Direct Comparison of 18 Carbon n-3 and n-6 Fatty Acids at Equal Levels in an Oil Blend on Tissue Enrichment of Long-Chain Polyunsaturated Fatty Acid in Broiler Chickens.

BACKGROUND: Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) are of interest because of their health effects. However, most experiments use natural oils and are confounded by PUFA concentrations and other fatty acids (FAs) that impact biosynthesis of the very long-chain derivatives (VLC). OBJECTIVES: To directly compare the effect of 18 C n-3 or n-6 FA fed at similar rates on their elongation and desaturation to VLC PUFA and their incorporation into tissues. METHODS: Oil blends that substituted ∼23% points of stearidonic acid (SDA) with alpha-linolenic acid (ALA), gamma-linolenic acid (GLA), or linoleic acid (LA) while minimizing differences in other FA were prepared. COBB500 broilers were fed the oil blends at 1.25% of the diet from day 14-35 age. RESULTS: There was greater enrichment of VLC PUFA in breast, thigh, liver, and plasma when diets were supplemented with high-SDA and high-GLA oil blends than high-ALA and high-LA oil blends. The efficiency of VLCn-3 PUFA synthesis from SDA and ALA was lower than the efficiency of VLCn-6 PUFA synthesis from GLA and LA, suggesting that the elongation and desaturation enzymes more efficiently utilized n-6 substrates. The efficiency of biotransformation of SDA to VLCn-3 PUFA was greater than that of high-ALA, and synthesis of VLCn-6 PUFA from GLA was higher than that of high-LA in breast, thigh, liver, and plasma. There were minimal effects on tissue-saturated and monounsaturated FA. CONCLUSIONS: The high-SDA and high-GLA oil blends efficiently enriched tissues with their VLC-PUFA more than high-ALA and high-LA treatments.

From Bench to Bytes: Utility of Social Media Platforms by Pathology Residents.

Background: The rise of virtual media has expanded to various fields and the medical profession has not been immune to its influence. The purpose of our study was to analyse and evaluate the impact of virtual social networks, on the professional growth and career progression of Pathology residents. Materials and Methods: A cross-sectional survey was undertaken at the section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi. An online, questionnaire based on google forms was sent via WhatsApp application to the Pathology residents (n = 30) from July to August 2023. The anonymity of the participants was maintained. The statistical analysis was performed using Microsoft Excel 2019. Results: A total of 25 (83%) Pathology residents participated in the survey. 72% of the participants were females and 28% were males. Chemical Pathology residents constituted the largest proportion at 44%, followed by 24% from Hematology, 24% from Microbiology and 8% from Histopathology. 60% of the trainees acknowledged using social media platforms routinely for professional development. The most used social media platforms were YouTube (48%), Twitter (36%), Facebook (12%) and Instagram (4%). Social media network was perceived the most useful in increasing understanding regarding the profession (60%), strengthening the proficiency in problem-solving (56%) and enhancing critical thinking abilities (52%) whereas it was regarded as somewhat useful in enhancing clinical/professional decision-making skills (52%) and clinical expertise (60%). Conclusion: Social media is gaining popularity in the realm of medicine and this survey reveals the perspective of Pathology residents on the social media networks and its growing impact on their professional growth.

The deacylase SIRT5 supports melanoma viability by influencing chromatin dynamics.

Cutaneous melanoma remains the most lethal skin cancer, and ranks third among all malignancies in terms of years of life lost. Despite the advent of immune checkpoint and targeted therapies, only roughly half of patients with advanced melanoma achieve a durable remission. Sirtuin 5 (SIRT5) is a member of the sirtuin family of protein deacylases that regulates metabolism and other biological processes. Germline Sirt5 deficiency is associated with mild phenotypes in mice. Here we showed that SIRT5 was required for proliferation and survival across all cutaneous melanoma genotypes tested, as well as uveal melanoma, a genetically distinct melanoma subtype that arises in the eye and is incurable once metastatic. Likewise, SIRT5 was required for efficient tumor formation by melanoma xenografts and in an autochthonous mouse Braf Pten-driven melanoma model. Via metabolite and transcriptomic analyses, we found that SIRT5 was required to maintain histone acetylation and methylation levels in melanoma cells, thereby promoting proper gene expression. SIRT5-dependent genes notably included MITF, a key lineage-specific survival oncogene in melanoma, and the c-MYC proto-oncogene. SIRT5 may represent a druggable genotype-independent addiction in melanoma.

Effect of self-administered vaginal dinoprostone on pain perception during copper intrauterine device insertion in parous women: a randomized controlled trial.

OBJECTIVE(S): To assess efficacy and safety of self-administered 3 mg dinoprostone vaginally in reducing pain during copper intrauterine device (IUD) insertion in parous women. DESIGN: Randomized, double-blinded, placebo-controlled trial. SETTING: Family planning clinic in a tertiary referral hospital. PATIENT(S): Multiparous women who were attending a family planning clinic and requesting copper IUD insertion. INTERVENTIONS(S): We randomly assigned 160 participants into two groups: The dinoprostone group (n = 80) received 3 mg dinoprostone vaginally, and the placebo group (n = 80) received placebo vaginally. MAIN OUTCOME MEASURE(S): Our primary outcome was mean pain scores during IUD insertion. Our secondary outcomes were mean pain scores during tenaculum application, during uterine sounding, and 15 minutes after insertion, ease of insertion, satisfaction score, need for additional analgesics, and side-effects. RESULT(S): Both groups showed no significant difference in anticipated pain score (P=.41), pain during tenaculum placement (P=.22), and pain during sound insertion (P=.07). The dinoprostone group had significantly lower pain scores during IUD insertion (34.8 ± 10.1 vs. 57.8 ± 11.8) and 15 minutes after insertion (20.6 ± 6.4 vs. 29.6 ± 6.2), easier IUD insertion (43.6 ± 21.9 vs. 64.7 ± 18.1), and higher satisfaction (83.9 ± 11.6 vs. 63.0 ± 9.1) compared with the placebo group. Fewer patients required additional analgesics in the dinoprostone group compared with the placebo group (P=.01). Side-effects were similar between the groups. CONCLUSION(S): Self-administered 3 mg dinoprostone vaginally before copper IUD insertion in parous women reduces pain scores during IUD insertion, making insertion easier and increasing women's satisfaction, with tolerable side-effects. CLINICAL TRIAL REGISTRATION NUMBER: NCT04046302.

Comparative study regarding effect of pH on Misoprostol in induction of labor in full term primigravida pregnant women, a double blind randomized controlled trial.

OBJECTIVES: To evaluate the effect of altering vaginal pH on induction of labor in full-term pregnancies using Misoprostol. METHODS: This randomized controlled trial was conducted at Kasralainy Hospital, Cairo University, Egypt and Algezeera Hospital, Egypt. A total of 218 healthy term primigravida pregnant women who were scheduled for pregnancy termination were recruited in the study. The included patients were divided into three groups; Group A: Those who received normal saline vaginal wash (0.9% NaCl), Group B: those who received alkaline vaginal wash (5% sodium bicarbonate) and Group C: those who received acidic vaginal wash (5% acetic acid). Patients received 25 µg of Misoprostol E1 (Vagiprost® Adwia Pharmaceuticals, Egypt) every 6 h for a maximum of 24 h (total of four potential doses). RESULTS: The 'acid' group participants took a mean time of 20.46 h to reach active stage of labor, followed by the 'normal saline' group with 21.45 h and the 'alkaline' group with 22.59 h. The difference between the groups was statistically significant, with a p-value of 0.013. CONCLUSIONS: Douching the vagina with acidic solution seems to supplement the effect of Misoprostol on inducing labor in full-term pregnancies, as evidenced by having the shortest mean time needed to reach active stage of labor.

Epidemic Analysis of COVID-19 in Egypt, Qatar and Saudi Arabia using the Generalized SEIR Model

BackgroundSince its emergence in late December 2019 and its declaration as a global pandemic by World Health Organization (WHO) on March 11, 2020, the novel coronavirus disease known as (COVID-19) has attracted global attention. The process of modeling and predicting the pandemic behavior became crucial as the different states needed accurate predictions to be able to adopt suitable policies to minimize the pressure on their health care systems. Researchers have employed modified variants of classical SIR/SEIR models to describe the dynamics of this pandemic. In this paper, after proven effective in numerous countries, a modified variant of SEIR is implemented to predict the behavior of COVID-19 in Egypt and other countries in the Middle East and North Africa region (MENA). MethodsWe built MATLAB simulations to fit the real data of COVID-19 Active, recovered and death Cases in Egypt, Qatar and Saudi Arabia to the modified SEIR model via Nelder-Mead algorithm to be able to estimate the future dynamics of the pandemic. FindingsWe estimate several characteristics of COVID-19 future dynamics in Egypt, Qatar and Saudi Arabia. We also estimate that the pandemic will resolve in the countries under investigation in February 2021, January 2021 and 28th August 2020 With total death cases of 9,742, 5,600, 185 and total cases of 187,600, 490,000, 120,000, respectively.

Relationship between Sinonasal Anatomical Variations and Symptom Severity in Patients with Chronic Rhinosinusitis.

Background: Anatomical variations are subtle structural abnormalities around the osteomeatal complex that might obstruct paranasal sinus drainage and ventilation. The role of these anatomical variants in chronic rhinosinusitis is still controversial and unclear. The aim of this study was to determine the prevalence of anatomical variations and their relationship with the severity of symptoms in patients with chronic rhinosinusitis. Materials and Methods: This was a cross-sectional study conducted among randomly selected patients with chronic rhinosinusitis. Sinonasal Outcome Test-20 (SNOT-20) was used to assess the patient's severity of symptoms. Computed tomographic scan was used to determine the presence of anatomical variations. The relationship between anatomical variations and symptom severity was determined using the Statistical Products and Service Solution (SPSS) version 20.0. Results: There were 70(58.3%) males and 50(41.7%) females within the age range of 17-60 years. SNOT-20 scoring showed 6(5.0%) of the patients with mild symptoms, 69(57.5%) with moderate, 37(30.8%) with severe, and 8(6.7%) with profound symptoms. The prevalence of sinonasal anatomical variants was 26.7%, which comprised of septal deviation (10.8%), agger nasi (6.7%), concha bullosa (4.2%), Haller cells (3.3%), and Onodi cells (1.7%). There was a statistically significant relationship between the anatomical variations and symptom severity (P = 0.000). Conclusion: This study found a significant relationship between anatomical variations and severity of chronic rhinosinusitis. The prevalence of anatomical variants was found to be 26.7%.

Contexte: Les variations anatomiques sont des anomalies structurelles subtiles autour du complexe ostéoméatal qui peuvent obstruer le drainage et la ventilation des sinus paranasaux. Le rôle de ces variantes anatomiques dans la rhinosinusite chronique est encore controversé et peu clair. Le but de cette étude était de déterminer la prévalence des variations anatomiques et leur relation avec la sévérité des symptômes chez les patients atteints de rhinosinusite chronique. Méthodologie: Il s'agissait d'une étude transversale menée auprès de patients sélectionnés au hasard et atteints de rhinosinusite chronique. Sinonasal Outcome Test-20 (SNOT-20) a été utilisé pour évaluer la gravité des symptômes du patient. La tomodensitométrie a été utilisée pour déterminer la présence de variations anatomiques. La relation entre les variations anatomiques et la gravité des symptômes a été déterminée à l'aide de la version 20 de la solution SPSS. Résultats: Il y avait 70 (58,3%) hommes et 50 (41,7%) femmes dans la tranche d'âge de 17 à 60 ans. Le score SNOT-20 a montré que 6 (5,0%) des patients présentaient des symptômes légers, 69 (57,5%) des symptômes modérés, 37 (30,8%) des symptômes graves et 8 (6,7%) des symptômes profonds. La prévalence des variantes anatomiques naso-sinusiennes était de 26,7%, comprenant la déviation septale (10,8%), l'agger nasi (6,7%), la concha bullosa (4,2%), les cellules de Haller (3,3%) et les cellules d'Onodi (1,7%). Il y avait une relation statistiquement significative entre les variations anatomiques et la sévérité des symptômes (P = 0,000). Conclusion: Cette étude a trouvé une relation significative entre les variations anatomiques et la sévérité de la rhinosinusite chronique. La prévalence des variantes anatomiques était de 26,7%.

Healthcare Leaders Develop Strategies for Expanding National Surgical, Obstetric, and Anaesthesia Plans in WHO AFRO and EMRO Regions.

BACKGROUND: Worldwide, five billion people lack access to safe, affordable surgical, obstetric, and anaesthesia (SOA) care when needed. In many countries, a growing commitment to SOA care is culminating in the development of national surgical, obstetric, and anaesthesia plans (NSOAPs) that are fully embedded in the National Health Strategic Plan. This manuscript highlights the content and outputs from a World Health Organization (WHO) lead workshop that supported country-led plans for improving SOA care as a component of health system strengthening. METHODS: In March 2018, a group of 79 high-level global SOA stakeholders from 25 countries in the WHO AFRO and EMRO regions gathered in Dubai to provide technical and strategic guidance for the creation and expansion of NSOAPs. RESULTS: Drawing on the experience and expertise of represented countries that are at different stages of the NSOAP process, topics covered included (1) the global burden of surgical, obstetric, and anaesthetic conditions; (2) the key principles and components of NSOAP development; (3) the critical evaluation and feasibility of different models of NSOAP implementation; and (4) innovative financing mechanisms to fund NSOAPs. CONCLUSIONS: Lessons learned include: (1) there is unmet need for the establishment of an NSOAP community in order to provide technical support, expertise, and mentorship at a regional level; (2) data should be used to inform future priorities, for monitoring and evaluation and to showcase advances in care following NSOAP implementation; and (3) SOA health system strengthening must be uniquely prioritized and not hidden within other health strategies.

Two-phase survey to determine social anxiety and gender differences in Omani adolescents.

INTRODUCTION: There is a lack of studies examining the effectiveness of some of the commonly used instruments to elicit the presence of social anxiety disorder (SAD) in Arab-speaking populations, such as those in Oman. The aim of this study was to establish the influence of social anxiety and the role of gender among Omani adolescents. METHODS: A two-phase protocol was used, entailing the psychometric properties of the Arabic version of the Liebowitz Social Anxiety Scale (LSAS) against the gold standard, the Diagnostic and Statistical Manual of Mental Disorders (DSM). RESULTS: According to DSM and LSAS, the prevalence of social phobia among Omani students was generally higher compared to what has been reported in other parts of the world and the crosstabs analysis showed a significant correlation between gender and SAD. DISCUSSION: The Arabic version of LSAS proved to be an effective tool for assessing and quantifying the presence of SAD. This study discusses the sociocultural factors affecting social phobia in Omani society.

Adolescent abuse in a community sample in Beni Suef, Egypt: prevalence and risk factors

Adolescent abuse was studied in 555 school students [mean age 15.6 +/- 1.5 years] selected by multistage random sampling in Beni Suef in 1998. Each student received a general physical examination and a pre-coded questionnaire to identify determinants of abuse. Prevalence of abuse was 36.6%. Emotional, physical, sexual and combined abuse prevalence was 12.3%, 7.6%, 7.0% and 9.7% respectively. Significant predictors of sexual abuse were hyperactive child, disabled child, disinterested mother, low birth order child or wasted child. For physical abuse, significant predictors were maternal disinterest, maternal education and injuries. Significant predictors of emotional abuse were overcrowding, disease and mistreatment by a teacher. Violent behaviour was reported for more than 20% of the emotionally and the sexually abused