBC, bladder cancer, bladder masses, TCC.

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Comparison between Intubating and Recovery Characteristics of Succinylcholine, Rocuronium and Atracurium in Parturients Undergoing Cesarean Sections.

Prof. Dr. Hany Mohamed Mohamed El Zahaby, Prof. Dr. Abeer Mohammad Abdel Aziz El Deek. Dr. Reham Mostafa Hashim Kotb, Rabie Ahmed Sayed Rayan.

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

Abstract: Woman undergone general anesthesia for caesarean section, need a rapid sequence induction to protect against pulmonary aspiration. Succinylcholine is the most commonly used muscle relaxant due to its fast onset and short duration but it has many serious complications. Rocuronium a new muscle relaxant with a brief onset of action, but devoid of the succinylcholine adverse effects may be a suitable alternative to it and to test this hypothesis, the intubating and recovery characteristic of succinyl choline, recuronium and atracurium were compared. This study was conducted on 60 parturients delivered by elective cesarean section. Aged 18 to 37 years and physical status ASA I and II. They were divided into 3 groups: group I was given 0.6 mg. kg-1 rocuronium (n = 20), group II was given 0.5 mg. kg-1 atracurium (n = 20) and group III was given 1 mg. kg-1 succinylcholine (n = 20). The intubation conditions were assessed. heart rate and mean arterial blood pressure were monitored before induction of general anesthesia after induction of general anesthesia and then at 1, 3, 5, 10, 15 and 20 minutes after muscle relaxant administration then every 10 minutes. Subjective TOF ratio was recorded at 0, 1, 2 and 3 minutes from injection of the muscle relaxant and then every 5 minutes until reverse. The onset time, the clinical duration of action of the muscle relaxants, recovery time and recovery index were recorded. The main results of the present study were as follow: Rocuronium gave good and excellent intubating conditions at 60 seconds significantly higher than atracurium and comparable to intubation at 60 seconds following succinylcholine. Rocuronium had significantly shorter onset time and clinical duration than atracurium and had rapid onset of action approaching that of succinylcholine. It had significantly shorter recovery time than atracurium and had significantly lower number of patients with fade in TOF at 1 minute post its injection than atracurium. Number of patients with zero fade in TOF at 1 minute post injection of rocuronium was significantly higher than atracurium. Rocuronium had significantly lower number of patients with no fade in TOF at 60 minutes post injection of NDMR than atracurium.

[Hany Mohamed Mohamed El Zahaby, Abeer Mohammad Abdel Aziz El Deek. Reham Mostafa Hashim Kotb, Rabie Ahmed Sayed Rayan. Comparison between Intubating and Recovery Characteristics of Succinylcholine, Rocuronium and Atracurium in Parturients Undergoing Cesarean Sections. Nat Sci 2020;18(2):40-51]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www. sciencepub. net/nature. 8. doi:10.7537/marsnsj180220.08.

.

Keywords: Comparison; Intubating; Recovery; Characteristics; Succinylcholine; Rocuronium; Atracurium; Parturients; Undergoing Cesarean Section.

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Endoscopic Evacuation of Spontaneous Supratentorial Intracerebral Hematoma

Mohamed Ahmed Mahmoud Abdelaal MSc; Hytham Shokry Al Atrozy MD; Esam Abd El Hay Ali Mokbel, Yasser Fouad El Sawaf, Ali Ibrahim Saif El Deen

Department of Neurosurgery, Faculty of Medicine, Tanta University, Egypt

mohamed.abdelaal@med.tanta.edu.eg

Abstract: Background: Spontaneous Supratentorial Intracerebral Hematoma (SICH) is one of the most common types of stroke. It is estimated that this condition affects 10- 20 in 100 000 people every year with a mortality between 23- 58%. The decision about whether and when to surgically remove ICH remains controversial because the traditional surgical approach (craniotomy) sometimes causes further brain injury. The introduction of the neuroendoscope has brought with it the new idea of minimal invasiveness which may improve the surgical results of ICH. Purpose: To study the surgical outcome of endoscopic evacuation of spontaneous supratentorial intracerebral hematoma. Patients and Methods: This study was conducted in Department of Neurosurgery at Tanta University, Twenty patients underwent endoscopic evacuation of Spontaneous Supratentorial Intracerebral Hematoma. Results: Male constituted 70% of the patients of the study while females constituted 30% of them. The mean age of the patients was 57.75 years. 80% were hypetensive. The mean evacuation rate was 84.89 % with median GOS was 3. Conclusion: The future treatment of SICH should convert to the minimally invasive surgery. Endoscopic evacuation of spontaneous supratentorial ICH is becoming a standard surgical procedure and promising clinical results can be expected with a learning curve. Using the neuroendoscope can create an improved view, limit adjacent brain tissue injury, reduce bleeding, and enhance time efficiency. Therefore, being familiar with the neuroendoscope and related instrumentation is the best way to create a better result and fewer complications.

[Mohamed Ahmed Mahmoud Abdelaal; Hytham Shokry Al Atrozy; Esam Abd El Hay Ali Mokbel, Yasser Fouad El Sawaf, Ali Ibrahim Saif El Deen. Endoscopic Evacuation of Spontaneous Supratentorial Intracerebral Hematoma. Nat Sci 2020;18(2):52-61]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj180220.09.

Keywords: Spontaneous Supratentorial; Intracerebral Hematoma; Stroke; Endoscope; Outcome; Neurosurgery

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Non invasive methods for diagnosis of nonalcoholic fatty liver disease

Shimaa Abdeloneim Mashaal¹, Hanan Ahmed Elbassat², Hanan Hamed Soliman², Fathyia Elsayed Assal²

¹Assistant Lecturer Tropical Medicine and Infectious Disease Faculty of Medicine Tanta University, Egypt

^2,Professor of Tropical Medicine and Infectious Disease Faculty of Medicine Tanta University, Egypt

Abstract: Background & Aim: Non Alcoholic fatty liver disease is the coming epidemic after eradication of HCV by DAA. NAFLD is a common cause of chronic liver disease with a prevalence ranges from 17% to 33%. It is present as simple steatosis, nonalcoholic steatohepatitis, Liver cirrhosis or even HCC which can develop at NAFLD patients even without cirrhosis. The diagnosis of NAFLD was traditionally based on the histopathological changes. The fibrosis may be assessed noninvasively using serum biomarkers and (NAFLD, FIB4, APRI and BARD) scores as well as by measuring certain intrinsic physical properties of the liver parenchyma by transient elastography. TE, the most widely used and validated noninvasive technique, offers several advantages: it is user-friendly, machine-independent and painless, has a short duration of examination. Compared to liver biopsy, the technique is less prone to sampling errors as it explores a liver volume about 100 times larger. The aim of this study was to evaluate the measurement of liver stiffness by transient elastography as a noninvasive method for diagnosis of NAFLD. Methods: The study was conducted on 200 patients who had bright liver with or without elevated liver enzymes collected from the outpatient clinics and inpatients of Tropical Medicine and Infectious Diseases Department at Tanta University Hospitals. Other causes of chronic liver disease such as Alcoholics, Chronic HCV, Chronic HBV, Drugs induced liver injury, Schistosomal hepatic fibrosis and Metabolic diseases were excluded. diagnosis was confirmed by history taking, clinical examination, Liver function tests, Renal function tests, BMI, Lipid profile, (APRI, BARD, FIB4 NAFLD) scores. US and fibroscan. Results: Transient elastography was done and there were 71(35%) patients F0, 53(26.5%) patients F1,25(12.5%) patients F2,40 (20%) patients F3 & 11 (5.5%) patients F4 and has sensitivity 86.36, accuracy 95.4%, PPV 96 & NPV 85.1. As regard to Controlled Attenuation Parameter (CAP), There were 38 patients S1, 60 patients S2 & 102 patients S3 with sensitivity 90% & accuracy 80.7%. Conclusion: TE was found to have a very good performance in diagnosing stages of fibrosis and steatosis (CAP) in patients with NAFLD.

[Shimaa Abdeloneim Mashaal, Hanan Ahmed Elbassat, Hanan Hamed Soliman, Fathyia Elsayed Assal. Non invasive methods for diagnosis of nonalcoholic fatty liver disease. Nat Sci 2020;18(2):62-72]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj180220.10.

Keywords: Non invasive; method; diagnosis; nonalcoholic fatty; liver; disease

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Relation between HbA1c Levels and the Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

Asmaa Abd El-Hakim Abo El-Magd Mahmoud (M.B.B.CH).* Raghda Ghonimy El-sheikh (M.D), and Hatem Mohamed El-Sokary (M.D).

Emergency Medicine and Traumatology Department Faculty of Medicine, Tanta University, Egypt

Email: Asmaaabdelhakim92@gmail.com

Abstract: Background: One of the major risk factors of coronary artery disease is diabetes mellitus. It is well known that the risk of coronary heart disease is higher in patients with type 2 diabetes than in patients without diabetes and that man with diabetes has a worse survival from coronary heart disease than do those without diabetes. Aim of the study: This study aimed to evaluate the relation between HbA1c levels and the severity of coronary artery disease in patients with acute coronary syndrome. Patients and Methods: A prospective study was conducted in the Emergency and Cardiology Department of Tanta University Hospitals. Our study was carried out upon (120) patients of both sex. They were selected from patients presented with acute coronary syndrome. Patients were classified into two groups based on HbA1c level at time of admission. Group I: Patients with HbA1c < 5.7%. Group II: patients with HbA1c ≥ 5.7%. Results: The results indicated that there is positive significant relation between HbA1c with acute coronary syndrome, while no significant relationship found between the other factors including age, gender, obesity, family history, smoking and hypertension with ACS. Conclusions: In non-diabetic patients, higher glycated hemoglobin levels are significantly associated with coronary artery disease. This association is continuous, graded and independent of conventional major cardiovascular risk factors.

[Asmaa Abd El-Hakim Abo El-Magd Mahmoud, Raghda Ghonimy El-sheikh, and Hatem Mohamed El-Sokary. Relation between HbA1c Levels and the Severity of Coronary Artery Disease In Patients With Acute Coronary Syndrome. Nat Sci 2020;18(2):73-77]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj180220.11.

Keywords: Relation; HbA1c Level; Severity; Coronary Artery; Disease; Patient; Acute Coronary Syndrome

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Serum Levels of 25-Hydroxyvitamin D in Children with Autism

Amira R. Youghry MSc, Tarek Mohamed El-gohary MD, Sahar Abdel-Azeem Abdel-Aziz MD.

Paediatric Department, Faculty of Medicine, Tanta University, Egypt.

Abstract: Autism spectrum disorder (ASD) is a neurodevelopment disorder characterized by impairment in socio-communicative functioning and by limited interests and repetitive and stereotypic behaviors. Vitamin D has a unique role in brain homeostasis, embryogenesis and neurodevelopment, immunological modulation, antioxidation, antiapoptosis, neural differentiation and gene regulation. Recently, it has been reported that Children with ASD have significantly lower serum levels of 25-hydroxy vitamin D than healthy children. Objectives: T his study is to evaluate serum 25-hydroxy vitamin D levels in children with autism and to evaluate the relationship between vitamin D deficiency and the severity of autism. Methods: Comparing serum levels of 25-hydroxy vitamin D in 50children diagnosed with Autism, with CARS score >30, and 30 control children. Conclusion: Serum levels of 25-hydroxy vitamin D in the autistic children were significantly lower than that of the control group. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-hydroxy vitamin D had significant negative correlations with Childhood Autism Rating Scale (CARS).

[Amira R. Youghry, Tarek Mohamed El-Gohary, Sahar Abdel-Azeem Abdel-Aziz. Serum Levels of 25-Hydroxyvitamin D in Children with Autism. Nat Sci 2020;18(2):78-82]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj180220.12.

Keywords: ASD-Autism- CARS- vitamin D

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Presepsin as an Early Diagnostic Marker of Neonatal Sepsis in Preterm Neonate

Abdel-Rahman A. Al-Shafei MSc, Mohamed A. Rowisha MD, Ashraf M. Ibrahim MD.

Paediatric Department, Faculty Of Medicine, Tanta University, Egypt

Abstract: Sepsis remains a major challenge in clinical practice with considerable morbidity and mortality despite modern treatments. In the era of multi-drug resistance, definite and early diagnosis of neonatal sepsis is important for avoiding its fatal outcomes and improving the prognosis of patients especially because symptoms and signs are non-specific. Recently, presepsin has been shown to be beneficial as sepsis marker. Objectives: This study is to evaluate the diagnostic accuracy of presepsin as an early diagnostic marker of sepsis in preterm new born in comparison with CRP. Methods: Comparing clinical and lab results regarding demographic data, measuring the sepsis work up including (CRP level and presepsin level) in 90 preterm infants 30 diagnosed as early onset sepsis,30 diagnosed as late onset sepsis and 30 control. Conclusion: Serum P-Sep level was significantly elevated in preterm with neonatal sepsis either early or late onset sepsis, positively correlated with CRP, TLC, ANC and I/T ratio, at cut of value of >799 pg./dL serum P-Sep yielded a sensitivity of 93.33 %, specificity 90.0 %, positive predictive value 94.9 % and negative predictive value 87.1 so Serum P-Sep was superior than CRP as an early diagnostic marker of neonatal sepsis with more sensitivity and specificity.

[Abdel-Rahman A. Al-Shafei, Mohamed A. Rowisha, Ashraf M. Ibrahim. Presepsin as an Early Diagnostic Marker of Neonatal Sepsis in Preterm Neonate. Nat Sci 2020;18(2):83-90]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj180220.13.

Keywords: sepsis- CRP- presepsin-preterm

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Effect of antiepileptic drugs on Vitamin D status in children with idiopathic epilepsy

Eriny S. Aziz MSc¹, Khaled T. Muhammad MD¹, Sahar A. Abdel Aziz MD¹; Hesham A. El-Serougy MD²

¹Pediatric department, Faculty of medicine, Tanta University, Tanta, Egypt

²Clinical pathology department, Faculty of medicine, Tanta University, Tanta, Egypt

Abstract: Background: Epilepsy is a common neurological disorder that affects individuals of all ages. Epileptic children experience fractures 2-6 times more frequently than the general population. Treatment with anti epileptic drugs (AEDs) is chronic and associated with significant metabolic effects including decreased bone mass and increased bone fractures. In pediatric patients, controversies still remain regarding the effect of anticonvulsants on vitamin D levels and bone health. Objectives: This study is to evaluate the effects of the antiepileptic drugs (AEDs): Valproate, Carbamazepine, Levetiracetam and Topiramate on the biochemical markers of bone metabolism (Vitamin D, Parathormone, Alkaline phosphatase, serum calcium and phosphorus) in children with idiopathic epilepsy. Methods: Comparing clinical and lab results regarding demographic data, levels of (serum calcium, serum phosphorus, alkaline phosphatase, parathyroid hormone and 25-OH Vitamin D ) in 100 children with idiopathic epilepsy aged 6-15 years and 50 healthy children of the same age and sex. Results: There was significant decrease in serum calcium and phosphorus levels in children treated with Valproate (p1<0.001) and carbamazepine (p2<0.001) and the control. There was significant increase in serum alkaline phosphatase and parathormone levels in both valproate treated group (p1<0.001) and carbamazepine treated group (p2<0.001) and the control. There was significant decrease in the mean serum 25-OH Vitamin D level in both valproate treated group (p1<0.001) and carbamazepine treated group (p2<0.001) and the control. There was inverse correlation between the duration of treatment with valproic acid and carbamazepine and the mean level of 25-OH Vitamin D. Conclusion: Vitamin D deficiency is common in children with epilepsy who had received valproate or carbamazepine as a monotherapy for twelve months. There was inverse correlation between serum 25-OH Vitamin D level and duration of treatment with valproate and carbamazepine. Levetiracetam and Topiramate have no significant effect on 25-OH vitamin D level on the studied children.

[Eriny S. Aziz, Khaled T. Muhammad, Sahar A. Abdel Aziz; Hesham A. El-Serougy. Effect of antiepileptic drugs on Vitamin D status in children with idiopathic epilepsy. Nat Sci 2020;18(2):91-98]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj180220.14.

Key words: Epilepsy - ­antiepileptic drugs – bone density – vitamin D

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Intra-peritoneal Bupivacaine in Two Different concentrations for Effective Pain Relief After Laparoscopic Cholecystectomy

Sahar Youssef osman¹, Horia Ahmed farran¹, Rehab Elsaeid Younes Elashmawy^2*

¹Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

²Damanhour Teaching Hospital, Damanhour, Egypt

E- mail: dr.rehabelashmawy@Gmail.com

Abstract: Background: The laparoscopic technique has many advantages compared with open surgery for symptomatic cholecystolithiasis. Despite these advantages, many patients complain about pain after laparoscopic cholecystectomy. Methods: A prospective, randomized, double-blinded study at Al-Zahraa university hospital study included 60 patients undergoing elective laparoscopic cholecystectomy. Patients were divided into 2 groups. (Group H received bupivacaine 0.5% ( 100 mg ) was added to 80 ml of normal saline, Group Lreceived bupivacaine 0.5% ( 100 mg ) was added to 280 ml of normal saline) by iteraperitoneal irrigation after extraction of gall bladder Postoperatively the patients were assessed for pain score (VAS ), vital signs (heart rate and blood pressure), and analgesic consumption. Results: A highly significant difference was found between both groups regarding heart rate, mean blood pressure, amount of analgesia, 1^st order of analgesia, VAS of pain (P<0.05) but no significant difference regarding age, sex, BMI, So2, shoulder pain (P>0.05). Conclusion:. Intra-peritoneal instillation of bupivacaine at high concentration causes good pain relief after laparoscopic cholecystectomy. The method is easy, with no adverse effects and may become a routine practice.

[Sahar Youssef osman, Horia Ahmed farran, Rehab Elsaeid Younes Elashmawy. Intra-peritoneal Bupivacaine in Two Different concentrations for Effective Pain Relief After Laparoscopic Cholecystectomy. Nat Sci 2020;18(2):99-103]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj180220.15.

Keywords: Intra-peritoneal; Bupivacaine; Different; concentration; Effective; Pain; Relief; Laparoscopic; Cholecystectomy

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Fetal Hemoglobin in Maternal Serum as A Predictor of Severe Preeclampsia

Kareem Mohamed Kamal Abd EL ALL (MSCh)¹, Nagwa Ibrahim Elsaid Mohamed Aglaan (MD)², Wesam Salah Mohamed Ibrahim (MD)³, Mohamed Ahmed Talaat El Sharawy (MD)²,

¹Ministry of Health, Egypt

²Obstetrics and Gynecology, Faculty of Medicine- Tanta University, Egypt

³Clinical Pathology, Faculty of Medicine- Tanta University, Egypt

Abstract: Introduction: About 10% of pregnancies are complicated by hypertension. Preeclampsia accounts for 70% of hypertension in pregnancy. preeclampsia is a disease associated with high maternal and perinatal morbidity and mortality. Fetal hemoglobin is structurally made up of 2 alpha and 2 non-alpha chains; in addition, Hb-F has 2 - gamma chains and the predominant adult blood HbA1 has 2 beta chains. Aim of the Work: The aim of the study was to assess the role of measuring free fetal haemoglobin of maternal serum as a predictor of severe preeclampsia in cases of mild preeclampsia. Patients & Methods: The study included fifty pregnant women admitted to tanta University Hospital. 50cases presented with signs and symptoms of mild preeclampsia as follows: arterial blood pressure ≥ 140/90 mm Hg and < 160/110 mm Hg (measured 2 times at least 6 hours apart and less than 1 week) and proteinuria: ≥ 0.3g & < 5.0 g/24 hours or 2+ on dipstick analysis of midstream or catheter urine. Methods: after history, examination & ultrasound assessment of fetal condition 5 ml of maternal venous blood were collected & Free fetal hemoglobin (Hb-F) was differentiated from the adult form (Hb-A) by Human fetal Hemoglobin ELISA Quantitation Set. Results: The study is comparative study which there was statistical significant higher level of free fetal hemoglobin in cases of severe preeclampsia terminated before 34 weeks more than cases terminated after 34 weeks including mild preeclampsia and severe preeclampsia and also there was statistical significant higher level of free fetal hemoglobin in cases ended by severe preeclampsia after 34 weeks more than cases ended by mild preeclampsia. Conclusion: Fetal hemoglobin level in maternal blood is considered as a good predictor of severe preeclampsia.

[Kareem Mohamed Kamal Abd ELALL, Nagwa Ibrahim Elsaid Mohamed Aglaan, Wesam Salah Mohamed Ibrahim, Mohamed Ahmed Talaat El Sharawy. Fetal Hemoglobin in Maternal Serum as A Predictor of Severe Preeclampsia. Nat Sci 2020;18(2):104-108]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 16. doi:10.7537/marsnsj180220.16.

Keywords: Fetal hemoglobin, maternal serum, preeclampsia

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Efficacy of Transcerebellar diameter/ Abdominal circumference Versus Head circumference/ Abdominal circumference in predicting Asymmetric Intrauterine Growth Retardation

Prof. Dr. Asmaa Mahmoud Abd El-Wahab, Dr. Hend Salah and Dina Mahmoud Gamal Mohamed Elboghdady

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

dinaboghdady8@gmail.com

Abstract: Accurate gestational dating is of paramount importance and the cornerstone for management of pregnancies, easily reproducible sonographic fetal biometric parameters for gestational dating are clinically important for the optimal obstetric management of pregnancies. This is especially true in determining timing of a variety of gestational tests, assessing adequacy of growth and timing of delivery for the optimal obstetric outcome. As Determination of fetal age and growth is crucial in planning pregnancy management, especially for low-birth-weight infants, Ultrasound screened and managed pregnancies with low-birth-weight babies reduce the mortality rate by 60%. Fetal age and growth are assessed by crown-rump length during the 5th to 10th weeks of gestation. After that, a combination of measurement including the biparietal (BPD) diameter of the skull, Femur length and abdominal circumference are used. IUGR is caused mostly by asphyxia and reduced uteroplacental blood flow. In acute asphyxia, cerebellar blood flow remains unchanged as a consequence of redistribution of cardiac output. The blood flow shifts mainly to the central parts including the brain, heart and adrenal glands. In humans, cerebellar growth may be least affected by IUGR, therefore TCD measurement is mostly accurate in prediction of gestational age and so IUGR. The transverse cerebellar diameter (TCD) has been one of the most reliable ultrasound parameters for growth especially early gestation. The TCD was the only parameter that correlated with gestational age by the end of the second trimester (Pinar et al., 2002). The aim of the study is to evaluate the accuracy, usefulness and efficacy of TCD/AC versus HC/AC in singleton pregnancies as a reliable predictor of GA in fetuses with IUGR after 20 weeks of gestation by ultrasound. This cross-sectional study was conducted on 50 pregnant women diagnosed as IUGR at El-Zahraa University hospital (outpatient clinic), the transcerebellar diameter, the biparietal diameter, the head circumference, the abdominal circumference and the femur length were measured for determination of gestational age and so assessing the efficacy of TCD/AC in predicting asymmetric IUGR. The mean age of the study population was 25.8 years, while the mean gestational age by the LMP was 30.7, by the TCD was 29.9, by HC was 28.8, by AC was 26.1, by TCD/AC was 13.74 and by HC/AC was 1.04.

[Asmaa Mahmoud Abd El-Wahab, Hend Salah and Dina Mahmoud Gamal Mohamed Elboghdady. Efficacy of Transcerebellar diameter/ Abdominal circumference Versus Head circumference / Abdominal circumference in predicting Asymmetric Intrauterine Growth Retardation. Nat Sci 2020;18(2):109-116]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj180220.17.

Keywords: Efficacy; Transcerebellar; diameter; Abdominal circumference; Versus; Head; circumference; Abdominal circumference; predicting; Asymmetric; Intrauterine; Retardation

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Study of the Effect of Naltrexone and Silymarin on Amiodarone Induced Pulmonary Fibrosis in Albino Rats

Asmaa Fawzy El-Tantawy, Samia Hussein Abo Al-Soud, Ahmed Ismaeil Yassin, Amany Abd El-Rahim Abdin

Pharmacology Department, Faculty of Medicine, Tanta University, Egypt

E-mail: asmaa.fawzy55@gmail.com.

Abstract: Background: Pulmonary fibrosis (PF) is a progressive interstitial lung disease that is characterized by increased deposition of extracellular matrix proteins. Amiodarone-induced PF model shows the main fundamental features of pulmonary fibrosis, including the same morphological pattern that mimics PF in humans. Naltrexone acts as a pure non-specific opioid receptor competitive antagonist that blocks all opioid receptors, it can decrease tissue inflammation and fibrosis through potential mechanisms including removal of the free radicals. Silymarin has reported over the last decade as a herbal remedy for hepatoprotection due to its antioxidant properties. The aim of this study was to evaluate the possible anti-fibrotic, anti-inflammatory and anti-oxidant effects of naltrexone and silymarin in amiodarone induced-PF in albino rats. Methodology: This experiment was performed on 48 male albino rats divided into 6 equal groups; normal control group, untreated amiodarone induced PF group, amiodarone induced PF group protected by naltrexone, amiodarone induced PF group protected by silymarin, amiodarone induced PF group treated by naltrexone, amiodarone induced PF group treated by silymarin. The results showed that the untreated induced-PF group showed a significant increase in transforming growth factor β₁ (TGF-β₁), hydroxyproline (Hyp), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) levels, and decrease in Superoxide dismutase (SOD) activity, when compared to normal control group, also the present study showed that prophylaxis and treatment with naltrexone and silymarin produce significant decrease in all parameters except for SOD activity which showed significant increase. There was a non-significant difference between naltrexone and silymarin groups regarding all measured parameters except for SOD activity where there was a significant increase in SOD activity with silymarin compared to naltrexone. Also histopathological examination of lung tissue stained with Mallory stain showed improvement of fibrosis score in protected and treated groups when compared to untreated group. These findings suggest that naltrexone and silymarin have a significant role either in protection or treatment of amiodarone induced-PF, in regard to improvement of inflammation, anti-fibrotic and antioxidant effects. It could be recommended to verify these results in further clinical studies.

[Asmaa Fawzy El-Tantawy, Samia Hussein Abo Al-Soud, Ahmed Ismaeil Yassin, Amany Abd El-Rahim Abdin. Study of the Effect of Naltrexone and Silymarin on Amiodarone Induced Pulmonary Fibrosis in Albino Rats. Nat Sci 2020;18(2):117-130]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 18. doi:10.7537/marsnsj180220.18.

Keywords: Pulmonary fibrosis (PF), Amiodarone, Naltrexone, Silymarin.

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Formulation and Development of Mirzachul Landscapes

Toshboev Zafarjon Makhramkulovich¹, Yarashev Kuvondik Safarovich²

¹Jizzakh State Pedagogical Institute. e-mail: zafartoshboyev76@gmail.com

²Samarkand State University. e-mail: yarashev2008@mail.ru

Annotation: Today, there is a growing interest in the study of oasis landscapes in the country, which accounts for one tenth of the total land area. This article considers the factors of formation of the Mirzachul oasis.

[Toshboev Zafarjon Makhramkulovich, Yarashev Kuvondik Safarovich. Formulation and Development of Mirzachul Landscapes. Nat Sci 2020;18(2):131-134]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 19. doi:10.7537/marsnsj180220.19.

Keywords: anthropogenic oasis, celestial landscapes, cone spreading, reclamation, soil-reclamation state, reclamation assessment.

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