Role of ACE2 Gene Expression in Renin Angiotensin System and Its Importance in Covid-19: In Silico Approach

Abstract We aimed to analyze the expression profile of ACE2 and similar genes with ACE2, predict the number of variations in ACE2, detect the suspected SNPs on ACE2 gene, and perform the pathway analysis of renin-angiotensin system (RAS) and protein absorption-digestion. Moreover, we have predicted the gene-related diseases with ACE2. STRING was used to analyze functionally similar genes with ACE2. Exome Variant Server, SIFT, Polyphen2 were used to predict the number of variations in ACE2 and detect the suspected SNPs on ACE2. KEGG database and STRING were used to draw pathway of ACE2. Then, DISEASES resource, FitSNPs, UniProt, BioXpress, IGV Browser, Ensembl Genome Browser, and UCSC Genome Browser were used to predict the ACE2 gene-related diseases and expression profile in human normal and cancer tissues. We have shown that expression of ACE2 was correlated with AGT, REN, AGTR1, AGRT2, MME2, DPP4, PRCP, MEP1A, XPNPEP2, MEP1BandACE2 is expressed in testis, kidney, heart, thyroid, colon, esophagus, breast, minor salivary gland, pancreas, lung, liver, bladder, cervix, and muscle tissues. We found 99 variations in ACE2 gene, in which no previous study has been performed. In the future, this in silico analysis should be combined with other pieces of evidence including experimental data to assign function.

Optical properties of polyvinyl alcohol membrane with n-HAp for bio-medical applications

Composite membrane as a flexible materials have found diverse applications in industrial and biomedical simultaneously, the recent studies have shown intrinsic improvement for membrane properties by inclusion of nanoparticles as a fillers with high portion ratio in inorganic polymers, the combination between two parts polymer and filler is as a result of collection the advantage of two component systems parts together. In this work, samples of polyvinyl alcohol (PVA)-nanoHaydroxyapatite (nHAp) composites were prepared by using casting method. The effects of addition of (nHAp) with different concentration on the optical properties of (PVA- nHAp) composite membrane have been studied by using wavelength range (220-820) nm. The absorption spectra, transmittance spectra, absorption coefficient, energy gap, refractive index, optical conductivity and extinction coefficient have been determined. The results show that the optical constants change with the increase of nHPA concentrations.

The Effect of Resistance Training on the Selected Physical and Physiological Variables of the Male Students

The importance of marine snails in the transfer of cercariae to fish as a provenance of zoonoses should be considered.Parasitic studies in marine snails have been uncommon in Saudi Arabia. In the present study, 550 Nerita genus of marinesnails were monthly and randomly collected from January to December 2016 from Obhor bay, Saudi Arabia. The snailswere subjected to light. They were crushed to evaluate the presence of larval trematodes. PCR technique was performedusing the internal transcribed spacer region of ribosomal DNA (ITS-rDNA) which has been a specific primer to detect theextent of larval trematode infection in some snails infected as positive control samples and all non-infected snails to assess ifthey were infected or not. PCR technique showed a high prevalence of infection (55.82%) than the classical methods(21.45%). These studies can help in collecting data on the ecological importance of the distribution of disease insympathetic fish, and the transmission of digenean trematodes disease through snails. Moreover, they can be useful inpreventing and control of fish and human diseases.

Vitamin B12 status among pregnant women and Its association with obesity and gestational diabetes

Background: pregnant women in resource-poor areas are at risk of multiple micronutrient deficiencies, and diets that are low in animal products place women at increased risk of vitamin B12 deficiency. Aim of the Work: to investigate the vitamin B12 status of pregnant women in Egypt and its relationship with obesity and gestational diabetes mellitus (GDM). Patients and Methods: this clinical observational prospective study has been conducted at Bab Al-Shaaria University Hospital Obstetrics and Gynecological Department from April 2018 to January 2019. To assess vitamin B12 status among pregnant woman and its association with obesity and gestational diabetes. 80 pregnant women attended to out-patient clinic were included in the study. The evaluation included data collection through: history taking, examination, anthropometric measurement, maternal blood vitamin B12 level estimation at second and third trimester and blood glucose level. Results: vitamin B12 deficiency in pregnancy is common particularly in obese women and those with GDM. Conclusion: vitamin B12 deficiency is silent and common in general population. Causes of vitamin B12 deficiencies are multifactorial and associated with many health problems. Also, obesity is common and its prevalence is increasing in the world. Therefore, both health problems have gained importance in family medicine practice in the last decades

Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals

Introduction: dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. Methods: data from Hospital based cross sectional study were used to assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant.Results: more than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR=2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation.Conclusion: non-adherence to recommended dietary practice was observed in more than fifty percent of patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence

Screening of some drugs of abuse in outpatient clinics in Al-Azhar university hospitals

Background: Substance, which use among the youth worldwide is a major problem that has elicited concern from different individuals and groups. In Egypt, drug dependence is considered one of the serious problems that worry both the people and government; however, epidemiological data on drug dependence are still few. Drug addiction is one of the serious problems that worry the Egyptian government, as it deals with young people within the age of work and productivity. It may lead to many problems such as bad social adaptation, decreasing productivity at work or dismissing from job

Aim of the work: The study aims to give an information about the degree of prevalence of a social problem like drugs of abuse in ages more than 18 years in the Egyptian society from May 2016 to April 2017

Methods: This study was a cross sectional study which done on random urine sample of 500 persons in age of more than 18 years coming to outpatient clinics of Al-Azhar university hospitals namely El-Hussein and Bab Elshaaria university hospitals after taking full history for each one [patient sheet] with informed written consent

Results: This study found that prevalence of drugs abuse among all studied sample, negative were 215 [43.0%], and positive were 285 [57.0%]. Regarding prevalence of types of drugs abuse among all studied sample; negative were 215 [43.0%], THC 105 [21.0%], THC and Opiate 15 [3.0%], THC and tramadol were 40 [8.0%], THC, tramadol and opiate 20 [4.0%], tramadol 55 [11.0%] and tramadol and opiate were 50 [10.0%]. Percent of males was significantly higher among the studied groups positive than negative [100.0%, 95.3% respectively, p =0.000]. Mean value of age was significantly lower among the studied groups positive than negative [37.96, 43.88 respectively, p <0.000]

Conclusion: prevalence of drugs abuse among all studied sample, negative were 215 [43.0%], and positive were 285 [57.0%]

Assessment of cases of acute tramadol toxicity as regards clinical, laboratory and management procedures in some university hospitals in Cairo

Tramadol, a widely used opioid in recent years, is a centrally acting analgesic drug that has been used clinically for the last two decades to treat pain in humans. Tramadol also has antitussive activity. Tramadol is a centrally acting analgesic which is extensively used in the management of moderate to severe pain. It slightly affects opioid receptors and inhibits the reuptake of norepinephrine and serotonin in the CNS. The aim of this study was to evaluate the clinical manifestations, the laboratory findings, the different lines of treatment and the outcome of cases presented with acute toxicity by tramadol overdoses. This study was carried out at Al-Azhar University Emergency Hospitals in Cairo [El-Hussein and Bab El-Shaaria University Hospitals] and Ain Shams University Hospitals on one hundred subjects in the period from July 2016 to February 2018. Toxicological screening was done for every patient by rapid lateral flow chromatographic immunoassay for detection of tramadol and its principal metabolites in human urine by special kits at a cut off level of 1000 ng/ml. In this study, 95% of studied cases fully recovered and 5% died

Vardenafil versus tamsulosin as a medical expulsive therapy for distal ureteral stones

Background: urolithiasis is one of the most common diseases of the urinary tract. The lifetime prevalence of urinary stones is around 1% to 15% and the peak age of incidence is at 30 years. Men are affected 2 to 3 times more often than women. Ureteral stones account for 20% of the calculi in urolithiasis and about 70% of ureteral stones are present in the distal third of the ureter at the time of presentation

Aim of the work: this study aimed to compare the efficacy and safety of vardenafil [5mg twice daily] vs tamsulosin [0.4mg once daily] as a medical expulsive therapy in the management of distal ureteric stones [DUS] in terms of stone expulsion rate, stone expulsion time, number of pain episodes, analgesic use and side effects related to medical therapy

Patients and Methods: this was a prospective randomized comparative study conducted on 50 patients admitted through the outpatient Urology Clinic in Ain shams University Hospitals and Nasser Institute Hospital between February 2018 and August 2018. The patients were randomized using a closed envelope method. The patients were categorized into 2 main groups 25 patients each. Results: this study showed non significant stone expulsion rates and faster expulsion times in favor of vardenafil when compared to tamsulosin

Conclusion: both of the medications demonstrated a good safety and tolerability profile for medical expulsive therapy in patients with lower ureteric stones

Incidence of placenta accreta and its complications in cases of previous cesearean sections with placenta praevia anterior at El-Sayed Galal Hospital

Background: due to the increasing rate of cesarean delivery, there has been a 10-fold rise in the incidence of placenta accreta since the 1970. In a recent survey, placenta accreta was even found to become the leading cause of emergency peripartum hysterectomy which represented 40–60% of cases

Aim of the Work: the purpose of this study was to determine the incidence of placenta accreta and its complications in cases of previous cesarean sections with placenta praevia anterior at El-Sayed Galal Univerity Hospital

Patients and Methods: this prospective study was done at El-Sayed Galal Maternal Unevirsity Hospital during the period from March 2017 to March 2018 on 100 pregnant women diagnosed by ultrasound as placenta praevia or low lying placenta anterior with previous cesarean section, they were selected from Outpatient Clinic, Ultrasound Unit and women admitted in El-Sayed Galal Maternal University Hospital Departments

Results: the incidence of placenta accreta in cases of previous cesarean section with placenta praevia anterior were 63%. Risk factors of placenta accreta were: 1] Placenta praevia with prior cesarean section. All cases had placenta praevia and had at least one previous CS, 2] Increased maternal age [the mean age 32.60+/-5.018 years in cases of placenta accrete ], and 29.14+/-4.889 years in cases with normal placenta. 3] Multiparity [the median parity was 3 [range: 1-6]. The ultrasonography and Doppler was suggestive of morbid adherence in 60 cases [95.2%]of cases approved with placenta accreta, with accuracy 96, sensiyivity 95.24, specificity 97.3, +ve predictive value 98.36, and -ve predictive value 92.31. The intraoperative data were:, - Cesarean hysterectomy performed in all cases of placenta accrete [63 cases], and 2 cases [5.4%] of normal placenta due to severe bleeding from placental ped and uterine atony. , - Bladder injury occured in 31 cases[49.2%] all of them approved placenta accreta, all of them do C.S hystrectomy and performed bladder repair. Bowel injury in 2 cases [3.2%] all of them have placenta accreta and C.S hysterectomy done. All cases of placenta accreta received intra operative blood transfusion. Uterine preserving procedures [Bakry balloon] done in one case after spontaneous separation of the placenta. The postoperative data were:, - ICU admission occurred in 40 cases [63.5%] of cases with placenta accrete, and in 2 cases [5.4%] of cases with normal placenta. 61 cases [96.8%] of cases with placenta accreta received postoperative blood transfusion. -No cases complicated with DIC or death

Conclusion: from the above our results showed that the incidence, risk factors and Feto-maternal outcome of management of Patients with placenta accreta at El-Sayed Galal University Maternity Hospital are comparable with those in the previous literatures

Prediction of preterm birth in women with short cervix

Background: Second trimester short cervical length identifies women at increased risk for an early spontaneous Preterm birth [sPTB], hence raising a compelling needed for Cervical Assessment for prediction and possible Preventing Preterm Delivery

Objective of the study: to assess the implications associated with a short cervical length as well as the use of ultrasonographic-derived cervical length measurement in predicting preterm birth. Methods: the present review includes relevant randomized controlled trials [RCTs] that investigated the in Medline [via PubMed], Cochrane Library and Embase. Retrospective and Prospective Cohort studies, Case-control and Randomised controlled trials. There were no restrictions by outcomes examined, language or publication status

Results: The critical search results yielded 6 articles [randomized trials=2, cohort studies=3, case-control study=l] representing 653 patients . Five of the 6 presented similar pregnancy outcomes [spontaneous preterm birth or pregnancy Joss < 24 weeks' gestation] between the ultrasound-indicated and the history-indicated cerclage groups. 45-69% of the patients followed with cervical ultrasound were able to avoid cerclage

Conclusion: Evidence from randomized trials supports that transvaginal ultrasound is predictive of preterm birth in women with prior preterm birth and a short cervix. The thresholds proposed vary from 15 mm to 28 mm and cerclage is thus recommended

Differential expression of stem cell-like proteins in normal, hyperplastic and dysplastic oral epithelium

Objective The identification of stem cells (SC) remains challenging. In the human oral mucosal epithelium, these cells are believed to be in the basal layer (stem cell niche), but their exact location is unclear. The aim of this study was to examine the dysplastic oral epithelium for these SC-like proteins in order to assess their diagnostic value as biomarkers complementing the histological grading of dysplasia. Material and Methods Thirty oral epithelial dysplasia (OED), 25 oral lichen planus (OLP), 10 oral hyperkeratosis and 5 normal oral epithelium (OE) were immunohistochemically examined for four SC markers [integrin β1, neuron-glial-2 (NG2), notch 1 (N1) and keratin 15 (K15)]. Results Three of four SC markers were heterogeneously detected in all samples. K15 overexpression in the lower two-thirds of severe OED suggests an expanded SC niche. Integrin β1 distribution pattern was not measurably different between OEDs and control. NG2 was almost negative to absent in all samples examined. N1 expression was weak and highly variable in normal and dysplastic epithelium, making it an unreliable epithelial stem cell marker. Conclusions Present findings suggest that these markers were unable to identify individual epithelial stem cells. Instead, subpopulations of cells, most probably stem cells and transit amplifying cells with stem cell-like properties were identified in the dysplastic oral epithelium. The characteristic expressions of K15 might be of diagnostic value for oral dysplasia and should be investigated further. .

Measurement skills development program effectiveness [length, distance, size] for kindergarten child

Problem: The study problem is shown in negligence in submitting some of concepts of measurement [length, distance, size] for kindergartners despite awareness that increases for children of this stage with the technological revolution and opening to the world, to try to solve this problem, the current study is trying to implement a program for the development of the concepts of measurement and this by answer to the main question follows How effective is the program for the development of some of concepts of measurement with a kindergarten child?

Objectives: Verification of the program effectiveness to develop the concept of measuring the length, the distance and the size with a kindergarten child

Sample: Study sample is represented in a random sample of Kindergarten School [Hussein Bin Ali] of the Ministry of Education and educational peace management [second level for kindergarten], the age of the sample of 5 to 6 years old and consists of 32 children, child 16 males 0.16 females and divided into 16 children [8 Males and 8 Females] matched controls not exposed to the program of study, 16 children [8 Males and 8 Females] as a sample exposed to an experimental program of study

Instruments: Test drawing "A Man" [Good Enough Harris], A child Primary questionnaire [prepared by the researcher], The proposed program [prepared by the researcher]

Results: There are no statistically significant differences between the scores of the control group differences before and after the application of the test program as the value of [t] 1.41. There are statistically significant between the scores of the experimental group differences before and after the implementation of the program on the development of the skills test measurement [height, distance, size] of kindergarten children in favor of the post application, reaching 24.92 value [t] at the level of significance 0.01 There are significant differences between the control and experimental groups after the application of the program for the experimental group, reaching 22.31 value [t] at the level of significance 0.01

Adolescents dependence on talk shows that deal with Muslim's relationship to Christian and their relationship to their affiliation

Introduction: No doubt, media plays a principal role in conserving the national identity, yet it endures the greater burden in this side, not only in facing the cultural effects that affect our national identity and its different components, but also in caring for establishing the new generation of the young and youth on original values and manners and traditions

Problem: Determined in this main question: Adolescents Dependence on talk shows that deal with Muslim's relationship to Christian and their relationship to their affiliation?

Significance: Examining Adoption Adolescents Dependence on talk shows that deal with Muslim's relationship to Christian and their relationship to their affiliation

Objectives: Identifying the Adolescents Dependence on talk shows that deal with Muslim's relationship to Christian and their relationship to their affiliation

Type and Method: A qualitative study using the sample survey method

Sample and Population: Represented in youth aged [18-21] year olds in Cairo University, Ain Shams University, Bani Suef University, Alexandria University, and Almenya University. It is administered on a random of 500 Single [250 Muslim, Christian 250]

Instruments: A Questionnaire Form. Scale of affiliation

Statistical Approaches: Chi Square and [Z] Tests

Results: The presence of correlation statistically significant between the adoption of adolescents on the talk shows that deal with the Muslim's relationship to Christian and relationship of belonging to have at the level of significance 0.01. Thus, we accept the first hypothesis, The existence of differences between the mean scores of adolescents in the study on the scale of affiliation in accordance with the religion at a confidence level of 99.9%, and The existence of differences between the mean scores of adolescents in the study to belong scale according to type at a confidence level of 99.9%

Burden and Pattern of Cancer in the Sudan, 2000-2006.

Aims: The aim of this study is to determine the number of newly diagnosed cancer cases and their distribution in two cancer-care providing facilities in Sudan. Study Design: This is a retrospective descriptive study. Methodology: Data was retrieved from patients’ records that were diagnosed and treated at the Radiation Isotope Center in Khartoum (RICK) and National Cancer Institute at Wadmadani (NCI -UG) in Sudan over the period between 2000 and 2006 and then statistically analyzed. Results: A total of 26652 cancer cases were retrieved with a noticeable increase in numbers from year 2000 to 2006. The maximum cancer number was observed in 45-64 year age group in both male and female patients with a male to female ratio of 1.3:1.0. The most common cancer sites for females were: the breast (29.3%), cervix uteri (8.2%), leukemia (7.2%), ovary (6.8%), and esophagus (5.9%) and for males: were prostate (7.6%), followed by leukemia, (7.0%), NHL (6.8%), esophagus (5.4%) and bladder (4.4), while leukemia (25.2%), NHL (12.4%), lymphoma (10.8%), retinoblastoma (6.6%) and brain tumors (3.3%) dominated in younger patients (<14 years old). Conclusions: This study provided some knowledge about the cancer situation in two institutions providing cancer care in Sudan that may draw attention of policy maker and aid in formulating appropriate cancer-control strategies in the country.

Treatment Strategies for Childhood Steroid-Resistant Nephrotic Syndrome.

Background: Nephrotic syndrome (NS) is a common childhood kidney disease caused by impaired glomerular function, characterized by protein leakage from the blood to the urine through the glomeruli, resulting in proteinuria, hypoalbuminemia, hypercholesterolemia and generalized edema. NS is descriptively classified upon the patients’ response to steroid treatment as steroid-sensitive NS (SSNS) or steroidresistant NS (SRNS). Aim: describe and compare different management strategies for SRNS. Methods: This retrospective study included 53 SRNS who were attending the Nephrology Outpatient Clinic, Children's Hospital, and Cairo University for follow-up. Results: out of 53 SRNS patients, 29 (54.72%) patients showed complete response to immunosuppressive therapy, while 14 (25.42%) showed partial response and the remaining 10 (18.87%) showed no response. Conclusion: Partial response to steroids or to first line of immunosuppressive therapy predicts better response to further immunosuppressives in SRNS patient. Cyclophosphamide is a preferable line in MCNS as it gives good results (50% complete response) with the advantage of lower cost and shorter duration of use. In patients with non-minimal change lesions or those who failed to respond to cyclophosphamide, cyclosporine is used.

Medications use among pregnant women in Ethiopia: A cross sectional study.

Despite lack of scientific evidence about the safety of some medications, the reported use of medications during pregnancies has increased. This may lead to adverse reproductive outcomes, due to potential risk to the mother and the fetus. In contexts of most developing countries including Ethiopia, it is difficult to elucidate medications use prevalence during pregnancy and their relative contributions to birth defects for several reasons. Institutionbased cross sectional study was conducted in Tertiary care hospital Ethiopia. Current medication use data were collected by reviewing patients' charts in the antenatal care follow up clinic, chronic care (internal medicine) as well as psychiatry clinic and by interviewing pregnant women using semi-structured questionnaire. Medications were classified using the United States Food and Drug Administration pregnancy risk classification system. A total of 339 women were included in the study; of which 187 (55.2%) had used at least one prescription and 162(52.2%) had used over the counter medications during pregnancy. The majority of the medications were antibiotics (42.5%) and analgesics (40.1%). 57(16.8%) and 24(7.1%) of medications were prescribed from category D and X respectively. Out of 187 (55.2%) prescription medications used, 51 (15.0%) were obtained without prescribers order. Majority (70.8%) of the women did not have awareness regarding risks associated with self medication. Prescription medications use was 0.08 times less among women with a co-morbidities (AOR 0.08(.05, 0.13), p=0.001) and 2.5 times higher among women from rural areas (AOR 2.53 (1.15, 5.56); P=0.02). Compared to employed women, over the counter medications use were 1.9 times more among house wife women (AOR1.87 (1.12, 3.09), p= 0.02) and about thrice higher among merchant women (AOR 2.88(1.10, 7.55), p= 0.03). Likewise, presence of medical problems was found to have 60% protective against OTC medications use (AOR 0.40 (.26, 0.64), p=0.01). The overall medications use during pregnancy was found to be high. Medications use without prescribers order was common and potentially harmful medications (category-D and X) use appeared to be higher in all trimesters. The findings of this study argue in favor of prescribing some potentially harmful medications which could have been avoided during pregnancy. Majority of the women lacked awareness about the potential risks associated with medications use in pregnancy without prescribers order.

Prevalence of Hepatitis B virus infection among premarital people in Sulaimani Governorate

The magnitude of chronic infection with hepatitis B virus [HBV] varies substantially between the countries. Previous study in Sulaimani revealed that 2.3% of blood donors were positive for HBsAg. A better understanding of incidence and/ or prevalence of HBV infection and associated risk factors provides insight into the transmission of this infection in the community. Transmission of hepatitis B virus results from exposure to infectious blood or body fluids containing the virus. Possible forms of transmission include unprotected sexual contact, blood transfusions, re-use of contaminated needles, and vertical transmission from mother to child during childbirth

Objective: To know the prevalence of HBsAg among premarital people in Sulaimani governorate, and to identify the associated risk factors responsible for seropositivity

Patients and Methods: This prospective study was conducted in the premarital consultation clinic in Sulaimani city from November 2008 to February 2009, 1500 premarital people(750 males,750 females] from age 18 years and above of either sex

Results: The prevalence of HBsAg among premarital people was 0.67%. In multivariate analysis, factors associated with an increased HBsAg risk were occupation, history of surgical operation, blood transfusion and tattooing

Conclusion: The prevalence of HBsAg among premarital people in Sulaimani province is lower than that previously reported, with male predominance. A positive relationship between HBsAg with occupation, history of surgical operation, blood transfusion and tattooing was reported

Survey of perceived stress-inducing problems among dental students, Saudi Arabia

This study was conducted to assess the problems related to stress encountered by Saudi dental students. One thousand and thirty questionnaires were distributed in four dental schools to all students from 2nd year level up to the internship level. The questionnaire contained 66 items organized into four categories: personal and administrative, theoretical, preclinical and clinical. The relationship between the demographic variables and students' academic performance with the investigated items was also assessed. The response rate was 53%. Saudi dental students showed high levels of perceived stress. The clinical training issues imposed the highest level of stress on the students. Some significant relationships between the investigated variables and the level of the perceived stress were found. Female students had higher mean overall problem scores compared to male students, and second-year students showed lower perceived problems compared to other students

Early risk stratification of cases with acute coronary syndrome [unstable angina and non- ST elevation myocardial infarction]

This is a prospective clinical study, in which we applied the modern risk stratification strategies, such as the TIMI risk score of. acute coronary syndrome, [Thrombolysis in myocardial infarction], associated with unstable angina and non-ST segment elevation. For this purpose, 188 Yemeni patients were followed up in Al-Gamhuria Teaching Hospital in Aden for 4 years from January 2004 to January 2008. According to the TIMI risk score of ACS, the investigated patients were divided into 3 subgroups: high, intermediate and low risk patients. Coronary angiography, performed in all patients, proved that the correlation between the coronary findings and the clinical risk status was reflecting the benefit of using clinical predictors for early diagnosis. We concluded that the application of the more detailed TIMI risk score was proved to be an effective tool not only for early prognosis, but also for designing therapeutic strategies in patients presented with symptoms of UA/NSTEML

Acute Abdomen at El Obeid Hospital; Western Sudan

Background: Acute abdominal pain is the presenting complaint in emergency departments of all hospitals worldwide; resulting in a huge drain of human and non-human resources. Objectives: To study the pattern; causes and management outcomes of patients presenting with acute abdomen to El Obeid Hospital; Western Sudan. Patients and Methods: This was a prospective study. All patients who presented with acute abdomen to the University Surgical Unit at El Obeid Hospital between January 1999 and December 2000 were included. The patient characteristics; clinical features; investigations; management and postoperative care were recorded in a pre-designed sheet. Results: There were 421 patients. 242 were males (57.5). Acute appendicitis was the commonest cause accounting for 63of the patients; followed by acute intestinal obstruction 20.4and abdominal trauma 11.6.One third of the patients with acute appendicitis reported with complications. The majority of acute intestinal obstruction cases were due to obstructed and/or strangulated hernia. Acute cholecystitis and perforated duodenal ulcers were not common. Perforated typhoid ulcers and tuberculous peritonitis were less frequent but had high mortality. The overall mortality was 8.5and those deaths occurred mostly in patients presenting late with generalized peritonitis. Conclusions: Acute abdomen was a common surgical emergency at El Obeid Hospital; Western Sudan. The leading causes were acute appendicitis; acute intestinal obstruction and abdominal trauma. Awareness of the seriousness of the condition and better hospital facilities and care may reduce an unacceptable high mortality