Impact of the vertical division of the rectum on the decrease in reloading of the endostapler for a complete division in colorectal cancer

Background: Despite several improvements in surgical techniques, the intracorporeal division of the distal end of the rectum is still challenging, particularly when it is too deep in a narrow pelvis. Even though it helps avoid spillage, the double-stapling technique (DST) raises concerns regarding safety and anastomotic leakage if multiple stapler firings are essential to complete the rectal division. Objective: To assess the feasibility of vertically dividing the rectum and its impact in reducing the number of reloads essential for that division in non-low rectal cancer patients undergoing total mesorectal excision (TME). Materials and Methods A retroprospective study. Results: From January 2017 to November 2021, a total of 123 patients with sigmoid and rectal cancers were enrolled in the present study; their data were collected and analyzed, and 21 patients were excluded. The remaining sample of 102 subjects was composed of 47 male (46%) and 55 female (54%) patients with a median age of 54 years (range: 30 to 78 years). Only 1 reload was enough to complete the rectal division in 82 (80.39%) cases, and 2 reloads were used in the remaining 20 (19.61%) patients. Anastomotic leakage was clinically evident in 4 cases (3.9%). No statically significant difference was observed when firing one or two staplers. No 30-day mortality was recorded in this series. Conclusion: Our early experience indicates that this type of division has a real advantage in terms of decreasing the number of reloads needed and, in turn, lowering the incidence of anastomotic leakage after partial mesorectal excision (PME) or TME when applied with proper patient selection. (AU)

Potential effect of methanol leaf extracts from three Podocarpus species on experimental cryptosporidiosis

@#Cryptosporidiosis causes diarrhea in both immunocompetent and immunocompromised individuals, with acute manifestations occurring particularly in children and the elderly. Up till now, there is no curative therapy for cryptosporidiosis, so discovery of new classes of drugs are of great importance. This study aimed to examine the effect of methanol leaves extracts of the three Podocarpus species; P. macrophyllus (Thunb.), P. gracilior (Pilg.) and P. elongatus (Aiton) L’ Hér. ex Pers and their combination on Cryptosporidium parvum (C. parvum) in experimentally infected mice in comparison with the commercially used drug, Nitazoxanide. As well as spectrophotometric estimation of the total phenolic and flavonoid content of these extracts was done. Results revealed that treatment with these three Podocarpus extracts and their combination showed a significant reduction of the number of C. parvum oocyst shed in the stool of infected mice compared to infected control group and Nitazoxanideinfected treated group at P < 0.001. The combination of the three Podocarpus extracts was the most effective treatment showing the lowest number of oocysts shedding in comparison with other used extracts and Nitazoxanide. Histopathological inspection of sections from ilium and colon displayed signs of improvement after treatment with P. macrophyllus and P. gracilior extracts and more remarkable improvement when the three extracts were combined. It was concluded that the three Podocarpus species extracts used in this study had a promising anti-Cryptosporidium activity especially when they were combined.

C-glycosyl flavonoids-rich extract of Dipcadi erythraeum Webb & Berthel. bulbs: Phytochemical and anticancer evaluations

Dipcadi erythraeum Webb & Berthel. is a wild edible species belonging to family Asparagaceae and commonlyused in folk medicine. The D. erythraeum bulbs extract was subjected to chemical investigation using LiquidChromatography-Electrospray Ionization Mass Spectrometry (LC-ESI-MS) technique to identify its polar activeconstituents and evaluated against four human carcinoma cell lines; MCF7, HEPG2, A549, and HCT116. The D.erythraeum bulbs extract revealed 22 phenolic compounds characterized for the first time from the studied species,14 of them were identified as C-glycosyl flavonoids. Moreover, the studied extract showed moderate activity againstMCF7 and HCT116 at 100 µg/ml with cell viability of 43.6% and 48.4%, respectively. From the chemotaxonomicpoint of view, the presence of C-glycosyl flavonoids supported that D. erythraeum has a closer relationship with thespecies of Asparagaceae family than Liliaceae.

Effect of transdermal nitroglycerin patch on severe preeclamptic women with abnormal Doppler indices

Background: The aim is to evaluate the effect of maternal transdermal nitro-glycerine patch administration on blood flow resistance on maternal uterine artery, fetal umbilical and middle cerebral arteries in patients with severe pre-eclampsia in early gestational age (24 weeks to 33 weeks) associated with abnormal Doppler indices (placental insufficiency) and also its effect on maternal mean arterial blood pressure.Methods: This is a prospective interventional clinical trial conducted on (50) pregnant women with singleton pregnancy diagnosed with severe pre-eclampsia admitted in high-risk pregnancy unit at the Department of Obstetrics  in Tanta University Hospitals, A 50-mg transdermal GTN patch (Novartis Pharma) was applied to the abdominal skin, releasing nitroglycerin at a rate of 0.4 mg/h. Doppler ultrasonography and measurement of maternal blood pressure were performed before application of transdermal GTN patch, after 4 hours of application, after 24 hours and after 48 hours.Results: the application of a 50-mg transdermal GTN patch to the maternal abdomen was associated with a significant decline in the PI of the uteroplacental and fetoplacental blood flow. No change was observed in the PI of the cerebral circulation. And also, there was a significant decrease in maternal blood pressure (MAP).Conclusions: Nitroderm patch (nitric oxide donors) may be used as initial therapy in cases of severe preeclampsia complicated by placental insufficiency in the form of abnormal Doppler indices.

Purification and characterization of xanthine oxidase from liver of the water buffalo Bubalus bubalis.

Xanthine oxidase (XO) is an important enzyme with broad medical applications as detecting reagent in many diagnostic kits. In this study, buffalo liver xanthine oxidase (BLXO) was purified to homogeneity by acetone precipitation and chromatography on DEAE-cellulose and Sephacryl S-300 columns with a specific activity of 7.2 units / mg protein which represent 31.3 folds. The native molecular weight of the purified enzyme is 200 kDa and its subunit molecular weight was determined by SDS-PAGE to be 67 kDa. The isoelectric point (pI) value of BLXO isoenzyme is at pH 6.0 – 6.2. It displayed its pH optima at 7.6 and the Km value is 1.1 mM xanthine. FeCl2 increased the activity of BLXO while CuCl2, MnCl2 and ZnCl2 were found to be inhibitors of the purified enzyme. Allopurinol inhibits BLXO competitively and has one binding site on it with Ki value of 0.025mM. Abbreviations: BSA, Bovine serum albumin, XO, Xanthine oxidase, NBT, Nitroblue tetrazolium, PAGE, Polyacrylamide gel electrophoresis, PMS, Phenazine methosulphate, BLXO, Buffalo liver xanthine oxidase

Morphometric Study of the Right Coronary Artery.

Introduction: The anatomy of the coronary arteries is fascinating and most varied. The aim of the present work was to study the gross anatomy of the right coronary artery (RCA) regarding its importance for interventional cardiologists and cardiac surgeons. Materials and Methods: The material of the present study included 30 preserved hearts obtained from the dissecting rooms of anatomy departments, Faculty of Medicine, Beirut Arab University and Alexandria University. Results: Present study revealed that the length of the first segment of RCA ranged from 5.7 to 8.0 cm with a mean of 6.3 ± 0.6 cm; Its external diameter ranged from 4.0 mm to 7.0 mm with a mean of 5.1 ± 0.7 mm. The length of the second segment of RCA ranged from 3.4 to 6.0 cm with a mean of 4.9 ± 0.7 cm; Its external diameter ranged from 3.1 mm to 5.6 mm with a mean of 4.3 ± 0.8 mm. The right conus artery was found to arise at a distance 0.5 to 2.4 cm with a mean of 1.5 ± 0.6 cm from the beginning of RCA. At a distance 0.6 cm to 2.6 cm with a mean of 1.6 ± 0.6 cm from its beginning, the RCA was found to give its SAN branch. At a distance 2.7 cm to 5.6 cm with a mean of 4.2 ± 0.8 cm from its beginning, the RCA was found to give its acute marginal branch. Whether it terminated at or beyond the cardiac crux, RCA was found to give origin to the posterior interventricular branch in all specimens. In all specimensthe AVN artery was found to arise from RCA at the region of cardiac crux. Myocardial bridging was recorded in 2 specimens. Conclusion: This study directs the attention towards the importance of the right coronary artery in the supply of the myocardium and the patterns obtained here may be clinically relevant during percutaneous coronary interventions or surgical revascularization.

Total Phenolics and Antioxidant Activity of Defatted Fresh Taif Rose, Saudi Arabia.

Recently, the residues or by-products of agriculture industry take attention for their valuable source of natural antioxidants. Taif rose (Rosa damascena trigintipetala Dieck) is considered one of the most important economic products of Taif, Saudi Arabia. In this study, the antioxidant and total phenolic contents of the defatted flowers of fresh Taif rose were investigated. The antioxidant activity was chemically determined using three methods; 1,1-diphenyl picrylhydrazyl (DPPH.) free radical scavenging activity, phosphomolybdenum method and reducing power activity. The methanol extract showed antiradical activity with SC50=49.44 g/ml. Different fractions obtained from successive fractionation of the methanol extract with organic solvents of different polarities; chloroform (CHCl3), ethyl acetate (EtOAc) and n-butanol (n-BuOH); showed that, the EtOAc fraction had higher antiradical activity than n-BuOH fraction, and their respective SC50 were 15.62 and 36.29 g/ml. On the other hand, CHCl3 fraction had a poor antiradical activity (SC50>100 g/ml). The total phenolics, flavonoids, flavonols and RPHPLC analysis of the methanol extract and its EtOAc and n-BuOH fractions were determined. The ethyl acetate fraction had the highest contents of phenolics, flavonoids and flavonols that correlated with the antioxidant activity. From this work, it is obvious that the by-product from concrete oil production of Taif rose could be used as a good inexpensive source of antioxidant polyphenolics.

Phytochemical Studies and Evaluation of Antioxidant, Anticancer and Antimicrobial Properties of Conocarpus erectus L. Growing in Taif, Saudi Arabia.

The use of plants and their derived substances increases day by day for the discovery of new therapeutic agents owing to their versatile applications. Conocarpus erectus L. (family Combretaceae) is one of two species in the genus Conocarpus widely spread in Taif and other parts of the Kingdom of Saudi Arabia. It is used in some countries as folk remedy for anemia, catarrh, conjunctivitis, diabetes, diarrhea and fever. To our knowledge from literatures there is little work about phytochemical contents and biological activities of C. erectus which encouraged the authors to carry out this study. The four defatted methanol extracts of C. erectus different parts (leaves, stems, fruits and flowers) showed high free radical scavenging activity toward DPPH radical with SC50 between 6.47-9.4 μg/ml. The n- BuOH fractions obtained from successive fractionation of the four defatted methanol extracts had radical scavenging activity with SC50 between 4.43-5.89 μg/ml higher than the EtOAc fractions (7.04-10.71 μg/ml). Due to the high antioxidant activity of the EtOAc and n-BuOH fractions, it was in vitro assayed toward two human cancer cell lines; HepG2 & MCF-7; using Sulphorhodamine-B assay method. The results showed that most fractions had cytotoxic activity with IC50< 20μg/ml which fall within the American Cancer Institute criteria. A preliminary antibacterial screening of the four defatted methanol extracts of the different parts toward five bacterial strains were done. Phytochemical investigation of the EtOAc and n-BuOH fractions showed that phenolic compounds constitute the major components of it. In conclusion this is the first report on the phytochemical and biological properties of Conocarpus erectus growing in Taif governorate, KSA. More in vivo and in vitro studies along with detailed phytochemical investigation are needed in the hope to can use this plant (crude extract, fractions, sub-fractions or pure compounds) in the prevention and therapies of some diseases.

Histopathological changes in some organs of Japanese quail after different levels of jojoba meal

The present study was conducted to investigate the effect of different jojoba meal as a replace of soybean protein and to detect the histopathological changes in some organs of Japanese quail [one week old] for 5 weeks. The present study included two experiments, the first aimed to investigate the incorporation of treated jojoba meal seed [bentonite + autoclaving + fungus] in Japanese quail diets as replacer to soybean meal protein and to detect the histopathological changes in some organs of the Japanese quail. The treated jojoba meal was incorporated in the experimental diets to replace 0 [control]; 4 [T[1]]; 8 [T[2]] and 12% [T[3]] of soybean meal protein. The second experiment, dietary treatment included the control diet [The same control of experiment I] and groups 2 [UT[1]], 3[UT[2]], 4 [UT[3]], 5 [UT[4]], which were supplied with untreated jojoba meal at 0.0, 0.2, 0.4, 0.6 and 0.8% levels, respectively. Observations of the present study showed that liver of T[2] group revealed ruptured endothelial lining of the central vein, and T[3] group showed elongated walls of the bile ducts. Ileum of T[2] group showed highly thickened muscle layer and ileum of T[3] group showed distorted tissue. Kidney of T[2] group showed congested inters tubular spaces and T[3] group showed normal convoluted tubules with congested and dilated blood vessels. Testis of T[2] and T[3] groups showed hypocellularity of cells of the spermatognic layers with absence of mature sperms. Ovary of T[3] group showed somewhat normal mature ovum with reduced internal content. Results of experiment II showed that the liver tissue was normal.Ileum of birds of UT[3] and UT[4] groups showed somewhat normal appearance. Kidney of UT[3] group showed that some cells of the convoluted tubules were faintly stained with hemorrhagic areas. Testis of UT[3] and UT[4] groups showed decreased Leydig cells with absence of mature sperms and increased number of primary spermatocytes. Ovary of UT[3] group showed reduced stroma, and those of UT[4] showed highly reduced storma in the cortex and medulla of the ovary with malformed mature follicles and irregular membranes, but somewhat normal growing follicles. It is clear that 4% [At the level 1.55] of the treated jojoba meal and 0.4% untreated meal give the best results

Measuring parents'satisfaction with pediatric in -hospital care

Measurement of parent satisfaction has the potential to be an important component in evaluating service adequacy because parents usually are [a] responsible for obtaining health services for their children, [b] key to the success of treatment through their participation, [c] the best source of information about the effects of caring for a child with health problems, and [d] the primary caregivers after service completion. Research consistently shown that the most important factor contributing to satisfaction in the healthcare context has been interpersonal relationship between staff and consumers. Technical aspects of care, although an important determinant of clinical outcomes, have not been found to account for significant variance in consumer satisfaction. Focusing on interpersonal interactions of staff, therefore, served as the common denominator when developing items for the parent satisfaction questionnaire described in this thesis. So, the purpose of that study is twofold. First, to attempt to develop an Arabic language questionnaire for assessing parent satisfaction with inpatient care in pediatric hospitals, taking into account that item pool selection should incorporate the importance of the communication skills of the physicians. Second, to elicit parents' assessments of care in the particular setting of Children's hospital and possibly identify the contributing factors to their dissatisfaction

Foreign body in the vallecula presenting as acute epiglottitis with unilateral supraglottitis

Life threatening inflammatory swelling of the epiglottic and supraglottic regions secondary to a foreign body in the vallecula is an unusual occurrence. Upper airway obstruction is potentially a life threatening sequela. We present a unique case of acute epiglottitis with unilateral supraglottitis secondary to foreign body in the vallecula, which gradually improved after emergency endotracheal intubation for respiratory arrest, followed by intensive conservative management with intravenous antibiotics, cortisone and intravenous fluids. This case emphasizes that a foreign body in the vallecula presenting with severe dysphagia should be taken seriously as it may lead to life threatening complications

Quick gene expression profiling of promyelocytic cell line Hl-60

A number of techniques have been developed to perform gene expression profiling. We report preliminary results from our exploratory study, using sequential analysis of gene expression [SAGE] technique, to profile the undifferentiated and differentiated HL-60 cells in line with our interest to characterize the cancer phenotype. The aim of the study is to evaluate the technique and to understand the molecular bases of these 2 states of cells. HL-60 cells were differentiated after treatment with dimethyl sulfoxide. Tag libraries were prepared from the messenger RNAs of the undifferentiated and differentiated cells according to the SAGE protocol. The search for genes corresponding to the tags was carried out using SAGE software. The tags and the genes from the 2 libraries were compared for their levels of expression. The study was carried out at the King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia during the year 2001. A comparison of tags from the 2 libraries revealed that 151 tags corresponding to 57 genes expressed differentially: 60 tags were elevated and 59 were repressed in the undifferentiated cells. Thirty- two tags were equally expressed in both types of cells. Of the corresponding genes, 25 were expressed at higher, 17 at lower, while 15 were expressed at comparable levels in both cell types. In the profile of undifferentiated cells, the genes involved in mitochondrial function and protein synthesis were prominent, while in the differentiated cells, the genes coding for proteins associated with cell membranes, signal transduction and for cell specific functions were prominent. The genes, expressed equally in both the cell types, were concerned with the maintenance of the living state. Sequential analysis of gene expression is a useful technique for gene expression profiling. As previously indicated by others, a dedicated team can generate useful data within reasonable time limits

Scanning electron microscopic study of hair weathering

The present work aimed at evaluating the weathering changes in human hair by using a scanning electrone microscope which is a useful diagnostic tool for hair disorders. This study included 28 persons. 18 patients classified into 2 groups and 10 controls having normal hair. The first patients group included 8 children with known inherited hair shaft defects [5 with monilethrix and 3 with pilitorti]. The second patients group involved 10 females, 8 of them were suffering from broken and splitted hair ends and 2 had dry, brittle, and curly hair. This work demonstrated the weathering changes in the studied cases

new analgesia protocol for cataract surgery

Our objective was to describe the safety and efficacy of a new analgesia protocol that enables the surgeon to maintain control over an alert patient experiencing seemingly painless ambulatory cataract surgery, while eliminating the risks and side effects associated with general, local, and intracameral anesthesia. This study was carried out on two thousands cataract surgery cases. This technique produces profound ocular analgesia, avoiding any undesired sedative effects, using very low-dose, titrated, intravenous alfentanil. Complete control of the uncooperative patient, including lid squeezing and ocular and genera! body movements, is obtained whenever necessary using very low-dose, titrated, intravenous propofol. Success was defined as surgery completed in a controlled manner without the need to convert to general, local, or intracameral anesthesia and the patent's experience being perceived as pain free. One thousand nine hundred ninety-five [99.75%] of the cases were successful without ever deviating from the protocol. This analgesia protocol offers advantages for cataract surgery. It virtually eliminates the morbidity of cataract surgery associated with other anesthesia techniques while providing excellent and reliable control with minimal side effects. It allows for an immediate postoperative recovery with instantaneous vision restoration. These patients are generally awake, alert, and retain their protective reflexes

Safety and efficacy of intracameral injections of preservative - free lidocaine as an adjuvent to topical anesthesia to reduce intraocular sensation versus peribulbar anesthesia

This study was done to evaluate the efficacy and safety of intracameral lidocaine in cataract surgery compared to peribulbar anesthesia. This study was carried out on rabbits [n = 20] and patients [n = 160]. Our primary concern was the potential for corneal toxicity from the intracameral lidocaine. The preliminary study with rabbits showed no significant difference in corneal endothelial toxicity between the 20 rabbit eyes injected with 1% preservative-free lidocaine and the 20 eyes injected with BSS [p = 0.42]. As regards the human studies, a total of 160 cataract patients [160 eyes] participated. Eyes were classified to two groups: one group [n = 80] received 0.2 ml intracameral 1% unpreserved lidocaine combined with topical anesthesia [bupivacaine]; the other group [n = 80] received a peribulbar block with a sharp 26-gauge needle using a solution of lidocaine 2% [3 ml], bupivacaine 0.5% [2 ml], and hyaluronidase [wydase] 150 U before phacoemulsification with sclerocorneal tunnel incision .Duration of surgery was measured; implicit time and amplitudes of the b-waves of the photopic electroretinogram [ERG] potentials [single-flash ERG and the 30-Hz flicker ERG] were recorded; frequencies of intraoperative problems, complications, intraoperative, and postoperative pain were evaluated. Surgeon assessments of operative conditions and patient cooperation were recorded. The attending anesthesiologist recorded any increase in pulse or increase in blood pressure. After lidocaine anesthesia combined with topical anesthesia, similar complications were found, longer operation time [p < 0.001], and significantly better visual acuity immediately after surgery [p < 0.001]. The ERG amplitudes were not significantly reduced after 0.2 ml intracameral lidocaine half an hour after surgery [p > 0.05]. The surgeon assessment showed more patient cooperation in the peribulbar group [p = 0.012]. No patient in either group was rated as poorly cooperative. Intracameral lidocaine 1% combined with topical anesthesia can be recommended as an alternative procedure to peribulbar anesthesia in cataract surgery especially in the following situations: in patients with high myopia, fear of syringes, or prolonged coagulation

study of an outbreak of itchy skin lesions in Tanta University campus in Kafr Al-Sheikh

This study was carried out in Tanta University Campus in Kafr Al-Sheikh. It was conducted to find the nature and the underlying factors of itchy skin lesions that appeared among some of the campus residents. The work included dermatological, histopathological, entomological, and epidemiological studies in addition to surveying the surrounding environment. The target population involved all the affected cases [86 females] and a sample of the non-affected residents [100 females]. Dermatological and histopathological examination of the lesions indicated a contact dermatitis. The epidemiological study revealed that the situation could be considered an outbreak. The environmental survey and the circumstantial evidences pointed out to an insect that was found to be a beetle known as Paederus alfierii Koch. The direction of both the wind and the smoke, that resulted from the burnning dry remains of plants were the factors that induced the insect movement towards the females campus where the outbreak was reported. Our recommendations included dealing with the environment, use of insecticides, prohibition of burnning of the dry remains of plants, and screening of windows and doors of the residential buildings

Umbilical artery velocimetry and conventional sonographic biometry in fetal evaluation of hypertensive pregnant patients

Umbilical artery Doppler velocimetry and conventional ultrasonographic biometry were evaluated as parameters for fetal evaluation in 20 primigravida hypertensive patients and 20 matching normotensives. Doppler parameters were the S/D ratio and the Pourcelot index. Conventional sonographic parameters were the amniotic fluid index, the umbilical cord diameter and placental thickness. The fetal outcome was judged by the fetal weight. In normotensive pregnancy, the fetal weight correlated with conventional sonographic biometry, while in hypertensive pregnancy, it correlated only with Doppler umbilical artery velocimetry

Hansen's disease, a cause of hearing loss

In this study, 84 leprosy patients and 10 controls were subjected to hearing evaluation. Mild to moderate sensorineural hearing loss was found in 28 [33.3%] patients, 8 borderline and 20 lepromatous. Tests for middle ear affection or retrocochlear disease were found to be negative. From this work, we can conclude that loss of hearing among leprosy patients is most probadly due to a cochlear type of hearing loss