Nursing students' perspectives on patients' safety competencies: a cross-sectional survey.

BACKGROUND: Nurses constitute the largest body of healthcare professionals globally, positioning them at the forefront of enhancing patient safety. Despite their crucial role, there is a notable gap in the literature regarding the comprehension and competency of nursing students in patient safety within Egypt. This gap underscores the urgent need for research to explore how nursing students perceive patient safety and the extent to which these competencies are integrated into their clinical and educational experiences. Understanding these perspectives is essential for developing targeted interventions that can significantly improve patient safety outcomes. The objective of this study was to fill this gap by assessing the perspectives of nursing intern students on patient safety competencies, thereby contributing to the global efforts in enhancing patient safety education and practice. METHODS: In this research, a cross-sectional study design was employed to investigate the topic at hand. A purposive sample of 266 nursing intern students was enrolled from the Faculty of Nursing at Mansoura University. The data were collected using a patient safety survey. Subsequently, the collected data underwent analysis through the application of descriptive and inferential statistical techniques using SPSS-20 software. RESULTS: Among the studied intern nursing students, we found that 55.3% and 59.4% of the involved students agreed that they could understand the concept of patient safety and the burden of medical errors. Regarding clinical safety issues, 51.1% and 54.9% of the participating students agreed that they felt confident in what they had learned about identifying patients correctly and avoiding surgical errors, respectively. Concerning error reporting issues, 40.2% and 37.2% of the involved students agreed that they were aware of error reports and enumerated the barriers to incident reporting, respectively. There was a statistically significant difference between the nursing student patient safety overview domain and their age (p = 0.025). CONCLUSIONS: Our study's compelling data demonstrated that intern students who took part in the patient safety survey scored higher overall in all patient safety-related categories. However, problems with error reporting showed the lowest percentage. The intern students would benefit from additional educational and training workshops to increase their perspectives on patients' safety competencies.

Live-donor kidney transplant outcome prediction (L-TOP) using artificial intelligence.

Outcome prediction for live-donor kidney transplantation improves clinical and patient decisions and donor selection. However, the concurrently used models are of limited discriminative or calibration power and there is a critical need to improve the selection process. We aimed to assess the value of various artificial intelligence (AI) algorithms to improve the risk stratification index. We evaluated pre-transplant variables among 66 914 live-donor kidney transplants (performed between 01/12/2007-01/06/2021) from the United Network of Organ Sharing database, randomized into training (80%) and test (20%) sets. The primary outcome measure was death-censored graft survival. We tested four machine learning models for discrimination (time-dependent concordance index, CTD, and area under the ROC curve) and calibration (integrated Brier score, IBS). We used decision curve analysis to assess the potential clinical utility. Among the models, the deep Cox mixture model showed the best discriminative performance (AUC = 0.70, 0.68, and 0.68 at 5, 10, and 13 years post-transplant, respectively). CTD reached 0.70, 0.67, and 0.66 at 5, 10, and 13 years post-transplant. The IBS score was 0.09, indicating good calibration. In comparison, applying the Living Kidney Donor Profile Index (LKDPI) on the same cohort produced a CTD of 0.56 and an AUC of 0.55-0.58 only. Decision curve analysis showed an additional net benefit compared to the LKDPI, 'Treat all' and 'Treat None' approaches. Our AI-based deep Cox mixture model, termed Live-Donor Kidney Transplant Outcome Prediction outperforms existing prediction models, including the LKDPI, with the potential to improve decisions for optimum live donor selection by ranking potential transplant pairs based on graft survival. This model could be adopted to improve the outcomes of paired exchange programs.

Prospective comparison of tadalafil 5 mg, dapoxetine 30 mg, and the combination of both in the treatment of premature ejaculation.

Objective: To compare the efficacy of tadalafil alone, dapoxetine alone, and tadalafil with dapoxetine as a combination therapy for the treatment of premature ejaculation. Patients and Methods: Eligible patients attended our andrology clinic with premature ejaculation were randomly allocated into three groups: group A (92 participants) received on-demand tadalafil, 5 mg; group B (91 participants) were given on-demand dapoxetine, 30 mg; and group C (89 participants) received on-demand combination of tadalafil, 5 mg, and dapoxetine, 30 mg. We assessed the changes in the intravaginal ejaculatory latency time (IELT) and the satisfaction scores 1, 2, and 3 months after treatment. Results: Highly statistically significant improvements were found in the mean IELT and satisfaction scores 1, 2, and 3 months post-treatment in all groups (P = <0.001). Post hoc analysis suggested this improvement was more pronounced in group C (P < 0.001). Conclusion: Both tadalafil and dapoxetine are effective in the treatment of patients with premature ejaculation, but the combination of both drugs gives better results.

Genetic diversity of macrolides resistant Staphylococcus aureus clinical isolates and the potential synergistic effect of vitamins, C and K3.

BACKGROUND: Macrolide antibiotics have been extensively used for the treatment of Staphylococcus aureus infections. However, the emergence of macrolide-resistant strains of S. aureus has become a major concern for public health. The molecular mechanisms underlying macrolide resistance in S. aureus are complex and diverse, involving both target site modification and efflux pump systems. In this study, we aim to overcome the molecular diversity of macrolide resistance mechanisms in S. aureus by identifying common molecular targets that could be exploited for the development of novel therapeutics. METHODS: About 300 Staphylococcus aureus different isolates were recovered and purified from 921 clinical specimen including urine (88), blood (156), sputum (264), nasal swabs (168), pus (181) and bone (39) collected from different departments in Tanta University Hospital. Macrolide resistant isolates were detected and tested for Multi Drug Resistant (MDR). Gel electrophoresis was performed after the D test and PCR reaction for erm(A), (B), (C), msr(A), and mph(C) genes. Finally, we tried different combinations of Erythromycin or Azithromycin antibiotics with either vitamin K3 or vitamin C. RESULTS: Macrolide resistance S. aureus isolates exhibited 7 major resistance patterns according to number of resistance markers and each pattern included sub patterns or subgroups. The PCR amplified products of different erm genes; analysis recorded different phenotypes of the Staphylococcus aureus isolates according to their different genotypes. In addition, our new tested combinations of Erythromycin and vitamin C, Erythromycin, and vitamin K3, Azithromycin and vitamin C and Azithromycin and vitamin K3 showed significant antibacterial effect when using every antibiotic alone. Our findings provide new insights into the molecular mechanisms of macrolide resistance in S. aureus and offer potential strategies for the development of novel protocols to overcome this emerging public health threat.

The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors.

BACKGROUND: Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge. METHODS: The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving. RESULTS: Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group. CONCLUSIONS: The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.

[Amélioration précoce de la fraction d'éjection chez les patients ayant une fraction d'éjection réduite après un pontage coronarien]. / Early improvement of ejection fraction in patients with reduced ejection fraction after coronary artery bypass grafting.

BACKGROUND: Despite advancements in surgical technique, myocardial shield, and postoperative care, Coronary artery bypass grafting (CABG) among patients with reduced ejection fraction (EF) remains a surgical challenge due to their greater postoperative morbidity and mortality. This study aims to determine the early outcome of patients with reduced LVEF undergoing CABG and the improvement in the ejection fraction after revascularization. METHODS: A total of 62 patients with impaired Left Ventricular (LV) systolic function (LVEF = 35-40 %) who underwent isolated On-pump CABG at the Department of Cardiothoracic Surgery in Assiut University Hospitals and who had met the listed inclusion and exclusion criteria were eligible for the study. Different variables (preoperative, intraoperative, and postoperative) were collected, studied, and compared. RESULTS: The mean age of the patients was 57.81 ± 7.57 years, 66.1 % were male and 33.9 % were female. 44 (71.0%) patients were administered antegrade cardioplegia, whereas 18 (29.0%) patients were administered antegrade plus retrograde cardioplegia. Mean LVEF increased significantly from 37.97 ± 1.38% before surgery to 51.87 ± 3.54% after surgery (P ˂ 0.05). Post-operative low cardiac output syndrome occurred in 37 (59.7 %) of patients, pulmonary complications in 15 (24.2%), neurological complications in 10 (16.1%), sternal wound infection in 9 (14.5%), atrial fibrillation in 5 (8.1%) and acute kidney injury in 5 (8.1 %) of patients. In-hospital mortality was 16.1% (10 patients). CONCLUSION: Based on the findings, CABG in patients with reduced preoperative LVEF improves the postoperative LVEF and NYHA functional class.

A simple transseptal approach versus the conventional left atrial approach for mitral valve procedures: a retrospective study.

Background: Having good exposure to the mitral apparatus during mitral valve replacement is a vital decision every cardiac surgeon must take. This study was conducted to compare the simple transseptal approach and the conventional left atrial approach for mitral valve procedures, to evaluate the safety and efficacy of the simple transseptal approach during open heart mitral valve procedures, as the conventional left atrial approach may not provide optimal exposure, especially in unfavorable anatomical and operative situations. Methods: This is a retrospective study. It has been conducted on 140 patients who were diagnosed with heart diseases that required mitral valve replacement. Surgeries were performed in the Cardiothoracic Surgery Department. Mitral procedure was done through median sternotomy incision under general anesthesia on a cardiopulmonary bypass machine with cold antegrade cardioplegia. Demographic data, preoperative diagnosis, intraoperative findings, hospital stay, complications, and mortality were documented and revised. Results: One hundred and forty patients were enrolled in this study with a median age of 39 years, and no significant differences as regards the baseline demographic data as age, sex, and body mass index (BMI). A total of 68 patients underwent mitral valve replacement through the simple transseptal approach and 72 patients through the conventional left atrial approach. Both studied groups had insignificant differences as regards bypass time, re-operation rate, postoperative complications, hospital stay, and mortality. Conclusion: The simple transseptal approach through the midpoint of the fossa ovalis could be a safe and even favorable alternative to the traditional left atriotomy approach in certain difficult operative situations during mitral valve replacement surgery.

Integrated whole exome and transcriptome sequencing in cholesterol metabolism in melanoma: systematic review

Background: Melanoma is a highly malignant form of skin cancer that exhibits remarkable metabolic adaptability. Melanoma cells exhibit the capacity to adapt to specific conditions of the tumor microenvironment through the utilization of diverse energy sources, thereby facilitating the growth and advancement of the tumor. One of the notable characteristics of metabolic reprogramming is the heightened rate of lipid synthesis. This review was conducted to illustrate how the integration of whole exom and transcriptome sequencing will enhance the detection of the effect of cholesterol metabolism in melanoma. Methods: The Cochrane database, Embase, PubMed, SCOPUS, Google Scholar, Ovid, and other databases were thoroughly searched for works addressing integrated whole exome and transcriptome sequencing in cholesterol metabolism in melanoma. Skin malignancy, melanoma progression, transcriptome sequencing, whole exome sequencing, transcriptome sequencing by RNA sequencing, and integrated transcriptome and whole exome sequencing were the key phrases employed. This article underwent a phased search for pertinent literature using a staged literature search methodology. Each section's relevant papers were identified and summarized independently. The results have been condensed and narratively given in the pertinent sections of this thorough assessment. Results: DNA-based analysis has proven to be ineffective in identifying numerous mutations that have an impact on splicing or gene expression. RNA-Sequencing, when combined with suitable bioinformatics, offers a reliable method for detecting supplementary mutations that aid in the genetic diagnosis of geno-dermatoses. Therefore, clinical RNA-Sequencing expands the scope of molecular diagnostics for rare genodermatoses, and it has the potential to serve as a dependable initial diagnostic method for expanding mutation databases in individuals with inheritable skin conditions. Conclusion: The integration of patient-specific tumor RNA-sequencing and tumor DNA whole-exome sequencing (WES) would potentially enhance mutation detection capabilities compared to relying solely on DNA-WES.

Vagino-Laparoscopic Conservative Strategy of Hysterectomy in Indicated Cases of Severe Pelvic Endometriosis Followed by 24 Months of Depot-Medroxyprogesterone Acetate Therapy- A Symptom-Solving Treatment Model to Ease Surgical Challenges.

Purpose: To demonstrate the long-term outcome of a symptom-solving treatment model (SSTM). Patients and Methods: An observational study was carried out between June 2016 and December 2022 in our private setup on consecutive candidates of hysterectomy for severe pelvic endometriosis. Candidates were treated by the SSTM, which constitutes a systematic vagino-laparoscopic conservative strategy of hysterectomy with preservation of the ovary or ovaries followed by 24 months of postoperative depot-medroxyprogesterone acetate (DMPA) therapy. Cases were followed up to December 2022, 2.5 years beyond the last hysterectomy in May 2020. Main Outcome Measures: Relief of endometriosis-associated symptoms and prevention of recurrence in the long term. Results: Symptomatic relief of endometriosis-related pain, such as cyclical dysmenorrhoea, pelvic pain, dyschezia, and vaginal pain, occurred in all 68 (100%) cases from the next expected date of menstruation. None of the cases showed a recurrence of endometriosis-related pelvic pain; overall, 37 (54.41%) cases crossed 4-6 years, and 31 (45.58%) cases crossed 2.5-4.0 years following the hysterectomy operation. Four (5.88%) cases had non-endometriotic pelvic pain. None of the cases required repeat surgery or had any major side effects or complications due to DMPA. No major perioperative complications were observed. The results were achieved without the requirement of challenging extensive retroperitoneal laparoscopic dissection, ureterolysis, and rectum surgeries. Conclusion: This SSTM can be an option in indicated cases of severe pelvic endometriosis to provide symptom relief and prevent the recurrence of endometriosis-associated pelvic pain in the long term.

A Literature Review of Perioperative Outcomes of Robotic Radical Nephrectomy (RRN) Versus Laparoscopic Radical Nephrectomy (LRN) for Renal Cell Carcinoma (RCC).

Renal cell carcinoma (RCC) is an adenocarcinoma of the renal cortex. Radical nephrectomy remains the standard of care for managing massive renal tumours. Robotic-assisted radical nephrectomy is an increasing alternative technique to laparoscopic radical nephrectomy (LRN). The da Vinci Surgical System allows for improved dexterity, increased visualisation, tremor filtration and an ergonomic setting to enhance surgeon comfort. The aim was to compare the perioperative outcomes pertaining to operative time, intraoperative complications, blood loss and length of hospital stay between the robotic and LRN for RCC. Studies that compared the perioperative findings between robotic radical nephrectomy (RNN) and LRN for RCC were included. The literature review was carried out according to the Cochrane collaboration standards where applicable. Highly sensitive search strategies like MeSH terms and controlled vocabularies were used to identify relevant studies that compare the RNN outcomes to the LRN. Following the literature search, a total of 73 articles were collected, 60 articles were excluded at the stage of reviewing the titles, eight articles were excluded after reading the abstracts, and five articles were included in this paper. Five studies were included in this analysis, with a total sample size of 1770 patients, 735 were in the robotic arm, and 1035 were in the laparoscopic arm. Generally, there were no differences between both arms in terms of demographic data and age of patients. Closer analysis of the perioperative outcomes did not reveal significant differences between the two groups related to the estimated blood loss, length of hospital stay or post-operative complications. The laparoscopic techniques have less operative time than the robotic ones. RRN is an expanding approach for patients with RCC with some potential technical benefits over laparoscopic ones. RRN is similar to LRN in the perioperative outcomes, with few potential drawbacks of RRN, including higher costs. However, a prospective comparison of RRN with LRN in many cases at multiple centres with long-term oncological results best illustrates the status of RRN versus LRN.

A qualitative study of dental internships in Saudi Arabia: moving beyond perceptions to the reality of the practices of dental interns.

BACKGROUND: Dental internships are a vital way for recent graduates of undergraduate dentistry courses to bridge the gap between study and clinical practice. Interns' perceptions of dental internships have been explored in certain studies but the reality of the dental internship and dental interns' practical performance has not been examined. Therefore, this study aims to explore the reality of the dental internship as a transitional stage after completion of an undergraduate course in dentistry. METHODS: This qualitative research recruited 23 dental interns from Saudi Arabia's Riyadh Province. To explore the reality of dental internships, the research relied on a performative knowledge approach to examine interns' practices and performance. Diaries and semi-structured interviews conducted virtually were used to gather data across three months. The data was then subject to thematic analysis that applied an inductive strategy. The data analysis's credibility and trustworthiness were verified using triangulation techniques, an audit trail and member-checking. RESULTS: Five key themes concerning dental interns' practices were identified in this research: exploration, addressing knowledge gaps, responsibilities, decision-making and social connections. The most significant findings reveal that dental internships go beyond clinical work to include certain personal and social aspects that dental interns undertake during their internships. CONCLUSION: The findings of this research indicate that more real-world, practical knowledge should be integrated into the curricula of undergraduate dentistry programmes. In sum, this work highlights the need for holistic dental education that encompasses not only the clinical development of interns and students but also other elements such as their personal and social growth. Moreover, this research reveals that a performative knowledge approach can help researchers to identify significant findings regarding the practical experiences of dental interns. This study has implications for dentistry and any other medical speciality education programme that involves an internship.

Public Awareness Regarding Corticosteroid Use and Side Effects: A Cross-Sectional Study in Riyadh, Saudi Arabia.

The administration of corticosteroids may have possible hazards, ranging from minor adverse medication reactions to more serious considerations. We aimed to assess levels of public awareness concerning corticosteroid use, side effects, and predictors of its use. A cross-sectional study was conducted online throughout the period of May to July 2023. The present investigation utilized a previously developed questionnaire tool. The study encompassed a cohort of 732 individuals. Upon inquiry regarding the adverse effects of corticosteroid treatment, the participants predominantly reported weight gain, skin alterations, and fluid retention leading to breathing difficulties, constituting 44.4%, 30.3%, and 27.7% of the responses, respectively. The prevailing adverse effects observed in individuals using corticosteroids were weight gain, alterations in mood, and changes in skin characteristics, which accounted for 38.1%, 25.7%, and 21.8% of reported cases, respectively. Individuals within the age range of 41-50 years and those who are currently not working show a higher propensity for utilizing corticosteroids in comparison to other demographic groups (p < 0.05). The level of general public knowledge about corticosteroids and the side effects connected with them in Saudi Arabia was adequate. Demographic factors, such as age, gender, and education, have an impact on the use of corticosteroids.

The Management of Bacillus Calmette-Guérin (BCG) Failure in High-Risk Non-muscle Invasive Bladder Cancer: A Review Article.

Non-muscle invasive bladder cancer (NMIBC) is a common urological malignancy, and bacillus Calmette-Guérin (BCG) therapy is the gold standard treatment in intermediate and high-risk groups. However, BCG failure occurs in a significant proportion of patients, emphasizing the need for effective alternative treatment modalities to address this burden. These treatments include immunotherapy, enhanced drug delivery, targeted therapy, device-assisted chemotherapy, vaccine therapy, and gene therapy, which show varying degrees of safety and efficacy. The objective of this review is to summarize the current evidence and ongoing research on these emerging therapies, offering insight into their potential for improving patient outcomes and quality of life. Although radical cystectomy remains the standard of care for high-risk NMIBC patients unresponsive to BCG, novel treatment modalities hold promise for the future management of this challenging patient population.

Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis.

AIMS: To evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. METHODOLOGY: Individuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro­aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. RESULTS: The mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). CONCLUSION: Combined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.

Effectiveness of photodynamic therapy adjunct to oral debridement in improving clinical, microbiological, and pain in necrotizing ulcerative gingivitis.

To evaluate the efficacy of photodynamic therapy (PDT) as adjunctive to oral debridement (OD) in the improvement of clinical, microbiological, and pain in patients with necrotizing ulcerative gingivitis (NUG). Patients with NUG were split into two groups: Group-OD + PDT received PDT with OD, while Group-OD underwent OD alone. Clinical inflammatory parameters including full mouth plaque scores (FMPS), full mouth bleeding scores (FMBS), and probing depth (PD) were assessed. Fusobacterium nucleatum and Prevotella intermedia were analyzed using the polymerase chain reaction technique. Pain examination was done using various pain scales. Group PDT + OD showed more reduction in FMPS, FMBS, and greater reduction in F. nucleatum and P. intermedia count compared to group OD at 12 weeks follow up (p < 0.01). Group PDT + OD showed significantly lower pain scores at 12 weeks (p < 0.05). PDT was more effective in improving clinical parameters, and reducing bacterial counts and pain in NUG patients than dental scaling alone.

Outcomes of thymoglobulin versus basiliximab induction therapies in living donor kidney transplant recipients with mild to moderate immunological risk - a retrospective analysis of UNOS database.

INTRODUCTION: The aim of this study is to assess the outcomes of different induction therapies among mild to moderate immunological risk kidney transplants in the era tacrolimus and mycophenolate-derivate based maintenance. METHODS: This was a retrospective cohort study using data from the United States Organ Procurement and Transplantation Network among mild to moderate immunological risk living-donor KTRs, defined as having first transplant and panel reactive antibodies less than 20% but with two HLA-DR mismatches. KTRs were divided into two groups based on induction therapy with either thymoglobulin or basiliximab. Instrumental variable regression models were used to assess the effect of induction therapy on acute rejection episodes, serum creatinine levels and graft survival. RESULTS: Of the entire cohort, 788 patients received basiliximab while 1727 patients received thymoglobulin induction. There were no significant differences between basiliximab versus thymoglobulin induction in acute rejection episodes at one-year post-transplant (coefficient= -0.229, p value = .106), serum creatinine levels at one-year post-transplant (coefficient= -0.024, p value = .128) or death-censored graft survival (coefficient: - <0.001, p value = .201). CONCLUSION: This study showed no significant difference in acute rejection episodes or graft survival when using thymoglobulin or basiliximab in mild to moderate immunological risk living donor KTRs, maintained on tacrolimus and mycophenolate-based immunosuppressive regimen.

Methanol electro oxidation on Ni-Pt-CrO/CNFs composite: morphology, structural, and electrochemical characterization.

In this work, prepared nanoparticle samples of Ni1-xCrx with a fixed ratio of platinum (3%) were synthesized and loaded onto carbon nanofibers, which were produced by an electrospinning technique and carbonized at 900 °C for 7 h in an argon atmosphere. A variety of analysis techniques were applied to examine the stoichiometry, structure, surface morphology, and electrochemical activity. The carbonization process produces carbon nanofibers decorated with metal nanoparticles. Typical fibre diameters are 250-520 nm. The fibre morphologies of the treated samples don't exhibit any overt alterations. A study of the samples' methanol electrocatalytic capabilities was conducted. Cyclic voltammetry, chronoamperometry, and electrochemical impedance measurements were used to investigate catalytic performance and electrode stability as a function of electrolyte concentration, scan rate, and reaction time. The electrooxidation reaction's activation energy is increased, and the electrode's stability is increased, when Cr is added to Ni. In sample C3, the maximum current density (JPE) was 170.3 mA/cm2 at 0.8 V with an onset potential of 0.352 V. Utilizing our electrocatalysts, the electrooxidation of methanol involves a mix of kinetic and diffusion control limiting reactions. This study has shown how to fabricate a powerful Ni-Pt-Cr-based methanol electrooxidation catalyst using a novel approach.

Effect of Clavipectoral Fascia Suturing on Postmastectomy Seroma Formation.

<b><br>Introduction:</b> Post-mastectomy seroma formation is a challenging sequela which has a negative impact on patient recovery and quality of life.</br> <b><br>Aim:</b> We aim to publicize our technique of clavipectoral fascia re-closure and to assess its efficacy in reducing the incidence of seroma formation.</br> <b><br>Methods:</b> This is a prospective randomized controlled trial, conducted in South Cancer institute, Assiut University, Egypt. It included 84 breast cancer patients who were randomly divided into two groups: a control group (n = 44) and a fascia suture group (n = 40). The patients were followed up until drain removal and then to 3 months after surgery.</br> <b><br>Results:</b> The fascia suture group showed significantly shorter duration of drain removal with a significant reduction in the total amount of drained fluid and the amount of drained fluid 1 week postoperatively. One patient in the fascia suture group developed Grade 2-3 seroma vs. 7 in the control group (P < 0.05).</br> <b><br>Conclusions:</b> Clavipectoral fascia suture technique is a simple and effective method for reducing seroma formation after mastectomy in breast cancer patients and is advisable in patients at a high risk for seroma formation.</br>.

Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder in children and adults, which increased over the past twenty years. The Mediterranean diet is a well-known diet full of antioxidants and anti-inflammatory ingredients. AIM: To evaluate the safety, tolerability, and effects of adherence to the Mediterranean diet on disease patterns in children and adolescents with IBS. METHODS: This prospective, cross-sectional case-controlled study included 100 consecutive IBS patients diagnosed according to Rome IV criteria, aged 12-18 years. Patients were subdivided into two groups (50 patients each); Group I received a Mediterranean diet, and Group II on their regular diet for six months. Besides IBS scores (IBS-SSS, IBS-QoL, and total score), different clinical and laboratory parameters were evaluated at the start and end of the study. RESULTS: The Mediterranean diet was safe and well-tolerated in IBS patients. IBS children and adolescents with good adherence to the Mediterranean diet (KIDMED Score ≥ 8 points); group I showed significant improvement in IBS scores. IBS-SSS in the Mediterranean diet group was 237.2 ± 65 at the beginning of the study and decreased to 163.2 ± 33.8 at the end of the study (P < 0.001). It did not show a significant improvement in the group with a regular diet (248.3 ± 71.1 at the beginning of the study compared to 228.5 ± 54.3 at the study end with P < 0.05). The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet. Mean IBS-QoL in group I improved from 57.3 ± 12.9 at the start of the study to 72.4 ± 11.2 at the study end (P < 0.001) and significantly improved when compared to its level in group II at the study end (59.2 ± 12.7 with P < 0.001), while group II showed no significant improvement in IBS-QoL at the study end when compared to the beginning of the study (59.2 ± 11.7 with P >0.05). The mean total IBS score in group I became 28.8 ± 11.2 at the end of our study compared to 24.1 ± 10.4 at the start (P < 0.05) and significantly improved when compared to its level in group II at the end of the study (22.1 ± 12.5 with P < 0.05), while in group II, non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study (22.8 ± 13.5 with P > 0.05). CONCLUSION: The Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.

A recent chikungunya outbreak associated with the occurrence of Aedes vectors (Diptera: Culicidae) in Kassala state, eastern Sudan in 2018.

Aedes aegypti and Ae. albopictus (Diptera: Culicidae) are primary vectors of human arboviral diseases such as dengue, chikungunya, yellow fever, and Zika viruses. Aedes aegypti is well distributed in Sudan, except in Northern and Khartoum states, while Ae. albopictus has not been previously reported. Recently, Eastern Sudan witnessed an unprecedented large outbreak of chikungunya fever between 31 May 2018 and 30 March 2019. The outbreak was composed of four waves; one of them was in Kassala state. Aedes survey in localities of Kassala state (rather than Kassala city) is carried out to assess the possible expansion of the disease in the state. The results showed the presence of immature stages of Aedes spp. in four localities from ten localities. From the four localities that recorded Aedes spp., two localities (Rural Kassala and West Kassala) were reported with chikungunya cases. From this investigation, Ae. albopictus was reported for the first time in Sudan. Also, this investigation showed the importance of conducting entomological surveys with epidemiological surveys during outbreaks of arboviral diseases.