Distribution of terminal nerve entry points to the flexor and extensor groups of forearm muscles: an anatomical study

The motor points of the skeletal muscles, mainly of interest to anatomists and physiologists, have recently attracted much attention from researchers in the field of functional electrical stimulation. The muscle motor point has been defined as the entry point of the motor nerve branch into the epimysium of the muscle belly. Anatomists have pointed out that many muscles in the limbs have multiple motor points. Knowledge of the location of nerve branches and terminal nerve entry points facilitates the exact insertion and the suitable selection of the number of electrodes required for each muscle for functional electrical stimulation. The present work therefore aimed to describe the number, location, and distribution of motor points in the human forearm muscles to obtain optimal hand function in many clinical situations. Twenty three adult human cadaveric forearms were dissected. The numbers of primary nerves and motor points for each muscle were tabulated. The mean numbers and the standard deviation were calculated and grouped in tables. Data analyses were performed with the use of a statistical analysis package (SPSS 13.0). The proximal third of the muscle was the usual part of the muscle that received the motor points. Most of the forearm muscles were innervated from the lateral side and deep surface of the muscle. The information in this study may also be usefully applied in selective denervation procedures to balance muscles in spastic upper limbs

Radial Access in Primary PCI for Acute Myocardial Infarction

Transradial approach (TRA) is now considered the standard of care in many centers for elective and primary percutaneous coronary intervention (PCI). The use of the radial approach in ST‐segment elevation myocardial infarction (STEMI) patients has been associated with a significant reduction in major adverse cardiac events. However, it is still unclear if the side of radial access (right vs. left) has impact on safety and effectiveness of TRA in primary PCI. So this chapter was conducted to summarize the benefits of transradial access over transfemoral access based on the most recent studies and to compare between using either right radial or left radial as an access for transradial procedure

The blackberry frozen puree dessert

This investigation was a trial to check the possibility of developing a frozen blackberry puree dessert. A blend of different varieties and selections of blackberries, as it may be expected in commercial production was preferred to provide the fruit-puree-mix. Several stabilizers bearing different commercial names were added to the fruit puree mix to produce an overrun percent and texture comparable to that of ice cream. These stabilizers used in the study were as follows: Gelatin (275 Bloom), methocel 1500 and 4000 cps., pectin (150) grade, Krim-Ko-Gel, Stavel and CMC high and medium viscosity. The results obtained have indicated that gelatin (275 Bloom) was the easiest to bring into solution; significantly increased the viscosity of the puree-mix, produced the highest overrun percent at a comparable concentration and was the most successful stabilizer to preserve the color, flavor and texture of the puree-mix, either after freezing or at an extended storage period of fourteen months at 0 F

The economic causes of the Egyptian revolution January 25, 2011

A growing number of recent studies on the Egyptian revolution attribute its beginning to a set of socio-economic and political factors. On the political side, explanations includes a) the persistent rule by terror for thirty years through the emergency law, b) the prohibition on political rights and civil freedoms and lack of free and fair elections, c) police brutality against activists– namely the case of Khaled Said) the wide spread corruption, e) the spread of virtual-opposition through social networking websites and the Arabic satellite, f) the success of the Tunisian revolution as a bloodless and fast change, the sacrifice of Mohammed Bouazizi, and finally the spread of wikileaks scandals that threw more mud over the regime\u27s face. . On the socio-economic side, the revolution is largely attributed to the rise of unemployment, inflation of food prices, low income and rising inequality, the lack of health services. In short, the revolution is explained by the increasing density and pervasiveness of social, economic and political grievances that culminated into an uncontrollable anger towards a diminishing legitimacy of Mubarak\u27s thirty-years-rule of the country. This was largely reflected in the main demands of the protestors to end Hosni Mubarak\u27s rule, end emergency law, freedom, social justice and human dignity. This paper suggests a growing significance of the economic motives of social and political change through highlighting the economic dimensions of Egypt before 25th January 2011. It reviews different indicators of the economic conditions in Egypt before the revolution, in a way to answer a main question, “what are the economic motives behind the 25th January revolution in Egypt?” The structural approach followed on this paper slightly touches on the Marxian conception of dependency– by which social, political and cultural structures are perceived as dependent on the economic super-structure. In this paper, these dimensions are seen as rather intertwined and mutually dependent on each other; the economic motives are only one face of a complex web of explanations that generate meaning and resonance to similar experiences elsewhere. Meanwhile, the structural approach is deemed suitable to a leaderless revolution, since it provides a set of ‘totalising\u27 factors that facilitate collective action on massive scales by creating a national narrative of the revolution. This paper is organized around eight sections that circumscribe the economic situation in Egypt; economic stagnation, income inequality and poverty levels, the demographic aspect–population size, unemployment, rise of food prices compared to income levels, education and market matching and wealth and gender gaps

Diesel engines and solar energy for electric and cooling applications

[no abstract

Linguistic phenotype in a sample of Arabic speaking children with Williams and fragile X syndromes

The detailed linguistic assessment of children with Williams syndrome (WS) in comparison to typically developing (TD) children and other genetic syndromes such as fragile X syndrome (FXS) could reveal the language specific difficulties and help in better designing of intervention plans. Aim: To investigate the linguistic abilities with detailed syntactic performance in a sample of Egyptian children with WS in comparison to TD and FXS children from the same pool. The participants (n=30) included WS, TD children of similar sex and age of WS group and FXS group matching the WS group for mental age. The linguistic assessment was established using the Wechsler intelligence scale for children-III, Vineland social maturity scale and the standardized Arabic language test. The linguistic abilities of WS group were delayed even in relation to their mental age and when compared to TD children. WS group manifested deficits in past verb tense, manner adverbs and in spatially related syntax. The overall WS group language profile differed from that of FXS group especially regarding Pragmatics. The cognitive assessment revealed differences between the groups. The in depth detailed language assessment supports the presence of certain profile in the Arabic speaking WS participants. Individuals with WS do need language and social intervention plans as early as possible in addition to the original required visuospatial improvement strategies

Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy

<p>Abstract</p> <p>Background</p> <p>The superiority of a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy in direct cord implantation was investigated as to providing adequate exposure to both the cervical cord and the brachial plexus, as to causing less tissue damage and as to being more extensible than current surgical approaches.</p> <p>Methods</p> <p>The front and back of the neck, the front and back of the chest up to the midline and the whole affected upper limb were sterilized while the patient was in the lateral position; the patient was next turned into the supine position, the plexus explored anteriorly and the grafts were placed; the patient was then turned again into the lateral position, and a posterior cervical laminectomy was done. The grafts were retrieved posteriorly and side grafted to the anterior cord. Using this approach, 5 patients suffering from complete traumatic brachial plexus palsy, 4 adults and 1 obstetric case were operated upon and followed up for 2 years. 2 were C5,6 ruptures and C7,8T1 avulsions. 3 were C5,6,7,8T1 avulsions. C5,6 ruptures were grafted and all avulsions were cord implanted.</p> <p>Results</p> <p>Surgery in complete avulsions led to Grade 4 improvement in shoulder abduction/flexion and elbow flexion. Cocontractions occurred between the lateral deltoid and biceps on active shoulder abduction. No cocontractions occurred after surgery in C5,6 ruptures and C7,8T1 avulsions, muscle power improvement extended into the forearm and hand; pain disappeared.</p> <p>Limitations include</p> <p>spontaneous recovery despite MRI appearance of avulsions, fallacies in determining intraoperative avulsions (wrong diagnosis, wrong level); small sample size; no controls rule out superiority of this technique versus other direct cord reimplantation techniques or other neurotization procedures; intra- and interobserver variability in testing muscle power and cocontractions.</p> <p>Conclusion</p> <p>Through providing proper exposure to the brachial plexus and to the cervical cord, the single stage combined anterior (first) and posterior (second) approach might stimulate brachial plexus surgeons to go more for direct cord implantation. In this study, it allowed for placing side grafts along an extensive donor recipient area by end-to-side, side-to-side grafting neurorrhaphy and thus improved results.</p> <p>Level of evidence</p> <p>Level IV, prospective case series.</p

Screening of dystrophin gene deletions in Egyptian patients with DMD/BMD muscular dystrophies

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are allelic disorders caused by mutations within the dystrophin gene. Our study has identified 100 Egyptian families collected from the Human Genetics Clinic, National Research Center, Cairo. All cases were subjected to complete clinical evaluation pedigree analysis, electromyography studies, estimation of serum creatine phosphokinase enzyme (CPK) levels and DNA analysis. Multiplex PCR using 18 pairs of specific primers were used for screening of deletion mutations within the dystrophin gene. A frequency of 55% of deletions were found among the families. Sixty per cent of detected deletions involved multiple exons spanning the major or the minor hot spot of the dystrophin gene. The remainder 40% involved single exon deletions, which mainly involved exon 45. Comparing these findings with frequencies of other countries it was found that our figures fall within the reported range of 40%-60% for deletions. The distribution of deletions in our study and other different studies was variable and specific ethnic differences do not apparently account for specific deletions. In addition this study concluded that employment of the 18 exon analysis is a cost effective and a highly accurate (97% detection rate) method to be considered when planning to launch a nationwide program

Therapeutic Interventions for COVID-19

SARS-CoV-2, a novel coronavirus, is currently represented a major public health concern. The high transmission rate of this virus increases the mortality rate worldwide. To date, significant efforts and restricted regulations were performed around the world to control this crisis effectively, but unfortunately, there is no specific and successful therapy for COVID-19. Many approaches have been repurposed for SARS-CoV-2 treatment such as antivirals and anti-inflammatories. Furthermore, antibody therapies are one of the main and important approaches of SARS-CoV-2 infection treatment. In recent trials, various immunotherapeutic interventions such as convalescent plasma therapy and monoclonal antibodies, as well as immunomodulatory agents are being proposed. However, the development of a vaccine that provides durable protective immunity will be the most effective therapy for controlling possible epidemics of this virus. The current review summarized all the proposed therapeutic approaches together with information on their safety and efficacy in treating COVID-19, as well as the vaccine candidates. The provided comprehensive information regarding the applied therapeutic strategies against COVID-19 might help the scientific community in any progress toward the treatment of COVID-19 infection