Clinical patterns of facial aging among egyptian females

Background: the skin displays the most visible manifestations of aging. Research interest in aging process has grown and people are becoming obsessed with looking young. The face has received most of the attention and generated most of the studies related to beauty and aging because it is the most expressive part of human body

Aim of the Work: to assess the different clinical patterns of facial wrinkles and signs of skin aging among different age categories of Egyptian females

Subjects and Methods: this cross-sectional study was carried out in the Dermatology, Venereology and Andrology department of Ain Shams University Hospitals after Institutional Review Board approval. The study included included 100 adult females ranged from 20-60 years old

Results: the mean age was [38.570 +/- 11.634] with a range of 20-60 years. Skin phototype was Fitzpatrick Type III in 8 patients [8%], IV in 55 females [55%] and V in 37 females [37%]. Glogau classification for severity of skin aging signs was type I in 39 cases [39%], Type II in 20 [20%], Type III in 26 [26%] and type VI in 15 [15%]. All patients reported history of excessive sun exposure for extended hours; 32 cases reported sunscreen use but not regular, while 68 cases didn't use sunscreen

Conclusion: skin Type IV showed more wrinkles indentation index, roughness, melanin concentration, melanin heterogeneity and HGB heterogeneity. There was a significant correlation between the sunscreen use and average melanin concentration, where cases that used sunscreen showed lower average melanin concentration. The relation between sun screen use and severity of wrinkles [Indentation index] was non-significant

Characterization of some probiotic bacteria isolated from different dairy products at Assiut Governorate

Background: Probiotics are health promoting microorganisms incorporated into various kinds of food. Members of Lactobacillus and Bifidobacterium are the most commonly used

Objectives: This study aimed toisolate Lactobacillus and Bifidobacterium from different productsat Assiut Governorate, to detect its antibacterial activities against pathogenic bacteria, to evaluate probiotic, haemolytic and enzymatic activates, to compare between conventional methods for identification and PCR as gold standard

Methodology: Isolation and identification of Lactobacillus and Bifidobacterium by conventional methods. Probiotic properties were determined by growth at differenttemperatures, different NaCl concentrations, pH and bile tolerance. Antibacterial activity examined against three indicator pathogenic organisms. PCR was used for identification of Lactobacillus and Bifidobacterium species. Also haemolytic and enzymatic activities were determined

Result : The identified Lactobacillus spp. were L. acidophilus 54[29.5%],L. fermentum 50[27.3%], L. rhamnosus 34 [18.6%], L. plantarum 27[14.8%],L . paracasei 13[7.1%] and L.GG 5[2.7%].The Bifidobacterium species were B. Breve 59[31.7%], B. dentium 42 [22.6 %] , B . bifidum 53 [28.5%] , B . subtile 15[8%] B. longum 6[3.2%], B . animalis 7 [3.7% ] and B. infantis 4 [2.2%]. All the isolates tolerated low pH and bile salts, non heamolytic and had good antibacterial activity. The sensitivity and specificity of the conventional methods was [94.7%, 95.97%] and [93.86%, 94.97%] in Lactobacillus and Bifidobacterium respectively. Isolated strains produced ß-galactosidase which is beneficial for lactose intolerance and did not produce carcinogenic enzymes

Conclusion: Rayeb, yogurt, milk powder and cereals can be used as potential source of probiotics because they tolerate acidic media, bile salts, have good antibacterial activity. Also, they have beneficial enzymatic activities.PCR was a rapid method for identification of probiotic strains

role of tonsillectomy in the treatment of obstructive sleep apnea

Background: Obstructive Sleep Apnea [OS A] is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients' case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR. Methods: a systematic search in the scientific database [Medline, EMBASE, Google Scholer and Ovid] from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-control studies were analyzed and included based on the preset inclusion and exclusion criteria

Results: the search has yielded twelve studies to be included in the present SR [n = 206 patients, 34.4+/- 10.0 years and body mass index: 29.3 +/- 9.6 kg/m2] met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% [from 43.73 +/- 21.7 /hour to 13.7 3 +/- 12.7 /hour] [n - 198]. The AHI mean difference [MD] was -30.2 per hour [95% confidence interval [CI] -39.3, -21.1] [P value < 0.00001]

The AHI SMD was -1.37 [-1.65, -1.09] [large effect]. Lowest oxygen saturation improved from 77.7 3 +/- 11.9% to 85.5 3 +/- 8.2% [n = 186]. Lowest oxygen saturation MD was 8.5% [95% CI 5.2, 11.8] [P value < 0.00001]

The Epworth Sleepiness Scale decreased from 11.6 3 +/- 3.7 to 6.1 3 +/- 3.9 [n = 125]. Individual patient outcomes [n = 52] demonstrated an 85.2% success rate [AHI < 20/hour and > 50% reduction] and a 57.4% cure rate. Conclusion: tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity

Epidemiology of nosocomial infections and mortality following congenital cardiac surgery in Cairo University, Egypt

Background: Nosocomial infections [NI] have been associated with significant morbidity and attributed mortality, as well as increased healthcare costs. Relatively few data on congenital cardiac surgical ICU NI have been reported from developing countries. Little is known about the epidemiology of NI following congenital cardiac surgery in Egypt. The aims of the present study were: [a] to estimate the incidence rate and types of NI among children admitted to Pediatric Surgical Cardiac ICU in Cairo University Children's Hospital [Egypt] and [b] to estimate the mortality rate related to congenital cardiac surgery and identify its contributing risk factors

Participants and methods: A follow-up study in the period between 1 January 2009 and 1 January 2010 included all patients admitted to the Pediatric Surgical Cardiac ICU in Cairo University, Abo El Reesh Children's Specialized Hospital [Egypt]. Data were collected for each patient during the preoperative, intraoperative, and postoperative periods. Certain infection control procedures were carried out in certain months

Results: Of 175 patients, NI were identified in 119 [68%]. Poor hand hygiene was associated with increased NI in certain months of the study duration. NI were significantly higher at a younger age [median 9 [5-30] months, P<0.03]. Mortality was found in 54 patients, that is, 31% of the study population. Mortality was significantly observed with younger age, higher complexity score for congenital cardiac lesions, prolonged cardiopulmonary bypass and ischemic times, NI, prolonged mechanical ventilation, prolonged central line insertion, and the use of total parenteral nutrition. Mortality among the NI patients was found in 44 of 119 [37%]. On carrying out a multivariate analysis, Acute Physiology and Chronic Health Evaluation II score [P<0.001, odds ratio [OR] 1.13, 95% confidence interval [CI] 1-1.2], age [P<0.001, OR 0.3, 95% CI 0.2-0.4], and prolonged duration of mechanical ventilation [P<0.03, OR 2.8, 95% CI 1.1-7.2] were identified as risk factors of mortality

Conclusion and recommendations: NI rate and subsequent mortality were high among cases followed up during the period from 1 January 2009 to 1 January 2010 in the University Children's Hospital [Cairo, Egypt]. Early surgical interference, enforcement of proper infection control practices, especially hand hygiene, can reduce NI and trials for early extubation from mechanical ventilation might improve outcome following congenital cardiac surgery in pediatrics