Is sdLDL a valuable screening tool for cardiovascular disease in patients with metabolic syndrome?

Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardiovascular disease. Among high risk patients, those with metabolic syndrome represent an important target population. Different methods of small dense low density lipoprotein measurement were developed. Accordingly, two phenotypes of low density lipoprotein are recognized: Phenotype A (predominance of large buoyant low density lipoprotein) & phenotype B (predominance of small dense low density lipoprotein). However, none of the methods has been yet considered as a gold standard one. A lot of studies confirmed the role of small dense low density lipoprotein in the development of cardiovascular disease through atherogenic properties & clinical trials. However, others failed to do so. These discrepancies may be due to different sample sizes, different populations, different age groups, different methods of measurement & other possible confounding factors. The aim of this review is to discuss the role of small dense low density lipoprotein as a valuable screening/ preventive tool of cardiovascular disease in patients with metabolic syndrome

The Impact of Antiepileptic Drugs on Thyroid Function in Children with Epilepsy: New Versus Old

 Abstract ObjectivesTo investigate the effects of traditional antiepileptic drugs (AEDs) versus newer AEDs on the thyroid hormone profile of children with epilepsy.Materials & MethodsA total of 80 children with epilepsy were included in this study and were divided into two groups. Group 1 included 40 children with epilepsy on traditional AEDs, and group 2 included 40 children with epilepsy on newer AEDs. Forty healthy children were also included as the control group (group 3). We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH).Results: Epileptic children treated with traditional drugs showed a statistically significant decrease in the serum fT4 and increase in TSH concentrations compared to the control group (P < 0.001). Whereas epileptic children treated with newer drugs showed no statistically significant changes in the serum fT3, fT4 and TSH concentrations compared to the control group Conclusions: Traditional AEDs have a significant impact in the thyroid hormone profile compared to the newer AEDs

Initial T wave morphology in the chest leads in patients presenting with anterior ST-segment elevation myocardial infarction and its correlation with spontaneous reperfusion of the left anterior descending coronary artery

Background: T wave inversion in leads with ST-segment elevation after reperfusion therapy is considered a sign of reperfusion. However, the significance of T wave inversion on presentation before the initiation of reperfusion therapy is unclear. Aim of the Work: The current study aimed to assess whether the initial T wave morphology in the electrocardiographic (ECG) at presentation can predict patency of the left anterior descending artery (LAD) in patients with acute anterior ST segment elevation myocardial infarction (STEMI) before undergoing primary percutaneous coronary interventions (PCIs). Methods: This study included ninety patients who presented to the emergency department with acute anterior ST-elevation MI. We excluded patients with bundle branch block, postcoronary artery bypass grafting patients, patients with paced rhythm, and patients who received thrombolytic therapy. The T wave morphology in the 2 leads with maximal ST-segment elevation on the presenting ECG was identified as one of the three morphologies, positive T waves (T+; initial positive deflection ≥0.5 mm above the isoelectric line), biphasic T waves (T+/−; where the T wave initially showed a positive deflection above the ST segment afterward followed by a negative deflection ≥0.5 mm below the isoelectric line), and negative T waves (T−; where the T wave initially showed a negative deflection ≥0.5 mm below the isoelectric line without showing any initial positive deflection). Then, according to the results of the initial angiography, patients were classified into spontaneous reperfusion (SR) (those with thrombolysis in MI [TIMI] II or TIMI III flow in the infarct-related artery [IRA] prior to intervention) or non-SR (those with TIMI 0 or TIMI I flow in the IRA prior to intervention). Results: Ninety consecutive patients (77 males and 13 females) presented by STEMI and treated by primary PCI at cath lab of Ainshams University Hospitals (a 24/7 tertiary referral center for primary PCI) between January 2015 and March 2016 were included in this study, of which 40 patients (44.4%) had positive T waves (T+), 34 patients (37.8%) had negative T waves (T−), and 16 patients (17.8%) had biphasic T waves (T+/−). Initial angiogram showed that 18 patients had SR and 72 patients had no SR. With regard to T wave morphology, negative T waves were significantly present in SR group (66.7% vs. 30.6%, P = 0.004), whereas positive T waves were predominantly present in non-SR (50% vs. 22.2%, P = 0.033). Conclusions: For SR of LAD in anterior STEMI patients, prior to primary PCI, T wave inversion had a good sensitivity of 66.7%, a specificity of 69.4%, and a good negative predictive value of 89.29%

Case Report: Root resorption caused after pulp death of adjacent primary molar [version 1; referees: 2 approved]

Necrotic decayed primary molars with necrotic pulp tissues may show periapical involvement and root resorption. In this case report, a pediatric patient with a very common chief complain and clinical picture of necrotic badly decayed molar, introduced a very interesting case when radiographic investigation was performed, which showed that root resorption of the adjacent healthy molar occurred. The current report is, to the best of our knowledge, the first to report such finding in primary dentition

Analgesia and sedation strategy for mechanically ventilated patients in the respiratory ICU

Background Mechanical ventilation is typically required for ICU patients as part of their care. This recommends the use of analgesia and sedation in a balanced strategy to alter patients’ comfort and assist synchronization with mechanical ventilation while avoiding the downsides of excessive sedation. Objective The aim of the study was to compare between deep sedation and light sedation, analgesia, and no sedation strategies and their effects on the length of mechanical ventilation, and their effects on patients’ prognosis. Patients and methods This cohort prospective pilot study was conducted at the medical respiratory ICU at Ain Shams University Hospital in Cairo, Egypt, on 54 patients separated into four groups according to the type of sedation and analgesia suited for each patient’s severity condition. Results In this study, 54 mechanically ventilated patients in respiratory ICU were recruited. The patients were divided into group 1: no sedation or analgesia, group 2: analgesia only, group 3: light sedation, and group 4: deep sedation. There was a significant difference in Acute Physiology and Chronic Health Evaluation score and severity%, although the Acute Physiology and Chronic Health Evaluation score and severity % were the highest in group 1 (25.53, 55.11%) and group 4 (23.40, 47.68%), but the prognosis was poorer in group 4 and was affected by deep sedation (100% death rate) than that in group 1 (60.0%). The average infusion rate of fentanyl and the total dose were significantly different between groups, the highest being in the deep sedation group. ICU length of stay was nonsignificant between groups but it was lower in group 4 (median: 9 days) than other groups. The average rate of dormicum infusion in the deep sedation group was 5 µg, while there was no daily vacation period; so, it can be explained that higher doses of sedation and analgesia in group 4 affected their prognosis to be poorer than other groups. Delirium occurred in 80% of group 4 patients, but only in 6.7% of subgroups, indicating a highly significant difference. Complications either metabolic, cardiac, or hematologic in the postextubation period were higher in group 4 (60%), than in group 1 (47.7%), group 2 (40%), and group 3 (15%). Conclusion Light sedation and analgesia strategies with daily sedation interruption would have a better survival outcome and cause fewer issues in patients, who were on mechanical ventilation than a heavy sedation approach

Is sdLDL a valuable screening tool for cardiovascular disease in patients with metabolic syndrome?

Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardiovascular disease. Among high risk patients, those with metabolic syndrome represent an important target population. Different methods of small dense low density lipoprotein measurement were developed. Accordingly, two phenotypes of low density lipoprotein are recognized: Phenotype A (predominance of large buoyant low density lipoprotein) & phenotype B (predominance of small dense low density lipoprotein). However, none of the methods has been yet considered as a gold standard one. A lot of studies confirmed the role of small dense low density lipoprotein in the development of cardiovascular disease through atherogenic properties & clinical trials. However, others failed to do so. These discrepancies may be due to different sample sizes, different populations, different age groups, different methods of measurement & other possible confounding factors. The aim of this review is to discuss the role of small dense low density lipoprotein as a valuable screening/preventive tool of cardiovascular disease in patients with metabolic syndrome

Illumina MiSeq Sequencing for Preliminary Analysis of Microbiome Causing Primary Endodontic Infections in Egypt

The use of high throughput next generation technologies has allowed more comprehensive analysis than traditional Sanger sequencing. The specific aim of this study was to investigate the microbial diversity of primary endodontic infections using Illumina MiSeq sequencing platform in Egyptian patients. Samples were collected from 19 patients in Suez Canal University Hospital (Endodontic Department) using sterile # 15K file and paper points. DNA was extracted using Mo Bio power soil DNA isolation extraction kit followed by PCR amplification and agarose gel electrophoresis. The microbiome was characterized on the basis of the V3 and V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. MOTHUR software was used in sequence filtration and analysis of sequenced data. A total of 1858 operational taxonomic units at 97% similarity were assigned to 26 phyla, 245 families, and 705 genera. Four main phyla Firmicutes, Bacteroidetes, Proteobacteria, and Synergistetes were predominant in all samples. At genus level, Prevotella, Bacillus, Porphyromonas, Streptococcus, and Bacteroides were the most abundant. Illumina MiSeq platform sequencing can be used to investigate oral microbiome composition of endodontic infections. Elucidating the ecology of endodontic infections is a necessary step in developing effective intracanal antimicrobials

Evaluation of Hazard Analysis and Critical Control Points Implementation in Milk Collection Centers in Qalyubia Governorate

Hazard Analysis and Critical Control Point (HACCP) is a system that concerns with the identification, evaluation and management of risks that have a potential impact on food safety and quality; especially in a highly nutritious yet easily perishable food like milk and dairy products that can be easily contaminated with contain such biological, physical, and chemical hazards. Therefore, this study aimed to evaluate the returns from HACCP implementation in dairy farms and milk collecting centers (MCCs) located in Qalubiya governorate, Egypt through assessment of the quality, safety and potential adulteration in the collected raw milk samples, along with environmental swabbing for the sanitary condition monitoring pre- and post HACCP implementation, which included an overall improvement in sanitary and hygienic quality of milking, transportation, storage, and personnel conditions, along with documentation and traceability processes at the examined farms and MCCs. Statistical analyses were conducted to compare findings before and after a one-month duration of HACCP application. The results revealed a significant improvement (p ≤ 0.05) in the physico-chemical and microbiological quality of milk samples at both farm and MCC levels. This improvement directly reflected on the quality and fitness of milk for human consumption. In conclusion, the application of HACCP effectively controlled various hazards during milk production, even adulteration, and improved the hygienic quality of raw milk. Therefore, it is highly recommended for HACCP implementation in milk production facilities, with continuous monitoring for optimal results

Physiological Performance of Rabbits Administered Buffalo Milk Yogurts Enriched with Whey Protein Concentrate, Calcium Caseinate or Spirulina platensis

The present study examines the impacts of supplementing yogurt with 1% whey protein concentrate (WPC), Ca-caseinate (Ca-CN) and Spirulina platensis on the physiological performance of V-line rabbits receiving diets containing yogurt (at a dose of 5 g/kg body weight/day) and the different meat quality aspects. The results show that fat content was highest (p < 0.05) in yogurt fortified with Spirulina powder, but protein (%) was highest in yogurt enriched with WPC. Yogurt containing Spirulina powder showed a significant (p < 0.05) increase in total antioxidant activity. The final live body weight for G1 was higher than the other groups. However, additives affected the saddle, hind legs, liver and neck percentages significantly (p < 0.05). There were not significant differences for all groups in the forelegs, lung and heart percentages. LDL-cholesterol, total protein, globulin, albumin, creatinine and immunoglobulin M values were lowest (p < 0.05) in the WPC group. Significant improvements appeared in the small intestinal wall, microbiology, growth performance, serum biochemistry, organ histology and meat quality of the group receiving enriched yogurt. Yogurts enriched with WPC, Ca-CN and Spirulina platensis can be used as functional foods

Bio-Growth Stimulants Impact Seed Yield Products and Oil Composition of Chia

Chia (Salvia hispanica L.) is a specialty crop capable of providing healthy food and metabolites. The goal of our study was to explore the possibility of expanding seed yield, oil production, and metabolites of chia in response to amino acid, barthenosteriode, and algae extract treatments used as bio-stimulants. The experiment was conducted in the field in a randomized complete block design with three repeats. The treatments were (1) control (spray only with water), (2) amino acids with nutrients (2 mL/L vs. 4 mL/L), (3) brassinolide (5 mL/L vs. 10 mL/L), and algae extract (2 mL/L vs. 4 mL/L). The growth and yield measurements of chia, such as chlorophyll, carotenoids, amino acids, indoles, phenols, macro- and micronutrients, carbohydrates, total oil, and fatty acids were analyzed. The chia plants sprayed with growth stimulant materials showed increases in most studied characteristics, particularly algae extract at 4 mL/L, followed by algae extract at 2 mL/L during the first and second seasons. Meanwhile, amino acids at 4 mL/L led to the third-highest increases in most cases. Conversely, all bio-stimulant treatments decreased total phenols in leaves (mg/100 g f.w.), especially seaweed at 4 mL/L, compared to high levels in the control during both seasons. Control plants showed the lowest levels of the measurements mentioned previously when scored by barthenosteriode at 5 mL/L during the first and second seasons. GLC for fixed oil in chia showed the recognition of four biocomponents. i.e., oleic, linoleic, palmitic, and α-α linolenic acids. The main biocomponent was α-α linolenic acid and reach (49.7 to 57.9%). The application of seaweed at 4 mL/L could be exploited to improve growth, seed crop, fixed oil production, chemicals and bio-constituents, especially the fixed oil composition of chia (Salvia hispanica L.) plant