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1.
Ann Med Surg (Lond) ; 86(6): 3577-3590, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38846838

ABSTRACT

Aortic valve stenosis is a disease characterized by thickening and narrowing of the aortic valve (AV), most commonly due to calcification, which leads to left ventricular outflow obstruction called calcific aortic valve disease (CAVD). CAVD presents as a progressive clinical syndrome with cardiorespiratory symptoms, often with rapid deterioration. The modern-day pathophysiology of CAVD involves a complex interplay of genetic factors, chronic inflammation, lipid deposition, and valve calcification, with early CAVD stages resembling atherosclerosis. Various imaging modalities have been used to evaluate CAVD, with a recent trend of using advanced imaging to measure numerous AV parameters, such as peak jet velocity. Significant improvements in mortality have been achieved with transcatheter AV repair, but numerous therapeutics and modalities are being researched to delay the progression of CAVD. This article aims to provide a comprehensive review of CAVD, explore recent developments, and provide insights into future treatments with various novel modalities.

2.
Heliyon ; 10(9): e30280, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38707422

ABSTRACT

A methodology for the mapping of residual stresses in metal alloys has been developed by analyzing an isotropic and homogeneous Al2024 alloy with scanning transmission electron microscopy (STEM), combined with diffraction (4DSTEM) and electron energy loss spectroscopy (STEM-EELS) techniques of TEM. The investigations on the alloy's microstructure and elemental distributions were also carried out with conventional dark-field STEM (DFSTEM) and X-ray energy dispersive (EDS) techniques, respectively. Using the STEM-EELS technique, the Young's modulus (YM) is mapped in the (001) plane of the Al alloy in the same regions where the residual strain maps are generated in [1‾ 00] and [010] directions by using 4DSTEM technique. The YM vs. residual strain plot for the Al 2024 alloy revealed that the value of YM decreased by about ∼ 7 % after the tensile residual strain reached 0.02 %. Whereas such a decrease in YM happens after the compressively residual strain reaches -0.015 %. The residual stress maps were also obtained in accordance with the Hooke's law i.e., by multiplying YM map with the corresponding residual strain maps.

4.
Ann Med Surg (Lond) ; 86(5): 2911-2925, 2024 May.
Article in English | MEDLINE | ID: mdl-38694361

ABSTRACT

Background: Recent guidelines suggest that antiplatelet therapy (APT) is the standard of care in the absence of long-term oral anticoagulation (OAC) indications in patients post-transcatheter aortic valve replacement (TAVR). The superiority of one method over the other remains controversial. Materials and methods: Several databases, including MEDLINE, Google Scholar, and EMBASE, were electronically searched. The primary endpoint was the all-cause mortality (ACM) rate. Secondary endpoints included cardiovascular death, myocardial infarction (MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism, and valve thrombosis in post-TAVR patients receiving APT and oral anticoagulants (OACs). Forest plots were generated using Review Manager version 5.4, with a p value less than 0.05 indicating statistical significance. Subgroup analysis was performed to explore potential sources of heterogeneity. Results: Twelve studies were selected. No significant differences were observed in APT and OAC group for ACM [risk ratio (RR): 0.67; 95% CI:0.45-1.01; P=0.05], cardiovascular death [RR:0.91; 95% CI:0.73-1.14; P=0.42], MI [RR:1.69; 95% CI:0.43-6.72; P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58-1.06; P=0.12], ischaemic stroke [RR:0.83; 95% CI:0.50-1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI: 0.23-5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51-1.21; P=0.28], minor bleeding [RR:1.09; 95% CI: 0.80-1.47; P=0.58], life-threatening bleeding [RR:0.85; 95% CI:0.55-1.30; P=0.45], any bleeding [RR:0.98; 95% CI:0.83-1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44-1.70; P=0.68]. The risk of valve thrombosis was higher in patients receiving APT than in those receiving OAC [RR:2.61; 95% CI:1.56-4.36; P =0.0002]. Conclusions: Although the risk of valve thrombosis increased in patients receiving APT, the risk of other endpoints was comparable between the two groups.

5.
JBRA Assist Reprod ; 28(1): 47-53, 2024 Feb 26.
Article in English | MEDLINE | ID: mdl-37962967

ABSTRACT

OBJECTIVE: To evaluate the correlation between yolk sac diameter at 6 to 12 weeks of gestation measured via transvaginal ultrasound and adverse pregnancy outcomes. METHODS: This prospective cohort study was conducted at the Ain Shams University Maternity Hospital from July 1, 2019 to January 30, 2020. It included 120 pregnant women attending the outpatient clinic at 6 to 12 weeks of gestation. Transvaginal ultrasound was performed to measure inner yolk sac diameter. Normal diameter was considered to be 2-5 mm. Cases were followed up in routine antenatal care until the 16th week of gestation. RESULTS: Significant associations were found between maternal age and yolk sac diameter; yolk sac diameter and early miscarriage; a high percentage of cases of positive fetal life occurred when a normal yolk sac diameter (2-5 mm) was present (p<0.001); in yolk sac diameters <2mm positive fetal life was 0.0% and negative fetal life was 42.9%; in yolk sac diameters of 2-5mm positive fetal life was 81.1% and the negative fetal life was 7.1%; and in yolk sac diameters >5mm positive fetal life was 18.9% and negative fetal life was 50.0% (p<0.001), x2 60.094; and the best cutoff value for yolk sac diameter was >0.56, with a sensitivity of 78.6%, a specificity of 84.3%. CONCLUSIONS: We found a highly significant correlation between yolk sac diameter and early pregnancy loss.


Subject(s)
Abortion, Spontaneous , Pregnancy Outcome , Female , Pregnancy , Humans , Pregnancy Outcome/epidemiology , Yolk Sac/diagnostic imaging , Prospective Studies , Ultrasonography, Prenatal , Ultrasonography
6.
Materials (Basel) ; 16(24)2023 Dec 06.
Article in English | MEDLINE | ID: mdl-38138671

ABSTRACT

Following the finding of power conversion efficiency above the Shockley-Queisser limit in BaTiO3 (BTO) crystals, ferroelectric oxides have attracted scientific interest in ferroelectric photovoltaics (FPV). However, since ferroelectric oxides have a huge bandgap (>3 eV), progress in this sector is constrained. This paper proposes and demonstrates a new ferroelectric BaTi1-xCoxO3 powder (0 ≤ x ≤ 0.08), abbreviated as BTCx, that exhibited a bandgap decrease with increased Co content. Notably, changing the composition from x = 0.0 to 0.08 caused the system to show a bandgap drop from 3.24 to 2.42 eV. The ideal design with x = 0.08 displayed an abnormal PV response. Raman spectroscopy measurements were used to investigate the cause of the bandgap decrease, and density functional theory was used to interpret the analyzed results. According to our findings, Co2+ doping and oxygen octahedral distortions enhance bandgap reduction. This research sheds light on how bandgap tuning developed and laid the way for investigating novel low-bandgap ferroelectric materials for developing next-generation photovoltaic applications.

7.
Int J Biol Macromol ; 237: 124140, 2023 May 15.
Article in English | MEDLINE | ID: mdl-36965568

ABSTRACT

An excess of thyroid hormones in the blood characterizes hyperthyroidism. Long-term use of prescription medications to treat hyperthyroidism has substantial adverse effects and when discontinued, the symptoms frequently recur. Several plant species have been utilized to cure hyperthyroidism. In the present work, we investigated the impact of polyherbal extract (POH) of four medicinal plants to treat hyperthyroidism. Biochemical analysis revealed the presence of a high concentration of phytochemicals in the POHs. The in vitro antioxidant study revealed their antioxidant and free radical scavenging capacity. The gas chromatography coupled mass spectrometry analysis of the POHs showed the presence of 13 bioactive phytochemical compounds. The effect of various concentrations of POHs on L-thyroxine-induced hyperthyroidism in Wistar albino rats was evaluated for 18 days. The TSH, T3 and T4 levels increased significantly and reduced the increase of liver enzymes caused by hyperthyroidism in POH-treated rats. The data showed that POH therapy could restore thyroid function to normal. The injection of POH increased the size comprising vacuolated cells, columnar follicular cells and highly coloured nuclei with increasing POH content and the number of normal thyroid follicles rose. The findings indicate that polyherbal formulations of these medicinal plants include credible antithyroid compounds that may offer a protective and an effective alternative treatment to synthetic thyroid medications.


Subject(s)
Hyperthyroidism , Thyroxine , Animals , Rats , Thyroxine/adverse effects , Antioxidants/pharmacology , Rats, Wistar , Gas Chromatography-Mass Spectrometry , Thyroid Hormones/adverse effects , Hyperthyroidism/chemically induced , Hyperthyroidism/drug therapy , Phytochemicals/therapeutic use
8.
Pediatr Surg Int ; 39(1): 106, 2023 Feb 09.
Article in English | MEDLINE | ID: mdl-36757505

ABSTRACT

BACKGROUND: Blunt abdominal trauma is a prevailing cause of pediatric morbidity and mortality. It constitutes the most frequent type of pediatric injuries. Contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT) are considered pivotal diagnostic modalities in hemodynamically stable patients. AIM: To report the experience in management of pediatric split liver and spleen injuries using CEUS and CECT. PATIENTS AND METHODS: This study included 246 children who sustained blunt abdominal trauma, and admitted and treated at three tertiary hospitals in the period of 5 years. Primary resuscitation was offered to all children based on the advanced trauma and life support (ATLS) protocol. A special algorithm for decision-making was followed. It incorporated the FAST, baseline ultrasound (US), CEUS, and CECT. Patients were treated according to the imaging findings and hemodynamic stability. RESULTS: All 246 children who sustained a blunt abdominal were studied. Patients' age was 10.5 ± 2.1. Road traffic accidents were the most common cause of trauma; 155 patients (63%). CECT showed the extent of injury in 153 patients' spleen (62%) and 78 patients' liver (32%), while the remaining 15 (6%) patients had both injuries. CEUS detected 142 (57.7%) spleen injury, and 67 (27.2%) liver injury. CONCLUSIONS: CEUS may be a useful diagnostic tool among hemodynamically stable children who sustained low-to-moderate energy isolated blunt abdominal trauma. It may be also helpful for further evaluation of uncertain CECT findings and follow-up of conservatively managed traumatic injuries.


Subject(s)
Abdominal Injuries , Wounds, Nonpenetrating , Humans , Child , Spleen/diagnostic imaging , Spleen/injuries , Retrospective Studies , Contrast Media , Abdomen , Liver/diagnostic imaging , Abdominal Injuries/diagnostic imaging , Abdominal Injuries/therapy , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Nonpenetrating/therapy
9.
Environ Manage ; 71(6): 1129-1144, 2023 06.
Article in English | MEDLINE | ID: mdl-36571621

ABSTRACT

This paper aims to examine the stakeholders' interaction in the water management system at the R'Dom Sub-basin (Morocco). For this purpose, The MACTOR participatory approach was implemented to involve all key water stakeholders and to analyze their interactions. The action system was characterized by the analysis of related water issues and relevant actors on the ground. Thus, ten actors and twelve objectives were identified and assessed in this study. The analysis of stakeholder role allowed to identify the typology of stakeholders according to their strategic objectives and to evaluate their power, influence and dependence, as well as their convergence in a global water cycle management. The results show a significant level of convergence among stakeholders, despite the existence of certain stakeholders who may be considered autonomous, given their low involvement in integrated water management. Furthermore, there was a limited involvement of stakeholders in certain strategic objectives such as capacity building, technical means, and awareness-raising actions. The paper shows the need to generate greater collaborative efforts among water stakeholders involved in the implementation of integrated water resources management in the R'Dom sub-basin.


Subject(s)
Water Resources , Water , Morocco , Stakeholder Participation , Water Supply
10.
Urol Case Rep ; 45: 102289, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36465264

ABSTRACT

Bilateral ectopic pelvic kidney is an exceptional finding and it may be associated rarely with other abnormalities of the kidney such as uretero-pelvic junction syndrome. We report a case of bilateral ectopic pelvic kidney revealed by left flanc pain with a left uretero-pelvic junction syndrome and a right ureteral duplication proved by computed tomography. A MAG3 renal scintigraphy was performed confirming the obstructive uretero-pelvic junction. An open left Anderson-Hynes pyeloplasty was performed without objectifying, preoperatively, any extrinsic compression without any postoperative complication. This case emphasizes on the possibility of the reconstructive management in such cases.

11.
Urol Case Rep ; 45: 102246, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36212223

ABSTRACT

Hydatid disease is frequent in endemic regions especially in sheep farming areas. Kidneys are uncommonly affected (2%-4%). We report a case of right renal colic with hydatiduria revealing a primary renal hydatid cyst ruptured in the mid calyx proved by computed tomography scan and laboratory testing. A kidney sparing surgery was performed by excision of the protruding dome and suturing of the fistula without any postoperative complication. This case emphasizes on further studies to define a standard treatment modality for renal hydatidoses.

12.
Gynecol Endocrinol ; 38(4): 296-302, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34907828

ABSTRACT

OBJECTIVE: The aim of this study was to compare reduced needle versus standard needle regarding pain experience among women undergoing oocyte retrieval procedures. METHODS: A systematic search was done in Cochrane Library, PubMed, ISI web of science, and Scopus during April 2021. We selected randomized clinical trials (RCTs) compared reduced needle versus standard needle among women undergoing ultrasound-guided oocyte retrieval procedures. Revman software was utilized for performing our meta-analysis. Our primary outcomes were pain scores evaluated by the Visual Analog Scale (VAS) during the procedure, directly post-procedure, and 30 min post-procedure. Our secondary outcomes were the request for more analgesia, clinical pregnancy rate, and rate of vaginal bleeding less than expected. RESULTS: Six RCTs met our inclusion criteria with a total number of 1063 patients. We found reduced needle was linked to a significant reduction in VAS pain score during and directly after the procedure, respectively (MD= -1.54, 95% CI [-2.38, -0.70], p = .003 and MD= -1.14, 95% CI [-1.38, -0.91], p < .001). After removal of the reported heterogeneity, the reduced needle had significantly reduced the pain score 30 min post-procedure and request for more analgesia in comparison with standard needle (p < .001). No significant difference was found between both groups regarding clinical pregnancy rate (p = .17). More patients in reduced needle group were reported to vaginally bleed less than expected compared to standard needle group (RR = 1.91, 95% CI [1.35, 2.70], p = .003). CONCLUSIONS: Patient perceived pain, analgesic requirement, and vaginal bleeding are decreased with reduced needle administration versus standard needle without affecting the clinical pregnancy rate in oocyte retrieval procedure.


Subject(s)
Oocyte Retrieval , Pain , Female , Humans , Oocyte Retrieval/methods , Pain Measurement , Pregnancy , Pregnancy Rate , Randomized Controlled Trials as Topic
13.
Prog Urol ; 32(4): 291-297, 2022 Mar.
Article in French | MEDLINE | ID: mdl-34801388

ABSTRACT

INTRODUCTION: Detrusor thickness (DT) and intravesical prostatic protrusion (IPP) are closely related to bladder outlet obstruction. The aim of our study was to look for correlation between DT, IPP and maximum urinary flow (Qmax). METHODS: It is a prospective, observational study including men over fifty managed for benign prostatic hyperplasia. Low urinary tract symptoms were assessed with the International Prostatic Symptom Score (IPSS). Pelvic ultrasound was performed for all patients measuring prostatic volume, bladder volume, post- void residual, DT and IPP. Uroflowmetry was performed for all patients, Qmax was noted. Qmax equal or less than 15ml/s was considered pathologic. RESULTS: Sixty patients were included for our study. Strong negative correlation was noted between DT, IPP and Qmax (r=-0.59, r=-0.61 respectively). Patients with pathologic Qmax had higher DT and IPP than those with normal Qmax, the difference was significant (P<0.01). Threshold values predicting pathologic Qmax were 3mm for DT and 7mm for IPP. ROC analysis reveals for DT an AUC of 0.84 (95% CI 0.76-0.92) and for IPP an AUC of 0.88 (95% CI 0.80-0.97). CONCLUSION: Detrusor thickness and intravesical prostatic protrusion have strong negative correlation with Qmax. These parameters could be an alternative to Qmax measurement if uroflowmetry is unavailable. LEVEL OF EVIDENCE: Grade B.


Subject(s)
Prostatic Hyperplasia , Urinary Bladder Neck Obstruction , Humans , Male , Prospective Studies , Prostate/diagnostic imaging , Prostate/pathology , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnostic imaging , Ultrasonography , Urinary Bladder Neck Obstruction/diagnostic imaging , Urinary Bladder Neck Obstruction/etiology
14.
Environ Monit Assess ; 194(1): 37, 2021 Dec 21.
Article in English | MEDLINE | ID: mdl-34935078

ABSTRACT

Surface water is subject to strong anthropogenic pressures caused by the development and extension of agricultural activities and also by industrial and domestic activities. As a result, rational and sustainable management of water resources is necessary in order to protect them. The objective of this work is the use of geographic information system GIS and the application of the weighted index of the water quality evaluation system SEQ-Eau for the overall assessment of the physicochemical quality of surface waters of the Moulouya River. First, a cartographic representation of the study area was produced with the development of quality maps for the various alterations relating to acidification, temperature, mineralization, phosphorus materials, and organic and oxidizable materials. The overall quality map is generated from the lowest index of all the alterations considered. The results generally show surface water of excellent quality in the Upper Moulouya and of average to poor quality in the Middle and Lower Moulouya. The alteration of water, linked mainly to mineralization and phosphorus nutrients, organic and oxidizable matter, reveals a domestic type pollution in relation to urban wastewater and agricultural discharges in addition to the impact of the geological substratum of the watershed. The seasonal impact is influenced by the increase in the degree of deterioration of water quality due to the increase in the concentration of pollutants and the decrease in precipitation during the summer season.


Subject(s)
Rivers , Water Pollutants, Chemical , Anthropogenic Effects , Environmental Monitoring , Morocco , Water Pollutants, Chemical/analysis , Water Quality
15.
Insights Imaging ; 12(1): 128, 2021 Sep 09.
Article in English | MEDLINE | ID: mdl-34499281

ABSTRACT

BACKGROUND: Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. METHODS: This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. RESULTS: Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. CONCLUSION: Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

16.
Pan Afr Med J ; 38: 204, 2021.
Article in English | MEDLINE | ID: mdl-33995810

ABSTRACT

INTRODUCTION: the aim of this retrospective study is to review patients with malignant goiter, as regards their nature, demographic characterization, clinical presentation and preoperative histopathological data. METHODS: the study focused on a period of 4 years from December 2015 to January 2019. Patients´ demographic data, clinical presentation, Intra-operative findings, Pre and postoperative histopathological staging and grading were all recorded. Postoperative follow up whether early or late were also included. RESULTS: a total of 100% (n = 65) patients underwent surgery. The female to male ratio was found to be 5:1 (48 females and 17 males). Solitary nodule was the main clinical presentation in 80% (n = 52) of cases while 20% (n = 13) were multinodular swellings. Papillary carcinoma was recorded in 80% (n = 52) of patients while in 15.4% (n =10) of patients were having follicular carcinoma. The remaining 4.6% (n = 3) suffered of lymphoma; no medullary or anaplastic tumors were reported. CONCLUSION: thyroid cancer is the most commonly encountered endocrinal malignancy at our institute. Fine Needle Aspiration Cytology (FNAC) showed a high percentage of reliability in diagnosing thyroid cancer among our series. It is recommended to adapt this technique in initial screening of goiter patients in our local setting.


Subject(s)
Goiter/diagnosis , Thyroid Cancer, Papillary/diagnosis , Thyroid Neoplasms/diagnosis , Adolescent , Adult , Aged , Biopsy, Fine-Needle , Child , Cohort Studies , Female , Goiter/pathology , Goiter/surgery , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Treatment Outcome , Young Adult
17.
Acta Parasitol ; 64(2): 316-330, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30941669

ABSTRACT

INTRODUCTION: Passalurus ambiguus, a pinworm nematode parasite, infects domestic and wild rabbits, hares, and rodents worldwide. MATERIALS AND METHODS: The current parasitological study was performed during January-December 2016, to investigate helminth parasites infecting the domestic rabbit species Oryctolagus cuniculus at the Department of Animal Production, Faculty of Agriculture, Cairo University, Cairo, Egypt. RESULTS: Of the twenty rabbit specimens examined for gastrointestinal nematodes, 75% were infected with adult oxyurid species, which were morphologically characterized using light and scanning electron microscopy studies. The oxyurid species had a triangular mouth opening surrounded by simple lips with four cephalic papillae and a pair of lateral amphidial pores with three teeth-like structures, an esophagus divided into a cylindrical corpus and globular bulb supported internally with tri-radiate valvular apparatus, and four caudal papillae distributed on the posterior end of males with a single short protruding spicule and ovijector apparatus opening ventrally by the vulva, surrounded by protruded lips in female worms. The species were compared morphometrically with other Passalurus species described previously; light differences were found in different body part sizes. Molecular characterization based on 18 small subunit (SSU) rDNA sequences showed ~ 85% similarity with other Chromadorea species. A preliminary genetic comparison between the 18S rDNA sequences of the isolated parasite and those of other oxyurid species suggested that it belonged to Passalurus ambiguus. The 18S rDNA sequence of the parasite was deposited in GenBank (accession no., MG310151.1). CONCLUSION: The 18S rDNA gene of P. ambiguus was shown to yield a unique genetic sequence that confirms its taxonomic position within the Oxyuridae family.


Subject(s)
Enterobiasis/veterinary , Enterobius/anatomy & histology , Enterobius/genetics , Phylogeny , Rabbits/parasitology , Animals , Animals, Domestic/parasitology , DNA, Ribosomal/genetics , Egypt , Enterobiasis/parasitology , Enterobius/classification , Female , Male , Prevalence
18.
Asian J Surg ; 42(7): 761-767, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30396715

ABSTRACT

OBJECTIVES: To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. METHODS: A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported. RESULTS: During the 8-year period of the study, 149 pediatric and adolescent extremity arterial trauma patients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases. CONCLUSION: Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular trauma patients, whenever possible.


Subject(s)
Anastomosis, Surgical/methods , Arteries/injuries , Arteries/surgery , Extremities/blood supply , Vascular Surgical Procedures/methods , Adolescent , Anastomosis, Surgical/economics , Anastomosis, Surgical/statistics & numerical data , Aneurysm, False/epidemiology , Child , Child, Preschool , Cost-Benefit Analysis , Fasciotomy/economics , Fasciotomy/statistics & numerical data , Female , Humans , Male , Retrospective Studies , Saphenous Vein/transplantation , Treatment Outcome , Vascular Surgical Procedures/economics , Vascular Surgical Procedures/statistics & numerical data
19.
PLoS One ; 13(10): e0205274, 2018.
Article in English | MEDLINE | ID: mdl-30303997

ABSTRACT

Glutathione S‒transferases (GSTs) are multifunctional enzymes that play an important role in detoxification, cellular signalling, and the stress response. Camelus dromedarius is well-adapted to survive in extreme desert climate and it has GSTs, for which limited information is available. This study investigated the structure-function and thermodynamic properties of a mu-class camel GST (CdGSTM1) at different pH. Recombinant CdGSTM1 (25.7 kDa) was expressed in E. coli and purified to homogeneity. Dimeric CdGSTM1 dissociated into stable but inactive monomeric subunits at low pH. Conformational and thermodynamic changes during the thermal unfolding pathway of dimeric and monomeric CdGSTM1 were characterised via a thermal shift assay and dynamic multimode spectroscopy (DMS). The thermal shift assay based on intrinsic tryptophan fluorescence revealed that CdGSTM1 underwent a two-state unfolding pathway at pH 1.0-10.0. Its Tm value varied with varying pH. Another orthogonal technique based on far-UV CD also exhibited two-state unfolding in the dimeric and monomeric states. Generally, proteins tend to lose structural integrity and stability at low pH; however, monomeric CdGSTM1 at pH 2.0 was thermally more stable and unfolded with lower van't Hoff enthalpy. The present findings provide essential information regarding the structural, functional, and thermodynamic properties of CdGSTM1 at pH 1.0-10.0.


Subject(s)
Camelus/physiology , Glutathione Transferase/physiology , Hot Temperature/adverse effects , Protein Multimerization/physiology , Thermotolerance/physiology , Animals , Enzyme Stability/physiology , Glutathione Transferase/chemistry , Glutathione Transferase/isolation & purification , Hydrogen-Ion Concentration , Protein Denaturation , Protein Structure, Quaternary/physiology , Recombinant Proteins/chemistry , Recombinant Proteins/isolation & purification
20.
Gulf J Oncolog ; 1(28): 52-55, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30344135

ABSTRACT

BACKGROUND: Management of abdominal masses still pose a major challenge for pediatrician and surgeons with many controversy as regards the best investigatory tools. AIM OF THE WORK: This study was designated to evaluate the role of diagnostic laparoscopy in investigating equivocal pediatric masses that had undergone other imaging modalities. PATIENTS AND METHODS: A combined prospective and retrospective multicenter study over a period of 12 years from January 2005 to December 2016 was undertaken. This study included all children aged from 3 months to 15 years. Those having a documented diagnosis through other imaging modalities such as sonographic and/or computed tomography (CT) guided biopsy were excluded. All patients underwent multiport diagnostic laparoscopy for biopsy of the mass. All specimens were histologically assessed basically using Hematoxylin and Eosin (H and E) staining; some specimens had been immunohistochemically studied. RESULTS: One hundred and thirty-two patients were recruited in the study. They were 69 males and 63 females with a male to female ratio of1.1:1. The age ranged from 3 months up to 15 years with the mean age of 2.7 ± 0.8 years. Out of the total studied group, 54 patients were diagnosed with neuroblastoma (40.9%), while 66 (50%) were having nephroblastoma. The remaining 12 (9.1%) were having non-Hodgkin's abdominal lymphoma. Not all patients showed any complication related to the procedure. The mean follow up period was 3.6 years. Most of the cases (n=121) despite having a different diagnosis, were clinically staged as grade I to grade II (91.7%). Neither intraoperative nor postoperative complications were recorded during this technique. The mean operative time was 72 mins ± 20 in the earliest group; yet, it has declined to be 32 ± 12 minutes in the latest group due to the advancement of the learning curve. CONCLUSION: Laparoscopy is accurate and safe for investigating pediatric solid abdominal masses. It should be used as the sole tool for biopsy of solid abdominal tumors in pediatrics.


Subject(s)
Abdominal Neoplasms/pathology , Abdominal Neoplasms/surgery , Image-Guided Biopsy/methods , Laparoscopy/methods , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Postoperative Complications , Prognosis , Prospective Studies , Retrospective Studies
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