Role of Proangiogenic Tyrosine Kinase with Immunoglobulin and Endothelial Growth Factor Homology Domains 2 Expressing Monocytes in Chronic Lymphocytic Leukemia

Background: Globally, highest hematologic malignancy in prevalence is considered chronic lymphocytic leukemia (CLL). The expression of angiopoietin-2 (Ang2) and tyrosine kinase with immunoglobulin and endothelial growth factor homology domains (Tie1), two critical components of the Ang-Tie2 pro-angiogenic pathway, in CLL cells has been demonstrated. Objective: Clarification of Tie2-expressing monocytes’ (TEMs) involvement in the pathophysiology of CLL is the goal of this study. Patients and Methods: The study was case control, which was performed on 21 CLL patients; their age ranged from 46 to 71 with a mean of 58.2 ± 6.9, in addition to 21 age and sex matched healthy control subjects. Full medical histories, clinical examinations, and laboratory tests were conducted on all individuals. The percentage of TEMs in peripheral blood was determined by flow cytometry and their phenotypic characteristics defined as CD14+/CD16+/Tie-2+ cells. Results: Compared to the control group, there was a statistically significant increase in TEMs in the cases group. Among the cases group there was a statistical significant increase in LDH, uric acid, WBCs, reticulocyte, CD 38 β2 microglobulin and TEMS and statistical significant decrease in Hb with increase Binet stage. There was a statistical significant +ve correlation between TEMs and LDH, WBCs, reticulocytes, CD38 and β2 microglobulin. Also, there was a statistical significant negative correlation between TEMs and Hb and platelets count among the cases group. TEMs percentage had sensitivity, specificity and accuracy (100%) in diagnosis of leukemia at cut off > 20.95%. Conclusion: TEMs could be a part of CLL pathogenesis which can be a predictor of disease progression alongside with other prognostic indicators

Facial analysis using a new clinical device : The Kattan Facio-meter

The aim of the study was to attempt to set average faciometric standards for Egyptians using the Kattan Facio-meter. The sample consisted of 180 faculty students with age range 17-25 years. It was divided into three groups; Angle Class I, II and III. Class II was further subdivided into divisions 1 and 2. Linear and angular facial measurements in relation to K plane were taken using the Kattan facio-meter. The measurements were correlated to Angle?s classification and between genders. On comparing the different classes, Class II division 1 showed the statistically highest mean value for Orbitale-soft tissue A; p=0.042, Class II divisions 1 and 2 for Orbitale- Labrale superius; p=0.002 and soft tissue ANB; p<0.001. Females showed significantly higher mean value than males for the upper incisor/K plane; p=0.031. Males showed significantly higher mean value for the inter-incisal angle than females; p=0.001. Within the limitations of the current study, it was found that both linear and angular soft tissue measurements conformed to the antroposterior skeletal relation of the jaws and that Class II division 1 was due to protruded maxilla. Males had more prominent lips and deeper mentolabial sulcus. Egyptians had less prominent noses than Caucasians. The Kattan Facio-meter was a valuable tool for clinical analysis without the hazards of irradiation

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially