Assessment of YME1L and mitofusin2 as a possible diagnostic and/or therapeutic target in hepatocellular carcinoma

Mitochondrial dynamics are a contraversal issue in hepatocellular carcinoma. The present study tries to illustrate the role of mitochondrial dynamics proteins (mitofusin-2 (Mfn2) and YME1L) in hepatocarcinogenesis. Five groups were used: the control group and three HCC groups (after 8, 16, and 24 weeks from DENA induction). The last group was treated with Sorafenib (SP) (10 mg/kg), via oral gavage for 4 weeks after cancer induction. This study revealed that Mfn-2 was downregulated and YME1l was overexpressed in different HCC groups. This dysregulation of mitochondrial dynamics proteins was associated with high hepatic levels of cyclin D1, MMP-9, and MDA and overexpression of ki67 as well as decreasing the hepatic expression of tissue inhibitor of matrix metalloproteinase-3 (Timp-3) and Bax. To confirm the possible role of Mfn2 and YME1L in HCC, we assessed the effect of sorafenib on these parameters and its related HCC characteristics. Sorafenib corrected the level of Mfn2 and YME1L and decreased tumor cell proliferation as well. We also elucidated that mitochondrial dynamics proteins (Mfn2 and YME1L) could be a good therapeutic target for HCC.

The Pattern of Anosmia in Non-hospitalized Patients in the COVID-19 Pandemic: A Cross-sectional Study

Abstract Introduction It is now evident that the loss of smell and/or taste may be consistent accompanying symptoms of the SARS-CoV-2 infection. Objective To estimate the social behavior of recent anosmic non-hospitalized patients in the COVID-19 pandemic and to try to obtain the natural pattern in society in a cross-sectional study. Methods A cross-sectional study conducted on 4,860 patients with anosmia complaints during the COVID-19 pandemic. Patients who needed a consultation for an anosmia complaint confirmed that they had completed the survey regarding age, gender, history of general diseases, history of nasal disease, associated COVID-19 symptoms, smoking, blood group, and risk factors. Results A total of 4,860 patients with a mean age of 34.26 ± 11.91 years completed the study. There was a predominance of female patients: 3,150 (58.9%). Most patients (4,083 patients; 83%) developed sudden anosmia. In 85% (4131 patients) of the patients, a previous history of contact with anosmic patients was present. The most prevalent blood group was O (39%). In total, 67.4% of the patients underwent medical treatment. A history of unusual influenza attacks in December 2020 was reported by by 27% (1312 patients) of the patients. Conclusion Despite large diversity of behaviors among anosmic patients in the COVID-19 pandemic, we can observe a great similarity in the pattern of anosmia in non-hospitalized patients, especially in the way it spreads, the predisposing factors, and the individual recovery.

Fracture resistance of primary molars restored with endocrowns versus zirconia crowns (an in vitro study) / Resistência à fratura de molares decíduos restaurados com endocrowns versus coras de zircônia (um estudo in vitro)

Objective: This study aimed to assess the fracture resistance of primary molars restored with endocrowns compared to prefabricated zirconia crowns. Material and Methods: Twelve sound, defect-free primary second molars were selected and divided into two groups: group I included 6 molars restored with zirconia crowns, while group II included 6 teeth restored with endocrowns. For both groups access cavity was prepared for the teeth to open pulp chamber. Fracture resistance of both groups was tested using a universal testing machine. Results: Zirconia crown showed statistically significantly higher mean fracture resistance than Endocrown (P-value = 0.001, Effect size = 2.72). Conclusion: Pulpotomized primary molars restored with Zirconia crowns showed significantly higher mean fracture resistance compared to primary molars restored with endocrowns, meanwhile both restorations have shown higher mean fracture resistance than the maximum biting force in children. (AU)

Objetivo: Este estudo teve como objetivo avaliar a resistência à fratura de molares decíduos restaurados com endocrowns em comparação com coroas de zircônia pré-fabricadas. Material e Métodos: Doze segundos molares decíduos hígidos e livres de defeitos foram selecionados e divididos em dois grupos: o grupo l incluiu 6 molares restaurados com coroas de zircônia, enquanto o grupo ll incluiu 6 dentes restaurados com edocrowns. Para ambos os grupos, foi preparada uma cavidade de acesso à câmara pulpar. A resistência à fratura de ambos os grupos foi testada em uma máquina de ensaio universal. Resultados: A coroa de zircônia apresentou resistência média à fratura estatisticamente significativa maior do que endocrown (p=0,001, Tamanho do efeito = 2,72). Conclusão: Molares decíduos pulpotomizados restaurados com coroas de zircônia apresentam resistência média à fratura significativamente maior em comparação aos molares decíduos restaurados com endocrowns, entretanto, ambas as restaurações mostraram maior média à fratura do que a força máxima de mordida em crianças (AU)

Diagnostic and prognostic roles of miRNA and dielectric parameters in HCV Egyptian patients

Hepatic C virus (HCV) infection is a special case in Egypt due to its historical aspects, epidemiology, risk factors, andgenotype. Therefore, an urgent need arose to assess the HCV progression and efficacy of the used antiviral drugs. Thisstudy aimed to evaluate the role of different miRNAs types and blood dielectric measurements in the early diagnosisand prognosis of HCV in Egyptian patients. The study was carried out on a total of 80 blood samples. Twenty of theseblood samples were withdrawn from healthy volunteers and were served as the control group (G1). Sixty HCV patientsamples were divided according to the received treatment into four groups (15 for each). The second group (G2)included HCV patient samples, who did not receive any treatment. The third (G3), fourth (G4), and fifth (G5) groupsincluded the samples of HCV patients who were treated with Sovaldi (400mg) for 1, 2, and 3 months, respectively. G3,G4, and G5 were simultaneously administered Ribavirin (200 mg) and Daclatasvir (60mg) daily for 3 months. Theobtained results demonstrated the upregulation of miR-21, miR-155, and miR-205 and downregulation of miR-122and miR-133a in all HCV patients. HCV patients who did not receive any treatment showed a lower conductivity dueto the action of the virus; either the free charges on the surface of the red blood cells (RBCs) or membrane deformationor alterations were reduced. Noticeable improvement reached to nearly normal values in different miRNA expressionsand RBC dielectric relaxations was achieved by Sovaldi treatment.

Influence of some methylated hepatocarcinogenesis-related genes on the response to antiviral therapy and development of fibrosis in chronic hepatitis C patients

Epigenetics involved in multiple normal cellular processes. Previous research have revealed the role of hepatitis C virus infection in accelerating methylation process and affecting response to treatment in chronic hepatitis patients. This work aimed to elucidate the role of promoter methylation (PM) in response to antiviral therapy, and its contribution to the development of fibrosis through hepatocarcinogenesis-related genes. A total of 159 chronic hepatitis Egyptian patients versus 100 healthy control group were included. The methylation profile of a panel 9 genes (SFRP1, p14, p73, APC, DAPK, RASSF1A, LINE1, O6MGMT, and p16) was detected in patients’ plasma using methylation-specific polymerase chain reaction (MSP). Clinical and laboratory findings were gathered for patients with combined pegylated interferon and ribavirin antiviral therapy. Regarding the patients’ response to antiviral therapy, the percentage of non-responders for APC, O6MGMT, RASSF1A, SFRP1, and p16 methylated genes were significantly higher versus responders (P<0.05). Of the 159 included patients, the most frequent methylated genes were SFRP1 (102/159), followed by p16 (100/159), RASSF1A (98/159), then LINE1 (81/159), P73 (81/159), APC (78/159), DAPK (66/159), O6MGMT (66/159), and p14 (54/159). A total of 67/98 (68.4%) cases of RASSF1A methylated gene (P=0.0.024), and 62/100 (62%) cases of P16 methylated gene (P=0.03) were associated with mild-degree fibrosis. To recapitulate, the PM of SFRP1, APC, RASSF1A, O6MGMT, and p16 genes increases in chronic hepatitis C patients, and can affect patients’ response to antiviral therapy. The RASSF1A and P16 genes might have a role in the distinction between mild and marked fibrosis.

Evaluation of hepatoprotective activity of Polygonum equisetiforme methanolic extract

In the current study, the methanolic extract of Polygonum equisetiforme aerial parts was assessed for its protectiveeffect towards carbon tetrachloride (CCl4)-induced hepatic damage in Sprague-Dawley rats. Polygonum equisetiformeextract’s hepatoprotective activity was explored by calculating hepatic marker enzyme levels of the rats: alanineaminotransferase (ALT) and aspartate aminotransferase (AST) together with the oxidative stress mediator levelsas nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), and superoxidedismutase (SOD). Results showed that the use of the extract at concentrations of 100 and 200 mg/kg showed asubstantial reduction in ALT and AST serum levels as well as a considerable decrease in oxidative stress mediators NO,MDA and an increase in antioxidant enzyme levels GSH, GPx, and SOD. These biochemical results were reinforcedby examining the histopathological features of the liver. Thus, the P. equisetiforme aerial parts demonstrated markedprotective impact of the liver that likely due to the synergistic action of its flavonoids content

Bioluminescence of Vibrio fischeri: A novel application for PSP quantification

Paralytic Shellfish Poison (PSP) are the most harmful neurotoxins create a serious public health problem. It is important to assess PSP in Shellfish destined for human consumption. However, recommended methods have some limitations for example in the case of Mouse Bioassay (MBA) showed a low sensitivity and reproducibility, and undesirability for ethical reasons; while physico-chemical techniques rest expensive and time-consuming. The main objective of this study, after discovered that PSP inhibited the luminescence of Vibrio fischeri, was the quantification of PSP by using Bioluminescence Inhibition Assay (BIA), and comparing the results obtained with those determined by MBA and LC-MS. Bivalve used were collected from Corniche Martil, Kabila and Oued Laou, along the Mediterranean coast of Morocco in Mars-2015. Results showed a weak correlation between LC-MS and MBA with r = 0.11, while, the correlation between LC-MS and BIA was very strong with r = 0.97, which suggests that, BIA could offer an interesting additional assessment of PSP risk. In addition, after seen its rapidity, ease, reliability, sensitivity, reproducibility and cost effectiveness, it would be eligible to use for monitoring in surveillance programs.

Histological and immunohistochemical effects of neuroectodermal cells transplantation after spinal cord injury in rats / Efectos histológicos e inmunohistoquímicos del trasplante de células neuroectodérmicas tras una lesión de la médula espinal en ratas

SUMMARY: In spinal cord injury, radical treatment is still a persistent hope for patients and clinicians. Our study aimed to determine the different histological changes in central, cranial and caudal sites of compressed spinal cord as a result of neuroectodermal stem cells (NESCs) transplantation in rats. For extraction of NESCs, future brains were extracted from mice embryos (10-days old) and cultured. Eighty, male rats were divided randomly into control, sham (20 rats each); while 40 rats were subjected to compressed spinal cord injury (CSCI). Seven days after spinal cord injury, rats were subdivided into 2 groups (20 rats each); an untreated and treated with NESCs injected cranial and caudal to the site of the spinal cord injury. Rats were sacrificed 4 weeks after transplantations of NESCs and specimens from the spinal cord at the central, cranial and caudal to site of spinal cord injury were proceeded to be stained with haematoxylin & eosin, osmic acid and Immunohistochemistry of glial fibrillary acidic protein (GFAP). Sections of CSCI revealed areas of hemorrhages, necrosis and cavitation limited by reactive astrocytosis, with upregulation of GFAP expression. Evidence of remyelination and mitigation of histopathological features, reactive astrocytosis in CSCI sections were more pronounced in cranial than in caudal region. NESCs transplantation ameliorated the pathological changes, promoted remyelination.

RESUMEN: En la lesión de la médula espinal, el tratamiento radical aún sigue siendo el tratamiento preferente para los pacientes y los médicos. El objetivo de este estudio fue determinar los diferentes cambios histológicos en los sitios centrales, craneales y caudales de la médula espinal comprimida, como resultado del trasplante de células madre neuroectodérmicas (NESCs) en ratas. Para la extracción de NESCs, se extrajeron y cultivaron los cerebros de embriones de ratones de 10 días de edad. Se dividieron 80 ratas macho aleatoriamente en grupos control, simulado (20 ratas cada una); mientras que 40 ratas fueron sometidas a lesión de la médula espinal comprimida (CSCI). Siete días después de la lesión de la médula espinal, las ratas se subdividieron en 2 grupos (20 ratas cada uno); un grupo no tratado y un grupo tratado con NESCs inyectado craneal y caudal en el sitio de la lesión. Las ratas fueron sacrificadas 4 semanas después de los trasplantes de NESCs y las muestras de la médula espinal en el centro, craneal y caudal del sitio de lesión fueron teñidas con hematoxilina y eosina, ácido ósmico e inmunohistoquímica de la proteína ácida fibrilar glial (GFAP). Las secciones de CSCI revelaron áreas de hemorragias, necrosis y cavitación limitadas por astrocitosis reactiva, con una regulación positiva de la expresión de GFAP. Evidencia de remielinización y mitigación de características histopatológicas, astrocitosis reactiva en secciones de CSCI fue más pronunciada en la región craneal que en la caudal. El trasplante de NESC mejoró los cambios patológicos, promoviendo la remielinización.

Does neuroectodermal stem cells transplantation restore neural regeneration and locomotor functions in compressed spinal cord injury rat model? / ¿El trasplante de células madre neuroectodérmicas restaura la regeneración neural y las funciones locomotoras en el modelo de rata con lesión de la médula espinal comprimida?

SUMMARY: The aim of this study was to determine the possible regenerative effect of neuroectodermal stem cells on the ultrastructural, and locomotor function resulting from compressed injury to the spinal cord in a rat model. Forty male rats were divided into control and sham groups (20 rats each). Compressed spinal cord injured (CSCI) were forty rats which subdivided equally into: untreated, treated by neuroectodermal stem cells (NESCs). After four weeks, all rats in different groups were scarified, samples were taken from central, cranial, and caudal to the site of spinal cord injury. Specimens were prepared for light and electron microscopic examination. The number of remyelinated axons in central, cranial and caudal regions to the injured spinal cord after transplantation of NESCs was counted. The open field test assessed the locomotor function. Results revealed that compressed spinal cord injury resulted in loss and degeneration of numerous nerve fibers, myelin splitting and degeneration of mitochondria. Four weeks after transplantation of NESCs regenerated axons were noticed in cranial and central sites, while degenerate axons were noticed caudal to the lesion. Number of remyelinated axons was significantly increased in both central and cranial to the site of spinal cord injury in comparison with caudal region which had the least number of remyelinated axons. Transplantation of NESCs improved significantly the locomotor functional activity In conclusion, neuroectodermal stem cells transplantation ameliorated the histopathological and ultrastructural changes, and improved the functional locomotor activity in CSCI rat.

RESUMEN: El objetivo de este estudio fue determinar el posible efecto regenerativo de las células madre neuroectodérmicas en la función ultraestructural y locomotora de una lesión comprimida en la médula espinal en un modelo de rata. Cuarenta ratas macho se dividieron en grupos control y sham (20 ratas en cada grupo). La médula espinal lesionada (CSCI) tenía cuarenta ratas que se subdividieron de igual forma en los siguientes grupos: no tratadas, tratadas con células madre neuroectodérmicas (NESCs). Al término de cuatro semanas, todas las ratas en los diferentes grupos fueron escarificadas, se tomaron muestras de las áreas central, craneal y caudal en relación al sitio de la lesión de la médula espinal. Las muestras fueron preparadas para examen microscópico de luz y electrónica. Se contó el número de axones remielinizados en las regiones central, craneal y caudal de la médula espinal lesionada después del trasplante de NESCs. La prueba de campo abierto evaluó la función locomotora. Los resultados revelaron que la lesión de la médula espinal comprimida provocó la pérdida y degeneración de numerosas fibras nerviosas, la división de la mielina y la degeneración de las mitocondrias. Cuatro semanas después del trasplante de NESCs, se notaron axones regenerados en los sitios craneales y centrales, mientras que los axones degenerados se notaron caudal a la lesión. El número de axones remielinizados aumentó significativamente tanto en el centro como en el cráneo hasta el sitio de la lesión de la médula espinal en comparación con la región caudal que tenía el menor número de axones remielinizados. El trasplante de NESCs mejoró significativamente la actividad funcional locomotora. En conclusión, el trasplante de células madre neuroectodérmicas mejoró los cambios histopatológicos y ultraestructurales, y mejoró la actividad locomotora funcional en la rata CSCI.

Study of the relation between two common cyclooxygenase 2 gene polymorphisms with risk of developing and subtypes of vitiligo in Egyptian patients

Background/Purpose: Genetic factors play an important role in the pathogenesis of vitiligo. Cyclooxygenase 2 (COX2) gene induced by ultraviolet radiation controls the synthesis of prostaglandins, which are are found to be beneficial in treating vitiligo. COX2 gene polymorphism has been previously evaluated in Chinese population. We aimed to study the relation between two common COX2 gene polymorphisms with vitiligo and its subtypes amongEgyptian patients. Patients and Methods: This study included 200 participants (100 vitiligo patients and 100 healthy controls). COX2-765G/C and -1195A/G gene polymorphism was studied by restriction fragment length polymorphism polymerase chain reaction analysis and the results were compared between the two groups and among different subtypes of vitiligo. Results: Frequency of COX2-1195 AA, AG, GG genotypes showed no significant association among patients with vitiligo (P = 0.626, 0.321, 0.08, respectively); those with generalized vitiligo (P = 0.739, 0.291, 0.101, respectively) and those with segmental vitiligo (P = 0.410, 1.00, 0.676, respectively) compared to the control group. Regarding COX2-765G/C genotypes, GG genotype was more frequent among patients with vitiligo [84 (84%)] compared to controls [63 (63%)] (P = 0.001). GC genotype was significantly less frequent [15 (15%)] among patients compared to controls [32 (32%)] (P = 0.005). Generalized and segmental types of vitiligo also showed no significant difference in the frequency of COX2-765G/C genotypes compared with controls. Limitations: Being a pilot study, a relatively small number of participants were included. Conclusion: COX2-1195A/G gene polymorphism is not associated with the risk of developing vitiligo or with vitiligo subtypes. COX2-765 GG genotype is associated with vitiligo, especially of the generalized type.

Volatile Compounds in the Skin Essential Oil of Moroccan Feijoa sellowiana

The oil of Feijoa skin (Feijoa sellowiana, family Myrtaceae) was isolated by hydrodistillation in a Clevenger-type apparatus and analyzed by GC-MS analysis. As a result, 76 components were isolated. Among 19 peaks identified which three were reported for the first time in this plant (Elixene, Linalylanthranilate and Farnesol). The sesquiterpene group was predominant, accounting for 97.8% of the total oil. Of which Caryophyllene was the most abundant 17.7%, followed by Germacrene D14.4%, Humulene 10.5%, Ledene 14%, Spathulenol 8.5%, Cadina-3,9-diene 8.3%, Farnesol 8%, Linalylanthranite 5.6%, β-elemene 4.8%, α-Cubebene 2.7%. Other constituents were also present in oil such as Octanone 5.3%, D limoneme 0.17%, Ocimene 1.6%, Benzoicacidmethylester 1.1%.

Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined “delayed ejaculation,” “retarded ejaculation,” “inhibited ejaculation,” or “anejaculation” as Medical Subject Headings (MeSH) terms or keywords with “epidemiology,” “etiology,” “pathophysiology,” “clinical assessment,” “diagnosis,” or “treatment.” Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.

Detection of methicillin resistant staphylococcus aureus with reduced susceptibility to vancomycin

Background: As there is no molecular-based assays available for the detection of hVISA and VISA. However, increasing amounts of data support a number of methods for the screening and confirmation of heterogeneous vancomycin intermediate S. aureus [hVISA] and vancomycin intermediate S. aureus [VISA] infection. The vancomycin MIC result alone is unable to accurately distinguish hVISA from VSSA isolates, and the use of MIC testing alone will fail to detect h VISA strains that are relatively common among isolates of Staphylococcus aureus [S. aureus] with broth MICs of 2g per ml. of Staphlococcus aureus [S. aureus] with broth MICs of 2 g per ml

Objective: The aim of the present work was to detect the efficacy of phenotypic and automated methods for detection of MRSA with reduced susceptibility to vancomycin. It aimed also, to determine the best MIC concentration in vancomycin screening agar for detection of VISA among MRSA isolates

Methods: one hundred MRSA isolated were obtained from 100 patients from different departments of Ain Shams University Hospitals during the period from October 2015 to the end of April 2016. They were isolated from different clinical specimens; sputum, wound swabs, blood, pus, urine, and body fluid that were referred to central microbiology laboratory for routine culture and sensitivity. Detection of S. aureus with reduced susceptibility to vancomycin was done by vancomycin screening agar with different concentrations 2,4,6 ug/ml with and without casein, MIC broth microdilution method for vancomycin according to CLSI

Results: Out of 100 MRSA isolates, vancomycin screening agar 2 ug/ml with casein showed highest detection rate for VISA isolates [48%] among other screening agars. Vancomycin screening agar 6 ug/ml without casein gave the lowest detection rate [29%]. So, adding casein to vancomycin screening agar did not increase detection of VISA in any of vancomycin screening agar except for that with 2 ug/ml vancomycin. Vancomycin screening agar 2 ug/ml with casein gave the best sensitivity among all vancomycin screening agar tested. VITEK 2 system failed to detect any isolates with reduced susceptivility to vancomycin. They were sensitive to linezolid [100%] followed by tigecyclin [99%] then Quinupristin-dalfopristin [91%]. However, most of the isolates were resistant to tetracycline [85%] followed by gentamicin [80%] then ciprofloxacin [63%]

Conclusion: BHI agar with 2 ug/ml vancomycin and 16 g/l casein is a reliable, easy to perform, and inexpensive method to screen large number of S. aureus isolates for detection of reduced susceptibility to vancomycin on a daily basis. Applying quadruplicate technique in vancomycin screening agar may increase the yield for detection of VISA isolates. Although vancomycin screening agar 6 ug/ml is recommended by CLSI as a screening method for detection of VISA, yet it did not perform well and underestimated VISA isolates. VITEK 2 system is not an appropriate method for detection of S. aureus with reduced susceptibility to vancomycin [VISA]. MRSA isolates with reduced susceptibility to vancomycin can be treated effectively with Linezolid

Role of diffusion weighted MR imaging in assessment of hepatocellular carcinoma after radiofrequency ablation

Background: hepatocellular carcinoma [HCC] is the most common primary liver malignancy. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation cannot be offered

Aim of the work: this study aimed to evaluate the feasibility of DWI and the corresponding ADC values to detect tumor response after radiofrequency ablation for hepatocellular carcinoma

Patients and methods: MR examinations were done for 20 HCC patients post-RFA. Pre and post gadolinium enhanced images as well as DW sequences were performed. ADC values of ablation zones and liver parenchyma were assessed. ADC values of ablation zones and adjacent signal alterations identified in DWI were analyzed

Results: residual or recurrent lesions were detected in 4 patients [20%]. The mean ADC value of ablated zones differed significantly from that of normal liver parenchyma. The corresponding ADC values were significantly lower in patients with residual lesion than in patients without residual lesion

Conclusion: it can be concluded that DWI is a feasible follow-up tool for post ablation liver contributing in detection of residual lesion

Dexmedetomedine versus standard sedatives in weaning from mechanical ventilation

Background: Sedation in the intensive care unit Patients is assumed to reduce discomfort from care interventions, increase tolerance of mechanical ventilation, prevent accidental removal of instrumentation, and reduce metabolic demands during cardiovascular and respiratory instability

Aim of the Work: The aim of the work was to evaluate the use of dexmedetomedine as a sedative to facilitate weaning from mechanical ventilation and extubation, so decrease the incidence of reintubation, ventilator complications and decrease the ICU cost and stay

Patients and Methods: This was a controlled randomized prospective clinical trial carried out at Ain-Shams University Hospitals. After approval of institutional ethical committee, the study included 90 adult postoperative patients and requiring postoperative mechanical ventilation in the surgical ICU for maximum duration of 48 hours postoperatively

Results: As regard to time to extubation, results of the current study showed a highly statistically significant difference between three groups regarding time to extubation [hr] when p-value was < 0.001

Conclusion: dexmedetomidine has clinically relevant benefits compared to midazolam and propofol in facilitating extubation because of its shorter time to extubation, more hemodynamic stability, easy arousability and lack of respiratory depression; hence, it can be used as an effective, and safe sedative agent to facilitate extubation in ICUs and decreasing ICU length of stay

comparative study between anterior lamellar repositioning and anterior lamellar repositioning with blepharoplasty in management of upper eyelid entropion trichiasis

Background: Entropion is the inward turning of the lid margin that brings both lashes and external keratinized skin into contact with the globe

Aim of the study: It was to compare the surgical outcome and aesthetic appearance between anterior lamellar repositioning only and anterior lamellar repositioning with blepharoplasty in management of upper eye lid entropion trichiasis

Patients and Methods: This was prospective interventional study includes 20 lids of 13 patients with upper eyelid cicatricial entropion selected from the ophthalmology outpatient clinic of "Ain Shams University" Hospitals. Patients were randomly divided in 2 groups: group A: Ten lids had an anterior lamellar reposition technique [ALR] with grey line split [GLS] technique. Group B: Ten lids had an anterior lamellar reposition with GLS technique and blepharoplasty. All surgeries were performed by one surgeon [third author] in Ain Shams University hospital

Results: Our study showed that after 3 month follow up, success rate of first group was 70 %, patient satisfaction was 60% and final aesthetic outcome was 30% excellent, 30% fair and 40% poor results. The second group success rate was 100%, patient satisfaction was 100% and final aesthetic outcome was 100% excellent results

Conclusion: Combining the procedure of ALR with GLS technique with blepharoplasty in surgical correction of upper eye lid cicatricial entropion has excellent both functional and aesthetic outcome and a higher success rate with minimal complication than anterior lamellar reposition only

Microscopic evaluation of the testis in azoospermic patients with reference to androgen receptors in sertoli cells

Background: The reproductive ability of sexually mature males is dependent on the capacity of the testes tubules to produce large numbers of highly viable sperms and the interstitial cells to produce adequate levels of androgens to ensure maturation of the reproductive system. Azoospermia, defined as the complete absence of spermatozoa in the ejaculate, invariably results in infertility but does not necessarily imply sterility. It is identified in approximately 1% of all men and in 10 to 15% of infertile males

Patients and methods: The use of biopsies had been approved by the ethics committee of the Faculty of Medicine, Al Azhar University. All testicular biopsies were taken after written informed consent at the Department of Clinical Andrology, International Islamic Center for Population and Research Studies. Eleven patients with idiopathic infertility, were enrolled in this study and were assessed and diagnosed by a complete examination and specific investigations

Results: This study included 11 patients. They were divided into two groups obstructive azoospermia [OA] and Non-obstructive azoospermia. Non-obstructive azoospermia is subdivided into 4 groups: Early maturation arrest, late maturation arrest, Sertoli cell only [Sco] and Klienfilter syndrome

Conclusion: Spermatogenesis and maintenance of reproductive functions are controlled by androgens which are steroid hormones. Androgens exert most of their effects through genomic actions, which involve their binding to the androgen receptor [AR].AR plays important roles during later stages of sperm formation and maturation by influencing the four major cell types: Sertoli, Leydig, peritubularmyoid, and germ cells. Except for maturation arrest non-obstructive azoospermia, AR positive staining was not detected in germ cells. The highest number of Sertoli cell androgen receptors was in sections of testis from obstructive azoospermia and non- obstructive late maturation arrest patients, Testicular sections from patients with Klinefelter syndrome presented the lowest number of androgen receptor positive cells. It was concluded that the present study revealed that demonstration of androgen receptors in testicular sections is a good indicator of spermatogenic activity. Such information is valuable for the decision of obtaining spermatozoa from the testis for ICSI

Total laparoscopic hysterectomy versus total abdominal hysterectomy in uterine tumors

Background: laparoscopic hysterectomy [LH] rates have increased but abdominal hysterectomy [AH] still high and often the first choice for many surgeons even with most of studies reported that the minimal access method offers significant patient benefit over open surgery

Aim of the Work: we aimed to compare the outcome of total laparoscopic hysterectomy as regard the result and safety compared to total open abdominal hysterectomy in cases of uterine tumors

Patients and Methods: this prospective randomized controlled study performed on 25 patients who underwent LH [group 1] compared to 25 patients who underwent AH [group 2]. The mean age of the cases, body mass index [BMI], duration of operation, estimated blood loss [EBL], rate of complications, post-operative hospital stay and convalescence time were compared for two groups

Results: LH was associated with a significantly longer operating time [139.96 +/- 22.66 minutes vs. 106.54 +/- 21.8 minutes P 0.001]. As regard intraoperative complications and estimated blood loss there was no difference in both groups. In LH group the pain score and analgesia requirements in post-operative period were significantly less with fewer requiring opioid analgesia. There was a highly significant difference between groups in postoperative wound infection which was higher in AH group. LH was also associated with a significantly shorter inpatient hospital stay [2.22 days vs. 5.52 days P= 0.022] and earlier returned to normal life [7.5 days vs. 20.6 days P<0.001]

Conclusion: total laparoscopic hysterectomy is safe and feasible procedure in treatment of uterine tumors with accepted peri-operative morbidity and good improvement of quality of life post-operative

Change in left ventricular end diastolic pressure [lvedp] as apredictor of adverse effect in patients undergoing primary pci

Background: in acute myocardial infarction [MI], decreasing compliance of the left ventricle is directly associated with prognosis

Patients and Methods: 30 patients presented with acute ST segment elevation MI Who underwent primary PCI within 12 hours of presentation. All patients were subjected to full history taking, physical examination, serial ECG, cardiac enzymes and measurement of LVEDP just before and after Primary PCI using end hole catheter

Results: post revascularization left ventricular end diastolic pressure [LVEDP] decreased. There is significant correlation between LVEDP change and left ventricular dysfunction [p value:0.014]. Significant correlation between LVEDP and mortality are present

Conclusion: change in LVEDP measured just pre and post primary PCI are significantly correlated with adverse clinical outcome in patients with acute STEMI

comparative study of the diagnostic and prognostic value of squamous cell carcinoma antigen and alfa-foeto protien in hepatocellular carcinoma before and after therapeutic intervention

Background: hepatocellular carcinoma [HCC] is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients

Aim of the Work: was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC

Patients and Methods: the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group

Results: the plasma SCCA level was significantly higher in group I patients [with HCC], than in the group II patients [cirrhosis] and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion

Conclusion: plasma SCCA is a sensitive and specific serum marker for the diagnosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC