Assessment of humoral immune response to different COVID-19 vaccines in patients undergoing maintenance hemodialysis / Avaliação da resposta imune humoral a diferentes vacinas contra a COVID-19 em pacientes submetidos à hemodiálise de manutenção

ABSTRACT Introduction: The immune response to different Coronavirus Disease 2019 (COVID-19) vaccines is under-investigated in end-stage kidney disease (ESKD) patients, especially in the Middle East and North Africa. We carried out this research to estimate the effectiveness of COVID-19 immunization in ESKD patients on regular hemodialysis (HD). Methods: In this prospective observational study, we enrolled 60 ESKD patients on regular HD who had completed COVID-19 vaccination and 30 vaccinated healthy participants. Serum levels of severe acute respiratory syndrome coronavirus 2 immunoglobulin G (SARS-COV2 IgG) were quantified 1 month after completing the vaccination schedule, and all participants were followed up from October 2021 to March 2022. The vaccines used in the study were from Pfizer-BioNTech, AstraZeneca, and Sinopharm. Results: The median level of SARS-COV2 IgG was lower in HD patients than in healthy participants (p < 0.001). Regarding the type of COVID-19 vaccination, there was no statistical difference in SARS-COV2 IgG levels among HD patients. During the observation period, none of the HD patients had COVID-19. Conclusion: COVID-19 vaccination appeared to be protective in HD patients for 6 months and the side effects of vaccines were tolerable.

RESUMO Introdução: A resposta imune a diferentes vacinas contra a doença do coronavírus 2019 (COVID-19) é pouco investigada em pacientes com doença renal em estágio terminal (DRET), especialmente no Oriente Médio e norte da África. Realizamos esta pesquisa para estimar a eficácia da imunização contra a COVID-19 em pacientes com DRET em hemodiálise regular (HD). Métodos: Nesse estudo observacional prospectivo, inscrevemos 60 pacientes com DRET em HD regular que haviam concluído o esquema de vacinação contra a COVID-19 e 30 participantes saudáveis vacinados. Os níveis séricos de imunoglobulina G da síndrome respiratória aguda grave do coronavírus 2 (SARS-COV2 IgG) foram quantificados um mês após a conclusão do esquema vacinal, e todos os participantes foram acompanhados de outubro de 2021 a março de 2022. As vacinas utilizadas no estudo eram da Pfizer-BioNTech, AstraZeneca e Sinopharm. Resultados: O nível mediano de SARS-COV2 IgG foi menor em pacientes em HD do que em participantes saudáveis (p < 0,001). Com relação ao tipo de vacinação contra a COVID-19, não houve diferença estatística nos níveis de SARS-COV2 IgG entre pacientes em HD. Durante o período de observação, nenhum dos pacientes em HD teve COVID-19. Conclusão: A vacinação contra a COVID-19 pareceu ser eficaz na proteção de pacientes em HD por 6 meses e os efeitos colaterais das vacinas foram toleráveis.

Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents / Glomerulonefrite membranoproliferativa relacionada à hepatite C na era dos agentes antivirais diretos

Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.

Resumo A glomerulonefrite membranoproliferativa (GNMP) é a glomerulopatia associada ao vírus mais típico da hepatite C (HCV), e os dados disponíveis sobre a utilização de antivirais de ação direta (AAD) na glomerulonefrite associada ao HCV são inadequados. Avaliamos a resposta renal e viral em dois casos de GNMP relacionados ao HCV; o primeiro causado por crioglobulinemia, enquanto o segundo era negativo para crioglobulina. Ambos os pacientes receberam imunossupressão além de AAD em diferentes esquemas terapêuticos. Eles alcançaram remissão parcial, mas permaneceram dependentes da imunossupressão por mais de 6 meses após os AAD, apesar da resposta virológica sustentada, que permitiu a retirada da imunossupressão mais segura, mas incompleta. Ambos os pacientes foram testados para HCV oculto em células mononucleares do sangue periférico e deram resultados negativos. Portanto, o tratamento do GNMP relacionado ao VHC deve ser de acordo com a condição clínica e os efeitos da terapia medicamentosa. É importante considerar que a resposta renal pode ficar aquém da resposta virológica.

Effectiveness of Active Rehabilitation Program on Sports Hernia: Randomized Control Trial

OBJECTIVE: To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective. METHODS: Forty soccer players with sports hernias were randomly divided into two equal groups: group A (active rehabilitation program) and group B (conventional treatment). The methods of assessment included a visual analog scale (VAS) and hip internal and external range of motion assessments. Group A received conventional treatment (heat, massage, transcutaneous electrical nerve stimulation, and mobilization) plus an active rehabilitation program, while group B received only conventional treatment. Three treatment sessions were given each week for 2 months. Evaluations were performed pre- and post-treatment. RESULTS: A decrease in VAS was seen in both groups at the end of treatment, 80.25% in group A and 41.93% in group B. The difference between the two groups was statistically significant (p=0.0001), whereas there were no statistical differences in internal and external rotation between the groups at the end of treatment (p>0.05). After treatment, an improvement in outcome measures of group A compared to group B (p=0.01) was seen. Thirteen patients in group A and only three patients in group B returned to sports activities without groin pain. CONCLUSION: Active rehabilitation was effective for sports hernia management measured by a decrease in pain and the return to sports.

In-vitro antimicrobial susceptibility testing of bacteria causing diarrhea in children at Khartoum StateSudan.

Background: Diarrhea remains a major public health problem in developing countries. The current study was design to assess the antimicrobial susceptibility testing of bacteria causing diarrhea in children those antibiotics are recommended by Integrated Management-of Childhood illness (IMCI) . Methods: A total number of 114 bacterial pathogens isolated from 432 children patients with diarrhea attending Khartoum Pediatric Hospital & Omdurman Pediatric Hospital during the period of May 2005 to July 2007 were enrolled into the study. The antimicrobial activity against five commonly used antibiotics: ciprofloxacin, gentamicin, co-trimoxazole, nalidixic acid and amoxicillin were performed using Kirby-Bauer method. Results: Out of 114 isolates about 63% were susceptible to co-trimoxazole; where as 71.4% & 80.4% of the isolates were susceptible to amoxicillin & nalidixic acid, respectively. All (100%) of isolated pathogens were susceptible to ciprofloxacin where as the susceptibility of gentamicin among all isolates were 96.4%. Among 61 Shigella spp. isolates only 49.2% were susceptible to co-trimoxazole compared with 54.1% of Shigella spp isolates that were susceptible to amoxicillin. 96.8% of Shigella isolates were susceptible to gentamicin. Conclusion: In vitro sensitivity test of isolates showed that ciprofloxacin, and gentamicin were the most effective antibacterial drugs for bloody diarrhoea compared to co-trimoxazole & amoxicillin

Deaf children uses of social network sites and their gratifications

Aims: To identify the uses for deaf children social sites and their gratification, and identify the rate of use of the study sample social sites, as well as topics and attributes favored by these children on social sites, as well as to identify the motives for use and gratifications for those deaf children, and to identify the impact of those sites on social relations have, belong to study current studies descriptive approach used media survey, and have been applied to study a sample of deaf children in [Cairo, Monofiya] ranging in age from [12 to 18], and the study sample of 200 deaf children. Results: The more social sites used by deaf children is Facebook, then Youtube and Tweeter, the results showed that the study sample use social sites more than once a day by 51.5% and they are using those sites in the length of time ranging from less than an hour to more than three hours. Results showed the existence of a correlation between rates of uses of deaf children social sites and their gratifications at the level of moral 0.001, followed by the value of the Pearson 0.583, which has a direct correlation of any whenever the rate of use social sites, the more gratifications accruing from such use. The results proved that the use of the study sample social sites for extended periods of time does not affect the links with social realism. There is also a function of statistical differences between the region the study sample rates and deaf children social sites, at the level of moral 0.000, the value of 17.3, and degrees of freedom 198, and for children living in urban areas by an average of my account 2.75, in return for 2.55 for children belonging to the countryside

Surgical treatment of keratocystic odontogenic tumour: a review article

KCOT is one of the most aggressive odontogenic cysts with a high recurrence rate, this was explained histopathologically as it typically shows a thin, friable wall, which is often difficult to enucleate from the bone in one piece, and have small satellite cysts within the fibrous wall. Multiple surgical approaches were introduced including decompression, marsupilization, enucleation with or without adjunct [Carnoy's solution, enucleation] and resection. Depending on other studies KCOT can be conservatively treated with enucleation and application of Carnoy's solution or cryotherapy. This can be used specially in the large lesions that when treated with resection, the continuity of the jaw will be interrupted. This technique shows comparable results to other more aggressive techniques

Multivessel coronary stenting versus bypass surgery in patients with multivessel coronary artery disease and normal left ventricular function immediate and six months follow up

The usual goal for CABG is complete revascularization, which may be associated with greater freedom from recurrent angina and better long-term survival. In selected patients with multivessel coronary artery disease and normal left ventricular function, intracoronary stenting may offer an effective alternative to coronary bypass surgery. was to compare the immediate and six months follow up of the results of percutaneous coronary intervention [PCI] and the conventional coronary bypass surgery [CABG] in symptomatic patients with multivessel coronary artery disease and normal left ventricular function. The study included 61 patients who were randomly selected and divided into two groups: group [1]: 33 patients who underwent CABG and group [2]: 28 patients who underwent percutaneous coronary intervention. Both groups were followed up immediately post procedures and for a period of six months after. Stress ECG was done for returning patients during the 6 months follow up. During the immediate post operative follow up, only one patient in group 1 [3%] and 19 patients in group 2 [67.6%] were free of complications [P<0.001] Postoperative angina, acute renal failure, need for inotropic support, blood transfusion and lung atelectasis were significantly higher in group [1] than group [2]. Coronary dissection was found only in the PCI group. Other complications found in both groups were of no statistical significance. Regarding the cost and hospitals stay, it was significantly higher and more in group [1] than group [2]. During the 6 months follow up of the symptoms and the level of activity, there was no statistically significant difference regarding the angina and positive stress test between both groups. There was no statistical difference between the two groups in the composite end points [exercise tolevance, incidence of angina and mortality] during the 6 months follow up after the operation. PCI is relatively safer procedure, less costly and with lower hospital stay than CAVG, but it should be done in the presence of surgical back up because it is not completely free of risk and disadvantages. CABG still will have its role in managing patients with complex lesions not amenable to catheter interventions