Ehlers Danlos Syndrome: An Unusual Presentation You Need to Know about

The Ehlers Danlos syndromes (EDS) comprise a group of connective tissue disorders characterized by tissue fragility of the skin, ligaments, blood vessels and internal organs. Variable degrees of clinical severity and organ involvement are due to the molecular and biochemical heterogeneity of this group of disorders and have led to classification into well-characterized subtypes that are extending with the discovery of new genes and overlapping syndrome. Types include classical EDS (EDS I/II), hypermobility EDS (EDS III), vascular EDS (EDS IV), kyphoscoliosis EDS (EDS VI), arthrochalasia (EDS VIIA, B) and Dermatospraxis (EDS VIIC). Even to the well trained professional, the diagnosis of EDS remains a challenge due to overlapping symptoms and cases can remain without a well-defined classification. Life altering complications of this group of disorders include vascular and hollow organ rupture and ligamentous laxity leading to chronic dislocation with ensuing pain and long term disability. Patients initially present to the general practitioner who is expected to recognize the symptoms of EDS and to proceed with appropriate referral for definitive diagnosis and management to prevent devastating complications. In this paper, we describe a male with classical EDS complicated by devastating vascular and orthopedic events

Using Recorded Earthquake Signals for Dynamic Analysis of Masjed Soleiman Embankment Dam

There is a worldwide interest in the proper seismic design of embankment dams in high seismic hazard zones. The seismic behavior of embankment dams can be evaluated by in-situ dynamic tests (such as processing recorded earthquake signals on dam body), experimental methods (i.e. experiments using large shaking table, centrifuge tests) and numerical methods Using recorded earthquake signals on dam body is a powerful tool for researchers for dynamic analysis of embankment dams. In this research, recorded accelerograms are used to dynamic analysis of Masjed Soleiman embankment dam, the highest rockfill dam in Iran. Using recorded earthquake signals in the basement of the dam as input excitation, dynamic analysis of the dam body was also performed and the results of the numerical modeling was compared with recorded earthquake signals on the dam body. The calculated responses are compared with recorded accelerograms on mid-height and crest of the dam. In comparison, the modern signal processing method, Time-Frequency Distribution (TFD), is used. This comparison leads to more appropriate modeling of the dam body in earthquake loading condition. The results indicate that TFD results show that %20 to 30% mass foundations have closer results to the recorded earthquake signal

Systematic Collective e-Cheating in a Saudi Arabian Higher Education Context: A Case Study

Objectives: The primary purpose was to investigate organized group cheating in a Middle Eastern institution during the shift to e-learning brought on by the COVID-19 pandemic in 2019. Method: The study explores the personal experiences of ten Saudi Arabian English as a Foreign Language program graduates in a higher education institution through in-depth interviews via qualitative interpretative phenomenological analysis. The study was guided by Ajzen’s theory of planned behavior. Results: A novel type of misconduct coined systematic collective e-cheating was identified and discussed. In addition, insights on the causes and types of e-cheating in a Middle Eastern context were provided. Conclusions: Academic misconduct was directly influenced by a rapid transition to e-learning, societal culture, and subjective norms, all of which jointly contributed to shifts in ethical perceptions leading to increased reports of cheating. Objectives: The primary purpose was to investigate organized group cheating in a Middle Eastern institution during the shift to e-learning brought on by the COVID-19 pandemic in 2019. Method: The study explores the personal experiences of ten Saudi Arabian English as a Foreign Language program graduates in a higher education institution through in-depth interviews via qualitative interpretative phenomenological analysis. The study was guided by Ajzen’s theory of planned behavior. Results: A novel type of misconduct coined systematic collective e-cheating was identified and discussed. In addition, insights on the causes and types of e-cheating in a Middle Eastern context were provided. Conclusions: Academic misconduct was directly influenced by a rapid transition to e-learning, societal culture, and subjective norms, all of which jointly contributed to shifts in ethical perceptions leading to increased reports of cheating. Implication for Theory and/or Practice: Education professionals need to be aware of underlying issues related to unethical behavior and encourage students to understand and address negative ideologies regarding ethics on a societal level. Efforts must also be made to raise instructor awareness of academic misconduct in e-learning through comprehensive professional development programs. Furthermore, with the increased use of technology in education, if the social, cultural, and perceptional factors are not addressed, educational systems will be impacted, affecting the credibility and value of academic degrees should cheating become the norm

TWO NOVEL FLAVONE C-GLYCOSIDES ISOLATED FROM AFROCARPUS GRACILIOR: POM ANALYSES AND IN VITRO CYTOTOXIC ACTIVITY AGANIST HEPATOCELLULAR CARCINOMA

Objective: Cancer is considered as one of the top reasons of death and the number of cases increasing gradually. Cancer is severe clinical difficulty to the health caution system. This study explored two novel polyphenols of Afrocarpus gracilior Pilger growing in Egypt and evaluated their cytotoxic activity. Methods: Methanolic (80%) extract of the leaves of A. gracilior was subjected to column chromatography; the chemical structures of the isolated compounds were established by advanced spectral techniques: UV, 1H, 13C NMR, two dimensional NMR (2D NMR) and electron spray ionization mass spectroscopy (ESI-MS). Compounds 1 and 2 were studied for their cytotoxic activity against hepatocellular carcinoma (Hep-G2) using sulforhodamine B (SRB) assay. Furthermore the pharmacokinetics profiles of these molecules were accessed by employing Petra/Osiris/Molinspiration (POM) analyses. Results: Two novel C-flavonoid glycosides were isolated [1: Apigenin 8-C-β-D-glucopyranosyl-(1```→4``)-O-β-D-glucopyranoside] and [2: 7-O methyl-luteolin 8-C-β-glucopyranosyl-(1```→4``)-O-β-D-glucopyranoside]. They exhibited significant cytotoxic activity (IC50 = 9.02 and 15.61 µg/ml, respectively) against Hep-G2 cells. The POM analyses revealed that the activity of these two compounds depends on the presence of glucosyl and alkyl groups at the internal and terminal atmosphere of the compounds. Conclusion: These findings demonstrated that the leaves of A. gracilior contain a series of bioactive polyphenolic compounds with significant cytotoxic properties against hepatocellular carcinoma and may be used as alternative anticancer agents for doxorubicin. On the basis of POM calculations, it will be interesting to develop some alternative flavones because the deglucosylated derivatives have a better drug score than parent molecules. This preliminary study will be extended to other strains of cancer

Preoperative Fasting Time and Selected Postoperative Outcomes among Patients Undergoing Abdominal Surgeries: Correlation Study

Background: Prolonged preoperative fasting time had a negative impact on the recovery of the patient in the postoperative period. Aim of the study: was to determine the relationship between the preoperative fasting time and selected postoperative outcomes among patients undergoing abdominal surgeries at one of the University Hospitals Cairo-Egypt. Research question: What is the relationship between the preoperative fasting time and the selected postoperative outcomes (patients' blood glucose levels, blood pressure and vomiting frequency) among patients undergoing abdominal surgeries? Design: Descriptive-correlation design was utilized. Setting: The study was conducted on waiting areas of general surgery operating room at 2nd and 3rd floor in addition to the general surgical wards at one of the University Hospitals. Subjects: A convenience sample of 60 female & male adult patients with the following inclusion criteria: 1- undergoing abdominal surgeries, 2- have no diabetes or hypertension were recruited in the current study Tools: Two tools were utilized to collect data pertinent to the study; I- A semi-structured interview questionnaire, it contained two parts: 1: Demographic data 2: Surgical patient’s clinical data.  II - Postoperative outcomes data sheet: It included measurement of the three selected postoperative outcomes. Results: The current study findings revealed that nearly three quarters of the study sample fasted for longer than required time with a mean+ SD= 11.1 + 2.5 and more than two third of the study sample had waiting time between 3->6 hrs. There was a significance difference between pre-operative & post-operative, post-operative & baseline readings regarding the systolic blood pressure and between the baseline and the pre-operative diastolic blood pressure. There was a positive moderate correlation between the pre-operative fasting time and the post-operative blood glucose results r=0.41. Also, there was a strong correlation between baseline and preoperative blood glucose results r=0.77, while, There was no correlation  between frequency of vomiting post operatively and age, preoperative fasting time, waiting time, blood glucose, and blood pressure.  Conclusion: There was a correlation between preoperative fasting time and blood glucose level followed by blood pressure while no correlation with vomiting frequency postoperatively. Recommendations: Awareness of heath care team regarding updating evidence-based preoperative fasting guidelines, nurse should measure blood glucose level and blood pressure for the non-diabetic as well as the diabetic patients before the surgical procedure and further studies are needed to determine the optimal fasting time and its effect on postoperative outcomes. Keywords: Preoperative fasting time, waiting time, abdominal surgery, blood glucose level, blood pressure, postoperative vomiting

Surface Modification and Dyeing of Ultra-High Molecular Weight Polyethylene Fibers by Plasma Discharge Mode

       In this study Ultra-high molecular weight polyethylene (UHMWPE) fibers were subjected to oxygen/argon plasma treatment in order to improve the wettability without changing bulk properties. The results showed that surface roughnesshave been modified by plasma treatment, indicating that the plasma treatment favored the interaction with dyeing UHMWPE fibers. After the treatment the treated fibers were characterized by using scanning electron microscopy (SEM),Fourier transforms infrared spectroscopy analysis (FT-IR), X-ray Diffraction (XRD), atomic force microscopy (AFM). Dyeability of the modified fibers were investigated by dyeing using disperse blue dye and also fibers were printed with pigment red colour.The obtained results were compared with the dyeability of the untreated fiber. The result showed that a significant increase of K/S value after dyeingandafter printing at dyeing temperature of 100 ° C. Thus, the oxygen/argon plasma treatment of UHMWPE fiber can obtain good dyeing properties overall, plasma treatment has a great improvementof theroughnesssurface and dyeing property of UHMWPE fiber.        تعرضت ألياف البولي إيثيلين عالية الوزن الجزيئي  للعلاج بتحفيز البلازما باستخدام خليط من الارجون والاكسجين من أجل تحسين قابلية الامتصاص دون تغيير خصائص الالياف. أظهرت النتائج أن خشونة السطح قد تم تحسينها عن طريق معالجة البلازما، مما يشير إلى أن معالجة البلازما تحسن التفاعل مع صباغة ألياف البولي إيثيلين عالية الوزن الجزيئي. اختبرت الألياف المعالجة عن طريق جهاز مجهر المسح الإلكتروني (SEM)، حيث يقوم فوراً بالتحليل الطيفي بالأشعة تحت الحمراء (FTIR)، انحراف الأشعة السينية (XRD)، الفحص بمجهر القوى الذرى (AFM). تم فحص صباغة الألياف المعدلة عن طريق الصباغة باستخدام الصبغة الناشرة الزرقاء وطباعة الياف أخرى بالوان البجمنت الحمراء. تمت مقارنة النتائج التي تم الحصول عليها بعد الصباغة مع الألياف غير المعالجة. أظهرت النتيجة ان هنالك زيادة كبيرة في قيمة K / S بعد الصباغة والطباعة عند الصباغة في درجة حرارة 100 درجة مئوية. وبالتالي، فإن معالجة ألياف البولي إيثيلين عالية الوزن الجزيئي  بتحفيز البلازما باستخدام خليط من الارجون والاكسجين يمكن أن تحصل على خصائص صباغة جيدة بشكل عام، والمعالجة بتحفيز البلازما يعمل على تحسن كبير في خشونة السطح وخاصية الصباغة لالياف البولي إيثيلين عالية الوزن الجزيئي. &nbsp

Effect of High-Intensity Focused Ultrasound on Vaginal Relaxation Syndrome

This study was conducted to determine the effect of high-intensity focused ultrasound (HIFU) on vaginal relaxation syndrome (VRS). Thirty sexually active women suffering from vaginal laxity aged 30-45 years participated in this study. Vaginal laxity is often overlooked and underreported, yet it significantly impacts sexual functioning, self-image, and overall quality of life (QoL) in women. These women were randomly assigned to two groups: control group (15 women) received pelvic floor exercises daily for 8 weeks and study group (15 women) received the same exercises daily for 8 weeks plus 2 sessions of HIFU with 4 weeks apart. Evaluation was done before and after the treatment program by vaginal laxity questionnaire (VLQ), sexual satisfaction questionnaire (SSQ), and female sexual function index-19 (FSFI-19) to assess sexual health; International Consultation on Incontinence Questionnaire short-form (ICIQ-SF) to evaluate urinary symptoms; vaginal pH strip to evaluate vaginal pH; vaginal pressure gauge to assess vaginal wall elasticity; and ultrasonographic imaging to assess pelvic floor biometers. The post-treatment results revealed significant improvements in VLQ, SSQ, all domains and total score of FSFI-19, ICIQ-SF, vaginal pH, intravaginal pressure, the length from symphysis pubis to anorectal angle at rest and at contraction, as well as the anteroposterior and transverse diameters, and area of the levator ani hiatus at rest and at Valsalva (p\u3c0.05) in favour of the study group. High intensity focused ultrasound is an effective and safe modality for improving sexual health, urinary symptoms, vaginal pH, vaginal wall elasticity, and pelvic floor biometers in women with vaginal relaxation syndrome