Can metformin limit weight gain in the obese with pregnancy?

Background: Maternal overweight and obesity is associated with many obstetric complications.  Obesity is linked to insulin resistance. Improving insulin sensitivity may therefore account for weight reduction. Metformin was found to be effective in type 2 diabetes and polycystic ovarian syndrome through improving insulin sensitivity. Several studies proved its efficacy in the obese non- pregnants, but its role during pregnancy is not yet well-established. In this study, we are testing the ability of metformin to limit weight gain with pregnancy and therefore reducing complications as gestational Diabetes and hypertension.Methods: A prospective study was conducted in Alexandria, Egypt. The study was registered in the South African Cochrane Centre under an identification number PACTR201505001142202. Two Hundreds participants with a BMI of ≥35 Kg/m2, pregnant in the early second trimester, were equally divided into two groups; in which group 1 will receive metformin 500 mg twice a day and group 2 will receive placebo. Prior to inclusion, 75 g oral glucose tolerance test, fasting insulin, fasting blood glucose, 1 h and 2 h glucose blood and HbA1C were measured .Both groups were followed up monthly for weight and for pregnancy complications namely gestational diabetes and pre-eclampsia till 36 weeks of pregnancy.Results: There was a significant difference in the weight gain and the one hour blood sugar measurement between the two groups, but not in the occurrence of pregnancy complications namely gestational diabetes and hypertension.Conclusions: Metformin succeeded to limit weight gain the obese with pregnancy

Can Co-enzyme Q10 improve the chances of conception after the age of 35?

Background: ovarian follicular quality diminishes with age, Free radicals and oxidative stress begin to accumulate in cells, aging or slowing down the metabolic energy production centers in the cell- the mitochondria. When the mitochondria cannot generate a certain amount of energy, it slows growth and proper development of the follicle making it more prone to DNA damage, including chromosomal abnormalities resulting in poor fertilization patterns, and early miscarriage. Co-enzyme Q10 (CoQ10) is a major cellular antioxidant. its tissue levels gradually decrease with age. We attempt to evaluate its protective effect on ROS-induced ovarian damage, which is one of the most important and widely accepted patho- mechanisms underlying cell ageing.Methods: 40 Participants   from El Shatby hospital infertility clinic 35 to 38 years old, with history of bad response to ovulation stimulation, were divided into two equal groups (group A given (CoQ10) 3mg|kg body weight for three cycles prior to stimulation Serum anti- mullarian hormone level was measured before and after CoQ10 administration, group B= twenty cases as control). Participants were given gonadotrophins (150 IU to 375 IU). Follicular growth was monitored by trans- vaginal ultra- sonography and serum estradiol level (E2). Ovulation trigger was achieved using 10,000 IU of human chorionic gonadotrophin.Results: The primary outcome was occurrence of normal pregnancy; secondary outcome was good response to stimulation (at least one mature follicle 18-22mm).Conclusions: CoQ10 has no significant effect on response to ovulation stimulation or on pregnancy rates

Effect of Hygiene Guidelines on Knowledge, Attitudes, and Practices of Food Handlers at University Cafeterias

Context: Safe food is a critical issue in the prevention of foodborne diseases. Food handlers play an essential role in preventing foodborne diseases and food poisoning at all stages of food preparation, storage, and handling.Aim: The study aimed to evaluate the effect of hygiene guidelines on the knowledge, attitudes, and practices of food handlers at University cafeterias. Methods: A quasi-experimental design was used to carry out the study. Setting: The study was conducted at the Faculties Cafeteria at Benha University. A convenient sample of (60) food handlers worked at Cafeterias of Benha University. Three tools were used for collecting data: A Structured interview questionnaire included two parts. The first is concerned with the assessment of the food handlers' demographic characteristics. The second part is concerned with assessing knowledge, and the third part included an assessment of food handlers' practices of the food handlers about food hygiene. The second tool is the food handlers' attitude assessment scale. The third tool is an environmental observational checklist that assessed the cafeteria's environmental condition. Results: 73.3% of the studied food handlers were male and single, 50.0% of them aged 20 - <30 years with mean± SD (32.63±4.71). Additionally, 76.7% of food handlers had a secondary education level, and they had health certificates. Only 18.3% of the food handlers had good knowledge regarding food hygiene before the guideline sessions compared to 85.0% after the guideline sessions. On the other hand, 65.0% of food handlers negatively affected food hygiene before the guideline sessions decreased to 15.0% after the guideline sessions. Moreover, 68.3% of food handlers had unsatisfactory practices regarding food hygiene before the guideline sessions compared to 76.7% after the guideline sessions. Conclusion: A considerable improvement was noticed among the studied food handlers after the guideline sessions related to the knowledge, attitude, and food hygiene practices. Recommendations: Further research should be geared towards regularly implementing health education programs for food handlers about food safety and hygiene at all faculties of Egyptian universities

The Impact of Talent Management Practices on Employee Performance: Leadership Competencies as a Mediator

ABSTRACT Purpose:  This research aims to fill some of the knowledge gaps in employee performance in the UAE through the direct impact of realistic job previews, performance-based compensation, perceived organizational support, mentoring, training and development on employee performance, and an indirect impact through the mediating effect of leadership competencies. By providing resource-based view (RBV) theory, this research aims to add to the body of knowledge and empirical data by explaining how employee performance in government organizations in the UAE may evolve.   Theoretical framework: Talent management practices are applied by leadership competencies if each employee inevitably plays his or her overall function in the performance of the organization (Wassem et al., 2019). It is important to look at how much talent management practises have enhanced employee performance since leadership competence has an effect on them.   Design/Methodology/Approach:  In this study, a cross-sectional design was appropriate. Moreover, 280 employees from Government Housing Programs Departments in United Arab Emirates were given questionnaires. The research found a significant impact of talent management practices on employee performance.   Findings:  the results demonstrated the function of leadership competencies as a mediator between talent management practices and employee performance. The current research also highlighted the research's implications, recommendations for future research, and limitations.   Research, Practical & Social implications:  One of the study's limitations is that it relies on a cross-sectional design; leadership competencies and employee performance are often time-consuming processes that may benefit from a longitudinal study. In addition, adopting quota sampling impacts the usable conclusion; the subsequent research may enhance the sample technique and be based on the effect of the described further circumstances.   Originality/Value: in its specific focus on the impact of talent management practices on employee performance, its exploration of an emerging field within HR management, its holistic examination of the talent management process, its potential to establish causal relationships, its practical implications for organizations, its guidance for HR strategies, its value for HR practitioners, and its contribution to the academic literature. These elements collectively emphasize the significance of the study in advancing understanding and practices in talent management and organizational performance

Novel Guidelines for Immunotherapeutic Treatment Options of Genital Warts: Review article

Background: The appearance of genital warts varies. Flat or resembling raspberries or cauliflower, they can be found in a variety of shapes. They begin as little red or pink growths and can reach a diameter of four inches or more before interfering with sexual activity or delivery (in certain circumstances) (in some cases). The warts thrive in the vaginal area's moist tissues. On the external genitals and the walls of the cervix and urethra, in women, as well as on the shaft of the penis in males, they are found. Despite the availability of different therapeutic modalities, treating warts with immunotherapy is a tremendous benefit. HPV vaccination has shown promising efficacy in the treatment of genital warts. Objective: To hallmark the new guidelines of immunotherapeutic options for treatment of genital warts. Conclusion: Immunotherapy with HPV vaccines is an effective and safe treatment modality of anogenital warts

Incidence of cervical stump metastasis after subtotal hysterectomy done to cases proved later by histopathology to be endometrial cancer in Al Shatby university maternity hospital patients

Background: Subtotal hysterectomy is associated with lesser complication, lesser time consuming than total one, but total hysterectomy has advantage of radicality of its management in cases of accidentally undiagnosed endometrial cancer proved later on by histopathology, that why hysterectomy should be total even in apparently benign causes that indicate it. The aim of this study was to access incidence of cervical stump invasion by malignancy in endometrial cancer cases and its relation to pathological types after subtotal hysterectomy done to cases proved later by histopathology to be endometrial cancer.Methods: Following approval by our institutional ethics committee a prospective and retrospective observational descriptive study was done on 100 patients recruited from gyne-oncological outpatient clinic of Shatby university hospital of Alexandria from August 2018 to June 2021 with past history of subtotal hysterectomy. All these cases were proved later after histopathological examination of the uterine body to have type 1 or type 2 endometrial cancer. Stumpectomy was done to all patients after a written informed consent were taken from them before the study. Histopathological examinations of the cervical stumps were done and incidence of stump invasion with cancer in relation to its type was analyzed.Results: Histopathological examination of the stump of all cases revealed that only 13 cases showed microscopic stump invasion. 7 cases with stump invasion were type 1 endometrial cancer, 4 cases were grade 1 and 3 cases were grade 2 in relation to 6 cases of stump invasion were type 2 endometrial cancer with papillary serous adenocarcinoma. Regarding relation between stump invasion and pathological types of endometrial cancer there was a significant statistical difference between them as type 2 are associated by higher number of stump invasion (p=0.0001).Conclusions: The present study concluded that cases subjected to subtotal hysterectomy with undiagnosed endometrial cancer are associated with considerable incidence of cervical stump invasion and type 2 endometrial cancer have higher incidence of cervical stump invasion in relation to type 1 endometrial cancer

Effect of Perioperative Instructions on Postoperative Discomforts and Satisfaction Level among Patients Undergoing Thyroidectomy

Context: Thyroidectomy is a type of surgery directed to remove all or part of the thyroid gland. Documented complications after thyroidectomy are rare, but their consequences can often be life-threatening. Patients who receive perioperative instructions about what to expect after the operation often have better coping with postoperative discomforts minimize post-surgical complications and reduce the duration of hospitalization. It also improves patient safety and reduces the anxiety induced by the intervention. In addition to this, it elevates the patient's satisfaction level. So, perioperative instructions are essential. Aim: The present study aims to determine the effect of perioperative instructions on postoperative discomforts and satisfaction levels among patients undergoing thyroidectomy. The study hypothesized that postoperative patients who receive the perioperative instructions exhibit fewer discomforts and more satisfaction than those who do not.Methods: The study utilizes a quasi-experimental (study/control group) design. It was conducted at the Head and Neck Surgical Department of Alexandria Main University Hospital. A convenience sample included 70 adult patients were selected from the setting mentioned above who have enrolled in either study or control groups of 35 patients for each. Three tools were used for data collection. A structured interview questionnaire aimed to assess the socio-demographic characteristics and clinical data of the study subjects. Discomfort assessment scale to rate the patient's level of discomfort against six common postoperative problems. Perioperative instructions patients’ satisfaction questionnaire developed to determine the patients′ satisfaction level regarding perioperative instructions. Results: There were statistically significant differences among the study and control groups in the first, second, and third weeks regarding total discomfort score level, where t=3.606, p=<0.001; t=3.049, p=<0.001; t=21.213, p=<0.001respectively. The studied patients had a higher level of satisfaction compared to those in the control group with statistically significant differences regarding overall scores of satisfaction, and with preoperative instruction, postoperative instruction, and psychological preparation, where t=48.382, p=<0.001; t=6.023, p=<0.001; t=27.997, p=<0.001; t=32.939, p=<0.001respectively. Conclusion: The study hypotheses were accepted as postoperative patients who receive perioperative instructions exhibit less discomfort and a more satisfying level than those who do not. The perioperative instructions should be applied to the care of patients undergoing thyroidectomy to decrease patients' discomfort and increase their satisfaction level

Reactivity of β-enamino ester of benzo[f]chromene: One pot synthesis of isolated and heterocycle-fused derivatives of benzo[f] chromene

The formation of isolated and fused benzo[f]chromene derivatives was achieved via reacting ethyl 3-amino-1-phenyl-1H-benzo[f]chromene-2-carboxylate (1) with some selected reagents under basic conditions. The new compound, ethyl 3-(dimethylaminomethyleneamino)-1-phenyl-1H-benzo[f]chromene-2-carboxylate  (2) was prepared from compound 1 and N,N-dimethyl formamide in presence of phosphorus oxychloride under mild conditions in excellent yield using Vilsmeier reaction. Also, 10-amino-12-phenyl-9-sulfanyl-12H-benzo[f] chromeno[2,3-d]pyrimidine-11(10H)-one (12), 10-aryl-14-phenyl-14H-benzo[f]chromeno [2,3-d][1,3,4]thiadiazolo[3,2-a]pyrimidine-13-one (15), ethyl 3-(4-oxo-2-thioxothiazolidin-3-yl)-1-phenyl-1H-benzo[f]chromene-2-carboxylate (18), ethyl 3-(4-phenyl-2-thioxothiazol-3(2H)-yl)-1-phenyl-1H-benzo[f]chromene-2-carboxylate (20), ethyl 3-acetamido-1-phenyl-1H-benzo[f]chromene-2-carboxylate (21), and 10-amino-9-methyl-12-phenyl-12H-benzo[f] chromeno[2,3-d]pyrimidine-11(10H)-one (23) were prepared. The structures of these compounds were established by elemental analysis, IR, MS and NMR spectral analy­sis

Double-Skin Façade (DSF) Application to Address the Performance Problems of the Contemporary Buildings in Yemen

The double-skin façade (DSF) recently received significant attention from specialists and researchers due to its possibility to improve the building's performance. In Yemen, which has various climates, contemporary buildings suffer from many performance problems due to the weak interaction of their facades with the surrounding environment. Therefore, this paper aims to explore the DSF possibilities in enhancing the contemporary buildings' performance in Yemen by reviewing previous studies investigating the DSF system and the performance of contemporary Yemen buildings to identify and summarize the solutions and treatments offered by the DSF to improve these buildings' performance. The analysis revealed that implementing the DSF system can enhance the performance of the contemporary buildings in Yemen in terms of interior comfort and energy-saving when reaching the proper design of this system that appropriately responds to the region's climate. Yet, there are problems that the DSF may not fully meet, represented by building loads and construction and maintenance costs