Opportunistic salpingectomy during hysterectomy for benign indications in women at low and high risk for ovarian cancer: a cross-sectional study

Objective Our study aims to evaluate the role of pathology evaluation of fallopian tubesduring hysterectomy for benign indications for the purpose ofearly detection of serous tubal intraepithelial carcinoma (STIC) in women at high and low risk for ovarian cancer. Material and methods This cross-sectional study was conducted at Minia Maternity University Hospital, Egypt, between June 2015 and December 2017. Our study included all women undergoing hysterectomy for benign conditions in the genital tract. Appropriate histories were taken, as well as physical exams, and laboratory and ultrasound evaluations were done prior to scheduling surgery. Abdominal hysterectomies including opportunistic salpingectomies were performed and the whole specimens including the tubal fimbria were sent to the pathology lab for histo-pathological examination. Results A total of 526 patients met inclusion criteria for this study. The mean age of the study participants was 49.75±8.95 years, the mean parity was 3.91±1.62 and the mean BMI was 24.21±2.38 Kg/m2. The most common surgical indications for hysterectomy were postmenopausal bleeding (34.6%), a clinically benign adnexal/pelvic mass (31.7%), and menorrhagia (24.7%). The fallopian tubes were found to have either no pathology or benign conditions in 500 out of the 526 patients. Among these patients, 56% had no pathologic abnormality. The most common benign conditions were paratubal cysts (25%), endometriosis (9%), torsion (2%) and hydrosalpinx (1%). STIC was identified in the fallopian tubes of 8 out of 526 patients. Conclusions Microscopic examination of the entire fimbriae from all patients regardless of the clinical context represents a novel method of early detection of sporadic tubal carcinoma, a putative precursor to advanced-stage pelvic cancer

Molecular subtype analysis determines the association of advanced breast cancer in Egypt with favorable biology

<p>Abstract</p> <p>Background</p> <p>Prognostic markers and molecular breast cancer subtypes reflect underlying biological tumor behavior and are important for patient management. Compared to Western countries, women in North Africa are less likely to be prognosticated and treated based on well-characterized markers such as the estrogen receptor (ER), progesterone receptor (PR) and Her2. We conducted this study to determine the prevalence of breast cancer molecular subtypes in the North African country of Egypt as a measure of underlying biological characteristics driving tumor manifestations.</p> <p>Methods</p> <p>To determine molecular subtypes we characterized over 200 tumor specimens obtained from Egypt by performing ER, PR, Her2, CK5/6, EGFR and Ki67 immunohistochemistry.</p> <p>Results</p> <p>Our study demonstrated that the Luminal A subtype, associated with favorable prognosis, was found in nearly 45% of cases examined. However, the basal-like subtype, associated with poor prognosis, was found in 11% of cases. These findings are in sharp contrast to other parts of Africa in which the basal-like subtype is over-represented.</p> <p>Conclusions</p> <p>Egyptians appear to have favorable underlying biology, albeit having advanced disease at diagnosis. These data suggest that Egyptians would largely profit from early detection of their disease. Intervention at the public health level, including education on the benefits of early detection is necessary and would likely have tremendous impact on breast cancer outcome in Egypt.</p

The psychological dimension's study for colors in the interior spaces designing.

یلقى البحث الضوء على الدراسة التحلیلیة للون و اثرها على الحالة النفسیة للمتلقى ، فالعمارة هى فن تشکیل الاسطح و الکتل بهدف ایجاد فراغات و تصمیمات جداریة تحقق الوظیفة النفعیة و الجمالیة فى تناسق و تناغم مع بعضها البعض، حیث ارتبطت الالوان بالعمارة منذ بدایة ظهور الحضارات الانسانیة المختلفة ، فالبحث یهتم بدراسة البعد النفسى للألوان فىتصمیم الفراغات الداخلیة من خلال التعرف على الخلفیة التاریخیة للألوان و أثرها عبر الحضارات المختلفة ، کما یهدف البحث الى الوصول الی خطط لونیة ذات منهجیة علمیة للمعالجات الجداریة طبقا لطبیعة ووظیفة المکان وذلک لتحقیق التوازن اللونى کوظیفة وشکل جمالى ولذلک جاءت مشکلة البحث للحد من استخدام الألوان بلا حدود وبلا ضوابط بدون الوعى الکامل لإستخداماتها والغرض من هذا الإستخدام الذى له مرجعیة سیکولوجیة محددة وذلک من خلال وضع حلول منهجیة فی تصمیم الفراغات المعماریة

EcoHealth journal special supplement November 2004

Includes abstract in French and SpanishEcosystem degradation caused by factors such as improper natural resources management and contamination with agricultural, industrial, and domestic wastes often results in the creation of an unhealthy ecosystem, a main cause for the prevailing poverty and poor health in many parts of rural Egypt. In collaboration with members of the community in some villages of El-Fayoum province, an interdisciplinary research team is currently employing an ecosystem approach to arrive at an understanding of community health problems with a view to develop resource management interventions and policies aimed at enhancing community health and well-being. Participatory rural appraisal (PRA) and knowledge, attitudes, and practices (KAP) techniques were used to measure the perceptions of the community’s men and women of their health and environmental priorities, and to test their current state of knowledge and awareness of the health-related issues. The results indicate that these perceptions were gender-sensitive and were different from those of Ministry of Health. Spatial and temporal monitoring and assessment of the ecosystem components revealed considerable land and water resources degradation. Presence of water pools and waterways in the vicinity of the residential areas enhanced the risk of water-associated diseases. Although, the disease-carrying vectors of schistosomiasis and malaria were detected in the waterways, the incidence of the two diseases was relatively low in the main village in contrast to the situation in the nearby hamlets. Prevalence of schistosomiasis was substantially higher in these hamlets (20–30% compared to 2–3% in the main village). Such a highly infected community represents a continuous pool of reinfection of the waterways, an issue that needs to be further examined to determine its relation to the hamlets’ specific ecosystem characteristics. A high incidence of hepatitis C and soil transmitted-intestinal parasites were markedly detected. It is concluded that in addition to natural resources degradation, other potential health risk factors were identified including socioeconomic, cultural, and institutional factors. Further studies are being conducted to explore these potential risk factors and their links to human health and well-being

Development of Health Interventions for El-Fayoum, Egypt : A Holistic Agro-Ecosystem Approach (Phase II); final report

Some text in ArabicThis phase of the research focuses on knowledge generated by the data collected in Phase I and how it was applied to develop packages of interventions, actions, and policy change recommendations designed to restore ecosystem integrity and enhance community health. A description of interventions and policy changes is provided with illustrations from the field. El-Fayoum province is a low-land fragile oasis-like ecosystem. Its peculiar topography and extensive irrigation system make it vulnerable to environmentally induced water-associated health and land productivity problems. These problems are exacerbated by poor natural resource management (NRM) practices and environmental pollution

Effect of statins as modulators of CD39+ tregs in patients with rheumatoid arthritis who were unsuccessfully treated with methotrexate

Objective The aim of this study was to determine the effects of combined atorvastatin (AV) with etanercept (ETA) in patients with active rheumatoid arthritis (RA), who were nonresponders to methotrexate (MTX) therapy, and its effect on disease activity and CD39+ regulatory T-cell (Tregs). Patients and methods This study included 50 patients with active RA. Patients with RA were divided into two groups. Group I (n=25) received MTX therapy plus ETA (50 mg/week) (ETA+MTX) and group II (n=25) received MTX and ETA plus AV therapy (20 mg/day) (ETA+MTX+AV). In addition, 25 healthy volunteers were used as controls. DAS-28, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, lipid profile, interleukin-6, CD39+ Tregs, ultrasonography 7 score (US7), carotid intima–media thickness, and flow-mediated dilatation (FMD) of the brachial artery were measured before and after 6 months of treatment. Results After 6 months of treatment, statin therapy combined with MTX and ETA significantly decreased disease activity variables, interleukin-6 and US7 synovitis, and tenosynovitis sum score. In addition, FMD% and CD39+ Tregs were significantly elevated. The increase in CD39+ Tregs was correlated with DAS-28 (P<0.001), FMD% (P<0.05), and US7 synovitis and tenosynovitis sum score (P<0.001). Conclusion Combination therapy with AV and ETA provides an added immunomodulatory benefit through enhancement of the immune suppression mediated by CD39+ Treg cells. Therefore, statins can be used safely with antitumor necrosis factor drugs to control disease activity and atherosclerotic changes in patients with RA, who are treated unsuccessfully with MTX

Sustainable Extraction, Chemical Profile, Cytotoxic and Antileishmanial Activities In-Vitro of Some <i>Citrus</i> Species Leaves Essential Oils

Anti-leishmanial drugs extracted from natural sources have not been sufficiently explored in the literature. Until now, leishmaniasis treatments have been limited to synthetic and expensive drugs. This study investigated, for the first time, the anti-leishmanial efficacy of essential oils (EOs) from the leaves of Citrus species (C. sinensis, C. limon, and C. clementina). Essential oils were extracted from three species by solvent free microwave extraction (SFME); in addition, lemon oil was also isolated by hydro-distillation (HD). These were investigated using gas chromatography coupled with mass spectrometry (GC–MS) and evaluated against Leishmania species, namely Leishmania major and Leishmania infantum, using a mitochondrial tetrazolium test (MTT) assay. The chemical compositions of Citrus limon EOs obtained by HD and SFME showed some differences. The identified peaks of C. limon (SFME) represented 93.96%, where linalool was the major peak (44.21%), followed by sabinene (14.22%) and ocimene (6.09%). While the hydro-distilled oil of C. limon contained geranial (30.08%), limonene (27.09%), and neral (22.87%) in the identified peaks (96.67%). The identified components of C. clementina leaves oil (68.54%) showed twenty-six compounds, where the predominant compound was geranial (42.40%), followed by neral (26.79%) and limonene (14.48%). However, 89.82% C. sinensis oil was identified, where the major peaks were for neral (27.52%), linalool (25.83%), and geranial (23.44%). HD oil of lemon showed the highest activity against L. major, with moderate toxicity on murine macrophage (RAW 264.7) cells, and possessed the best selectivity index on both Leishmanial species (SI: 3.68; 6.38), followed by C. clementina oil and C. limon using SFME (0.9 ± 0.29, 1.03 ± 0.27, and 1.13 ± 0.3), respectively. C. clementina oil induced the greatest activity on Leishmania infantum, followed by HD lemon and SFME lemon oils (0.32 ± 0.18, 0.52 ± 0.15, and 0.57 ± 0.09, respectively) when compared to Amphotericin B (0.80 ± 0.18 and 0.23 ± 0.13) as a positive control, on both species, respectively. Our study suggests a potent anti-leishmanial activity of lemon oil (HD) on L. major, followed by C. clementina. With the same potency on L. infantum shown by C. clementina oil, followed by HD lemon oil. This effect could be attributed to the major compounds of limonene, citral, and neral, as well as the synergistic effect of other different compounds. These observations could be a starting point for the building of new anti-leishmanial drugs from natural origins, and which combine different EOs containing Citrus cultivars

Neuronal autoantibodies in a sample of Egyptian patients with drug-resistant epilepsy

Abstract Background Epilepsy is one of the most common and chronic neurological diseases. About one-third of epilepsy patients do not achieve seizure freedom despite adequate therapy with antiseizure medications (ASMs) and develop drug-resistant epilepsy (DRE). Autoimmunity is increasingly being recognized as a cause of epilepsy in those patients. Some cases are associated with antibodies against several target antigens, including neuronal extracellular proteins as well as intracellular structures. In such patients, immunotherapy may be highly effective. This study aimed to investigate the presence of NMDA-R, AMPA1-R, AMPA2-R, CASPR2, LGI1, GABAB-R, and GAD65 autoantibodies in a sample of Egyptian patients with new-onset DRE; also, to assess the clinical, cerebrospinal fluid (CSF), electroencephalogram (EEG), and radiological characteristics of those patients. Twenty-five patients with recent onset DRE were recruited from the department of Neurology at Ain Shams University (ASU) hospitals. All patients underwent serum and CSF antibody testing using cell-based assay (CBA) at the Immunology unit of the Clinical pathology laboratory at ASU hospitals. This is beside routine CSF analysis, EEG and MRI brain with contrast. Results Out of 25 patients with recent onset DRE, one (4%) patient tested positive to anti-NMDA-R antibodies and another one (4%) tested positive to anti-GAD 65 in both serum and CSF. Although the remaining 23 patients tested negative for the 7 autoantibodies, yet 92% of them achieved either seizure freedom or more than 50% reduction in the frequency of seizure and 84% had marked improvement in seizure-associated symptoms after receiving immunotherapy trial. Also, evidence of neuroinflammation was detected in the CSF and MRI brain of the majority of those patients. Conclusions Autoimmunity should be considered as a possible etiology of new-onset DRE. It is essential to provide insight into the clinical phenotypes and other associated features of those patients, as there are probably numerous patients who are not positive for one of the available antibodies via clinical laboratory testing. In addition to early diagnosis, early treatment and empirical immunotherapy trial based on the clinical judgment is crucial and is likely to improve outcomes with near-complete seizure freedom