The role of preoperative computed tomography in surgical planning of intertrochanteric femur fractures fixation

Background: A precise preoperative evaluation of stability of intertrochanteric fractures is crucial for surgical planning. Three dimensional CT scanning is a useful tool for understanding the exact type of fracture pattern.  Methods: A prospective study included 40 patients with intertrochanteric femoral fractures. They were classified into stable and unstable intertrochanteric fractures according to the X-ray based AO/OTA classification and according to Nakano 3D-CT classification and both classifications were correlated. The patients were operated on using dynamic hip screw (DHS) and were assessed radiologically and clinically by Harris hip score (HHS) after 6 months. Results: There was significant statistical difference (p=0.031) and relation (p<0.001) between X-ray based AO/OTA classification and 3D-CT classification. Six cases from the 24 cases with stable pattern in AO/OTA system have unstable patterns in the 3D-CT (25%) and their percent from the 22 unstable patterns in 3D-CT is 27.27% and their percent from the total number of patients in the study is 15%.  Conclusions: The superolateral support in the form of the greater trochanter which affects the lateral wall thickness is as important as the posteromedial lesser fragment in assessing the stability of the fracture pattern.

Management of postpartum iron deficiency anemia: review of literature

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis

Video streaming in urban vehicular environments: Junction-aware multipath approach

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. In multipath video streaming transmission, the selection of the best vehicle for video packet forwarding considering the junction area is a challenging task due to the several diversions in the junction area. The vehicles in the junction area change direction based on the different diversions, which lead to video packet drop. In the existing works, the explicit consideration of different positions in the junction areas has not been considered for forwarding vehicle selection. To address the aforementioned challenges, a Junction-Aware vehicle selection for Multipath Video Streaming (JA-MVS) scheme has been proposed. The JA-MVS scheme considers three different cases in the junction area including the vehicle after the junction, before the junction and inside the junction area, with an evaluation of the vehicle signal strength based on the signal to interference plus noise ratio (SINR), which is based on the multipath data forwarding concept using greedy-based geographic routing. The performance of the proposed scheme is evaluated based on the Packet Loss Ratio (PLR), Structural Similarity Index (SSIM) and End-to-End Delay (E2ED) metrics. The JA-MVS is compared against two baseline schemes, Junction-Based Multipath Source Routing (JMSR) and the Adaptive Multipath geographic routing for Video Transmission (AMVT), in urban Vehicular Ad-Hoc Networks (VANETs)

Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001–2013 cross-sectional study

Introduction: The incidence of HIV/AIDS is increasing worldwide and in the Middle East. In this study, we analyzed the use of antiretroviral therapy (ART), the patterns of CD4 and viral load (VL), and stage of presentation. Methodology: Laboratory variables, ART use, and CD4 count were obtained and analyzed retrospectively. Results: A total of 997 cases from eight HIV/AIDS care providers were included. Of the total cases, 274 (28.3%) had a CD4 count of 5 log10. Of the total cases, 50% were on highly active antiretroviral therapy (HAART), and the majority of cases were asymptomatic (70%). Of those patients on ART, 247 (39.5%) took tenofovir/emtricitabine combined with either efavirenz (147; 14.7%) or lopinavir/ritonavir (100; 10%), and 158 (15.8%) were on lamivudine and zidovudine with either efavirenz (32; 3.2%) or lopinavir/ritonavir (126; 12.6%). Other combinations were used in 70 (7%) patients. The mean (± standard deviation) of baseline CD4 and viral load were 401 cells/mm3 (322 cells/mm3) and 4.6 log1010 (1.3 log10), respectively. At diagnosis, 72% of patients were asymptomatic; 50% had AIDS and 20% had CD4 count < 350. Conclusions: ART use was in line with international guidelines, but the number of patients receiving ART was lower than expected. Large proportions of cases presented late with AIDS at diagnosis or had CD4 < 350. Further data is needed to evaluate the medical care of patients with HIV/AIDS in the Kingdom of Saudi Arabia

Inhibitory activity of benzo[h]quinoline and benzo[h]chromene in human glioblastoma cells

Purpose: To carry out a neat synthesis of 2-amino-5,6-dihydro-8-methoxy-4-phenylbenzo[h]quinoline-3- carbonitrile (compound 2) and 2-amino-5,6-dihydro-8-methoxy-4-phenyl-4H-benzo[h]chromene-3- carbonitrile (compound 3) and evaluate their cytotoxic activity in human glioblastoma cells.Methods: Benzo[h]quinoline and benzo[h]chromene were synthesized by treating 6-methoxy-1- tetralone with benzylidenemalononitrile under microwave irradiation. The structures of compounds 2 and 3 were confirmed by elemental, spectral, and x-ray crystallographic analyses. The cytotoxic activity of compounds 2 and 3 was evaluated using WST-1 assay in U373 human glioblastoma cell line.Results: The molecular structures of compounds 2 and 3 were demonstrated unambiguously from single crystal x-ray measurements and they crystallized in triclinic form, P-1, for both compounds. In vitro cytotoxic activity data for compound 2 in human glioblastoma cell line (U373) indicate that no significant cytotoxicity was observed. On the other hand, compound 3 showed highly significant cytotoxic effects on U373 cells at concentrations starting from 0.1 μg/ mL.Conclusion: Compound 3 produces a decrease in cell viability with approximately 80 % cell death while compound 2 did not indicate significant cytotoxic activity. This suggests that the chromene moiety of compound 3 may be responsible for its high cytotoxicity.Keywords: Hydronaphthaline, Benzo[h]quinolone, Benzo[h]chromene, X-ray crystallography, U373 human glioblastoma, Cytotoxicity, Chromene moiet

Designing Lightweight 3D-Printable Bioinspired Structures for Enhanced Compression and Energy Absorption Properties

Recent progress in additive manufacturing, also known as 3D printing, has offered several bene-fits, including high geometrical freedom and the ability to create bioinspired structures with intri-cate details. Mantis shrimp can scrape the shells of prey molluscs with its hammer-shaped stick, while beetles have highly adapted forewings that are lightweight, tough, and strong. This paper introduces a design approach for bioinspired lattice structures by mimicking the internal micro-structures of a beetle’s forewing, a mantis shrimp’s shell, and a mantis shrimp’s dactyl club, with improved mechanical properties. Finite element analysis (FEA) and experimental characterisation of 3D printed polylactic acid (PLA) samples with bioinspired structures were performed to deter-mine their compression and impact properties. The results showed that designing a bioinspired lattice with unit cells parallel to the load direction improved quasi-static compressive perfor-mance, among other lattice structures. The gyroid honeycomb lattice design of the insect forewings and mantis shrimp dactyl clubs outperformed the gyroid honeycomb design of the mantis shrimp shell, with improvements in ultimate mechanical strength, Young’s modulus, and drop weight impact. On the other hand, hybrid designs created by merging two different designs reduced bend-ing deformation to control collapse during drop weight impact. This work holds promise for the development of bioinspired lattices employing designs with improved properties, which can have potential implications for lightweight high-performance applications

Designing Lightweight 3D-Printable Bioinspired Structures for Enhanced Compression and Energy Absorption Properties

Recent progress in additive manufacturing, also known as 3D printing, has offered several bene-fits, including high geometrical freedom and the ability to create bioinspired structures with intri-cate details. Mantis shrimp can scrape the shells of prey molluscs with its hammer-shaped stick, while beetles have highly adapted forewings that are lightweight, tough, and strong. This paper introduces a design approach for bioinspired lattice structures by mimicking the internal micro-structures of a beetle’s forewing, a mantis shrimp’s shell, and a mantis shrimp’s dactyl club, with improved mechanical properties. Finite element analysis (FEA) and experimental characterisation of 3D printed polylactic acid (PLA) samples with bioinspired structures were performed to deter-mine their compression and impact properties. The results showed that designing a bioinspired lattice with unit cells parallel to the load direction improved quasi-static compressive perfor-mance, among other lattice structures. The gyroid honeycomb lattice design of the insect forewings and mantis shrimp dactyl clubs outperformed the gyroid honeycomb design of the mantis shrimp shell, with improvements in ultimate mechanical strength, Young’s modulus, and drop weight impact. On the other hand, hybrid designs created by merging two different designs reduced bend-ing deformation to control collapse during drop weight impact. This work holds promise for the development of bioinspired lattices employing designs with improved properties, which can have potential implications for lightweight high-performance applications

Isolation and identification of a prodigiosin-like pigment producer Vibrio sp. isolate from a sea snail Thais sp

Marine bacteria associated with Mediterranean Sea snails have not been explored intensively. The aim of the study was to explore marine pigmented bacteria associated with the sea snail Thais sp. commonly found in Alexandria seashores where a red-pigmented bacterium was isolated and identified as Vibrio sp. based on phenotypic traits and 16S rRNA gene sequence analysis. Based on ultraviolet-visible (UV-vis) spectral and liquid chromatography-mass spectrometry (LC-MS) analysis, the red pigment was identified as a prodigiosin-like pigment. To our knowledge, this is the first report on the isolation of a Vibrio strain from a gastropod able to synthesize prodigiosin. Maximum production (7 mg/L) was achieved after two days in MZM cultures containing 0.5% mannitol and 2.5% soybean meal, pH 7 and statically incubated at 30 °C, using Plackett-Burman factorial design. RT-qPCR revealed that pks-1 and nrps responsible for the biosynthesis of prodigiosin and other bioactive compounds were up-regulated by the addition of sublethal concentrations of imipenem, DMSO, and the heavy metals copper oxide and chromium VI oxide. Through this work it can be concluded that marine invertebrates should be further explored for bacteria producing bioactive compounds whose synthesis can be enhanced or blocked depending on the carbon and nitrogen sources adopted in the fermentation medium. Moreover, the mRNA expression of the genes responsible for prodigiosin-like pigment production can be up-regulated through adopting sub-lethal concentrations of stress inducing compounds as well as co-cultivatio

Prevalence of Neospora caninum and Toxoplasma gondii Antibodies and DNA in Raw Milk of Various Ruminants in Egypt.

The prevalence of Neospora caninum and Toxoplasma gondii antibodies in raw milk samples was estimated in different ruminants and Egyptian governorates. Of 13 bulk milk samples tested by ELISA, five (38.5%) were positive for antibodies to N. caninum, and two samples were additionally positive for antibodies to T. gondii, resulting in a seroprevalence of 15.4% for both T. gondii and co-infection. In individual milk samples (n = 171) from the same bulks, antibodies to N. caninum were detected in 25.7%, to T. gondii in 14%, and 3.5% had antibodies to both parasites. A strong correlation between the OD values of the bulk samples and of the relevant individual milk samples was found for T. gondii (Pearson r = 0.9759) and moderately strong for N. caninum (Pearson r = 0.5801). Risk factor assessment for individual milk samples revealed that antibodies to T. gondii were significantly influenced by animal species, while no risk factors were detected for N. caninum antibodies. Additionally, DNA of N. caninum was detected in a bulk milk sample of cattle for the first time in Egypt, and DNA of T. gondii was found in bulk milk samples of cattle, sheep and goats. This is the first study in Egypt in which bulk milk samples of different ruminants were tested for the presence of N. caninum and T. gondii antibodies and DNA. Both individual and bulk milk samples are useful tools for monitoring antibody response to N. caninum and T. gondii infections in different ruminants in Egypt