Interleukin-1 receptor antagonist and interleukin-1\u3b2-511 gene polymorphisms among Egyptian children with febrile seizures

Febrile seizures (FSs) are the most common form of childhood seizures. The higher levels of pro-inflammatory cytokines in children may induce seizures, and alternatively, higher levels of anti-inflammatory cytokines may act as a defense mechanism against seizures. We aimed to investigate whether interleukin (IL)-1\u3b2-511 C/T (pro-inflammatory cytokine) (rs16944) and IL-1 receptor antagonist (IL-1Ra) (an anti-inflammatory cytokine) gene polymorphisms could be used as markers for prediction of susceptibility to FSs. The current study included 22 patients with FSs and 22 normal control subjects. All patients were subjected to thorough history taking, full neurological examination, electroencephalography, and peripheral blood sampling for genotype analyses. Detection of IL-1Ra gene polymorphisms was done using polymerase chain reaction (PCR), while a restriction fragment length polymorphism analysis of the PCR products was used for the detection of IL-1\u3b2-511 C/T gene polymorphisms. The mean age of onset of first febrile seizures was 15.7 months. Eighteen (81.8 %) cases had the criteria of complex FSs. Frequencies of alleles C and T for IL-1\u3b2-511 were 26/44 and 18/44, respectively, in FS patients and 22/44 for both in the control subjects. The CC genotype was significantly more common in the FS patients than in the control group. The IL-1Ra-I homozygote was more frequent in patients with FSs than in healthy controls. The IL-1Ra homozygous I/I and IL-1\u3b2-511 CC gene polymorphisms are associated with a higher susceptibility to febrile seizures, which may be useful markers for predicting the development of febrile seizures

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Adaptive building envelopes of multistory buildings as an example of high performance building skins

Recently developed generation of high-performance skins greatly leads to the emersion of innovative manufactures integrating real-time environmental response, enhanced materials, dynamic automation with built in microprocessors, wireless sensors and actuators, and design-for-manufacture techniques. This application has basically alter the thinking way of architects in the early design stages of the building with a shifting in importance from form to performance, from structure to envelope. In the field of high-performance buildings, the envelope begins to be the setting of research and development. The aim of the paper is to discuss the design of three strategies used in constructing adaptive building envelopes of multistory buildings, integrating improved energy performance and architectural innovation, in order to Control the physical environmental factors (heat, light, sounds), as well as improving occupants’ comfort. Finally, three case studies are analyzed to unveil the implementation of these strategies on constructing structures and study their effects on the building energy savings. Scope and objective: The objective of this paper is to illustrate and discuss new conceptual ways of designing adaptive building envelopes of multistory structures that respond to environmental changes in the surrounding climate of different places in the world, and how the usage of such adaptive envelopes can help reduce the energy consumption of the building. Methodology: The literature survey will first discuss the characteristics and properties of high performance facades. After that, the paper present and analyze existing examples and ideas of adaptive envelopes, gaining an overall understanding of the concept of three adaptive building envelopes. In addition, at the same time develop knowledge of the materials commonly used and how they perform. Finally, three case studies are presented to analyze the implementation of the three adaptive envelopes strategies and observe their effects on the building energy savings. Keywords: Adaptive envelopes, Adaptive architecture, Smart materials, Intelligent facades, Responsive facad

Prenatal genotyping of Gaucher disease in Egypt

AbstractObjectiveTo use chorionic villi sampling (CVS) and amniocentesis to determine the genotyping of Gaucher Disease (GD) of fetuses of pregnant mothers who had a previous child affected by GD.MethodsThe study was conducted between January 2009 and December 2012. It included 42 pregnant women that gave informed written consent. Thirty mothers presented early so they underwent CVS at 10–12weeks of pregnancy while 12 mothers presented later and underwent amniocentesis at 14–16weeks. Strip assay for the identification of Glucocerebrosidase (GBA) gene mutations in the samples of chrorionic villi and amniotic fluid was based on polymerase chain reaction (PCR) and reverse hybridization.ResultsThe age of the studied pregnant women ranged from 19 to 26years. Consanguinity was present in 38 cases. Eighteen women were pregnant in affected fetuses. The results of genotyping revealed 15 cases were homozygous L444P/L444P and one case homozygous (N370s/N370s) while two cases were heterogeneous (L444P/D409H). Twenty-four pregnant women had carrier fetuses which were all heterozygous L444P.ConclusionThis study highlights the findings of an extended gene mutation examination for prenatal diagnosis of Guacher Disease. The study found out that the most common mutation was L444P/L444P