Exposure of femoral vessels through transverse inguinal crease versus vertical incision

Background: Traditional vertical wound in the femoral triangle carries high risk of more lymphatic affection and complication. So, alternative transverse inguinal crease incision (TICI) is used to avoid such complications.Aim: to compare the transverse inguinal crease incision with the traditional vertical one (VII) during exposure of femoral vessels for any vascular purpose.Patients and methods: a comparative study was done. 80 groin incisions (40 for transverse and 40 for vertical incisions for femoral vessel exposure) in SAYED GALAL and ALHUSSIEN University Hospitals from January 2019 to January 2021.Results: Wound infection rate was 12.6% in VII group compared to 6.3% in TICI group. 13% seroma were observed in VII group; while in TICI group, only 6 (7.5%) seroma were observed. Nine hematomas were observed in VII group (11%) compared to 7.5% in TICI group. Graft occlusion was 7.5% in VII which was higher than TICI that was 5% (4 cases). 7.5% suffered from paresthesia in VII group compared to no case of paresthesia in TICI group. The duration of postoperative stay after VII surgery was relatively longer than that following TICI group which were 14 day compared to 9 days respectively.Conclusion: The TICI is a good maneuver for exposure of the femoral vessels used for all supra- and infra-inguinal procedures except when the wound extension is expected. TICI has decreased complications rate and shortened hospital stay compared to VII

USING PROBLEM-BASED LEARNING WITH THE HELP OF THE INTERNET FOR DEVELOPING SOME OF ESSAY SYNTACTIC STRUCTURES SKILLS

Each language has its own taste. Syntactic structures are important for student teachers at Faculty of Education. A student teacher develops his writing when he is able to make use of syntactic structures. Writing helps in communication, forming ideas, and makes information to be clear to student teachers. In English, syntactic structures are neglected in the communicative approach. The current study deals with syntactic structures as it has an important role in English writing to student teachers. The aim of the study is to investigate the effect of Problem-Based Learning Strategy with the Help of the Internet to Develop Some of Essay Syntactic Structures Skills in English of third year English majors at Faculty of Education. Questions of the study were:What are syntactic structures skills in which student teachers' achievement levels of third year English majors are low at Faculty of Education, Beni-Suef University?To what extent does using problem−based learning strategy with the help of the Internet affect essay syntactic structures skills of third year English majors at Faculty of Education, Beni−Suef University?To what extent does using problem problem−based learning with the help of the Internet affect essay syntactic structures skills of third year English majors at Faculty of Education, Beni−Suef University in general?In the diagnostic test, participants of the study were 31 student teachers at Faculty of Education, Beni-Suef University. In the post test, student teachers were 39 after they had been 45 in the pre/test.            Procedures included administering the diagnostic test after making sure of validity and reliability. According to the results of the diagnostic, test which was the first question of the study: the researcher designed a program to help student teachers develop their skills of essay syntactic structures skills. Before administering the pre/test, the researcher determined validity as the test was submitted to juries, then reliability was achieved. Student teachers' scores were low in the diagnostic and the pre/post/ tests. Afterwards, the researcher started teaching the program after it had been designed. Students were given the instructional materials. The researcher used the problem solving based learning strategy with the help of the Internet.            Results of the study: To answer question 2 it is shown in (table 4) where means were obvious stating the differentiation between the pre/test and post/test in every skill; To answer question 3, it is shown in (table 5) where means were clear stating the differentiation between the pre/test and post/test in all skill. T test was 18.373 student teachers at Faculty of Education made use of the program. It would be better to focus on the importance of problem−based learning with the help of the internet at schools and Faculties of Education to develop the skills of essay syntactic structures skills.  Article visualizations

Using phytoestrogens as aprophylaxis against irregular uterine bleeding possibly occurring while using Depot-medroxyprogesterone acetate (DMPA) as a contraceptive method

Background: High-dose progestogen - only contraceptives, such as injectable DMPA, inhibit follicular development and prevent ovulation as their primary mechanism of action. Inhibition of ovarian function during DMPA use causes the endometrium to become thin and atrophic. These changes in the endometrium in the first months of use results in irregular or unpredictable bleeding or spotting, or rarely, heavy or continuous bleeding  .Phytoestrogens are plant-derived xeno-estrogens functioning as the primary female sex hormone not generated within the endocrine system but consumed by eating phytoestrogenic plants. Also called “dietary estrogens”, they are a diverse group of naturally occurring non-steroidal plant compounds that, because of their structural similarity with estradiol (17-β-estradiol), have the ability to cause estrogenic or/and antiestrogenic effects through binding to estrogen receptors. The management of women who present with unscheduled bleeding while using hormonal contraception is challenging. Although numerous research studies have attempted to investigate preventative and therapeutic treatments for women using hormonal contraception with unscheduled bleeding, none are of sufficient quality to guide management in clinical practice usefully. In this study we are testing the ability of phytoestrogens to prevent the break-through bleeding that can occur during the use of depot medroxy-progesterone acetate as a contraceptive.Methods: Fifty cases of depot provera users are selected and divided into two groups: group I: 25 cases will start the injection alone. Group II: 25 cases will start the injection with using regular daily phytoestrogen. All cases are followed up for the first six months after the injection for the occurrence of break-through bleeding, and the endometrial thickness using the trans-vaginal ultrasonography.Results: There was a statistically significant difference in the endometrial thickness between group receiving depot provera alone and the group receiving both depot provera and phytoestrogen.Conclusions: We can use phytoestrogens to decrease DMPA-associated vaginal bleeding.

Can metformin limit weight gain in the obese with pregnancy?

Background: Maternal overweight and obesity is associated with many obstetric complications.  Obesity is linked to insulin resistance. Improving insulin sensitivity may therefore account for weight reduction. Metformin was found to be effective in type 2 diabetes and polycystic ovarian syndrome through improving insulin sensitivity. Several studies proved its efficacy in the obese non- pregnants, but its role during pregnancy is not yet well-established. In this study, we are testing the ability of metformin to limit weight gain with pregnancy and therefore reducing complications as gestational Diabetes and hypertension.Methods: A prospective study was conducted in Alexandria, Egypt. The study was registered in the South African Cochrane Centre under an identification number PACTR201505001142202. Two Hundreds participants with a BMI of ≥35 Kg/m2, pregnant in the early second trimester, were equally divided into two groups; in which group 1 will receive metformin 500 mg twice a day and group 2 will receive placebo. Prior to inclusion, 75 g oral glucose tolerance test, fasting insulin, fasting blood glucose, 1 h and 2 h glucose blood and HbA1C were measured .Both groups were followed up monthly for weight and for pregnancy complications namely gestational diabetes and pre-eclampsia till 36 weeks of pregnancy.Results: There was a significant difference in the weight gain and the one hour blood sugar measurement between the two groups, but not in the occurrence of pregnancy complications namely gestational diabetes and hypertension.Conclusions: Metformin succeeded to limit weight gain the obese with pregnancy

Can Co-enzyme Q10 improve the chances of conception after the age of 35?

Background: ovarian follicular quality diminishes with age, Free radicals and oxidative stress begin to accumulate in cells, aging or slowing down the metabolic energy production centers in the cell- the mitochondria. When the mitochondria cannot generate a certain amount of energy, it slows growth and proper development of the follicle making it more prone to DNA damage, including chromosomal abnormalities resulting in poor fertilization patterns, and early miscarriage. Co-enzyme Q10 (CoQ10) is a major cellular antioxidant. its tissue levels gradually decrease with age. We attempt to evaluate its protective effect on ROS-induced ovarian damage, which is one of the most important and widely accepted patho- mechanisms underlying cell ageing.Methods: 40 Participants   from El Shatby hospital infertility clinic 35 to 38 years old, with history of bad response to ovulation stimulation, were divided into two equal groups (group A given (CoQ10) 3mg|kg body weight for three cycles prior to stimulation Serum anti- mullarian hormone level was measured before and after CoQ10 administration, group B= twenty cases as control). Participants were given gonadotrophins (150 IU to 375 IU). Follicular growth was monitored by trans- vaginal ultra- sonography and serum estradiol level (E2). Ovulation trigger was achieved using 10,000 IU of human chorionic gonadotrophin.Results: The primary outcome was occurrence of normal pregnancy; secondary outcome was good response to stimulation (at least one mature follicle 18-22mm).Conclusions: CoQ10 has no significant effect on response to ovulation stimulation or on pregnancy rates

Craig Wishart interview

This is an interview with professor Craig Wishart, discussing the current safety conditions of Egypt

Finite element modelling of shear connection for steel-concrete composite girders

The main objective of this thesis is to develop effective 3-dimensional finite element models to trace the behaviour of headed stud shear connectors in composite girders with solid slabs and precast hollow core slabs. The finite element package ABAQUS was used to conduct the analysis. Push-off tests with both types of slabs were simulated taking into consideration all material nonlinearities of the components. The models are able to predict the headed shear stud capacity, the load-slip characteristic of the shear connection and modes of failure. The results obtained show good agreement with specified data from Codes of practice and results of available numerical and experimental literature. Parametric studies were carried out using both models to investigate the effects of the change in different parameters on the behaviour of shear connections. Full-scale push-off tests with solid and precast hollow core slabs have been carried out to verify the finite element models. The shear connection capacity, load-slip curves and modes of failure were detected from experimental investigation. Both numerical and experimental results were compared and good agreement has been achieved. The comparison has shown that the model is able to predict accurately the behaviour of headed studs in composite girders with both types of slabs. The non-linear load-slip characteristics of the headed shear stud connector obtained from FE models of push-off tests were used in modelling the structural behaviour of composite steel-solid slab concrete and steel-precast hollow core slab girders. A finite element model has been developed for the analysis of each type. The models took into account the non-linear behaviour of concrete slab, steel beam and shear connectors. The accuracy and efficiency of the models have been demonstrated by comparing finite element results with available published experimental and numerical research. An effective parametric study for the evaluation of the effective width for steel-precast concrete slab composite girders is presented