Evaluation of microalbuminuria in patients with systemic sclerosis as an indicator of early renal damage and increased morbidity

AbstractIntroductionRenal involvement and systemic vascular damage have been shown to be significantly affecting prognosis in systemic sclerosis.Aim of workMicroalbuminuria detection in SSc patients as an indicator of early renal involvement and its correlation with various SSc clinical, laboratory parameters and severity of organ systems’ damage assessed by Scleroderma Assessment Questionnaire.Patients and methodsForty SSc patients (33 females and 7 males) with mean age of 27.48±12.56years and mean disease duration of 6.2±4.14years were included. Twenty-four (60%) had lSSc; 13 (32.5%) had dSSc and 3 (7.5%) patients had SSc sine scleroderma.ResultsEight (20%) had microalbuminuria and 9 (22.5%) patients had decreased creatinine clearance. Albumin/creatinine ratio was significantly higher among dSSc patients compared to those with lSSc and SSc sine scleroderma (X2=9.077; p=0.01). Albumin/creatinine ratio showed significant positive correlations with telangiectasia (r=0.322; p=0.04) and mRodnan’s skin score (r=0.352; p=0.026) and negative correlations with inter-incisor distance (r=−0.525; p=0.001) and pleurisy (r=−0.446; p=0.004). Albumin/creatinine ratio correlated significantly and positively with IMSS and IDS indices of SAQ (r=0.378, 0.32; p=0.016, 0.044, respectively). SSc patients with microalbuminuria showed significantly higher mean IDS than those without (1.058 vs. 0.631, p=0.04). No statistically significant correlations were found between creatinine clearance and the different demographic, clinical features and the indices of SAQ.ConclusionMicroalbuminuria compared to creatinine clearance may be a more sensitive indicator of early renal affection and predictor of increased morbidity

Reading Body Posture: The Action Mechanism to Achieve Lively Urban Public Spaces the Lived Experience on Alexandria Corniche

Abstract: Urban open spaces help to improve air and water quality, improve public health, afford recreation and respite, in addition to enhancing cities' economy and vitality. In urban open spaces, planning and designing of physical facilities that include sitting, food, retailing and toilets have a great impact on the workability and appeal of such spaces. Refuge symbols, or more clearly benches and other sitting and resting elements, are the most vital aspects that encourage people to use urban open spaces. The issue of how to design and locate refuge symbols is inherent in focusing on people, understanding their posture and positioning. Therefore, this paper aims at interpreting body posture and positioning in relation to demographic variety; consequently, it suggests quality criteria for sitting elements in order to create lively urban spaces

Primary Adenocarcinoma in a Seminal Vesicular Cyst: A Case Report

Introduction: Primary adenocarcinoma of the seminal vesicle (SVC) is very rare. Presentation to the case: Herein, we reported a case of SVA of SV cyst arising in a 51-year-old deaf mute male patient. Laboratory parameters including serum prostate specific antigen (PSA) level were normal. Contrast-enhanced magnetic resonance imaging demonstrated large reterovesical cystic lesion with mural nodules. The patient was managed by radical prostatectomy and seminovesiculolectomy.  Microscopic examination revealed well-differentiated primary mucinous adenocarcinoma of left seminal vesicle cyst.   Conclusion: To the best of our knowledge, this was the first case of SVA of SV cyst arising in deaf mute patient

Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements

Background There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients

Diagnostic evaluation of blunt abdominal trauma scoring system (BATSS)

Background: Blunt force abdominal trauma is a typical emergency room presentation in both adults and children. Trauma is widely acknowledged as one of the primary causes of illness and mortality in poor nations, as well as the greatest cause of death in those under the age of 45.Objectives: This study aims to study the diagnostic evaluation of blunt abdominal trauma scoring system (BATSS) in patients with blunt abdominal trauma in Zagazig University Hospital.Patients and methods: This study was conducted on 48 patients suffering from blunt abdominal trauma in Emergency Department of Zagazig University Hospital from January 2021 to June 2021.Result: The mean age of patients in the study was 25.87±10.7 years (range 17–61 years). Of the forty eight patients in the study there were 13 females (27.1%) and thirty five males (72.9%).There was statistically significant difference between blunt abdominal trauma scoring system (BATSS) and types of injury p<0.001. There was no statistically significant difference between blunt abdominal trauma scoring system (BATSS) and each of patients' sex and causes of injury p>0.05. Conclusion: The BATSS score system can be used as an initial screening to predict blunt abdominal trauma outcome and can be the basis of management in patients who experience blunt abdominal trauma

Treatment of Atrophic Acne Scars with Platelet Rich Plasma Gel and Micro-needling

Background: Following the advancements in the treatment of acne, post-acne scarring is still a widespread problem. Platelet-rich plasma (PRP) gel is one formulation with beneficial biological or medicinal qualities that aid in the management of post-acne scarring. Objective: It was the goal of this work to evaluate the utilization of treatment of post-acne scars with micro-needling and plasma gel. Patients and Methods: Patients with post-acne scars were recruited from the university hospital's dermatology and venereology outpatient clinic. Our study was based on 23 patients (8 males= 34.8%, 15 females= 68.2%) having 3 skin types (II, III, IV); skin type III patients representing 56.2% of total patients, most of these patients have scars for less than 10 years. Dermapen has been done to the face then the PRP gel has been applied combined with microneedling to the post-acne scars. We performed four sessions of the previous treatment with two weeks intervals then one month’s follow-up. Results: The baron, as well as Goodman scale improvement significantly post-treated with Platelet Rich Plasma Gel Combined with micro-needling, where 69.6% of cases become grade1 post-treatment, drop grade 3 to be (8.7%) post-treatment compared to (47.8%) pre-treatment the difference statistically significant p=0.022. Furthermore, all grade4 fade out post-treatment p=0.008. Conclusion: Dermapen combined with plasma gel is a promising effective therapeutic modality for atrophic acne scars

Efficacy and Safety of Topical Tranexamic Acid Alone or in Combination with Either Fractional Carbon Dioxide Laser or Microneedling for the Treatment of Melasma

Introduction: Tranexamic acid (TXA) is a promising treatment modality for melasma. Microneedling (MN) and fractional carbon dioxide (CO2) laser were reported to enhance TXA transepidermal delivery. Objectives: To compare efficacy and safety of topical TXA alone or in combination with either fractional CO2 laser or MN for treatment of melasma. Methods: Thirty females with facial melasma were divided randomly into 3 equal groups after excluding pregnant and lactating women and those using oral contraceptives or other hormonal therapy. Patients of group A were treated with fractional CO2 laser and those of group B were treated with MN (4 sessions, 3 weeks apart for both) with immediate topical application of TXA 5% solution after sessions and daily application of 5% TXA cream for both groups. Patients of group C were treated by topical daily application of TXA 5% cream. Evaluation was done by modified melasma area and severity index scores (mMASI), patient satisfaction and dermoscopy. Results: Statistically significant improvement of mMASI was reported in all studied groups with a significantly better improvement in patients of groups A and B than those of group C, meanwhile the difference between groups A and B was statistically insignificant. Conclusions: Topical TXA is a safe and fairly effective treatment modality for facial melasma. Combining TXA with either fractional CO2 laser or MN yielded significantly better improvement than when used alone. Fractional CO2 laser carries the risk of post-inflammatory hyperpigmentation in patients with skin types III and IV and requires meticulous patient selection

Achieving sustainable, environmentally viable, solarized vaccine cold chain system and vaccination program—an effort to move towards clean and green energy-driven primary healthcare in Lebanon

IntroductionLebanon faces severe economic and energy crises, impacting its healthcare system, particularly vaccine storage. Traditional gas or kerosene-powered refrigerators often fail to maintain necessary temperatures for vaccine efficacy. This study explores transitioning to solar direct-drive (SDD) refrigerators to ensure reliable vaccine storage.MethodsA multi-phase methodology was employed, beginning with an inventory assessment of existing cold chain equipment. The implementation involved stepwise replacement of identified refrigerators across health facilities, including Primary Health Care Centers (PHCCs) and dispensaries. Feasibility, cost-effectiveness, and environmental impact were evaluated.ResultsFindings indicate that solarization significantly reduces vaccine wastage, ensures stable temperatures, and cuts operational costs by decreasing dependence on non-renewable energy sources. Over 1,000 SDD units were installed across more than 800 health facilities. Additionally, PHCC solarization improved vaccine preservation and enhanced the resilience of health services overall.DiscussionThe solarization initiative demonstrates the critical role of renewable energy in strengthening healthcare infrastructure, especially in crisis-hit regions. Solar-powered systems provide a reliable and sustainable solution for vaccine storage, reduce carbon footprints, and build public trust in the immunization system. Challenges included geographical and structural limitations, which were addressed through comprehensive planning and collaboration with local stakeholders. Solarization of Lebanon's vaccine cold chain and PHCCs marks a significant step towards sustainable and resilient healthcare infrastructure. The model offers a robust framework for other regions facing similar economic and energy challenges, highlighting the importance of renewable energy solutions in healthcare