Efficacy of Massage on Pain Intensity in Post-Cesarean Women: a Systematic Review and Meta-Analysis.

Background: Cesarean section is a common surgical procedure that may be considered a safe alternative to natural birth and helps to resolve numerous obstetric conditions. Still, the Cesarean section is painful; relieving pain after a Cesarean section is crucial, therefore analgesia is necessary for the postoperative period. However, analgesia is not free of complications and contraindications, so massage may be a cost-effective method for decreasing pain post-Cesarean. Our study aims to determine the massage role in pain intensity after Cesarean sections. Methods: We searched five electronic databases for relevant studies. Data were extracted from the included studies after screening procedures. We calculated the pooled mean difference (MD) and standardized mean difference (SMD) for our continuous outcomes, using random or fixed-effect meta-analysis according to heterogenicity status. Interventional studies were assessed for methodological quality using the Cochrane risk-of-bias assessment tool, while observational studies were assessed using the National Institutes of Health's tools. Results: Our study included 10 RCTs and five observational studies conducted with over 1,595 post-Cesarean women. The pooled MDs for pain intensity considering baseline values either immediately or post 60-90 minutes were favoring the massagegroup over the control group as follows:(stand. MD = -2.64, 95% CI [-3.80, -1.48], p >.00001; MD = -2.64, 95% CI [-3.80, -1.48], p >.00001, respectively). While pooled MDsregarding post-intervention only eitherimmediately or post 60-90 minutes were:(stand. MD = -2.04, 95% CI [-3.26, -0.82], p =.001; stand. MD = -2.62, 95% CI [-3.52, -1.72],p > .00001, respectively). Conclusion: Our study found that using massage was superior to the control groups in decreasing pain intensity either when the pain was assessed immediately after or 60-90 minutes post-massage application.

Electromagnetic field-enhanced novel tubular electrocoagulation cell for effective and low-cost color removal of beet sugar industry wastewater.

The treatment of real beet sugar mill effluent by a modified electrocoagulation process is proposed. An innovative design of an electromagnetic field-enhanced electrochemical cell consisting of a tubular screen roll anode and two cathodes (an inner and outer cathode) has been used. Different parameters have been investigated including current density, effluent concentration, NaCl concentration, rpm, number of screen layers per anode, and the effect of addition and direction of an electromagnetic field. The results showed that, under the optimum conditions, current density of 3.13 A/m2, two screens per anode, NaCl concentration of 12 g/l, and rotation speed of 120 rpm, the percentage of color removal was 85.5% and the electrical energy consumption was 3.595 kWh/m3. However, the presence of an electromagnetic field distinctly enhanced the energy consumption and the color removal percentage. Numerically, applying the magnetic field resulted in performing a color removal efficiency of 97.7% using a power consumption of 2.569 KWh/m3 which is considered a distinct achievement in industrial wastewater treatment process. The strong enhancement in color removal using a low power consumption significantly reduced the required treatment cost; the estimated treatment cost was 0.00017 $/h.m2. This design has proven to be a promising one for the continuous treatment of beet sugar industrial effluents and to be a competitor to the currently available techniques.

Toxicological effects of Saponin on the free larval stages of Schistosoma mansoni, infection rate, some biochemical and molecular parameters of Biomphalaria alexandrina snails.

Saponins have been used as biopesticides. The objective of the present study is to investigate the toxic effects of Saponin against Biomphalaria alexandrina snails. Results showed that Saponin exhibited a molluscicidal activity against adult B. alexandrina snails at LC50 (70.05 mg/l) and had a larvicidal effect on the free larval stages of Schistosoma mansoni. To evaluate the lethal effects, snails were exposed to either LC10 (51.8 mg/l) or LC25 (60.4 mg/l) concentrations of Saponin. The survival, the infection rates, protein, albumin, and total fat levels were decreased, while glucose levels were increased in exposed snails compared to control snails. Also, these concentrations significantly raised Malondialdehyde (MDA) and Glutathione S Transferase (GST) levels, whereas reduced Superoxide dismutase (SOD) activity and the total antioxidant capacity (TAC) in exposed snails. Furthermore, these concentrations resulted in endocrine disruptions where it caused a significant increase in testosterone (T) level; while a significant decrease in Estradiol (E2) levels were noticed. As for Estrogen (E) level, it was increased after exposure to LC10 Saponin concentration while after exposure to LC25 concentration, it was decreased. Also, LC10 and LC25 concentrations of Saponin caused a genotoxic effect and down-regulation of metabolic cycles in the snails. In conclusion, Saponins caused deleterious effects on the intermediate host of schistosomiasis mansoni. Therefore, B. alexandrina snails could be used as models to screen the toxic effects of Saponins in the aquatic environment and if it was used as a molluscicide, it should be used cautiously and under controlled circumstances.

Carbon Nanofibers-Sheathed Graphite Rod Anode and Hydrophobic Cathode for Improved Performance Industrial Wastewater-Driven Microbial Fuel Cells.

Carbon nanofiber-decorated graphite rods are introduced as effective and low-cost anodes for industrial wastewater-driven microbial fuel cells. Carbon nanofiber deposition on the surface of the graphite rods could be performed by the electrospinning of polyacrylonitrile/N,N-Dimethylformamide solution using the rod as nanofiber collector, which was calcined under inert atmosphere. The experimental results indicated that at 10 min electrospinning time, the proposed graphite anode demonstrates very good performance compared to the commercial anodes. Typically, the generated power density from sugarcane industry wastewater-driven air cathode microbial fuel cells were 13 ± 0.3, 23 ± 0.7, 43 ± 1.3, and 185 ± 7.4 mW/m2 using carbon paper, carbon felt, carbon cloth, and graphite rod coated by 10-min electrospinning time carbon nanofibers anodes, respectively. The distinct performance of the proposed anode came from creating 3D carbon nanofiber layer filled with the biocatalyst. Moreover, to annihilate the internal cell resistance, a membrane-less cell was assembled by utilizing a poly(vinylidene fluoride) electrospun nanofiber layer-coated cathode. This novel strategy inspired a highly hydrophobic layer on the cathode surface, preventing water leakage to avoid utilizing the membrane. However, in both anode and cathode modifications, the electrospinning time should be optimized. The best results were obtained at 5 and 10 min for the cathode and anode, respectively.

Enhancement of the CAST Block Algorithm Based on Novel S-Box for Image Encryption.

BACKGROUND AND AIM: due to the rapid growth of data communication and multimedia system applications, security becomes a critical issue in the communication and storage of images. This study aims to improve encryption and decryption for various types of images by decreasing time consumption and strengthening security. METHODOLOGY: An algorithm is proposed for encrypting images based on the Carlisle Adams and Stafford Tavares CAST block cipher algorithm with 3D and 2D logistic maps. A chaotic function that increases the randomness in the encrypted data and images, thereby breaking the relation sequence through the encryption procedure, is introduced. The time is decreased by using three secure and private S-Boxes rather than using six S-Boxes, as in the traditional method. Moreover, the CAST encryption algorithm was modified to be used on the private keys and substitution stage (S-Boxes), with the keys and S-Boxes of the encryption algorithm being generated according to the 2D and 3D chaotic map functions. The proposed system passed all evaluation criteria, including (MSE, PSNR, EQ, MD, SC, NC, AD, SNR, SIM, MAE, Time, CC, Entropy, and histograms). RESULTS: Moreover, the results also illustrate that the created S-Boxes passed all evaluation criteria; compared with the results of the traditional method that was used in creating S-Box, the proposed method achieved better results than other methods used in the other works. The proposed solution improves the entropy which is between (7.991-7.999), reduces the processing time which is between (0.5-11 s/Images), and improves NCPR, which is between (0.991-1). CONCLUSIONS: The proposed solution focuses on reducing the total processing time for encryption and decryption and improving transmission security. Finally, this solution provides a fast security system for surgical telepresence with secure real-time communication. The complexity of this work needs to know the S-Box creation method used, the chaotic method, the values of the chaotic parameters, and which of these methods was used in the encryption process.

Thais savignyi tissue extract: bioactivity, chemical composition, and molecular docking.

CONTEXT: Thais savignyi Deshayes (Muricidae) is widely distributed in the Red Sea. Its abundance and the history of Muricidae in traditional medicine make it a tempting target for investigation. OBJECTIVE: To investigate the chemical profile and biological activities of T. savignyi tissue extracts. MATERIALS AND METHODS: Methanol, ethanol, acetone, and ethyl acetate extracts from T. savignyi tissue were compared in their antioxidant by total antioxidant capacity, DPPH free radical scavenging, and total phenolic content. In addition, the antimicrobial, and antibiofilm properties (at 250 µg/mL) of the extracts were tested against Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans. The antioxidant extract with greatest activity was assessed for cytotoxicity (range 0.4-100 µg/mL) against 3 human cancer cell lines (UO-31, A549 and A431), and its chemical composition was investigated using GC-MS. Moreover, docking simulation was performed to predict its constituents' binding modes/scores to the active sites of thymidylate kinase. RESULTS: The ethyl acetate extract (Ts-EtOAc) showed the highest total antioxidant capacity (551.33 mg AAE/g dry weight), total phenolics (254.46 mg GAE/g dry weight), and DPPH scavenging (IC50= 24.0 µg/mL). Ts-EtOAc exhibited strong antibacterial (MIC: 3.9 µg/mL against K. pneumoniae), antibiofilm (MIC: 7.81 µg/mL against S. aureus), and antifungal (MIC: 3.9 µg/mL against C. albicans) activities and considerable cytotoxicity against cancer cells (UO-31: IC50= 19.96 ± 0.93, A549: IC50= 25.04 ± 1.15 µg/mL). GC-MS identified multiple bioactive metabolites in Ts-EtOAc extract belonging to miscellaneous chemical classes. Molecular docking studies revealed that the constituents of Ts-EtOAc have antibacterial potential. DISCUSSION AND CONCLUSIONS: T. savignyi extract has considerable antimicrobial and cytotoxic activities. Further studies are needed to isolate the active constituents of this snail for comprehensive drug discovery tests.

Crystal structure of 2-amino-5,6,7,8-tetra-hydro-7,7-dimethyl-4-(naphthalen-2-yl)-5-oxo-4H-chromene-3-carbo-nitrile.

In the title compound, C22H20N2O2, both six-membered rings of the fused heterocyclic system display envelope conformations; the two carbon atoms bearing the methyl groups and the naphthyl substituent both lie outside the planes of the other atoms of each ring. In the crystal, the amino group forms hydrogen bonds of the types N-H⋯O=C and N-H⋯N≡C, leading to the formation of a double layer structure propagating parallel to the bc plane. Weak C-H⋯O and C-H⋯π inter-actions may reinforce the layers.

Carbon Nanofiber Double Active Layer and Co-Incorporation as New Anode Modification Strategies for Power-Enhanced Microbial Fuel Cells.

Co-doped carbon nanofiber mats can be prepared by the addition of cobalt acetate to the polyacrylonitrile/DMF electrospun solution. Wastewater obtained from food industries was utilized as the anolyte as well as microorganisms as the source in single-chamber batch mode microbial fuel cells. The results indicated that the single Co-free carbon nanofiber mat was not a good anode in the used microbial fuel cells. However, the generated power can be distinctly enhanced by using double active layers of pristine carbon nanofiber mats or a single layer Co-doped carbon nanofiber mat as anodes. Typically, after 24 h batching time, the estimated generated power densities were 10, 92, and 121 mW/m2 for single, double active layers, and Co-doped carbon nanofiber anodes, respectively. For comparison, the performance of the cell was investigated using carbon cloth and carbon paper as anodes, the observed power densities were smaller than the introduced modified anodes at 58 and 62 mW/m2, respectively. Moreover, the COD removal and Columbic efficiency were calculated for the proposed anodes as well as the used commercial ones. The results further confirm the priority of using double active layer or metal-doped carbon nanofiber anodes over the commercial ones. Numerically, the calculated COD removals were 29.16 and 38.95% for carbon paper and carbon cloth while 40.53 and 45.79% COD removals were obtained with double active layer and Co-doped carbon nanofiber anodes, respectively. With a similar trend, the calculated Columbic efficiencies were 26, 42, 52, and 71% for the same sequence.

Impact of COVID-19 pandemic and related isolation measures on violence against children in Egypt.

BACKGROUND: Coronavirus disease 2019 (COVID-19) and related isolation measures have substantial adverse economic, social, and psychological consequences and expose children to increased risk of violence. The present study aimed to investigate the impact of the COVID-19 pandemic on violence against children in Egypt. METHODS: An online survey, in Arabic, was disseminated during the period from 9 to 13 April 2020, to parents of children who were up to 18 years old residing in Egypt, selected using a snowball sampling technique, during the period from 25 March to 8 April during the implementation of the nationwide compulsory isolation measures against COVID-19 (25 March to 8 April 2020). The survey covered three areas: socio-demographic data, psychological impact measured using the Impact of Event Scale-Revised (IES-R), and violence against children during the past 2 weeks measured using a modified parent-report of a child abuse screening tool (ICAST-P) developed by the International Society for the Prevention of Child Abuse and Neglect. RESULTS: Out of 1118 completed survey responses, 90.5% of children were subjected to violent discipline, 88.7% experienced psychological aggression, and 43.2% encountered severe physical punishment. Approximately 60% of respondents reported a moderate-to-severe psychological impact (IES-R scores ≥ 33), which was associated with a higher rate of violent discipline (OR: 9.3; 95% CI: 5.37-16.027; p < 0.001). CONCLUSIONS: This is the first study in Egypt to provide evidence on the association of COVID-19 pandemic, its psychological impact, and increased rates of violence against children. Effective multilevel strategies are urgently required to protect children from violence and its catastrophic consequences during the continually evolving COVID-19 pandemic.

Non-epileptic paroxysmal events in paediatric patients: A single tertiary centre study in Egypt.

PURPOSE: The misdiagnosis of non-epileptic seizures (NES) as epilepsy is one of the most common pitfalls in neuropsychiatric practice. This study aimed to describe the percentage and types of NES among children who were referred for a diagnosis of epilepsy in Upper Egypt. METHODS: We recruited a total of 876 patients who were referred to Sohag University Hospital, a tertiary referral centre in Upper Egypt, for the evaluation of suspected epilepsy. Relevant methods for the diagnosis of epilepsy, including medical history and examination, EEG, video-EEG, laboratory investigations, and brain imaging, were performed for all study participants. RESULTS: Among the 876 patients who were referred for the diagnosis of suspected epilepsy during the period from June 2017 to October 2018, 171 patients (19.5 %) were diagnosed as having NES. In general, we found that NES in the paediatric age groups did not differ from that reported in various studies across several different populations. The most prevalent NES in our study was breath-holding spells (32.2 %), followed by syncope (17.5 %), psychogenic nonepileptic seizures (12.3 %), motor tics (9.9 %), and benign sleep myoclonus (7.6 %). Other less frequent NES included infantile masturbation (7 %), spasmus nutans (5.3 %), migraine (2.9 %), benign paroxysmal torticollis (2.9 %), night terrors (1.8 %), and shuddering attacks (0.6 %). CONCLUSION: Ideally, neurologists should not misdiagnose NES as epilepsy, and whenever the diagnosis of NES is uncertain, an accurate diagnosis should be made using long-term video-EEG monitoring, especially in younger paediatric patients.

Folic acid ameliorates neonatal isolation-induced autistic like behaviors in rats: epigenetic modifications of BDNF and GFAP promotors.

The current study investigated the role of epigenetic dysregulation of brain derived neurotrophic factor (BDNF) and glial fibrillary acidic protein (GFAP) genes and oxidative stress as possible mechanisms of autistic-like behaviors in neonatal isolation model in rats and the impact of folic acid administration on these parameters. Forty Wistar albino pups were used as follows: control, folic acid administered, isolated, and isolated folic acid treated groups. Isolated pups were separated from their mothers for 90 min daily from postnatal day (PND) 1 to 11. Pups (isolated or control) received either the vehicle or folic acid (4 mg/kg/day) orally from PND 1 to 29. Behavioral tests were done from PND 30 to 35. Oxidative stress markers and antioxidant defense in the frontal cortex homogenate were determined. DNA methylation of BDNF and GFAP genes was determined by qPCR. Histopathological examination was carried out. Neonatal isolation produced autistic-like behaviors that were associated with BDNF and GFAP hypomethylation, increased oxidative stress, increased inflammatory cell infiltration, and structural changes in the frontal cortex. Folic acid administration concurrently with isolation reduced neonatal isolation-induced autistic-like behaviors, decreased oxidative stress, regained BDNF and GFAP gene methylation, and ameliorated structural changes in the frontal cortices of isolated folic acid treated rats. Novelty: Neonatal isolation induces "autistic-like" behavior and these behaviors are reversed by folic acid supplementation. Neonatal isolation induces DNA hypomethylation of BDNF and GFAP, increased oxidative stress markers, and neuroinflammation. All of these changes were reversed by daily folic acid supplementation.

COVID-19 related knowledge and practice and barriers that hinder adherence to preventive measures among the Egyptian community. An epidemiological study in Upper Egypt.

Background: This study aims to assess COVID-19 related knowledge and practice among the Egyptians in Upper Egypt and to identify barriers that hinder adherence to these preventive measures. Design and methods: We conducted a cross-sectional study using a structured questionnaire. Data was collected from 21 to 30 August 2020, via both online survey and personal interviews using a non-probability self-nominated sample. Results: A total of 731 participants completed the questionnaire. The mean age was 32.1± 2.1 and 64.3% were females. The main sources of knowledge were, Internet and Social Media followed by TV then family and friends. More than 96% of the respondents knew the origin, nature, the main symptoms, and the modes of transmission of COVID-19, however, 37.6% of them thought that COVID-19 patients must develop symptoms. 75.8% and 73.6% of the participants respectively covered their nose and mouth during sneezing and washed their hands regularly, 65.4% wore masks in crowded places, while only 31.1% and 30% of them respectively avoided touching their faces or shaking hands with friends. Knowledge and practice were positively correlated and both were linked to younger age and higher education and the female gender was also a predictor of better practice. The most common perceived barriers to adherence to preventive measures were feeling uncomfortable, forgetfulness then financial causes. Conclusions: the study subjects were aware of COVID-19 and its preventive measures however adherence to some of these measures was not prevalent amongst them, indicating an urgent need of addressing and targeting barriers that hinder adherence to COVID-19 preventive measures in the future policies to prevent the spread of COVID-19 in Egypt.

Biochemical and apoptotic changes in the nervous and ovotestis tissues of Biomphalaria alexandrina following infection with Schistosoma mansoni.

Infection with trematodes produces physiological and behavioural changes in intermediate snail hosts. One response to infection is parasitic castration, in which energy required for reproduction of the host is thought to be redirected to promote development and multiplication of the parasite. This study investigated some reproductive and biochemical parameters in the nervous (CNS) and ovotestis (OT) tissues of Biomphalaria alexandrina during the course of Schistosoma mansoni infection. Antioxidant and oxidative stress parameters including catalase (CAT), nitric oxide (NO) and lipid peroxidation (MDA) were measured. Levels of steroid hormones, including testosterone, progesterone and estradiol, were also assessed. Finally, flow cytometry was used to compare measures of apoptosis between control snails and those shedding cercariae by examining mitochondrial membrane potential with the stain 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimi-dazolylcarbocyanine iodide (JC-1) and poly(ADP-ribose) polymerase (PARP). Infection with S. mansoni caused a 47.7% reduction in the net reproductive rate (Ro) of B. alexandrina. CAT activity was increased in the CNS at 21 days post infection (dpi) but by 28 dpi it was reduced below control values. Also, CAT activity increased significantly in the OT at 14, 21 and 28 dpi. In CNS tissues, NO levels were reduced at 7 dpi, increased at 14 and 21 dpi, and reduced again at 28 dpi. The overall level of lipid peroxidation gradually increased during the course of infection to reach its highest levels at 28 dpi. Steroid hormone measurements showed that concentrations of testosterone and estradiol were reduced in the CNS tissues at 28 dpi, while those of progesterone were slightly increased in the CNS and OT tissues. The percentage of cells that positively stained with JC-1was significantly increased in CNS and OT tissues of infected snails while the percentage of cells positively stained with PARP was decreased compared to controls. Together, these findings indicate that infection initiates diverse biochemical and hormonal changes leading to loss of cells responsible for egg laying and reproduction in B. alexandrina.

A novel rotation invariant and Manhattan metric-based pose refinement: Augmented reality-based oral and maxillofacial surgery.

BACKGROUND: Augmented reality (AR) is gaining attention in medicine because of the convenience and innovation that it brings to operating rooms. Furthermore, oral and maxillofacial surgery (OMS), which is one of sensitive and narrow spatial surgery, requires high accuracy in image registration and low processing time of the system. However, the current systems are suffering from image registration problems while matching two different posture images. We thus aimed to increase that overlay accuracy and decrease the processing time. METHODOLOGY: The proposed system consists of an Iterative Closest Point (ICP) algorithm, which is the combination of a rotation invariant and Manhattan error metric, to provide the best initial parameters and to decrease the computational cost by sorting high and low processing pixel images, respectively. RESULT: The study on maxillary and mandibular jaw bone demonstrates that the proposed work overlay accuracy ranges from 0.22 to 0.30 mm, and processing time ranges from 10 to 14 frames per second as opposed to the 0.23- to 0.35-mm overlay accuracy and the current 8 to 12 frames per second processing time. CONCLUSION: This research aimed to improve the visualization and fast AR system for the OMS. Thus, the proposed system achieved an improvement in overlay accuracy and processing time by implementing the Rotation Invariant and Manhattan error metric ICP algorithm.

A novel augmented reality to visualize the hidden organs and internal structure in surgeries.

BACKGROUND: Augmented reality (AR) is still a primarily theoretical concept in areas such as bowel, liver, gallbladder, and jaw surgeries because of the limitation of visualization accuracy of hidden organs and internal structures. This paper aims to improve the cutting accuracy, visualizing accuracy, and processing time of the augmented video. METHODOLOGY: The proposed system consists of an enhanced block-matching algorithm (BMA) with ghosting map technique. RESULTS: Results proved that proposed system reduced the visualization error, which ranges from 1.48 to 1.83 mm against the existing system visualization error 1.67 to 2.0. Similarly, the processing time also improved 59 to 72 ms/frame over the 50 to 58 ms/frame. CONCLUSION: This study showed the improvement and solved the problem soft tissue reconstruction and visualization on the AR video that used in bowel and gallbladder surgeries.

Efficacy of Scintigraphy, Ultrasound and Both Scintigraphy and Ultrasonography in Preoperative Detection and Localization of Primary Hyperparathyroidism.

OBJECTIVE: The aim of our study was to evaluate the efficacy of preoperative dual-phase 99mTc-methoxyisobutylnitrile (MIBI) parathyroid scintigraphy (PS), and ultrasound (US) in primary hyperparathyroidism (pHPT) diagnosis and compare the results with the surgical findings. METHODS: Forty-five patients were enrolled in this study. Preoperative serum parathyroid hormone (PTH) levels, calcium (Ca), phosphate (P), and alkaline phosphatase (AP) levels were measured. All parathyroid patients were evaluated by ultrasonography, dual phase 99mTc-MIBI. Surgical findings were used as a reference standard. RESULTS: Of the 45 patients included in this study, 30 were females (66.7%) with an age range between 30 years and 70 years (mean age 41± 13). The sensitivity and specificity of 99mTc-MIBI scintigraphy was 97.4% and 71.4%, respectively, while the sensitivity of ultrasound was 94.4% and specificity 44.4%. The sensitivity, specificity, and accuracy of combined scintigraphy and ultrasound was higher-97.4%, 83.3%, and 95.6%, respectively. CONCLUSIONS: The combination of MIBI and US appears promising for localizing parathyroid pathology in patients with primary hyperparathyroidism. The concordance rate is high together with a lower chance of missing concomitant thyroid pathology, which might alter the surgical approach.

Pediatric Differentiated Thyroid Cancer: Our Experience.

OBJECTIVES: To report our experience in the management of thyroid cancer in children and adolescents in a tertiary referral hospital and regional cancer institute as compared to previously published data. METHODS:  A retrospective study was conducted for patients diagnosed with differentiated thyroid cancer (DTC) who received treatment during the period from January 2014 to August 2018. Medical reports from our hospital database were extracted and information of those under 18 years old were discussed regarding their demographics, treatment received, and follow-up outcomes. RESULTS:  Out of 300 patients with DTC diagnosed in the period of study, 12 were 18 years old or less (4%). Female to male ratio was 5:1. Their ages ranged from nine to 18 years old (average: 13.1 years). One patient had a positive family history for DTC, and one patient had lung metastasis. Total thyroidectomy and postoperative 131I were performed for all patients. The median follow-up period was 1.75 years (range: six months to four years). Eleven patients have shown complete remission after treatment (91.6%), and one case has had persistent disease. CONCLUSIONS:  Pediatric thyroid cancer is not uncommon. Despite its aggressiveness in this age group, outcomes are more favorable than in adults. We report our experience in the diagnosis and management of pediatric DTC in our community with satisfactory outcomes and comparable results to literature reports. Future studies are needed to evaluate the long-term complications of radioiodine therapy.

Biomphalaria alexandrina: a model organism for assessing the endocrine disrupting effect of 17ß-estradiol.

A wide range of endocrine disruptor compounds are routinely discharged to the ecosystem. Water contaminated with these compounds has a potential effect on the reproductive physiology of aquatic organisms as well as humans. In the present study, we tested the effect of the steroid estrogen, 17ß-estradiol, on Biomphalaria alexandrina, a snail species that is widely distributed in Egypt and that acts as an intermediate host for the human blood fluke, Schistosoma mansoni. The effects of exposure to 0.3 mg/L and 1 mg/L 17ß-estradiol on fecundity (MX) and reproductive rate (R0) of B. alexandrina were recorded. In addition, levels of steroid sex hormones and antioxidants in the hemolymph and ovotestis (OT) of exposed snails were measured. Histopathological changes in the OT of B. alexandrina were also investigated. Exposure to 0.3 mg/L and 1 mg/L 17ß-estradiol caused a significant increase in the number of egg masses per snail after 3 weeks and 1 week of exposure for the two tested concentrations compared with unexposed controls. An increase in the levels of progesterone hormone was recorded in the hemolymph of exposed snails in comparison with unexposed controls. Additionally, levels of the antioxidant enzyme glutathione (GSH) were increased in the hemolymph and OT tissues of snails after 2 and 4 weeks of exposure. Histopathological sections in the OT revealed an increase in the oocyte and a decrease in the sperm densities after 2 weeks and this effect was restored to normal conditions after 4 weeks of exposure to both tested concentrations. The current results indicate that B. alexandrina is sensitive to 17ß-estradiol and can therefore be used as bioindicator and model organism for the assessment of water pollution with endocrine disruptor compounds.

Protein Z and Endothelin-1 genetic polymorphisms in pediatric Egyptian sickle cell disease patients.

BACKGROUND: Sickle cell disease (SCD) is a monogenic disease associated with multisystem morbidity. Vasculopathy caused by delicate imbalance between coagulation and endothelial systems plays a pivotal role in disease course. As Protein Z and Endothelin-1 genetic polymorphisms may increase the thrombotic risk, the aim of the current work was to verify the possible impact of Protein Z (PROZ G79A) and Endothelin-1 (EDN1 G5665T) polymorphisms on the clinic-laboratory features of the SCD in a cohort of Egyptian pediatric patients. METHODS: Genotyping of Protein Z G79A and Endothelin-1 G5665T was carried out by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) assay for 100 SCD patients and 100 controls. RESULTS: Protein -Z G79A polymorphism was not associated with vascular complications in the studied SCD patients. Endothelin-1 G5665T polymorphism was associated with pulmonary dysfunction (pulmonary artery hypertension and acute chest syndrome) and severe vaso-occlusive crises (VOC). CONCLUSION: Endothelin-1 G5665T polymorphism could be considered as a molecular predictor for pulmonary dysfunction and severe VOC in SCD. Further researches with larger cohorts are recommended to understand the pathophysiology of SCD and to explain the inter-patients' variability of disease severity.

Internet addiction among medical students of Sohag University, Egypt.

BACKGROUND: Internet use may have many drawbacks. Among the main threats caused by internet use is wasting time and lack of self-control over internet use, which amounts to the level of addiction with several deleterious consequences. AIM: The aim of the study is to identify the prevalence of internet addiction (IA) and associated factors among medical students in Sohag University, Egypt. MATERIALS AND METHODS: The cross-sectional survey was conducted in October 2016 and November 2016 on a random sample of 587 students selected from three medical faculties in Sohag University. The self-administered questionnaire consisted of two sections; the first section was concerned with collecting the sociodemographic data, data about student's relations and internet use characteristics; the second one aimed at assessment of the level of IA using Young's 20-item scale for IA. RESULTS: The findings show that the prevalence of IA was 47.7%. Male sex, internet access on mobile phones, easy internet access at home, using internet for browsing social media and e-mail, and bad relation with the family were the most important predictors of IA. CONCLUSION: The high prevalence of IA among medical students in Sohag University (47.7%) is a matter of concern. Identification of factors significantly associated with IA can help in the planning of comprehensive programs to raise public awareness about the hazards and determinants of IA targeting the high-risk groups.