Comparative Study Between Antegrade Flexible Ureteroscopy and Reterograde Intrarenal Surgery in the Management of Impacted Upper Ureteric Stones 1.5 cm or Larger

OBJECTIVE: To prospectively investigate the safety and efficacy of antegrade flexible ureteroscopy (FURS) with the following criteria (supine, ultrasonic guided puncture through lower calyx with 14 fr tract, tubeless) versus retrograde intrarenal surgery (RIRS) in the management of large impacted upper ureteric stones ≥ 1.5 cm. PATIENTS AND METHODS: This study recruited 61 patients with single large impacted upper ureteric stone of ≥ 1.5 cm. The patients were randomly allocated to two groups. Group A, included 31 patients who treated by antegrade FURS, all patients were put in supine modified galadako Valdivia position and the renal access is reached by ultrasonic guided puncture through the lower calyx with dilatation upto 14 fr to insert ureteric access sheath and all cases were tubless with JJ stent insertion. Group B, included 30 patients who were treated by RIRS with JJ stent insertion. Stone fragmentation was done by holmium laser in both group. RESULTS: Group A was significantly associated with higher proportion of SFR (90.3%) compared to Group B (70%) (p = 0.046). Group B was significantly associated with shorter operative time and fluoroscopy time in comparison with Group A (p \u3c 0.001). No significant differences were found between studied groups regarding bleeding (p = 0.238). Urosepsis showed significantly higher proportion associated with retrograde approach when compared to antegrade approach (p = 0.024). CONCLUSION: This study showed that antegrade FURS is safe and more effective than RIRS for the management of large impacted upper ureteric stones ≥ 1.5 cm

Digenetic trematodes from siganid fish Amphacanthus sigan at Macady Bay, Southern Hurghada, Red Sea, Egypt

AbstractForty fish samples of Amphacanthus sigan were collected from Sharm El-Naga southern Hurghada to study the parasitic infection included and present a new individual to Helicometra species using light microscope and re-describe another digenean trematode species using scanning electron microscope (SEM). Two trematode species were identified and described; Helicometra siganus n. sp. Nov belonging to Helicometra Odhner, 1902 (family Opecoelidae Ozaki, 1925) which is different from all the listed species in many features as having an elongated body, tapering anteriorly and larger sucker ratio; the vitellaria extended from the intestinal bifurcation to the posterior extremity of the hind-body and finally the cirrus sac and cirrus longer than the other species and extended to the midpoint of esophagus level. So, these criteria are specific and sufficient to consider it as a new species. The other species, Gyliauchen volubilis Nagaty, 1956 (Gyliauchenidae Fuki, 1929 and Ozaki, 1933) which was described before but some other constituent are not evident and appeared using the electron microscope. However, the present sample illustrated transverse striations on the body surface, the acetabulum evaginates outward, ovoid shaped and surrounded by lip-like structures and finally, the excretory pore is situated at some distance from the acetabulum at the posterior end extremity

The Impact of National Private Investment on Manufacturing in Egypt

This paper aims to present national private investment development phases and its contribution in manufacturing sector in Egypt. Moreover it devoted to examine the effect of national private investment on Egyptian manufacturing. Vector Auto Regressive analysis (VAR) was adopted based on yearly data for the period (1990-2015). Time series stationarity are checked by Augmented Dicky Fuller (ADF) test, and co- integration existence tested by Johansen co- integration test. The vector Error Correction model (VECM) utilized to check the existence of long run relationship between the manufactured product as a dependent variable and the national private investment as explanatory variable. Finally this paper concluded that, however national private investment contribute high share to manufacturing sector, the empirical analysis results obtained negative impact of this type of investment on manufacturing sector in short and long run. Keywords: national private investment, manufactured product, vector error correction model. JEL Classifications: E22, C22, L60, N6

Assessment of patient safety culture perception among healthcare workers in intensive care units of Alexandria Main University Hospital, Egypt

Background: Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods: A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results: The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The “Teamwork within Units” dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the “Non-Punitive Response to Errors” dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient’s safety at the hospital as accepted. Conclusions: PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture

Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Abstract: Background: Obese T2DM patients are more prone to develop accelerated complications which burdens the global health systems with undue expenditure. Glycated haemoglobin (A1c) had been settled as a gold standard glycemic indicator though it's levels must be prudently interpreted in some patients. Glycatedalbumin (GA) as an alternative, intermediate glycemic indicator is gaining much attention. Aim: assessing the correlation of each of glycated albumin and glycated haemoglobin to body mass index (BMI) in T2DM patients Hypothesis: negative correlation existsbetween BMI & glycated albumin. Subjects and methods: Cross sectional study into which 62 participants-aged 25-60 years -who are T2DM on insulin were recruited at Suez Canal University hospital.None of them was smoker or known to be CLD or DKD patient, none was on regular statins, aspirin or metformin. All had normal CBC and albumin indices, they underwent thorough history taking & examination. anthropometric measurements namely body mass index (BMI) were taken.They were grouped into a non-obese group with BMI <25 Kg/m 2 & obese group whose BMI ≥25 Kg/m 2 , each with a sample size of 31 participants. FPG,PPPG, HbA1c, CBC, serum albumin, serum insulin and GA were analyzed.insulin resistance was measured by HOMA-IR. Results: GA was insignificantly lower in obese T2DM compared to non-obese (579.3 µmol/L vs 600.0 µmol/L,p-value = 0.631), while GA/HbA1c ratio was significantly low among obese compared to non-obese. (61.1 vs 66.8, p-value= 0.040). Also GA was insignificantly lower in obese with insulin resistance (615.0 ±177.5 µmol/L) than obese with no insulin resistance (550.0±148.2 µmol/L) and also lower than non-obese with insulin resistance (637.4±153.0 µmol/L).Similarly GA/HbA1c ratio was lower in obese with &without insulin resistance (mean 57.6 ±SD 12.8 & mean 64.1 ±SD 9.0 respectively) compared to GA/HbA1c ratio in non-obese with & without insulin resistance (mean 66.9 ±SD 11.0 & mean 66.7 ±SD 9.1 respectively). Conclusion: This study showed that care to be paid while interpreting GA levels in obese T2DM as GA and GA/HbA1c ratio are lower in this population. [Iman El -Sherif, Mohamed I. Shoeir, Mohamed M. Mohey El Din Awad, Amal Fathy and Seham Ahmed. Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Minerals and insulin dependent diabetes in children: A review article

Background: The human body contains trace levels of minerals and other micronutrients. Particularly advantageous for physiologic processes, a wide range of biochemical processes, stabilizing proteins and enzymes, and serving as cofactors for different enzymes. These essential micronutrients have a major physiological effect and are significantly associated with diabetes. Cobalt, boron, chromium, copper, Sulphur, iodine, fluoride, selenium, manganese, zinc, and molybdenum are examples of trace elements. Sodium, potassium, calcium, phosphorus, magnesium, and iron related to macro elements. The main focus of this review is the effect of particular minerals and trace elements on childhood insulin-dependent diabetes. Objective: Our understanding of how minerals and trace elements affect insulin-dependent diabetes in children will be improved as a result of this review, which is its main goal. Conclusion: The interaction, development, and outcomes of insulin-dependent diabetes in children are significantly influenced by minerals and trace elements

Tempol improves optic nerve histopathology and ultrastructures in cisplatin-induced optic neuropathy in rats by targeting oxidative stress—Endoplasmic reticulum stress—Autophagy signaling pathways

IntroductionOptic neuropathy is an affection of the optic neurons, which ends with blindness and occurs either primarily due to direct affection of the optic nerve or secondarily as a complication of chronic diseases and/or adverse effects of their therapy. The search for novel therapeutic tools is crucial in addressing the limited therapeutic approaches for optic neuropathy. Therefore, the present study was developed to investigate the possible ameliorative effect of tempol against cisplatin-induced optic neuropathy and its underlying mechanism.MethodsForty-eight adult male albino Wistar rats were divided into four equal groups—control, tempol (TEM), cisplatin (CIS), and tempol and cisplatin combined (TEM+CIS). Optic nerve oxidative stress (MDA, SOD, and GPx), gene expression of endoplasmic reticulum stress (ATF-6, XBP-1, BIP, CHOP, and JNK), autophagy 6 (LC3, Beclin-1, and p62) markers, nerve growth factor-1, immunohistochemical expression of (LC3 and p62), histopathological, and electron microscopic examination were performed.ResultsHistopathological and ultrastructure examination validated that cisplatin caused optic neuropathy by inducing oxidative stress, upregulating ER stress markers, and downregulating autophagy markers, and NGF-1 expression. TEM + CIS showed improvement in optic nerve structure and ultrastructure along with oxidative stress, ER stress mRNA, autophagy (immunohistochemical proteins and mRNA) markers, and nerve growth factor mRNA expression.ConclusionsBased on previous findings, tempol represents a valid aid in cisplatin-induced optic neuropathy by implicating new molecular drug targets (ER stress and autophagy) for optic neuropathy therapy

Genomic landscape of hepatocellular carcinoma in Egyptian patients by whole exome sequencing

Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Chronic hepatitis and liver cirrhosis lead to accumulation of genetic alterations driving HCC pathogenesis. This study is designed to explore genomic landscape of HCC in Egyptian patients by whole exome sequencing. Methods: Whole exome sequencing using Ion Torrent was done on 13 HCC patients, who underwent surgical intervention (7 patients underwent living donor liver transplantation (LDLT) and 6 patients had surgical resection}. Results: Mutational signature was mostly S1, S5, S6, and S12 in HCC. Analysis of highly mutated genes in both HCC and Non-HCC revealed the presence of highly mutated genes in HCC (AHNAK2, MUC6, MUC16, TTN, ZNF17, FLG, MUC12, OBSCN, PDE4DIP, MUC5b, and HYDIN). Among the 26 significantly mutated HCC genes—identified across 10 genome sequencing studies—in addition to TCGA, APOB and RP1L1 showed the highest number of mutations in both HCC and Non-HCC tissues. Tier 1, Tier 2 variants in TCGA SMGs in HCC and Non-HCC (TP53, PIK3CA, CDKN2A, and BAP1). Cancer Genome Landscape analysis revealed Tier 1 and Tier 2 variants in HCC (MSH2) and in Non-HCC (KMT2D and ATM). For KEGG analysis, the significantly annotated clusters in HCC were Notch signaling, Wnt signaling, PI3K-AKT pathway, Hippo signaling, Apelin signaling, Hedgehog (Hh) signaling, and MAPK signaling, in addition to ECM-receptor interaction, focal adhesion, and calcium signaling. Tier 1 and Tier 2 variants KIT, KMT2D, NOTCH1, KMT2C, PIK3CA, KIT, SMARCA4, ATM, PTEN, MSH2, and PTCH1 were low frequency variants in both HCC and Non-HCC. Conclusion: Our results are in accordance with previous studies in HCC regarding highly mutated genes, TCGA and specifically enriched pathways in HCC. Analysis for clinical interpretation of variants revealed the presence of Tier 1 and Tier 2 variants that represent potential clinically actionable targets. The use of sequencing techniques to detect structural variants and novel techniques as single cell sequencing together with multiomics transcriptomics, metagenomics will integrate the molecular pathogenesis of HCC in Egyptian patients