Effect of Mn2+ Doping on the Photoluminescence of Hybrid One-Dimensional Lead Halide Post-Perovskites.

Although organic-inorganic hybrid one-dimensional (1D) lead halide postperovskites (LHPPs) have been reported to show white luminescence and tunable photoluminescence quantum yield (PLQY), their structure-property relationships are not fully understood. Here, we used Mn2+ to test the doping effect on the luminescence of two 1D-LHPPs compounds, namely, {TETA[Pb2Br6]}n 1 and {TETA[Pb2Cl6]}n 2, where TETA = triethylenetetrammonium. We found the pristine compounds show yellowish (551 nm) and bluish (447 nm) emission for 1 and 2, respectively, nanosecond excitation lifetimes (4.17 ns for 1 and 2.29 ns for 2) and low PLQYs (4.65 and 3.57% for 1 and 2, respectively). By fine-doping the Mn2+ ions to ca. 8% the PLQYs for 1 and 2 are maximized to 24 and 25% for 1 and 2, respectively. Upon the increasing Mn2+ dopant, the emission wavelengths can also vary gradually from 551 to 615 nm and from 447 to 660 nm for 1 and 2, respectively, covering almost the whole visible-light range, and the excitation lifetimes are enhanced to microseconds (0.77 µs for 1 and 0.39 µs for 2), owing to the more spin-forbidden d-d transition (4T1-6A1) component from the Mn2+ ions present in the photoluminescence spectra. Moreover, these Mn2+-doped 1D-LHPPs demonstrate high structural and optical stability in humid and high-temperature environments. Hence, such doped materials can be fabricated into a UV-pumped white light-emitting diode, rendering the potential application for solid-state lighting and display systems.

Impact of prosthesis oversizing on clinical outcomes of transcatheter aortic valve implantation using a self-expandable Evolut R valve.

BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) has a growing target population after being indicated even in low-surgical-risk patients with severe symptomatic aortic stenosis. However, postoperative outcomes can be compromised due to para-valvular leakage (PVL). A lot of procedural steps have been investigated to decrease this partially avoidable operational hazard. Oversizing is a main technique to decrease the PVL, despite being itself a risky step. Many studies have been conducted to identify the optimum degree of oversizing. However, studies about oversizing by more than 20% are scarce. We aimed to evaluate the safety and efficacy of oversizing equal to or more than 20%. RESULTS: 209 patients who underwent TAVI using the self-expandable valve Evolut R were initially included. 66 patients were excluded because of the baseline conduction disturbance and lack of sufficient data, so 143 patients, 60 females and 83 males, were enrolled in our study as two groups based on the degree of oversizing: Group A included 97 patients with an oversizing index (OI) of less than 20%, and Group B included 46 patients with an OI of 20% or more. We conducted a new technique for more accurate measuring of the OI in the context of the implantation depth, and our patients were categorized using this technique. Our findings have met our primary end point in terms of the safety and efficacy of oversizing by 20% or more. There was no significant difference between both groups in terms of new-onset conduction disturbance (NOCD), with zero cases of annular rupture or coronary encroachment. In terms of efficacy, The incidence of significant PVL (grade 2 or more) in group B was less than in group A (P value 0.007). The ROC curve found that the minimum depth of implantation-derived oversizing (DIDO) to predict no significant PVL was less than 17%. CONCLUSION: Prosthesis oversizing by 20% using the self-expandable Evolut R valve is safe and effective, with no significant effect on the conduction system, coronary encroachment, or annular injury, and warrants a greater reduction in the incidence of significant PVL.

Fine Tuning Ag(I)-Sb(III) Hybrid Iodides for Light Detection.

Lead-free hybrid double perovskite iodides (HDPIs) have piqued increasing research interest due to their environmental friendliness and high stability. However, such antimony-based HDPIs with strong photocurrent response are currently very limited. Here, we successfully design and construct five Ag(I)-Sb(III)-based HDPIs using two types of cyclic aliphatic amines as A-site templates. Interestingly, these Ag(I)-Sb(III) HDPIs exhibit relatively narrow band gaps, preferred orientation, and high stability after being processed into thin films on the indium tin oxide (ITO) substrate. Notably, under illuminations of a xenon lamp, all HDPIs exhibit considerable photocurrent responses, reaching a maximum difference of 17 µA·cm-2 for ASI 1, which is the highest among lead-free halogen-based organic-inorganic hybrid compounds to date. Combining the considerable photocurrents and the high stability, the optoelectronic applications of two-dimensional Ag(I)-Sb(III) HDPIs can be expected.

Analysis of noise levels in the neonatal intensive care unit: the impact of clinical microsystems.

Reorganization of neonatal intensive care by introducing clinical microsystems may help to allocate nursing time more appropriately to the needs of patients. However, there is concern that cohorting infants according to acuity may enhance noise levels. This single-center study investigated the impact of reorganization of neonatal intensive care unit by implementing clinical microsystems in a Level III NICU on environmental noise. This prospective study measured 24-h noise levels over a period of 6 months during pre- and post-implementation of microsystems cohorting infants of similar acuity. Comparative analyses of the mixed acuity (i.e., before) and the cohorting (i.e., after) model were performed by creating daily profiles from continuous noise level measurements and calculating the length of exposure to predefined noise levels. Compared to baseline daytime measurements, noise levels were 3-6 dBA higher during physician handover. Noise levels were 2-3 dBA lower on weekends and 3-4 dBA lower at night, independent of the organizational model. The introduction of clinical microsystems slightly increased average noise levels for high-acuity pods (A and B) but produced a much more substantial decrease for low-acuity pods (E), leading to an overall reduction in unit-wide noise levels.    Conclusion: Our data show that noise levels are more driven by human behavior than by technical devices. Implementation of microsystems may help to reduce noise exposure in the lower acuity pods in a NICU. What is Known: • Excessive noise levels can lead to adverse effects on the health and development of premature infants and other critically ill newborns. • The reorganization of the neonatal intensive care unit following the clinical microsystems principles might improve quality of care but also affect noise exposure of staff and patients. What is New: • The transition from a mixed -acuity to cohorting model is associated with an overall reduction in noise levels, particularly in low-acuity pods requiring less nursing care. • Nevertheless, baseline noise levels in both models exceeded the standard permissible limits.

Insights into enlarged prostatic utricles and Müllerian duct system remnants associated with posterior hypospadias.

INTRODUCTION: The prostatic utricle (PU) consists of the caudal remnant of the Müllerian duct and the urogenital sinus. The term "vagina masculina" is used if other Müllerian structures are associated with the PU. This work aims to investigate the incidence, management, and follow up of enlarged PUs and Müllerian remnants in males with posterior hypospadias. PATIENTS AND METHODS: This study presents a retrospective review of cases presented with posterior hypospadias over a 5-year period. Prior to hypospadias repair, retrograde urethrograms were used to investigate enlarged PU. Subsequently, they were classified according to the Ikoma score and further assessed by karyotyping and cystoscope. Surgical excision was indicated in cases with symptomatic utricles or vagina masculina. RESULTS: Thirty patients were included in the study in the period between 2015 and 2020 (Table). All cases were asymptomatic initially. Twelve patients were diagnosed with enlarged PU; three of them had vagina masculina. One case with perineal hypospadias had a separate perineal opening for PU. Following hypospadias repair, three of the eight cases treated conservatively turned symptomatic. DISCUSSION: The incidence of enlarged PU and Müllerian remnants varied among different studies. However, it increased as the severity of hypospadias increased. Preoperative urethrogram was helpful in the diagnosis and classification of PU, but it had its limitations. Cystoscope was more advantageous in diagnosing vagina masculina. Although most cases were asymptomatic, some turned symptomatic after hypospadias repair. Some cases with perineal hypospadias had PU with a separate perineal opening. CONCLUSION: The incidence of enlarged PUs or Müllerian remnants was 40%. Although cases were asymptomatic before hypospadias surgery, some cases turned into symptomatic after hypospadias repair. In some cases, the PU or Müllerian remnants had a separate perineal opening. They can be classified as a particular form of Ikoma grade III necessitating surgical intervention.

Effectiveness of 3-Day Prophylactic Negative Pressure Wound Therapy on Closed Abdominal Incisions in the Prevention of Wound Complications: A Randomized Controlled Trial.

OBJECTIVE: To determine the impact of negative pressure wound therapy of closed abdominal incisions on wound complications. BACKGROUND: Surgical wound complications including surgical site infection complicating open abdominal operations are a burden on the economy. The outcomes of SSI include prolonged hospital stays, adjuvant treatment delay, and incisional hernias leading to a decrease in the quality of life. Prophylactic negative pressure wound therapy has recently been tried with promising results. METHODS: A randomized controlled trial involving 140 patients post-laparotomy with primary wound closure was divided into 2 groups (70 patients each). For the first group, NPWT dressings were applied for the first 3 days and then conventional dressings for 4 days after. For the second group, conventional dressings were applied for 7 days. Patients were followed up for SSI, seroma, wound dehiscence, and hospital stay. RESULTS: pNPWT was associated with a significantly lower rate of SSI development compared with gauze dressings (3/70 vs. 17/70) (p = 0.001). It also had a significant effect on lowering the incidence of seroma (0/70 vs. 7/70) (p = 0.007) and delayed wound healing (0/70 vs. 8/70) (p = 0.006) and on decreasing days of hospital stay (2.2 ± 0.6 vs. 3.5 ± 1.8) (p <0.00001). No significant difference was observed with regard to hematoma (0/70 vs. 1/70) (p = 0.5) or wound dehiscence (0/70 vs. 2/70) (p = 0.5). No burst abdomens or NPWT complications were recorded in our study. CONCLUSION: Three-day NPWT applied to primarily closed incisions is effective in reducing the incidence of SSI, seroma, and delayed wound healing in abdominal operations compared to conventional gauze dressings.

Prediction of side branch occlusion in bifurcational lesions during percutaneous coronary interventions by preprocedural coronary computed tomography using the CT bifurcation score.

Introduction: Coronary computed tomographic angiography (CCTA) is a highly diagnostically accurate non-invasive imaging method for a thorough evaluation of atherosclerotic plaques. Many CCTA-based imaging investigations concentrate on bifurcation lesions. Aim: To determine whether intraprocedural side branch (SB) obstruction during the percutaneous coronary intervention (PCI) of lesions involving bifurcations might be predicted by preprocedural CCTA. Material and methods: This retrospective observational study was conducted on 200 stentable bifurcation lesions of 200 coronary artery disease patients with the SB ≥ 2 mm in diameter. All patients were planned for elective bifurcation PCI after undergoing CCTA for quantitative plaque characterization of both the main vessel and SB to obtain the CT bifurcation score. Then, angiography-based bifurcations were classified using both the Medina classification and the RESOLVE score before PCI of the bifurcation lesions. Most of the cases were managed by the provisional technique. Results: The CT bifurcation score was substantially higher in patients with SB occlusion (p < 0.001) with 80% sensitivity and 60% specificity at a cut-off point of 3. There was a borderline significant relation between the Medina score and SB occlusion in the studied cases (p = 0.05) with 60% sensitivity and 40% specificity. The RESOLVE score was unexpectedly an insignificant predictor of SB occlusion (p = 0.25) in our study, with 40% sensitivity and 50% specificity. Conclusions: Intraprocedural SB occlusion can be predicted by a comprehensive CCTA evaluation. The CT bifurcation score, a novel and simple points scoring system based on six CCTA parameters, outperformed current angiographic classification or scoring systems for predicting SB occlusion.

Improving estimation of water soil erosion by introducing lithological formation for environmental remediation.

Soil erosion is a serious and complex environmental problem worldwide, especially in the centre west of Tunisia. Whereas the construction of hill reservoirs is part of the soil and water conservation strategy, many of these have a siltation problem. Dhkekira is one of the smallest watersheds in central Tunisia whose most lithological formation consists of materials that are quite susceptible to water erosion. Due to the lack of low-scale lithological data, digital IR aerial photos with 2 m spatial resolution were considered. A semi-automatic classification of aerial photos, based on the image's textural indices is developed. The lithologic map extracted from aerial photos was used as input for ANSWERS-2000 water erosion model. Results obtained indicate first, with the semi-automatic classification of the mean and standard deviation of the thumbnail histograms that image output could help to give an idea about the existence of some surface lithological formation. The model applied to Dhkekira watershed showed that the spatial difference in water erosion was not caused only by land cover and slope, but also by lithological formation. The percentage of each lithological formation in sediment yield at the Dhkekira hill reservoir was estimated to be 69% sediment yield from Pleistocene and 19.7% from Lutetian-Priabonian.

Synthesis of activated carbon composited with Egyptian black sand for enhanced adsorption performance toward methylene blue dye.

The present study reports the feasibility of the synthesis of a novel porous composite adsorbent, prepared from olive stone activated carbon (OS400) and garnet (GA) mineral impregnations (referred to as OSMG). This composite (OSMG) was applied for its ability to adsorb a macromolecular organic dye. The composite's structural characteristics were evaluated using various techniques such as Brunauer-Emmett-Teller (BET), Scanning Electron Microscopy equipped with Energy Dispersive X-ray spectroscopy (SEM-EDX), X-ray diffraction (XRD), and a Fourier transform infrared spectrometer (FT-IR). The specific surface area of the garnet (GA), (OS400), and (OSMG) were found to be 5.157 mg⋅g-1, 1489.598 mg⋅g-1, and 546.392 mg⋅g-1, respectively. The specific surface area of the new composite (OSMG) was promoted to enhance the adsorption of methylene blue (MB). Experiments were conducted under various conditions, including contact time, initial dye concentration, adsorbent dosage, pH, and temperatures. Data from these experiments were analyzed using several adsorption models including Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich (D-R). The results indicated that, the adsorption fit best with the Freundlich model and that the adsorption process followed a pseudo-second-order kinetic mechanism. Additionally, the thermodynamic analysis indicated the adsorption of MB onto garnet(GA) adsorbents is endothermic, while the sorption onto (OS400) and (OSMG) is an exothermic and non-spontaneous process. The OSMG composite can be used for at least five cycles without significant loss of adsorptive performance, and can easily be separated from the water after treatment.

Two-dimensional semiconducting Cu(I)/Sb(III) bimetallic hybrid iodides with a double perovskite structure and photocurrent response.

Stable lead-free hybrid halide double perovskites have sparked widespread interest as a new kind of photoelectric material. Herein, for the first time, we successfully incorporated copper(I) and antimony(III) into two two-dimensional (2D) hybrid bimetallic double perovskite iodides, namely (NH3C6H11)4CuSbI8·H2O (CuSbI-1) and (NH3C6H10NH3)2CuSbI8·0.5H2O (CuSbI-2), using cyclohexylamine and 1,4-cyclohexanediamine as organic components. The band gaps for CuSbI-1 and CuSbI-2 were determined to be 2.22(2) eV and 2.21(2) eV, respectively. Furthermore, these two layered perovskites were readily dissolved in an organic solvent (1 mL DMF can dissolve 1 g sample for each compound) and could form smooth, pinhole-free, and uniform thin films through a facile spin-coating method. Photocurrent experiments with xenon lamp irradiation revealed the obvious photoelectric responses for both 2D double perovskites. The ratio of the photocurrent to the dark current (Ilight/Idark) for CuSbI-1 and CuSbI-2 is about 23 and 10, respectively, further suggesting their potential to be applied as light harvesters or light detectors. More importantly, these 2D double perovskite iodides show high moisture and thermal stabilities, indicating their potential for optoelectronic applications.

Outcome of redo orchidopexy after previous laparoscopic orchidopexy.

PURPOSE: Testicular reascent is a recognised complication of orchidopexy, and redo surgery may be required. In this report, we present our experience of redo orchidopexy after initial laparoscopic surgery. METHODS: Patients who had undergone redo orchidopexy following an initial vessel-sparing (VS) or non-vessel sparing (NVS) laparoscopic orchidopexy between 2005 and 2019 were identified. Outcome data, including complications and testicular size, were recorded. RESULTS: The series comprised 23 patients (5: initial bilateral surgery with reascent on one side only; 18: unilateral surgery) with a mean age at original surgery of 3.5 years (range 8 months-6 years) and at redo surgery, 4 years (range 1.5-7 years). VS surgery had been undertaken in 15 and NVS in 8. A tension-free scrotal position was achieved in all cases. There were no complications and no patient required orchidectomy. At a minimum of 6-month follow-up after redo surgery, there were no cases of reascent and there was no change in testicular size/volume (based on clinical examination). CONCLUSION: Redo orchidopexy is an effective treatment following failed laparoscopic orchidopexy and a scrotal testis can be achieved in all cases. Complete testicular atrophy did not occur, but the risk of partial atrophy could not be accurately quantified.

Method validation and risk assessment for sulfonamides and tetracyclines in bees' honey from Egypt, Libya and Saudi Arabia.

Several studies worldwide have reported contamination of bees' honey by antibiotics, which may pose a hazard to consumers' health. The present study was thus established to: (1) introduce a validated multi-residue method for determining sulfonamides (SAs) and tetracyclines (TCs) in honey; and (2) characterize the potential risk due to the exposure to SAs and TCs in honey samples from Egypt, Libya, and Saudi Arabia. SAs and TCs were simultaneously extracted using solid-phase extraction and matrix solid phase dispersion methods. SAs and TCs were screened using HPLC-MS/MS and HPLC-DAD. The results confirmed detection limits for SAs and TCs by HPLC-MS/MS of 0.01 and 0.02-0.04 (ng g-1), respectively. The limits were 2.5-5.6 and 12.0-21.0 (ng g-1) for SAs and TCs by HPLC-DAD, respectively. The obtained accuracy rates were in the ranges of 83.07-86.93% and 86.90-91.19%, respectively, for SAs and TCs, with precision rates lower than 9.54%. Concerning the occurrence of antibiotics, the positive samples constituted 57.6%, 75%, and 77.7% of the Egyptian, Saudi Arabian, and Libyan samples, respectively. Notably, SAs antibiotics were the most prevalent in the Egyptian and Saudi Arabian samples; in contrast, TCs were the most dominant in Libya. Calculated parameters of risk assessment, concerning the aggregated exposure to SAs and TCs, showed no potential adverse effects from the exposure to contaminated honey in studied countries.

Omentopexy Effect on the Upper Gastrointestinal Symptoms and the Esophagogastroduodenoscopy Findings in Patients Undergoing Sleeve Gastrectomy.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained acceptance worldwide. However, SG has its own complications that need a specialized management. Omentopexy is a technique in which the sleeved part of the stomach is fixed to the greater omentum. AIM OF THE STUDY: The present work aimed to investigate the potential effect of omentopexy on the upper GIT disturbances in patients with severe obesity and undergoing LSG. PATIENTS AND METHODS: This study included patients who were recruited for LSG in our institution from June 2019 to October 2020. Patients having no upper GIT symptoms, no esophagogastroduodenoscopy (EGD) GERD signs, and no hiatus hernia were eligible for the study. Patients were randomly enrolled into the omentopexy group (underwent LSG with omentopexy) and the non-omentopexy group (underwent LSG only). Patients were followed up 1 month, 3 months, and 1 year after the operation. EGD was performed at the 1-year follow-up. RESULTS: Forty-five patients constituted the omentopexy group and forty-six constituted the non-omentopexy group. Omentopexy was associated with significant reduction in the early post LSG upper GIT symptoms, and less EGD evident reflux esophagitis at the 1-year follow-up (statistically non-significant). CONCLUSION: The current work adds a new evidence of the omentopexy benefits in patients undergoing sleeve gastrostomy, with an overall better outcome in regard to the upper GIT upset and GERD compared to LSG alone.

Combined Thoracic Spinal-Epidural Anesthesia for Laparoscopic Sleeve Gastrectomy; One Hundred Case Experience.

BACKGROUND: Obesity is a growingly impacting human health concern. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity. However, the general anesthesia (GA) used in this major surgery has its documented drawbacks in obese patients with high risk. On the other hand, combined thoracic spinal-epidural anesthesia (CTSEA), a modern regional anesthesia procedure, has the advantages of both spinal and epidural anesthesia but without their shortcomings. This prospective study is a case experience that assesses the feasibility of CTSEA as an anesthesia option for laparoscopic sleeve gastrectomy (LSG). METHODS: A total of 100 patients were recruited for LSG as a management procedure for morbid obesity, which was performed under CTSEA. Perioperative events, functional parameters, and patients' satisfaction scores were recorded. RESULTS: Our prospective study showed successful use of CTSEA in 99% of the patients, except for one patient (1%) in whom CTSEA was converted into GA due to severe pain and anxiety. Few adverse events occurred and were managed accordingly. The satisfaction score revealed that 94% of the patients were satisfied. CONCLUSIONS: CTSEA was a successful anesthetic alternative procedure for LSG surgery.

Factors affecting vitiligo response to treatment: do MiRNA 196a2C/T gene polymorphism and serum tyrosinase levels have any role?

BACKGROUND: Factors contributing to the pathogenesis of vitiligo and factors affecting its response to treatment are still a major area of debate. AIM OF THE WORK: The study aimed to assess the serum levels of tyrosinase and Micro-RNAs (miRNAs) gene polymorphism in a sample of Egyptian vitiligo patients, and to determine factors affecting the response of vitiligo to treatment. SUBJECTS AND METHODS: This prospective case-control interventional study included 212 non-segmental vitiligo patients and 96 control subjects. Before treatment, vitiligo was evaluated using Vitiligo Area Severity Index. Detection of miRNA 196a-2 polymorphism was done using PCR-REELP and serum tyrosinase was measured using ELISA. After treatment, patients were reevaluated clinically and serum tyrosinase levels were re-measured. RESULTS: The tyrosinase levels were significantly elevated in patients. The TT genotype was the most prevalent one in the patients. The percentage of improvement showed a significant positive correlation with patients' ages and age of the disease onset and a negative correlation with disease duration, baseline VASI scores and serum tyrosinase levels. CONCLUSION: MiRNA 196a-2 C/T (11614913) gene polymorphism and the elevated serum tyrosinase levels might be related to the pathogenesis of vitiligo and may affect its therapeutic response.

Polymethylmethacrylate Incorporating Nanodiamonds for Denture Repair: In Vitro Study on the Mechanical Properties.

OBJECTIVE: This study aimed to evaluate the effect of nanodiamond (ND) addition to repair resin with repair gap modifications on the flexural and impact strength of repaired polymethylmethacrylate denture base. MATERIALS AND METHODS: Heat-polymerized acrylic resin specimens (N = 100/test) were prepared and sectioned to half creating two repair gaps: 2.5- and 0 mm with 45 degrees beveling. They were further divided into subgroups (n = 20) according to ND concentration (control, 0.25%ND, and 0.50%ND), thermocycling (500 cycles) was done to half the specimens in each subgroup. Flexural strength was tested using 3-point bending test and impact strength was tested by Charpy's impact test. Analysis of variance and post-hoc Tukey's tests were performed for data analysis (α = 0.05). Scanning electron microscope was employed for fracture surface analysis and ND distribution. RESULTS: Before and after thermocycling, the addition of ND significantly increased the flexural strength and elastic modulus in comparison to control group (p ˂ 0.001), while 0 mm repair gap showed insignificant difference between ND-reinforced groups (p ˃ 0.05). Regarding impact strength, ND addition increased the impact strength with 0 mm gap in comparison to control and 2.5 mm with ND (p˂0.001), while later groups showed no significant in between (p ˃ 0.05). Comparing thermocycling effect per respective concentration and repair gap, thermocycling adversely affected all tested properties except elastic modulus with 0 mm-0.25 and 0 mm-0.5% and impact strength with 2.5 mm, 2.5 mm-0.25%, 2.5 mm- 0.5% (p ˃ 0.05). CONCLUSION: ND addition combined with decreased repair gap improved the flexural strength, elastic modulus, and impact strength of repaired denture resin, while thermocycling has a negative effect on denture repair strength.

Left Atrial Ejection Force as a Marker for the Diagnosis of Heart Failure with Preserved Ejection Fraction.

INTRODUCTION: Several echocardiographic techniques are used to diagnose heart failure with preserved ejection fraction (HFPEF). Left atrial ejection force (LAEF) is a measure of left atrial (LA) systolic function. The aim of this study was to examine the use of LAEF as a measure for the diagnosis of HFPEF. METHODS: A prospective study including 100 patients with HFPEF and 100 healthy controls. Heart failure association algorithm score for the diagnosis of HFPEF (HFA-PEFF score) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were assessed. Transthoracic echocardiography measured indexed left ventricular mass index (LVMI), left ventricular (LV) ejection fraction, LA volume index (LAVI), global longitudinal strain (GLS), trans-mitral Doppler velocities, E/A ratio, E/e' ratio, and estimation of LAEF. RESULTS: Patients in the HFPEF group were more frequently hypertensive, diabetic, and had a history of ischemic heart disease. NT-pro-BNP was higher in the HFPEF group (P < 0.0001). LVMI, relative wall thickness, and LAVI were all significantly higher in the HFpEF group (P < 0.0001 for all). LV-GLS was significantly lower in the HFPEF (P < 0.0001). LAEF was significantly higher in the study group 142.14 ± 24.27 versus 92.18% ±13.99% (P < 0.0001). A sub-group of 18 patients in the study group with a borderline HFA-PEF score of 4 had a LAEF that was significantly higher than the control group (P < 0.0001) but did not differ from the rest of the HFPEFF group patients. CONCLUSION: LAEF was significantly higher in patients with HFPEF compared to healthy controls. Patients with a borderline HFA-PEFF score of 4 had a significantly higher LAEF as compared to controls.

Multidetector computed tomography for patients with congenital heart disease: a multi-center registry from Africa and Middle East; patients' characteristics and procedural safety.

BACKGROUND: We aimed to establish a clinical registry for patients with congenital heart disease who referred to multidetector computed tomography in our country, to describe the pattern and clinical profile of such patients and document the safety and efficacy of the procedure in our daily practice. RESULTS: A total 2310 studies were analyzed after excluding studies with missed, and lost data. Half of our study population-1215 patients-52.5% were males. The median age of the patients was 12 months (IQR 37 months), and the youngest patient was 3 days old. The eldest patient was 50 years old. 68.27% of the patients were less than 2 years old, and two-third of the whole studied population 66.7% had cyanotic heart disease. Minor local access complications, complications related to anesthetic drugs, and allergic reactions were the most commonly encountered complications, with only single mortality mainly due to multiple associated multisystem congenital malformation. CONCLUSIONS: Most of our patients with congenital heart disease referred for MDCT study were infants and young children. The majority of them had complex cyanotic heart disease. The study is safe, with excellent diagnostic yield and safe with very low incidence of complications.

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention.

Objectives: Telemedicine appears to be a promising tool for healthcare professionals to deliver remote care to patients with cardiovascular diseases especially during the COVID-19 pandemic. We aimed in this study to evaluate the value of telemedicine added to the short-term medical care of acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Methods: Two hundred acute STEMI patients after primary PCI were randomly divided into two groups. One hundred patients in group A (study group) received a monthly videoconferencing teleconsultation using a smartphone application for 3 months starting 1 week after discharge and at least a single face-to-face (F2F) clinic visit. We reviewed in each virtual visit the symptoms of patients, adherence to healthy lifestyle measures, medications, smoking cessation, and cardiac rehabilitation. Group B (control group) included 100 patients who received at least a single F2F clinic visit in the first 3 months after discharge. Both groups were interviewed after 4 months from discharge for major adverse cardiac events (MACE), adherence to medications, smoking cessation, and cardiac rehabilitation. A survey was done to measure the satisfaction of patients with telemedicine. Results: There was no significant difference between both groups in MACE and their adherence to aspirin, P2Y12 inhibitor, and beta-blockers. However, group A patients had better adherence to statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, smoking cessation, and cardiac rehabilitation. Sixty-one percent of patients stated that these videoconferencing teleconsultations were as good as the clinic visits, while 87% of patients were satisfied with telemedicine. Conclusions: Telemedicine may provide additional benefit to the short-term regular care after primary PCI to STEMI patients through videoconferencing teleconsultations by increasing their adherence to medications and healthy lifestyle measures without a significant difference in the short-term MACE. These virtual visits gained a high level of satisfaction among the patients.

Magnet ingestion in children and its implications: tertiary centre experience.

BACKGROUND: Swallowing multiple magnets or a magnet and second metallic object can carry risks of intestinal obstruction, fistula and perforation because they can attach to each other with loop of bowel in between. An updated management plan and reviewing our experience are warranted because of increased incidence of magnets ingestion among children. METHODS: All the patients who had a history of single, multiple magnet or single magnet and second metallic object ingestion in Bristol Royal Hospital for children during the period from January 2014 till November 2020 were included in our study. RESULTS: A total of 46 patients were referred to our hospital with a history of magnet ingestion. The number of magnets ingested ranged between one and twenty one magnets. All patients had abdominal x-ray undertaken either Antero-posterior alone (AP) (n = 32) or both AP and lateral (n = 14). Surgical intervention was performed in 18 patients; Oesophago-gastro-duodenoscopy (n = 8), laparotomy/laparoscpy (n = 10) to retrieve the magnets or deal with the complications. CONCLUSIONS: Magnets ingestion in children can be tricky when it comes to management. Complications can happen quite often and carry severe risks on children. An updated structured algorithm is proposed to manage children with magnet ingestion.