DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up

Comparison of HemoCue® hemoglobin-meter and automated hematology analyzer in measurement of hemoglobin levels in pregnant women at Khartoum hospital, Sudan

<p>Abstract</p> <p>Background</p> <p>Assessment of hemoglobin is one of the most reliable indicators for anemia, and is widely used to screen for anemia among pregnant women. The HemoCue^®has been widely used for as a point-of-care device for hemoglobin estimation in health facilities. Previous studies showed contradictory results regarding the accuracy of HemoCue^®.</p> <p>Methods</p> <p>This was a hospital-based cross sectional study carried- out among pregnant women at Khartoum hospital in Sudan to find out whether the measurement of hemoglobin concentration by HemoCue^®using venous or capillary samples was comparable to that of the automated hematology analyzer as standard. Bland and Altman method was used to compare the measurements with an acceptable difference of ± 1.0 g/dl.</p> <p>Results</p> <p>Among the 108 subjects in this study the mean (SD) level of hemoglobin level using HemoCue^®venous sample, HemoCue^®capillary sample and automated hematology analyzer were 12.70 (1.77), 12.87 (2.04) and 11.53 (1.63) g/dl, respectively. Although the correlations between the measurements were all significant there was no agreement between HemoCue^®and automated hematology analyzer. The bias + SD (limits of agreement) for HemoCue^®venous versus hematology analyzer was 1.17 ± 1.57 (-1.97, 4.31) g/dl, HemoCue^®capillary versus hematology analyzer was 1.34 ± 1.85 (-2.36, 5.04) g/dl, and HemoCue^®venous versus HemoCue^®capillary samples was 017 ± 1.90 and (3.97-3.63) g/dl.</p> <p>Conclusion</p> <p>Hemoglobin concentration assessment by HemoCue^®using either venous or capillary blood samples has shown unacceptable agreement with automated hematology analyzer.</p> <p>Virtual slides</p> <p>The virtual slide(s) for this article can be found here: <url>http://www.diagnosticpathology.diagnomx.eu/vs/8797022296725036</url></p

Actual evapotranspiration evaluation based on multi-sensed data

The importance of active and passive remote sensing data integration appears strongly on cloudy days. The lack of passive remote sensing data on cloudy days prevents the benefit of large-scale satellite data in cloudy areas, while the advantage of active remote sensing, it could penetrate the cloud and collect data underneath the cloud. The main objective of this paper is to determine the benefits of combining active and passive remote sensing data to detect actual evapotranspiration (ETa). Sentinel-1 radar data represents active data, while Landsat-8 represents passive data. Multi-date data for Landsat-8 and Sentinel-1 were used during the 2016 summer season. The characteristic soil texture in the study region is clay. The meteorological data were used to estimate ETo based on the FAO-Penman-Monteith (FPM) process, while the Lysimeter data were used to test the estimated ETa. Landsat-8 data are used to measure the Normalized Difference Vegetation Index (NDVI) and the Crop Water Stress Index (CWSI). Crop Coefficient (Kc) is calculated on the basis of NDVI. The CWSI, Kc, and ETo were then used to determine ETa. Backscattering (dB) C-band Synthetic Aperture Radar (SAR) data extracted from the Sentinel-1 satellite was correlated with Kc and used to estimate ETa. The Root Mean Square Error (RMSE) reported relevant results for active and passive satellite data separately and the combination process. For Sentinel-1, Landsat-8 and combination methods, the RMSE reported 0.89, 0.24, and 0.31 (mm/day) respectively

Effect of Sildenafil Citrate on Success Rate of Ovulation Induction by Clomiphene Citrate

Background: Disorders of ovulation are common causes of infertility, and polycystic ovary syndrome (PCOS) is by far the most frequent condition. Objetive: The aim of this work was to evaluate the effect of adding vaginal sildenafil citrate to clomophine citrate used as ovarian stimulant drug on both endometrial thickness and pregnancy rate in patient with polycystic ovary syndrome (PCO). Patients and Methods: This prospective Comparative study included a total of 58 patients with primary and secondary infertility aged between18 years to 35 years, attending at Outpatient Clinics, Obstetrics and Gynecology Department, Zagazig University Hospitals. Patients were divided into two equal groups; each were 29. 1st Group was given clomiphene, and 2nd group was given Clomophine citrate and Sildenafil. A transvaginal Scan for imaging the uterus and adnexa for any pathology and measuring the basic endometrial thickness was also done on Day 3. Results: This study shows that there was an increase in endometrial thickness in sildenafil group (13.4±1.814 mm) comparable with clomiphene citrate group only (8.52±2.081 mm) (P=0.01). The result was statistically significant with increase threshold regard for implantation with statistically significant in group B (P=0.018). Conclusions: It could be concluded that addition of sildenafil citrate to clomiphene citrate therapy for induction of ovulation in patients with PCOS resulted in significant increase of endometrial thickness and non-significant increase of pregnancy Rates

Pars plana vitrectomy for tractional diabetic macular edema with or without internal limiting membrane peeling

Background: The effectiveness of internal limiting membrane (ILM) peeling in the surgical treatment of tractional diabetic macular edema (DME), although widely examined, remains controversial. This study aimed to assess the efficacy of pars plana vitrectomy (PPV) in the management of tractional DME and to highlight any benefits of additional ILM peeling. Methods: This was an open-label, prospective, comparative, and interventional study that enrolled 50 eyes with tractional DME that underwent PPV and allocated each to one of two groups: group A consisted of 25 eyes that had no ILM peeling and group B consisted of 25 eyes that underwent ILM peeling. Postoperative assessments of best-corrected distance visual acuity (BCDVA) in the logarithm of minimal angle of resolution (logMAR) notation and central macular thickness (CMT) were performed at 1, 3, and 6 months postoperatively. Results: At baseline, the two groups were comparable in terms of sex ratios, phakic status, insulin use, coexistence of hypertension, and mean (standard deviation [SD]) age, BCDVA, CMT, duration of diabetes mellitus, and glycosylated hemoglobin (HbA1c) levels. In group A, the mean (SD) BCDVA improved significantly from 0.89 (0.12) logMAR preoperatively to 0.64 (0.24) logMAR (P &lt; 0.001), and the mean (SD) CMT declined significantly from 471.28 (80.83) micrometer to 228.20 (26.45) micrometer (P &lt; 0.001), at the 6-month postoperative assessment. Likewise, in group B, the mean (SD) BCDVA improved significantly from 0.83 (0.10) logMAR preoperatively to 0.58 (0.24) logMAR (P &lt; 0.001), and the mean (SD) CMT decreased significantly from 496.84 (89.82) micrometer to 226.20 (18.04) micrometer (P &lt; 0.001), after 6 months. There were no significant differences between groups A and B in the changes in BCDVA (Delta BCDVA) or CMT (Delta CMT) at 1, 3, and 6 months postoperatively with respect to the baseline values (all P &gt; 0.05). Postoperative complications were comparable between the two groups. A significant negative correlation was detected between the preoperative HbA1c level and BCDVA improvement in all participants (r = - 0.82; P &lt; 0.001). Conclusions: PPV is an effective treatment for tractional DME. Additional ILM peeling was not significantly associated with functional and anatomical benefits over a short period. Long-term glycemic control plays a role in vision gain after vitrectomy in patients with diabetes. Further long-term studies are required to verify our findings

Dual Quaternions Robotics: A) The 3R Planar Manipulator

Kinematics analysis studies the relative motions, such as, first of all, the displacement in space of the end effector of a given robot, and thus its velocity and acceleration, associated with the links of the given robot that is usually designed so that it can position its end-effector with a three degree-of-freedom of translation and three degree-of-freedom of orientation within its workspace. This chapter presents mainly, on the light of both main concepts; the first being the screw motion or/ and dual quaternions kinematics while the second concerns the classical ‘Denavit and Hartenberg parameters method’ the direct kinematics of a planar manipulator. First of all, examples of basic solid movements such as rotations, translations, their combinations and general screw motions are studied using both (4x4) matrices rigid body transformations and dual quaternions so that the reader could compare and note the similarity of the results obtained using one or the other method. Both dual quaternions technique as well as its counterpart the classical ‘Denavit and Hartenberg parameters method’ are finally applied to a three degree of freedom (RRR) planar manipulator. Finally, we and the reader, can observe that the two methods confirm exactly one another by giving us the same results for each of the examples and applications considered, while noting that the fastest, simplest more straightforward and easiest to apply method, is undoubtedly the one using dual quaternions. As a result this work may as well act as a beginners guide to the practicality of using dual-quaternions to represent the rotations and translations ie: or any rigid motion in character-based hierarchies.We must emphasize the fact that the use of Matlab software and quaternions and / or dual quaternions in the processing of 3D rotations and/or screw movements is and will always be the most efficient, fast and accurate first choice. Dual quaternion direct kinematics method could be generalised, in the future, to more complicated spatial and/ or industrial robots as well as to articulated and multibody system

التخطيط الإقليمي مدخل لمواجهة المخاطر المرتبطة بالتغير المناخي لأقاليم الساحل الشمالي في مصر

تعد التغيرات المناخية من أهم المعضلات التي تواجة العالم خاصةً في ظل القضايا الشائكة من الاحتباس الحراري وتزايد ارتفاع درجة حرارة الأرض، وذوبان الصفائح الجليدية وارتفاع منسوب مياه البحار والمحيطات، مما دفع منظمة الأمم المتحدة لإبرام إتفاقية التغيرات المناخية وبروتوكول كيوتو، اللذان يهدفان لخفض هذه الانبعاثات، وأعلنت الهيئة الحكومية الدولية المعنية بتغير المناخ أن دلتا النيل في مصر من بين المناطق الثلاث الأولى على كوكب الأرض الأكثر عرضة لارتفاع مستوى سطح البحر، وأشار تقرير البنك الدولي انه يوجد فى مصر عدة مناطق أوشكت على الغرق تشمل هذه المناطق شديدة الخطورة أجزاء من محافظات الدلتاوالإسكندرية ومحافظات البحيرة وبورسعيد ومحافظات دمياط ومحافظة السويس. تهدف هذه الدراسة الى مواجهة اهم مخاطر التغيرات المناخية المتمثلة في ارتفاع منسوب البحر في ضوء صياغة التوجهات الاستراتيجية الاقليمية للمناطق الساحلية الشمالية المصرية ،وعلى هذا تم الوقوف في هذه الدراسة على المفاهيم المتعلقة بالتغيرات المناخية واهم تاثيرتها التي يتضح فيها ان التغير المناخي عالميًا يؤدي بشكل مباشرالى ارتفاع مناسيب سطح البحار والمحيطات بسبب ارتفاع درجات الحرارة مما يؤدي هذا الأمر الى محو مدن كبرى فى العالم، و تعتبر مصر من احد الدول التى ستتاثر بهذا الامر خاصة على المنطقة الساحلية الشمالية (الدلتا – اقليم الاسكندرية - اقليم القناة)، وخلال هذه الدراسة تم التركيز على الاقاليم الساحلية الشمالية التى ستتاثر بشكل مباشر حيث تم الوقوف على السيناريوهات المحتملة لارتفاع منسوب البحر على تلك المناطق والتي تراوحت من ( 0.5 -1.5 ) والنتائج المتوقعة لكل سيناريو على السكان والاراضي المعرضة للغرق وتم ترجيح السيناريو الثاني الذي يتوقع فيه ارتفاع منسوب البحر 100 سم واهم نتائجه غرق مساحة قدرها 4500كم2 وعدد السكان المتضررين حوالي 6 مليون • وتم اختيار السيناريو الثاني لانه اعلي من المقدار المتوقع 65 سم ، وعملية التخطيط لابد ان تتم في اطار اكثر حرصا لان المتغيرات المناخية لايمكن توقع سرعة وتيرتها . .كما تم الوقوف على الملامح الرئيسية للوضع الراهن لتلك الاقاليم ومن ثم استنباط المؤشرات التحليلية . في ضوء تلك المؤشرات تم اقتراح بدائل تخطيطية لتنمية الاقاليم الثلاثة في ضوء التغلب على احد اهم تهديدات و مخاطر التغيرات المناخية :البديل الاول ويتمثل في الابقاء على الوضع الحالي للاقاليم الثلاثة والاتجاه نحو التنمية للكيانات العمرانية في ضوء التكيف مع المعالجات التي تبناها الدولة في التصدي للمتغيرات المناخية . البديل الثاني ويتمثل في تكثيف اعمال التنمية في المناطق الماهولة بالاقليم خلال الفترة الزمنية الحالية حتى عام 2100 م، ثم يتم توجيه التنمية بعدها الى خارج نطاق المناطق الماهولة .أما البديل الثالث فيتمثل في سرعة التحرك لمواجهة التغيرات المناخية واثارها ،واستخدام اسلوب الاجلاء المخطط في هذا البديل ، وبحيث تكون البداية في اعمال التنمية من الان وتكون سنة الهدف2050 تمتد حتى سنة 2100م، وفي ضوء ترجيح البديل الثالث تم اقتراح الإستراتيجية المكانية للتنمية المقترحة لاقاليم الدراسة ، وتم وضع اليات تحديد مناطق التنمية الجديدة في اقاليم الدراسة ، ومقترحات التوزيع المكاني للتجمعات العمرانية المقترحة ، و تقدير والحجم السكاني المتوقع ،كما تم صياغة التوجهات الاستراتيجية المقترحة للتغلب على التغيرات المناخية من اهمها تشجيع العمل للحد من تعرض النظم البشرية والطبيعية لآثار تغير المناخ ،ودعم الجهات المعنية بالتعامل مع متغيرات المناخ والقدرة على إدارة التكيف مع تغير المناخ . كما تم تحديد دور الجهات المختلفة في تحقيق استراتيجية التغلب على المتغيرات المناخية . وفي الاخير تم استنباط النتائج التي تتمثل اهمها في وجود اساليب للتعامل مع مخاطر ارتفاع منسوب البحر مثل استخدام الحواجز والحماية الخطية والتنمية المرتفعة والتنمية العائمة والتنمية الفيضانية والاجلاء المخطط,كانت في اغلبها معيبة حيث انها قصيرة المدي وتكلفتها مرتفعة الا اسلوب الاجلاء المخطط الذي كان اقلهم كلفة ، ومن ثم كان اسلوب الاجلاء المخطط هو الاقرب في التعامل مع منطقة الدراسة حيث ان ارتفاع منسوب سطح البحر بالسواحل الشمالية لمصر سيؤدي إلى غرق الأراضي الساحلية حتى عمق 7 كيلومترات, وتوقع تهجير ما يقارب من 6 ملايين السكان من الدلتا، بحلول عام 2100 لذا كان من الضروري اعداد استيراتيجية تنموية تهدف الى اعادة توزيع استخدامات الاراضى فى منطقة الدراسة بما يتناسب مع تداعيات المتغيرات المناخية المتوقعة ، إقامة مجتمعات عمرانية جديدة للتنمية المتكاملة لرفع الأعباء عن المجتمعات القائمة.و اعادة تقسيم الاقاليم التخطيطية الساحلية بحيث يتم ضم اقليم الدلتا الى كل من اقليم الاسكندرية والقناة لايجاد بديل تنموي للتجمعات العمرانية الموجودة بالدلتا في الظهير الصحراوي المستجد

Benign prostatic hyperplasia: Enucleation versus resection using plasmakinetic energy: a prospective randomized study at Zagazig University Hospital

Background: Transuretheral resection of the prostate (TURP) has been the gold standard endoscopic treatment for bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH). New technologies have been developed to minimize the morbidity of TURP. Recently, the Gyrus Plasma Kinetic (PK) System is the first bipolar device used in urological practice, as a new modality in treatment of BPH.Objective: To evaluate the efficacy and safety of plasmakinetic enucleation compared to plasmakinetic resection of the prostate in the management of BOO induced by BPH. Patients and Methods: This study was conducted on 58 volunteers from Department of Urology, Faculty of Medicine, Zagazig University between January 2018, and January 2020. Patients were randomized to either plasmakinetic enucleation of the prostate (PKEP) group or plasmakinetic resection of the prostate (PKRP) group. All patients were indicated for surgical treatment (prostate size ≥ 60 g and ≤ 120 g). Results: There were no statistically significant differences between the two groups preoperatively. PKEP resulted in a greater volume of prostatic tissue removal than the PKRP. Tissue retrieved/total operative time in PKEP group was greater than in PKRP group (0.69 gm/min vs 0.67 gm/min respectively). The mean indwelling uretheral catheter time was shorter in PKEP group (34.7 ±4.40 hrs.) than in PKRP (48.79 ±4.31 hrs.). Regarding postoperative complication (early and late), there were no statistically significant differences between the two groups.Conclusions: We concluded that regarding, surgical safety and efficacy PKEP is comparable to PKRP for prostates (60-120 ml). Either PKEP or PKRP can be on an equal footing to TURP as an endoscopic management of BP

Determining of some physical and mechanical properties for designing tomato fruits cutting machine

الهدف من هذه الدراسة هو دراسة بعض الخصائص الفيزيائية والميكانيكية لثلاثة أصناف من الطماطم (نسمة ، ماسة ، 2020) للمساعدة في تصميم وتطوير آلة محددة لتقطيع الطماطم إلى نصفين متطابقين لاستخدامها في التجفيف الشمسي المفتوح. . تم تقدير الخواص عند محتوى رطوبة ثابت لثلاثة أصناف طازجة (نسمة ، ماسة ، 2020) من الطماطم عند 62.57 ، 68.58 ، 69.36٪ ديسيبل على التوالي. أظهرت النتائج أن متوسط قيمة الأبعاد المحورية ، المرتفع (H) ، القطر الأكبر (D max .) ، والقطر الأدنى (D min)..) من العينات كانت 73.98 و 69.26 و 61.03 ملم و 63.28 و 59.89 و 53.32 ملم ، و 70.99 و 53.86 و 49.60 ملم لأصناف ثمار الطماطم نسما وماسة و 2020 على التوالي. بلغ متوسط قيمة القطر الحسابي ، القطر الهندسي لثلاثة أصناف (نسمة ، ماسة ، 2020) للطماطم 69.26 و 58.76 و 58.11 و 67.69 و 58.52 و 57.33 على التوالي. وبلغ متوسط قيمة الكتلة والكثافة 181.74 و 120.14 و 109.96 و 0.991 و 0.991 و 0.972 على التوالي. في حين؛ متوسط قيمة مساحة السطح ومعامل التعبئة والكروية ونسبة العرض إلى الارتفاع كانت 144.61 ، 107.93 ، 103.65. ، 0.533 ، 0.572 ، 0.562. ، 92.13 ، 92.67 ، 81.11 ، 94.48 ، 94.99 ، 76.39 على التوالي لأصناف (نسمة ، ماسة). و 2020). كانت أدنى قيم لمعامل الاحتكاك الساكن 0.427 ، 0.266 ، 0.242 مع الخشب الرقائقي بينما أعلى قيمة كانت 0.566 ، 0.310 ، 0. 388 مطاط من ثلاثة أصناف (نسمة ، ماسة ، 2020) على التوالي. وتعني قيم الصلابة كانت 4.70 و 5.95 و 4.9 نيوتن / سم2 لأصناف (نسمة ، ماسة ، 2020) على التوالي

Epidemiology of ovarian cancer in Assiut Governorate, Egypt

Background: The aim of this study is to assess ovarian cancer epidemiology and detect its prognostic factors in Assuit, Egypt.Methods: This retrospective study was performed between January 2010 and December 2015, on all cases attending to Obstetrics and Gynecology Outpatient Clinic in all central hospitals in Assiut. 378 females (≥40 years old) came to Obstetrics and Gynecology Outpatient Clinic from January 2010 to December 2015. Inclusion criteria: All females (≥40 years old), history of current acute or chronic pelvic pain, mass; fixed, hard consistency, history of previous similar condition.Results: Mean age for whole ovarian cancer cases in this study was 56.44±10.08 (range, 40-85). Nulliparity was found in one case (0.3%), while multiparity was found in 252 cases (66.7%). Grand multiparity was found in 113 cases (29.9%). Twelve cases (3.2%) were virgin. Vaginal ultrasound can find all ovarian cancer cases. Regarding the serum levels of the tumor biomarker, CA-125, the average level of CA-125 is 300-1000 U/ml with 34.9% of cases had readings below to 300-1000 U/ml and 6.1% of cases had readings above to this average level. Regarding treatment, treatment combining surgery with chemotherapy was the main line of management in present study (46.3%). About 33.3% of cases underwent surgery, while only 18.3% took the chance of chemotherapy. Eight cases (2.1%) had no treatment.Conclusions: Epithelial ovarian cancer is a lethal disease. The age incidence of ovarian cancer in present patients is ten years younger than what is re¬ported in US SEER data and other Western countries. CA-125 level and ultrasonography are increasing the rate of suspicious for diagnosis of malignant tumors