Serum Squamous Cell Carcinoma Antigen Level in Cirrhotic Chronic Hepatitis C Patients With and Without Hepatocellular Carcinoma

This study will be carried out on 500 personnel divided into five groups : Group A: 100 cases of hepatocellular carcinoma without interventions. Group B: same 100 cases of group A before and 3 months after successful interventions.Group C: 100 cases of established cirrhosis. Group D: 100 cases with chronic hepatitis C virus infection without established cirrhosis. Group E: 100 healthy individuals as controls.Methods: Sera from selected patients and controls have been used for estimation of SCC-Ag using CanAg SCC EIA. Results: high significant increase in serum SCCA level in patients with HCC (groupA and groupB) when compared to cirrhotic, chronic HCV and control groups (P < 0.001). Positive significant correlation was found between AFP and serum SCCA level .The best cut-off value to differentiate HCC patients from cirrhotic patients was 3.2 ng/ml for SCCA yielded with 80% sensitivity and 90% specificity. When combined sensitivity of both markers was calculated in our study at the best-chosen cutoff values (SCCA 3.2 ng/ml and AFP 200 ng/ml) sensitivity improved to 93%.Conclusion: Combined SCCA and AFP can be used as in diagnosis of HCC and follow up 3 months after therapeutic intervention

Identification of parameters in photovoltaic models through a runge kutta optimizer

Recently, the resources of renewable energy have been in intensive use due to their environmental and technical merits. The identification of unknown parameters in photovoltaic (PV) models is one of the main issues in simulation and modeling of renewable energy sources. Due to the random behavior of weather, the change in output current from a PV model is nonlinear. In this regard, a new optimization algorithm called Runge–Kutta optimizer (RUN) is applied for estimating the parameters of three PV models. The RUN algorithm is applied for the R.T.C France solar cell, as a case study. Moreover, the root mean square error (RMSE) between the calculated and measured current is used as the objective function for identifying solar cell parameters. The proposed RUN algorithm is superior compared with the Hunger Games Search (HGS) algorithm, the Chameleon Swarm Algorithm (CSA), the Tunicate Swarm Algorithm (TSA), Harris Hawk’s Optimization (HHO), the Sine–Cosine Algorithm (SCA) and the Grey Wolf Optimization (GWO) algorithm. Three solar cell models—single diode, double diode and triple diode solar cell models (SDSCM, DDSCM and TDSCM)—are applied to check the performance of the RUN algorithm to extract the parameters. the best RMSE from the RUN algorithm is 0.00098624, 0.00098717 and 0.000989133 for SDSCM, DDSCM and TDSCM, respectively

Plasma soluble CD 163 level as a marker of oesophageal varices in cirrhotic patients

Background: Variceal bleeding (VB), the most common lethal complication of cirrhosis, associated with high mortality. Timely prediction of esophageal varices (EV) represents a real challenge for the medical team. This study evaluated the level of plasma soluble CD 163 as a marker of the presence of EVs and to compare it with other noninvasive clinical, laboratory and ultrasonographic parameters as well as endoscopy.Methods: This prospective controlled study was conducted on 80 adults. Gp I had no oesophageal varices, gp II had small varices, gp IIIa had large varices, gp IIIb are the same patients of gp IIIa but after eradication of varices and gp IV as healthy controls. Serum samples were assayed for soluble CD 163.Results: soluble CD163 was statistically significant different between controls and all liver cirrhosis. it showed a statistically significant difference between group I and II (p = 0.009) and between group I and IIIa (p &lt; 0.001) and between group II and IIIa (p &lt; 0.001) but, no difference between group IIIa and IIIb (p = 0.179).Conclusion: Serum soluble CD163 is a good noninvasive predictor for the presence of EVs and it may be used for grading of EVs. Its level does not change after esophageal varices eradication.Trial registration: IRB No: 00007589 FWA No: 00015712 The Ethics Committee of the faculty of medicine Alexandria University.Keywords: Hepatic, Cirrhosis, Varices, CD163, Endoscopy, Ultrasonograph

Use of sesame and sorghum crops to verify the remediation of contaminated sewaged soils

At the time being, treated sewage effluent is repeatedly used in farming, particularly in newly reclaimed sandy soils, as it fortify their content of nutrients and organic matter as time goes on, despite there are significant concerns about the long-term accumulation of PTEs in the soil ecosystem. Pot experiment was conducted to verify the effectiveness of bioremediation of two sewaged soils, highly and marginally contaminated, with either canola (Brassica napus) or Indian mustard (Brassica juncea) plants in the absence and presence of AM inoculation, by growing sesame (Sesamum indicum) and sorghum (Sorghum bicolor) plants. Results indicated that the vegetative parameters of both test crops did not show any sign of adverse symptoms when grown in either bioremediated sewaged soils. Phytoremediation with either canola or Indian mustard obviously reduced Cu and Zn contents in both sesame and sorghum plants and completely removed Ni from soil. Both sesame and sorghum plants grown in both bioremediated sewaged soils contained lower PTEs, however, at varying degrees. Zinc equivalent value in marginally and highly decontaminated soils after harvesting either sorghum or sesame obviously decreased compared to control soil. After phytoremediation, the dehydrogenase activity increased in all soils. Generally, the efficiency of phytoremediation with canola far exceeded that with Indian mustard, despite both were effective tools

The optimal succinylcholine dose for intubating emergency patients: retrospective comparative study

Background : Succinylcholine remains the drug of choice for satisfactory rapid-sequence tracheal intubation. It is not clear from the literature why the 1 mg/kg dose of succinylcholine has been traditionally used. The effective dose (ED95) of succinylcholine is less than 0.3 mg/kg. The dose of 1 mg/kg represents 3.5 to 4 times the ED95. Objectives : To compare the effect of the traditionally used 1 mg/kg of succinylcholine with lower doses of 0.6 mg/kg and 0.45 mg/kg on intubation condition regarding the onset time, duration of action, duration of abdominal fasciculation, and the intubation grading. Methods : This retrospective comparative study was carried into three groups of ASA III & IV (American Society of Anesthesiologist's Physical Status III and IV) non-prepared emergency patients who were intubated at emergency department of Hamad General Hospital, Doha, Qatar during January 1st 2007 to August 31, 2010. The Institutional Research Board (IRB) approval was obtained. This study was limited to 88 patients who received fentanyl 1 µg/kg followed by etomidate 0.3 mg/kg intravenously as induction agents and succinylcholine as a muscle relaxant agent in doses of 0.45 mg/kg, 0.6 mg/kg, or 1 mg/kg. Results : Increasing the succinylcholine dosage shortened the onset time, prolonged the duration of action, and prolonged the duration of abdominal fasciculation significantly (P<.001). Tracheal intubation was 100% successful in the three groups of patients. Conclusion : Succinylcholine dose of 0.45 mg/kg provides an optimal intubation condition in ASA III & IV emergency non-prepared patients. Duration of action of succinylcholine is dose dependent; reducing the dose allows a more rapid return of spontaneous respiration and airway reflexes

Comparison of Serum IgG Antibody Test with Gastric Biopsy for the Detection of Helicobacter Pylori Infection among Egyptian Children

BACKGROUND: In developing countries, Helicobacter pylori (H. pylori) infection is mainly acquired during childhood and may be a predisposing factor for peptic ulcer or gastric cancer later in life. Noninvasive diagnostic tools are particularly useful in children for screening tests and epidemiological studies. Data on serologic testing of children are lacking. Accurate noninvasive tests for diagnosing Helicobacter pylori infection in children are strongly required.AIM: The aim of this study was to evaluate the performance of a serological test (serum IgG antibody for H. pylori) in Egyptian children with recurrent abdominal pain necessitating endoscopy.SUBJECTS AND METHODS: One hundred children, referred to the endoscopy unit at Mansoura University. Upper endoscopy was done for each with rapid urease test (RUT) and histological examination as the gold standard test for detection of H. pylori infection. Serum samples were collected for detecting IgG for H. pylori infection.RESULTS: The mean age of the subjects included in the study was 7.23 ± 1.94 year. Serological test (IgG to H. pylori) was positive in 60% of all cases. A highly significant association between the standard test and the serological test at a cutoff &gt; 10 U/ml at p = 0.001 were detected for the diagnosis of H. pylori infection. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the IgG antibody a cutoff &gt; 10 U/ml, were 96.5%, 93%, 13.83, 0.038 respectively.CONCLUSION: Serum IgG antibody to H. pylori infection has a high diagnostic value and can be considered as a suitable and reliable noninvasive test for detection of H. pylori infection

Effect of Early Breast Milk Nutrition on Serum Insulin-Like Growth Factor-1 in Preterm Infants

BACKGROUND: Insulin-like growth factor 1 (IGF-1) is one of the essential intrauterine hormonal mediators of growth, and its serum values are often low after preterm delivery. AIM: To evaluate the influence of immediate breast milk feeding on serum IGF-1 in preterm newborns. SUBJECTS AND METHODS: This prospective, observational cohort study included 60 premature infants born &lt; 32 weeks of gestation, divided into group A and B regarding breastfeeding or formula feeding. Growth measurements were taken at birth. The standard deviation of each measurement was calculated. Serum IGF-I was measured one day postnatal and at a time equivalent to 40 weeks of gestation. RESULTS: Significant higher level of mean serum IGF-1 was detected in group A than B at postnatal age equivalent to 40 weeks of gestation. In group A, the higher significant level was detected in mean serum IGF-1 at an age equivalent to 40 weeks of gestation than at birth (25.21 ± 6.69 and 20.13 ± 5.46 p &lt; 0.05). Multiple linear regression analysis showed that high birth weight, increased age of gestation and breastfeeding were correlated to the elevated serum level of IGF-1 at a postnatal age corresponding to 40 weeks gestational age. CONCLUSION: Immediate breast milk feeding was accompanied by elevated IGF-1 in the serum of preterm infants

The Role of Family Physicians in Mental Health Care: Screening, Diagnosis, and Treatment Options

amily physicians play a pivotal role in the early detection, diagnosis, and management of mental health disorders within the community. This review article delves into the multifaceted responsibilities of family physicians in the realm of mental health care. Emphasizing the importance of primary care settings as the first point of contact for many patients, the article underscores the need for effective screening tools and methodologies tailored for these environments. The diagnostic precision of family physicians, often challenged by the broad spectrum of mental health symptoms, is explored alongside the potential implications of misdiagnoses. Furthermore, the article evaluates various treatment options, from pharmacological interventions to psychotherapy, and their applicability in primary care settings. The integration of technological advancements, such as electronic health records and telemedicine, is also discussed in the context of enhancing patient care. The review concludes by highlighting the importance of educating primary care physicians to not only pay close attention to the mental health of their patients, but also to be able to accurately screen and diagnose mental health issues using various diagnostic tools. Moreover, it is critical to develop more useful tools that can be used in the context of primary care settings

Dose optimization of β-lactams antibiotics in pediatrics and adults:A systematic review

Background: β-lactams remain the cornerstone of the empirical therapy to treat various bacterial infections. This systematic review aimed to analyze the data describing the dosing regimen of β-lactams. Methods: Systematic scientific and grey literature was performed in accordance with Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The studies were retrieved and screened on the basis of pre-defined exclusion and inclusion criteria. The cohort studies, randomized controlled trials (RCT) and case reports that reported the dosing schedule of β-lactams are included in this study. Results: A total of 52 studies met the inclusion criteria, of which 40 were cohort studies, 2 were case reports and 10 were RCTs. The majority of the studies (34/52) studied the pharmacokinetic (PK) parameters of a drug. A total of 20 studies proposed dosing schedule in pediatrics while 32 studies proposed dosing regimen among adults. Piperacillin (12/52) and Meropenem (11/52) were the most commonly used β-lactams used in hospitalized patients. As per available evidence, continuous infusion is considered as the most appropriate mode of administration to optimize the safety and efficacy of the treatment and improve the clinical outcomes. Conclusion: Appropriate antibiotic therapy is challenging due to pathophysiological changes among different age groups. The optimization of pharmacokinetic/pharmacodynamic parameters is useful to support alternative dosing regimens such as an increase in dosing interval, continuous infusion, and increased bolus doses

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London