Repair of low anorectal anomalies in female patients: risk factors for wound dehiscence

Background/purpose: Wound dehiscence after rectoperineal/vestibular fistulae repair may have adverse effects on the continence mechanism with delayed functional sequels. We report the incidence of wound complications following the sagittal anorectoplasty in a group of female patients, in addition to studying the effect of some possible risk factors.Patients and methods: This is a prospective cohort study conducted on female patients with rectoperineal or rectovestibular fistula operated during the period from January 2011 to December 2015. Patients were divided into three groups: group A (no dehiscence); group B (minor dehiscence); and group C (major dehiscence). Patients were compared regarding their age at the time of repair, the type of anorectal anomaly, the degree of dilation of the colon, and the prevalence of covering colostomy.Results: The study included 63 female patients. Group A included 34 patients (those with no dehiscence, 52.4%), group B included 17 patients (minor wound dehiscence, 26.98%), and group C included 13 patients (major wound dehiscence, 20.6%). There was no statistically significant difference between the three groups regarding the studied risk factors.Conclusion: With regard to the wound complications following the repair of rectoperineal/vestibular fistulae in the female patients, none of the studied risk factors appear to have a significant effect on the outcome.Keywords: anterior sagittal anorectoplasty, colostomy, posterior sagittal anorectoplasty, rectoperineal fistula, rectovestibular fistula, wound dehiscenc

One-stage transanal Swenson procedure for rectosigmoid Hirschsprung’s disease in infants and children

Objective: This study aimed to present the outcome of transanal one-stage Swenson pull-through procedure in the management of rectosigmoid Hirschsprung’s disease (HD).Background: HD is a common cause of intestinal obstruction in pediatric age. Several pull-through procedures have been used to treat this pathology.Patients and methods: Between June 2008 and June 2015, 84 children with biopsy-proven HD underwent transanal one-stage Swenson pull-through procedure. Intraoperative details, postoperative complications, and bowel habits were recorded. Follow-up period ranged from 6 to 42 months.Results: The age at the time of surgery ranged from 3 months to 2 years. The length of the resected aganglionic segment ranged from 12 to 34 cm. The operating time ranged from 72 to 180 min. Postoperative hospital stay ranged from 3 to 6 days. There were no anastomotic leaks, no perianal infection, or postoperative bowel obstruction. Twelve patients (14.28%) developed postoperative enterocolitis. Six patients (7.14%) required a posterior internal sphincter myectomy despite repeated dilatations. All patients had less than four times bowel motions per  day, 3 months after surgery. No voiding disturbances were encountered at the end of the follow-up period and none of the patients complained of recurrent constipation. Six patients developed perianal dermatitis, which was treated conservatively within 3 months after surgery. Anastomotic circumference could not be felt at digital examination in 78 patients 3 months after surgery.Conclusion: One-stage transanal Swenson pull-through procedure is a safe alternative and simpler procedure for rectosigmoid HD with low morbidities and accepted outcome as regards postoperative bowel habits.Keywords: Hirschsprung’s disease, rectosigmoid Hirschsprung’s, Swenson procedure, transanal pull-throug

Computational prediction of vaccine potential epitopes and 3-dimensional structure of XAGE-1b for non-small cell lung cancer immunotherapy

Background: XAGE-1b is shown to be overexpressed in lung adenocarcinoma and to be a strong immunogenic antigen among non-small cell lung cancer (NSCLC) patients. However, 3D structure of XAGE-1b is not available and its confirmation has not been solved yet. Methods: Multiple sequence alignment was run to select the most reliable templates. Homology modeling technique was performed using computer-based tool to generate 3-dimensional structure models, eight models were generated and assessed on basis of local and global quality. Immune Epitope Database (IEDB) tools were then used to determine potential B-Cell epitopes while NetMHCpan algorithms were used to enhance the determination for potential epitopes of both Cytotoxic T-lymphocytes and T-helper cells. Results: Computational prediction was performed for B-Cell epitopes, prediction results generated; 3 linear epitopes where XAGE-1b (13-21) possessed the best score of 0.67, 5 discontinuous epitopes where XAGE-1b (40-52) possessed the best score of 0.67 based on the predicted model of the finest quality. For a potential vaccine design, computational prediction yielded potential Human Leukocyte Antigen (HLA) class I epitopes including HLA-B*08:01-restricted XAGE-1b (3-11) epitope which was the best with 0.2 percentile rank. Regarding HLA Class II epitopes, HLA-DRB1*12:01-restricted XAGE-1b (25-33) was the most antigenic epitope with 5.91 IC50 value. IC50 values were compared with experimental values and population coverage percentages of epitopes were computed. Conclusions: This study predicted a model of XAGE-1b tertiary structure which could explain its antigenic function and facilitate usage of predicted peptides for experimental validation towards designing immunotherapies against NSCLC

Prospects for repurposing CNS drugs for cancer treatment

Drug repurposing is the idea of using an already approved drug for another disease or disorder away from its initial use. This new approach ensures the reduction in high cost required for developing a new drug in addition to the time consumed, especially in the tumor disorders that show an unceasing rising rate with an unmet success rate of new anticancer drugs. In our review, we will review the anti-cancer effect of some CNS drugs, including both therapeutic and preventive, by searching the literature for preclinical or clinical evidence for anticancer potential of central nervous system drugs over the last 8 years period (2010-2018) and including only evidence from Q1 journals as indicated by Scimago website (www.scimagojr.com). We concluded that Some Central Nervous system drugs show a great potential as anti-cancer in vitro, in vivo and clinical trials through different mechanisms and pathways in different types of cancer that reveal a promising evidence for the repurposing of CNS drugs for new indications

الأشجار والشجيرات المتزاجدة في الحرم الرئيس للجامعة الإسلامية بغزة، قطاع غزة، فلسطين

The Gaza Strip, which has a population of about 2.0 million and an area of about 365 km2, has many higher education institutions. The green quadrates, corridors and gardens of these institutions are commonly cultivated with many horticultural plants including trees and shrubs that provide many environmental, health, and aesthetic values. The Palestinian universities of the Gaza Strip have never been studied for the composition and numbers of their trees and shrubs. Therefore, the current study aims at identifying and recording the trees and shrubs prevailing and enhancing the ecology and environmental health aspects of the main campus of the Islamic University of Gaza (MC-IUG). Frequent surveys and observations were carried out during a six-month study extended from February, 2018 to July, 2018 in order to identify and totally count the trees and shrubs existing at MC-IUG. A total number of 2248 trees and shrubs belonging to 53 species, 25 families and 16 orders were identified and recorded at the MC-IUG. The Gymnosperms included 5 species (9.43%) only, while the Angiosperms was represented by 48 species (90.57%), of which the monocots were 9 species (16.98%) and the dicots were 39 species (73.59%). Rosales was the biggest order and comprised 9 (16.98%) of the recorded species. It was followed by Lamiales and Myrtales which comprised 5 (9.43%) for each. The orders Pinales, Arecales, Asparagales and Malpighiales were represented by 4 species (7.55%) for each. Moraceae was the biggest family and comprised 8 (15.09%) of the recorded species. It was followed by the two families Arecaceae and Asparagaceae, which comprised 5 species (9.43% for each). Six tree and shrub species (11.32%) of MC-IUG were found to exceed the threshold of 100 individuals for each. These comprised 1657 individuals (73.71%) of the 2248 counted. The Chinese Hibiscus (Hibiscus rosa-sinensis) was, by far, the most common species. It comprised 31.98% of the individuals counted. This was followed by the Benjamin Fig (Ficus benjamina) (10.45%), Hopbush (Dodonea viscose) and Moringa (Moringa oleifera) (8.63% for each), Dwarf Umbrella Tree (Schefflera arboricola) (8.19%) and Weeping Fig (Ficus nitida) (5.82%). The majority of tree and shrub species 49 (92.45%) recoded in the current study are exotic, while the native ones are restricted to only 4 species (7.55%). Finally, the current study recommends the selection of tree and shrub species corresponding with the local prevailing environmental conditions in order to ensure the ecological and environmental health values needed by the university community.The Gaza Strip, which has a population of about 2.0 million and an area of about 365 km2, has many higher education institutions. The green quadrates, corridors and gardens of these institutions are commonly cultivated with many horticultural plants including trees and shrubs that provide many environmental, health, and aesthetic values. The Palestinian universities of the Gaza Strip have never been studied for the composition and numbers of their trees and shrubs. Therefore, the current study aims at identifying and recording the trees and shrubs prevailing and enhancing the ecology and environmental health aspects of the main campus of the Islamic University of Gaza (MC-IUG). Frequent surveys and observations were carried out during a six-month study extended from February, 2018 to July, 2018 in order to identify and totally count the trees and shrubs existing at MC-IUG. A total number of 2248 trees and shrubs belonging to 53 species, 25 families and 16 orders were identified and recorded at the MC-IUG. The Gymnosperms included 5 species (9.43%) only, while the Angiosperms was represented by 48 species (90.57%), of which the monocots were 9 species (16.98%) and the dicots were 39 species (73.59%). Rosales was the biggest order and comprised 9 (16.98%) of the recorded species. It was followed by Lamiales and Myrtales which comprised 5 (9.43%) for each. The orders Pinales, Arecales, Asparagales and Malpighiales were represented by 4 species (7.55%) for each. Moraceae was the biggest family and comprised 8 (15.09%) of the recorded species. It was followed by the two families Arecaceae and Asparagaceae, which comprised 5 species (9.43% for each). Six tree and shrub species (11.32%) of MC-IUG were found to exceed the threshold of 100 individuals for each. These comprised 1657 individuals (73.71%) of the 2248 counted. The Chinese Hibiscus (Hibiscus rosa-sinensis) was, by far, the most common species. It comprised 31.98% of the individuals counted. This was followed by the Benjamin Fig (Ficus benjamina) (10.45%), Hopbush (Dodonea viscose) and Moringa (Moringa oleifera) (8.63% for each), Dwarf Umbrella Tree (Schefflera arboricola) (8.19%) and Weeping Fig (Ficus nitida) (5.82%). The majority of tree and shrub species 49 (92.45%) recoded in the current study are exotic, while the native ones are restricted to only 4 species (7.55%). Finally, the current study recommends the selection of tree and shrub species corresponding with the local prevailing environmental conditions in order to ensure the ecological and environmental health values needed by the university community