Frequentist Interpretation of Probability

Three series of azole piperazine derivatives that mimic dicyclotyrosine (cYY), the natural substrate of the essential Mycobacterium tuberculosis cytochrome P450 CYP121A1, were prepared and evaluated for binding affinity and inhibitory activity (MIC) against M. tuberculosis. Series A replaces one phenol group of cYY with a C3-imidazole moiety, series B includes a keto group on the hydrocarbon chain preceding the series A imidazole, whilst series C explores replacing the keto group of the piperidone ring of cYY with a CH2-imidazole or CH2-triazole moiety to enhance binding interaction with the heme of CYP121A1. The series displayed moderate to weak type II binding affinity for CYP121A1, with the exception of series B 10a, which displayed mixed type I binding. Of the three series, series C imidazole derivatives showed the best, although modest, inhibitory activity against M. tuberculosis (17d MIC = 12.5 μg/mL, 17a 50 μg/mL). Crystal structures were determined for CYP121A1 bound to series A compounds 6a and 6b that show the imidazole groups positioned directly above the haem iron with binding between the haem iron and imidazole nitrogen of both compounds at a distance of 2.2 Å. A model generated from a 1.5 Å crystal structure of CYP121A1 in complex with compound 10a showed different binding modes in agreement with the heterogeneous binding observed. Although the crystal structures of 6a and 6b would indicate binding with CYP121A1, the binding assays themselves did not allow confirmation of CYP121A1 as the target

Evaluation of Topical Capislow Extract and Long Pulsed Nd-YAG Laser in the Treatment of Idiopathic Hirsutism

Introduction: Hirsutism is a condition that affects 10% of women worldwide. In many cultures, hirsutism is regarded as loss of femininity and can be psychologically traumatizing to the suffering females. The aim of the present study was to evaluate how topical capislow would affect or enhance the efficacy of laser hair removal.Methods: A randomized, monoblinded, placebo controlled split face study of combined topical capislow and long pulsed Nd-YAG laser on one side of the face versus long pulsed Nd-YAG laser alone on the opposite side of the face. Laser sessions were done at 4 weeks interval for maximum seven sessions. Topical capislow and placebo were applied once daily from the day of the first laser session to the day of the last laser session. Patients were evaluated both subjectively and objectively in each laser session and for six months after the last laser session.Results: Both treatment modalities were well tolerated and accepted with significantly better results in combined capislow and laser group versus laser alone.Conclusion: Topical capislow can represent a safe and effective synergistic method for laser with faster results but this is a temporary effect retained only to the time of its application

Studying the Relation between lipid profile and HbA1c in elderly patients with Type 2 Diabetes

Introduction: Diabetes mellitus is characterized by chronic hyperglycemia with disturbances in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Glucose and lipid metabolism are linked to each other. It is well known that dyslipidemia is considered a major risk factor for macrovascular complications in patients with type-2 diabetes mellitus. Recently, obesity-related metabolic syndrome has received widespread attention. The aim of the current study was to find out the correlation between HbA1c, lipid profile and BMI of elderly patients with type 2 Diabetes mellitus.Methods: A cross-sectional observational study was conducted in a sample consists of one hundred and sixty elderly patients with type 2 diabetes. Glycemic control, lipid profile, body mass index (BMI) were assessed.Results: There was a significant positive correlation between HbA1c and FBS with total cholesterol, LDL and triglycerides and a significant negative correlation with HDL. Also, there was a significant positive correlation between HbA1c and FBS with BMI.Conclusion: Increased levels of HbA1c, is associated with dyslipidemia and increased BM

Off-pump coronary bypass grafting with or without the use of intracoronary shunts

Background: There is scarce literature comparing the role of the intracoronary shunt during off-pump coronary artery bypass grafting (CABG). This study aimed to compare off-pump CABG using intracoronary shunt versus the coronary clamp during distal coronary artery anastomosis. Methods: We conducted this randomized study between January and June 2018. We randomized 30 patients into two groups. Group A (n= 15) included patients who had coronary clamping during off-pump CABG, and Group B (n= 15) included patients who had intracoronary shunt during off-pump CABG. Study endpoints were anastomosis time and postoperative cardiac enzyme levels. Results: The mean age of the shunt group was higher than the mean age of the clamp group (61.06 ± 7.26 vs. 56.72 ± 12.44, respectively, p=0.03). Our study showed no statistical difference between the two groups regarding sex (p˃0.99), hypertension (p˃0.99), and diabetes (p=0.14). The distal anastomosis time was longer in the shunt group than in the clamp group (39.80±4.55 vs. 32.27±6.06 minutes, respectively, p=0.001). The postoperative troponin I (0.61±0.11 vs. 0.26±0.089 ƞg/ml, p<0.001), and CK-MB levels (44.27±5.34 vs. 35.5±4.86 IU/L, p<0.001) were significantly higher in the clamp group. Conclusion: The intracoronary shunt could be associated with lower cardiac enzyme release compared to the clamp technique. However, it was associated with a longer distal anastomosis time

Vitamin E Attenuates Cardiomyopathy Via Alleviation of Autophagic Stress

Introduction: Vitamin E (Vit E) is well known antioxidant. Bisphenol A (BPA), widely used industrial chemical product, is associated with increased risk for cardiac diseases to identify the potential protective effect of Vit E on BPA induced cardiomyopathy by alleviation of oxidative and autophagic stress through its antioxidant effect. Materials and Methods: Twenty –four adult male rates were used in the study. They were randomly divided into 4 groups; negative control, vit E positive control, BPA, and vit E treated group. All chemicals were given orally via gastric gavage for 14 days. Rats were sacrificed and their hearts were dissected out. Serum, cardiac homogenates, and cardiac tissues were obtained for biochemical and histopathological evaluation. Results: There were significant increase in serum DH and CK-MB, tissue homogenates showed elevated levels of NO and MDA and decreased level of GSH in BPA group. Immunohistopathological evaluation of autophagic mediators showed significant increase in LC3 and P62 in BPA group. On Histological examination, there was pathological alteration in BPA group compared to normal group. Vit E administration showed significant improvement in cardiac enzymes and oxidative stress. Also, alleviation of autophagic process and restoration of the myocardial architecture with reduction of the fibrous tissue were observed with vit E administration. Conclusion: These results demonstrate that vitamin E exhibit substantial protective effects in BPA induced cardiotoxicity by attenuating inflammation, oxidative stress, and alleviation the autophagic process

Intervention Study to Upgrade Patient Safety Practices in Pediatric Intensive Care Units of Cairo University Children Hospital

BACKGROUND: The World Health Organization calls patient safety “an endemic concern.†Keeping patients safe is viewed as a global public health problem and a human rights issue. An environment where safety culture prevails is considered the biggest obstacle to improve patient safety. Proactive efforts to identify, prevent, and eliminate errors have the potential to significantly improve safety. Pediatric intensive care unit (PICU) is high-hazard and -risk environments. AIM: The aim of this study is to enhance compliance to patient safety practices within the general PICUs in Cairo University Children’s Hospital. METHODS: This is a pretest-posttest interventional study. A tailored intervention after the baseline assessment was designed and implemented followed by reassessment. All physicians and nurses present in the general PICUs who were available and consented participated in the study. A questionnaire for knowledge and attitude and a checklist for practice assessment of the participants were used. RESULTS: The median age of the participants was 30 years and interquartile range (28–40). There was a statistically significant difference between those who received patient safety training and those who did not in patient safety knowledge. The median knowledge score increased significantly after the intervention. Regarding the attitude of the studied personnel toward their perception of patient safety culture’s dimensions before and after the intervention, there was no statistically significant difference in some dimensions and a statistically significant improvement in some others. CONCLUSION: The strategies based on patient safety awareness-raising among health-care providers together with commitment and enthusiasm among senior leadership in the hospital can potentially improve compliance with practice and consequently lead to better patient safety

Developing Monitoring and Evaluation Dynamic Systems for Alternative Families with Fostered Children/ تصميم أنظمة ديناميكية للمتابعة والتقييم للأسر البديلة للأطفال بالكفالة

Since 2016, the Egyptian Government has made many improvements to the Alternative Families System that aims to provide children without parental care with families. Yet, these families still face some obstacles in the monitoring and follow-up system after adoption. The paper sheds light on these obstacles; the roots and solution. We depend on qualitative methodological approaches, based on a purposive sample of key informants consisting of governmental officials, national and international entities, using in-depth interviews as the main tool for data collection, and surveys. As a result of our research, we found that there are limitations that affect the increasing number of abandoned children and make it harder for the families to take the decision of adoption, or worse, the deficiencies in the follow-up and monitoring system may lead to child abuse for the adopted children, such as the lack of skillful social workers. In addition, there is a dilemma in the Supportive role vs. the Supervisory role of the monitors. Finally, negative societal stereotyping towards abandoned children was identified especially by government officials in the MoSS. This paper recommends reviewing the existing monitoring and follow-up strategies, upgrading the existing human capital, criteria of their selection, and related systems, and developing a national awareness campaign, especially through social media channels, to work on eliminating the effect of the social stigma towards the concept of adopted children

FABP1 as an Early Marker of Diabetic Nephropathy in Type 2 Diabetic Patients

Background: The prevalence of diabetes mellitus, a worldwide burden, is expected to affect more than 350 million people by 2035, About one-third of diabetic patients have microalbuminuria after 15 years of disease duration, and nearly half of them develop real kidney disease, Early detection and intervention are essential in the prevention and treatment of diabetic nephropathy (DN). LFABP( u-LFABP) has been demonstrated to be a marker of tubular damage., Several studies have shown that u-LFABP could be a useful marker for the detection of early stage of DN. Aim: Assess if FABP1 is an early marker of diabetic nephropathy in type 2 diabetic patients. Methods: This is a cross sectional study 120 diabetic patients (40 with norm albuminuria, 40 micro albuminuria and 40 macroalbuminuric was conducted at El-Kasr Aini Cairo University Hospital. The patients were recruited from the outpatient clinics of endocrinology and internal medicine. Detailed medical history, complete physical examination for type II diabetic patients aged (35-65) years old., Laboratory investigations including Fasting blood glucose, blood urea, serum creatinine, HbA1c and lipid profile for all participants. Estimated GFR will be measured by Modification of Diet in Renal Disease (MDRD) equation, The relation between morning spot urine sample ACR and urinary FABP1 will be studied, also FABP1 urinary was correlated to (eGFR, HbA1c, lipid profile). Results: Urinary L-FABP1 levels were elevated in the microalbuminuric and macroalbuminuric groups compared to the normoalbuminuric group, but this difference was not statistically significant. The highest concentration was noted in the microalbuminuric group.Conclusion: urinary L-FABP1 may serve as a marker of tubular damage in diabetic nephropathy. However, its predictive and diagnostic value remains uncertain due to the lack of statistically significant differences observed in our study.. Larger-scale studies with longer follow-up periods may help clarify whether urinary L-FABP1 can be a reliable biomarker for DN progression in diabetic patients

Ligation of Intersphincteric Fistulous Tract versus Fistulotomy in Low Trans-Sphincteric Perianal Fistula

Background: Anal fistula, which causes periodic swelling and pain in the perianal area followed by spontaneous leakage, is an abnormal connection between the anal canal and the perianal skin. The majority are connected to the development of abscesses, with a perianal fistula existing at the time of presentation in one-third of patients with an anorectal abscess. Objectives: to determine the safety and efficacy of the Ligation of Intersphicteric Fistulous Tract operation (LIFT) in comparison with fistulotomy. Patients and methods: On 60 patients with low trans-sphincteric perianal fistulas, this prospective, randomized comparative research was done at the General Surgery Department of Qena Faculty of Medicine. Patients were split into two groups: Group (A): 30 patients underwent LIFT techniques. Group (B): 30 patients underwent fistulotomy. The duration of the study ranged between 6-12 months, Results: Body Mass Index (BMI) was statistically substantial greater in patients treated by LIFT than those treated by fistulotomy. While pain score and healing time were statistically substantial lower in patients treated by LIFT than those treated by fistulotomy. There is no statistically substantial variation between patients treated by fistulotomy and LIFT as regard the development of complications as recurrence or incontinence. Conclusion: In comparison to open fistulotomy, the LIFT operation is a successful and preferred sphincter-saving method for fistula-in-ano, with a quicker healing period and a decreased frequency of postoperative anal leakage

Protective Role of Nanocurcumin in Cyclophosphamide-induced Cardiac Toxicity in Adult Male Albino Rat: A Histological, Immunohistochemical, Biochemical Study

Background: Cyclophosphamide (CYP) is a cardiotoxic agent with antineoplastic and immunosuppressive properties. Objectives: To detect the histological, immunohistochemical, biochemical cardiac toxicity of CYP and determine the protective effectiveness of nanocurcumin on the cardiac muscle of albino rats. Material and methods: The current work used forty Wistar rats allocated into four groups; normal control (I), sham control (II), CYP-treated (III) and concomitant protective CYP + nanocurcumin (IV). Results: CYP-treated group (III) showed fragmented, disrupted cardiac myocytes with cellular infiltrates and interstitial edema. Blood vessels were dilated congested. Cardiac myocytes showed pyknosis, vacuolations and some showed karyolysis. Much improvement was observed in group IV. The area percentage of fibrous tissue, TNF-α and iNOS immunoreactivity in CYP-treated group III showed statistically significant increase in contrast to that of the control group. Use of nanocurcumin in groups IV ameliorate these changes. Biochemically, there were significant increase in means of CK-MB, cTn-1, MDA, levels and decrease of GPx activity in group III (CYP -treated group) compared to the control group. Uses of nanocurcumin has been observed to improve these changes. Conclusion: Cyclophosphamide (CYP) had deleterious effects on the histological structure of the heart, cardiac enzymes, collagen fibers deposition and myofibroblast proliferation in albino rats. Administration of nanocurcumin with CYP injection could largely ameliorate these changes