Removed versus unremoved vicryl sutures used for subcuticular skin closure

Background: The objective was to compare the difference between removing vicryl suture thread after skin healing or burry the knots and leaving it to be absorbed in situ, after subcuticular skin closure of Pfannesteil incisions.Methods: Prospective, randomized controlled trial included 449 eligible participants were prospectively recruited between July 2016 and June 2017. All selected patients had a pfannenstial incision with subcuticular skin closure using 2-0 absorbable vicryl stiches (for primary caesarean section or extra peritoneal surgical approach to the prostate, bladder and distal ureters). The left side knot was buried under the skin edge and a knot in the midline and the right edge was made. After 10 days postoperative, the right half of the stitch thread and the two knots were removed, and the left half of the thread was left in situ. Patients were observed for any complication at time of stitch removal, after one month and after 6 months' post-operative.Results: Wound infection rate, hypertrophic scars, keloids and skin itching were significantly higher in the un-removed wound sides while skin dehiscence was significantly higher in the removed wound sides.Conclusions: Leaving behind absorbable suture material after wound healing -when used in subcuticular pfannenstial skin closure- is associated with increased rates of wound infection, hypertrophic scars, itching and keloids, which of course overweight any known benefits of the technique

Evaluation of Subacute Toxicity Induced by Methoxychlor: The protective Effect of Ascorbic acid

The present study was designed to detect the effects of sublethal concentration of Methoxychlor (MXC) on hematological constituents, thrombocytic indices, liver and kidney damage biomarker and erythrocytic oxidative status. As well as the possible protective effect of ascorbic acid (vit-C) were tested in rats at subacute period under laboratory conditions. MXC was administered orally at a dose of 200mg/kg, twice weekly, to male rats, for one month. Co – administration of ascorbic acid at a dose of 1g\L drinking water was achieved. MXC caused a significant reduction in hematological constituents and thrombocytic indices. MXC induced a significant increase in the serum alkaline phosphatase (ALP), gamma glutamyle transferase (γ-GT), uric acid and creatinine, whereas decrease in total protein and albumin levels. With regards, to the results of oxidative status revealed that decrease in superoxide dismutase (SOD) and glutathione peroxidase (GSHPx) activities while increase in lipid peroxidation (LPO) components malondialdehyde (MDA). MXC plus vit-C treated group was significantly differed in most previous parameters than the MXC -treated group. These data, along with the determined changes suggest that MXC produce substantial systemic organ toxicity in rats during the period of a 30-days subacute exposure. The co- treatment with vit- C could ameliorate these toxic changes

Near-total pancreatectomy for persistent hyperinsulinemic hypoglycemia of infancy (nesidioblastosis): Mansoura experience

Background/purpose Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of persistent hypoglycemia in infancy with consequences such as seizures and brain damage. Treatment that prevents the occurrence of these sequele is essential. When medical therapy fails or complications are anticipated, early pancreatectomy is recommended to maintain euglycemia. The aim of this study was short-term evaluation of near-total pancreatectomy for PHHI after failure of medical treatment in patients in Mansoura, Egypt.Patients and methods During May 2002 to May 2010, 33 patients suffering from persistent hyperinsulinemic hypoglycemia were admitted to Mansoura university child hospital. Twenty patients responded to medical treatment and 13 patients (eight girls and five boys) were treated by near-total (90–95%) pancreatectomy after failure of medical treatment. Their ages at the time of surgery ranged from 20 days to 27 months. Only patients who were surgically managed were included in this study. All of them suffered from symptoms of PHHI: thermoregulatory problems in five cases, tremors in five cases, seizures in three, irritability in five, respiratory distress in eight, apnea in four, hypotonia in four, lethargy in five, and feeding difficulty in four cases. All cases were diagnosed following strict criteria that included bouts of hypoglycemia without acidosis coinciding with increased insulin level. Follow-up ranged from 3 months to 8 years.Results Primary success occurred in two cases (15%); four more cases (31%) developed temporary diabetes mellitus, and one case (8%) had a temporary pancreatic fistula. Eventually, total cure occurred in seven cases (54%); six cases (46%) developed a variety of complications; and persistent hypoglycemia was seen in two. Persistent diabetes mellitus was observed in three patients, developmental delay in one, and persistent neurological deficit in two patients; there was one case of mortality.Conclusion Near-total (90–95%) pancreatectomy is a suitable procedure for treatment of nesidioblastosis not responding to medical treatment and should be performed as early as possible. Keywords: Mansoura, near-total pancreatectomy, persistent hyperinsulinemic hypoglycemi

Classification system for Egyptian heritage buildings

To create a classification system for heritage buildings, it is essential to delve into the architectural components of the buildings following a specific procedure. First, the different objects’ properties (including their architectural style, geometric characteristics and ratio, condition, construction method, cultural value, material, color, reflectance characteristics) are identified. Second, creating a systematic framework that identifies the lifestyle of each element, stating the grouping principle of heritage elements and the design composition of tables that identifies the geometrical form, material and functional features whether insulation or load tolerance. This paper presents the challenges in creating a unified classification system for an Egyptian heritage palace built in 1896 with different architectural styles; i.e Rocco, Baroque, Islamic and even architectural customized elements with Royal slogan; through different historical periods, where multiple elements and sections were detached and attached to the place during its lifetime. The formulated classification system can be generalized in similar heritage buildings built in the same era

Tel Aviv Mizrah: The potential of Iraqi cultural identity within two generations

Before immigrating to Israel, first-generation Iraqi Jews were deeply attached to their identity as Mizrahi Jews. Their mother tongue was Arabic and they had grown up in an oriental environment. Therefore, it was not easy for them to adopt the Euro-Israeli identity that the dominant Ashkenazi-European stratum in Israel compelled them to accept. Despite strong Westernizing tendencies in Israeli society, the first generation of Iraqi Jewish immigrants maintained strong links to the Iraqi customs and traditions they had acquired in Iraq, particularly with regard to the musical folklore and oriental cuisine. On the other hand, second-generation Iraqi Jews were more familiar with Israeli society than their parents; they grew up in Israel and learned Hebrew in Israeli schools along with Ashkenazi Jews and other ethnic groups. This paper establishes connections between the historical realities of Iraqi Jewish immigrants and the literary representation of their world in the trilogy Tel-Aviv Mizrah (Tel Aviv East) written in 2003 by the Iraqi Jewish author Shimon Ballas, through a comparison of Ballas's literary vision with the historical realities of Iraqi Jewish identity in Israel over the course of two generations

Nuclear Shape Transition, Triaxiality and Energy Staggering of gamma Band States for Even-Even Xenon Isotopic Chain

The positive-parity states of even-even Xe nuclei are investigated within the framework of modified O(6) limit of the interacting boson model (IBM1). The effective three-body interaction [QQQ] where Q is the IBM O(6) quadrupole operator is introduced to exhibit the triaxiality nature. The shape of nuclear surface is described by the deformation parameters beta, gamma by using the intrinsic coherent state. The potential energy surfaces (PES) of the transition U(5)-Triaxiality-O(6) are calculated and analyzed and the critical phase transition points are identified. For each nucleus a fitting procedure is adopted to get the best model parameters by fitting some selected calculated energy levels and B(E2)transition rates ratios with experimental ones. These ratios are analyzed because they serve as effective order parameters in the shape phase transition. The nuclei in Xe isotopic chain evolve from spherical vibrator U(5) to gamma-soft rotor O(6) by increasing the boson number from N=3 (heavy isotope 132Xe) to N=10 (light isotope 120Xe) and the isotope 126Xe represent the critical nucleus. The nucleus 128Xe has triaxial nature. To deal with high spin states in gamma band in 118- 128Xe isotopic chain to investigate and exhibit the odd-even spin energy staggering, we introduce the two parameters collective nuclear softness rotor model (CNS2). Three different staggering indices depending on the dipole transitions linking the two families of spins and the quadrupole transitions within each spin family are considered. Strong odd-even spin energy staggering has been seen. As a link between the IBM and CNS2 models we observed that the energy difference between the gamma-band and ground state band normalized to decreases with increasing the mass numberComment: 20 pages,4 tables, 7 figures and 59 reference

Energy Saving of the Domestic Housing Stocks: Application Development as a Plug-In for Energy Simulation Software

The research investigates energy conservation in the UK domestic housing sectors. The UK government has been dedicated to saving energies from domestic sectors through the implementation of low-carbon retrofit schemes. The paper focuses on the future of energy simulation software and its impacts on a more successful delivery of low-carbon retrofit with respect to the concept of ‘Parallelism’. An obvious problem in the current market is that, for Post-Occupancy Evaluations (POE), the simulated energy performance result does not reflect the actual energy performance. It is widely recognized that the energy conservation of the domestic stock is not only subject to housing physical improvements, but is also related to a series of social, financial and behavioural issues. Among those factors, occupants’ behaviour has the most significant impacts on housing energy performance. The overestimations of those issues decrease the efficiency of low-carbon retrofit in the UK. The solution could be the development of an application that addresses all/most aspects concerned with energy performance variables as a plug-in within a conventional energy simulation software – Standard Assessment Procedure (SAP). To fulfil the research aim, Modelling has been created to examine the impacts of people’s lifestyle patterns, age groups, ethnic groups, etc., towards energy simulation results. A detailed questionnaire will be implemented into the research design. With the collaborations of Newham Council, survey questionnaires are expected to be carried out towards occupants’ behaviour, household profiles and housing conditions. The expected findings will conclude that people with different backgrounds will differently operate the dwellings differently. The collected data will be analysed in order to find the correlations between energy performance and the abovementioned social, financial and behavioural variables. The data analyses will be conducted by implementing Statistical Product and Service Solutions (SPSS)

Role of CD99 in adult patients with acute myeloid leukemia

Background: When it comes to acute myeloid leukemia (AML), the large proportion of patients usually have relapses. Acute myeloid leukemia, Lymphoblastic lymphoma/leukemia, as well as Ewing sarcoma all have high CD99 expression.Objective: The aim of the current work was to assess CD99 expression frequency in patients with AML, and also to evaluate its association with different clinical and laboratory data.Patients and Methods: This comprehensive study included a total of 40 AML patients and 20 matched healthy subjects, attending at Departments of Clinical Pathology and Medical Oncology, Faculty of Medicine, Zagazig University Hospitals. Clinical and laboratory data were correlated with CD99 expression frequency in patients with AML in order to examine its usefulness as a predictive and prognostic factor.Results: Examination of CD99 expression in AML patients revealed that 80% of patients are CD99 positive, while (20%) are negative.Conclusion: CD99 expression in acute myeloid leukemia patients is of good prognostic value

Diagnostics and outcome predictorso drug induced liver injury: a single center prospective study

Background: Although drug-induced liver injury (DILI) is a rare clinical event, it carries significant morbidity and mortality. The diagnostic approach of DILI is still challenging because of lack of reliable markers that would allow distinguishing DILI from other causes of liver injury. Objective: To study the demographic, clinical and laboratory characteristics, and their relation to outcome of patients with DILI. Patients and Methods: Case control study conducted on 80 participants divided into two groups; Group I 40 patients with acute DILI and Group II 40 patients with acute viral induced liver injury. Subjects were systematically evaluated for clinical and laboratory characteristics, other etiologies, severity of DILI with application of Roussel Uclaf Causality Assessment Method (RUCAM) and liver biopsy whenever feasible and were all followed for 6 months thereafter. Results: Diclofenac was the most incriminated drug in DILI group (16 cases, 40%). Hepatocellular injury pattern was more common (28 cases, 70%). Infection with acute hepatitis B virus (HBV) and hepatitis A virus (HAV) were the commonest etiology of viral hepatitis (32 cases, 80%). All patients with acute viral hepatitis, improved with no recorded mortality nor chronicity. While 6 patients (15%) with DILI died. Conclusion: The diagnostic approach of DILI is still rudimentary and inaccurate and require high index of suspicion and thus, careful assessment is required to distinguish DILI from other causes of liver injury