Comparison of serum cystatin C and creatinine based methods in detection of early renal dysfunction in critically ill patients

Early detection of renal dysfunction is of importance inthe care of critically ill patients. Cystatin C was proposedto be superior to serum creatinine in estimation of renal function. This work aimed to compare serum cystatin Cto serum creatinine and creatinine based formulae indetection of early decline in renal function at a singlepoint in critically ill patients. Fifty critically ill patientsadmitted to Cairo University Hospitals ICUs - Egypt wereincluded. Patients with chronic renal disease,thyroid disease, malignancy, patients receivingcorticosteroid therapy, with serum creatinine > 1.4 mg/dland patients receiving diuretics or large volumes of IVfluids were excluded. Serum creatinine, serum cystatinC, adjusted creatinine clearance (Adj Ccr), estimatedGFR (eGFR) by modification of diet in renal disease(MDRD), abbreviated MDRD (abb MDRD) andCockcroft-Gault (CG) formulae were measured. Patientswith renal dysfunction (adj Ccr < 80 ml/min/1.73m2)were 26 (52%) in number. Patients with renaldysfunction and high serum creatinine were 12/26(46.2%) while those with high cystatin C were 23/26(88.5%). Cystatin C was found to be significantlycorrelated with serum creatinine, adj Ccr and eGFR by all studied formulae. Using receiver operatingcharacteristic (ROC) analysis; AUC for Cystatin C(0.976) was more than that for eGFR by abb MDRD(AUC=0.839), MDRD (AUC=0.822), CG formulae(AUC=0.808) and serum creatinine (AUC=0.710)respectively. In conclusion; cystatin C was found to bebetter than serum creatinine, eGFR by abb MDRD,MDRD and CG formulae in detection of early renaldysfunction at a single point in critically ill patients

Comparative study between cases of previous one cesarean section delivered at Kafr El-Sheikh hospitals, versus those delivered at Tanta Uniersity Hospital

Background: Many factors have contributed to the increasing rates of CSs, including increases in maternal age, BMI, and changes in obstetric practices and technologies. CSs requested by the mother and fear of litigation among caregivers have now become one of the most common indications of CS. Aim of this study was to compare between conditions of previous one caesarean section subjects delivered at Kafr El-Sheikh general hospitals, versus those delivered at Tanta University hospital as regard integrity of the uterine scars, presence of adhesions, time of termination, and fetal outcomes.Methods: This study was an observational study that was carried out on 100 pregnant ladies with history of previous one caesarean section. Participants were divided into two groups: group I included 50 pregnant women selected from Tanta University hospitals, group II included 50 pregnant women selected from Kafr El-Sheikh General hospital.Results: The estimated blood loss was significantly higher in cases selected from Kafr El-Sheikh hospitals compared to that lost from cases selected from Tanta University hospitals. Furthermore, operation time was significantly longer in patients selected from Kafr El-Sheikh hospitals than those selected from Tanta University hospitals. Additionally, omental adhesion was observed in 5 cases (5%); 3 (6%) from those selected from Kafr El-sheikh hospitals and 2 (4%) from those selected from Tanta University hospitals. As regard post-operative blood transfusion, there were increase in the incidence of post-operative blood transfusion in pregnant women selected from Kafr El-Sheikh hospitals (8%) compared to those selected from Tanta University hospitals (4%), but without statistically significant difference (p=0.678).Conclusions: There is high rate of caesarean section in our country. But satisfactory results were present in both Tanta university hospitals and Kafr El-Sheikh general hospital with few complication rates found special in cases priory delivered at Tanta University hospitals including less adhesion finding and thus less intra and post-operative complications

Biochemical Evaluation of some Natural Feed Additives against Dexamethasone-induced Metabolic Alterations in Rabbits

Glucocorticoid therapy is limited by numerous metabolic adverse effects associated with long term exposure to excess doses. Therefore, the present study aims to determine the possible protective effects of date palm and/or Saccharomyces cerevisiae probiotics on dexamethasone-induced metabolic changes in rabbits. 25 healthy male white New Zealand rabbits were grouped into group 1 (control), group 2 (2 mg/kg bw/day dexamethasone I/M), group 3 (0.5 g/kg/day date palm flesh+2 mg/kg bw/day dexamethasone I/M), group 4 (1g/kg/day S. cerevisiae probiotic + 2 mg/kg bw/day dexamethasone I/M), group 5 (date palm flesh + S. cerevisiae probiotic + dexamethasone at the aforementioned doses). Dexamethasone injection resulted in marked increases (p≤0.05) in hepatic MDA concentration and catalase activity, as well as significant decreases in hepatic GSH concentration and body weight gain. The serum levels of glucose, lipid profile (TG, cholesterol, VLDL, LDL/HDL risk ratio), and liver function biomarkers (serum total proteins, albumin, ALT, ALP) showed significant variations (P≤0.05) between control and dexamethasone treated group. The ameliorative effect of date palm fruit and/or probiotics (S. cerevisiae) was markedly indicated by restoration of these tested parameters to near normalcy. Therefore, the co-treatment with date or S. cerevisiae could be considered of great interest as potential feed additives for reduction of the adverse metabolic effects induced by dexamethasone in rabbits

THERMO-PHYSICAL PROPERTIES OF LIGHT WEIGHT EPOXY FOAMED BY SILOXANE BLOWING AGENT

The purpose of this study is to investigate the direct effect of using a blowing agent of siloxane (1, 1, 3, 3-tetramethydisiloxane) on the thermo-physical properties of the foamed epoxy. These properties are: density, glass-transition temperature, thermal conductivity and thermal expansion. The work has been conducted experimentally by manufacturing several specimens with different siloxane contents as: 0, 5, 10, 15 and 20 wt%. The properties of the specimens have tested under suitable conditions using different reliable instruments: differential scanning calorimetry, Lee-discs apparatus, and push rod dilatometer. Scanning electron microscope was used as well to analysis the morphological characteristics of the epoxy with respect to the pores generated by the blowing agent. In general, the foamed epoxy has shown different sizes of pores and extra crosslinking which leads to increase the glass-transition temperature of the material. Results show that the addition of 20% siloxane to the neat epoxy (as maximum) leads to: decreasing by 50% in bulk density, increasing by 20% in glass-transition temperature, decreasing by 30% in thermal conductivity, and decreasing by 75% in thermal expansion.                                             

Towards Climate Resilient Coastal Cities: a Framework to Deploy Nature-Based Solutions in the Urban Planning Strategies of the North Coast Cities in Egyptp

Coastal zones of the Mediterranean region are severely affected by the effects of extreme climatic events, along with human-induced pressures, which causes their growing vulnerability. That leads to the urgency for sustainable and resilient long‐term strategies for coastal development projects. In Egypt, the North Coast zone is considered a hotspot for climate-related changes. It is undergoing a series of new urban development projects expanding the urban areas along the coast of the Mediterranean Sea. As anthropogenic consequences along its coasts increase, the need for sustainable Nature‐Based Solutions (NBS) will increase accordingly. Recently, adaptive management strategies have been considered an important tactic to atone the unknown environmental conditions that coastal areas struggle with. Adaptive management was exploited to lessen such uncertainty by incorporating adaptive management into climate change adaptation strategies. In response to this need, this paper proposes a framework for nature-based solutions. It consists of four stages, it is founded on a novel approach that combines system analysis and building scenarios. Moreover, the first stage mainly depends on using the structure of the DPSIR (Driving force–Pressure–State–Impact–Response) model to improve ecosystem services and generate the evidence-base for the environmental, social, and economic benefits of nature-based solutions for implementation. The last two steps mainly reflect the adaptive management process and it is well-suited to capitalise on the transformational character of naturebased solutions’ as it encourages “breakthrough” leaps rather than incremental improvements. In essence, this framework aims to employ nature-based solutions in urban planning strategies to increase the climate resilience of coastal cities and. in particular, to identify suitable and less suitable strategies to be deployed in each zone. The framework has yet to be tested in a real-world case study; instead, this paper intentionally focuses on describing its structure, goals, and methodology, discussing its features, and framing its role from a climate resilience standpoint. As a result, the paper lacks a results section. Finally, conclusions are drawn regarding its potential adoption and further development

Effect of global postural correction exercises on stress urinary incontinence during pregnancy: A randomized controlled trial

Background: One of the many consequences of pregnancy that may negatively affect a woman’s quality of life is stress urinary incontinence caused by activities of daily living especially those associated with increased intraabdominal pressure. Objective: This research aimed to explore the impact of global postural correction exercises on stress urinary incontinence among pregnant women. Participants and Methodology: Forty primigravida female at their third trimester (aged between 26–36 years), with a single fetus, diagnosed with stress urinary incontinence take part in the research. Participants were assigned randomly into two groups: Study group (group A; n = 20) and control group (group B; n = 20). The participants were tested twice, before and after a 12-week period, during which group A received global postural correction exercises in addition to Kegel exercises, while group B performed only Kegel exercises. A perineometer was used to evaluate the change in vaginal squeeze pressure both before and after conducting the study. UDI-6 was utilized to assess changes in incontinence severity symptoms. Results: Findings revealed a significant increase in the mean value of vaginal squeeze pressure (p < .05) in the post-test condition in comparison to the pre-test in both groups A and B. Additionally, there was a main decrease (p < .05) in the mean value of UDI-6 in both groups. Moreover, findings showed a significant negative (inverse) correlation (p < .05) between the difference in vaginal squeeze pressure and the UDI-6 in all patients. Conclusions: Postural correction exercises in addition to Kegel exercises are effective in reducing urine leakage in women with stress urinary incontinence and should be an integral part of the management of such condition

Impact of Seasonal Conditions on Quality and Pathogens Content of Milk in Friesian Cows

Heat stress negatively affects milk quality altering its nutritive value and cheese making properties. This study aimed at assessing the impact of seasonal microclimatic conditions on milk quality of Friesian cows. The study was carried out in a dairy farm from June 2013 to May 2014 at Beni-Suef province, Egypt. Inside the barn daily ambient temperature and relative humidity were recorded and used to calculate the daily maximum temperature-humidity index (mxTHI), which was used as indicator of the degree of heat stress. The study was carried out in three periods according to the temperature-humidity index (THI) recorded: from June 2013 to September 2013 (mxTHI>78), from October 2013 to November 2013 (mxTHI 72–78) and from December 2013 to April 2014 (mxTHI78 was observed. In addition, the isolation rate of both S. aureus and E. coli increased when the mxTHI increased. The results of this study show the seriousness of the negative effects of hot conditions on milk composition and mammary gland pathogens. These facts warrant the importance of adopting mitigation strategies to alleviate negative consequences of heat stress in dairy cows and for limiting related economic losses