Oropharyngeal and otorhinological changes in end stage renal patients undergoing hemodialysis

The study aimed to assess oropharyngeal and otorhinolaryngological changes in end stage renal disease (ESRD) patients undergoing hemodialysis and correlate the findings to renal functions. This case-control study compared oral and otorhinolaryngologica

A protein microarray assay for serological determination of antigen-specific antibody responses following Clostridium difficile infection

We provide a detailed overview of a novel high-throughput protein microarray assay for the determination of anti-C. difficile antibody levels in human sera and in separate preparations of polyclonal IVIg. The protocol describes the methodological steps involved in sample preparation, printing of arrays, assay procedure and data analysis. In addition, this protocol could be further developed to incorporate diverse clinical samples including plasma and cell culture supernatants. Herein, a combination of isotype (IgG, IgA IgM), subclass (IgG1, IgG2, IgG3, IgG4, IgA1, IgA2), and strain-specific antibodies to highly purified whole C. difficile toxins A and B (toxinotype 0, strain VPI 10463, ribotype 087), toxin B from a C. difficile toxin-B-only expressing strain (CCUG 20309), precursor form of B fragment of binary toxin, pCDTb, ribotype-specific whole surface layer proteins (SLPs; 001, 002, 027) and control proteins (Tetanus toxoid and Candida albicans) were determined by protein microarray. Microarrays were probed with sera from individuals with C. difficile infection (CDI), cystic fibrosis (CF) without diarrhea, healthy controls and individuals pre- and post-IVIg therapy for treatment of CDI, combined immunodeficiency disorder and chronic inflammatory demyelinating polyradiculopathy. Significant differences in toxin neutralization efficacies and multi-isotype specific antibody levels were seen between patient groups, commercial preparations of IVIg and sera before and following IVIg administration. A significant correlation was observed between microarray and enzyme-linked immunosorbent assay (ELISA) for antitoxin IgG levels in serum samples. These results suggest that microarray could become a promising tool for profiling antibody responses to C. difficile antigens in vaccinated or infected humans. With further refinement of antigen panels and a reduction in production costs, it is anticipated that microarray technology may help optimize and select the most clinically useful immunotherapies for C. difficile infection in a patient-specific manner

Photometric and Spectroscopic Analysis of the SX Phe Star BL Cam

In the present paper, we report the photometric and spectroscopic observations obtained by the 1.88 m telescope at the Kottamia astronomical observatory of the pulsating star BL Cam. Fourier analysis of the light curves reveals that the fundamental mode has two harmonics. The O-C method is used to establish the period changes. So far, the analysis has been very successful in mapping the pulsation amplitude of the star across the instability strip. By using the formalism of Eddington and Plakidis (1929), we found significant results and strong indications of the evolutionary period change. A total of 55 new maximum light timings are reported. New values of (1/P) dP/dt are estimated using the O-C diagram based on all newly obtained times of maximum light combined with those taken from the literature, assuming the periods are decreasing and changing smoothly. To compute the effective temperature and surface gravity of the star, we performed model atmosphere analysis on its spectra. The physical parameters of the star are calculated and compared with the evolutionary models

Design, synthesis and antitumor evaluation of novel pyrazolopyrimidines and pyrazoloquinazolines

A series of N-aryl-7-aryl-pyrazolo[1,5-a]pyrimidines 18a–u and N-aryl-pyrazolo[1,5-a] quinazolines 25a–c were designed and synthesized via the reaction of 5-aminopyrazoles 11a–c with enaminones 12a–g or 19, respectively. The new compounds were screened for their in vitro antitumor activity toward liver (HepG-2) and breast (MCF-7) human cancer cells using 3-[4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide MTT assay. From the results, it was found that all compounds showed dose-dependent cytotoxic activities against both HepG-2 and MCF-7 cells. Two compounds 18o and 18a were selected for further investigations. Cell cycle analysis of liver (HepG-2) cells treated with 18o and breast (MCF-7) cells treated with 18a showed cell cycle arrest at G2/M phase and pro-apoptotic activity as indicated by annexin V-FITC staining.publishedVersio

An Investigation of the Fundamental Period of Vibration for Moment Resisting Concrete Frames

The determination of fundamental period of vibration for structures is essential to earthquake design. The current codes provide empirical formulas to estimate the approximated fundamental period and these formulas are dependent on building material, height of structure or number of stories. Such a formulation is excessively conservative and unable to account for other parameters such as: length to width ratios, vertical element size and floors area. This study investigated the fundamental periods of mid-rise reinforced concrete moment resisting frames. A total of 13 moment resisting frames were analyzed by ETABS 15.2.2, for gross and cracked eigenvalue analysis and Extreme Loading for Structures Software® or ELS, for non-linear dynamic analysis. The estimated periods of vibration were compared with empirical equations, including current code equations. As expected, the results show that building periods estimated based on simple equations provided by earthquake design codes in Europe (EC8) and America (UBC97 and ASCE 7-10) are significantly smaller than the periods computed using nonlinear dynamic analysis. Based on the results obtained from the analyzed models, equations for calculating period of vibration are proposed. These proposed equations will allow design engineers to quickly and accurately estimate the fundamental period of moment resisting frames with taking different length to width ratios, vertical element size, floors area and building height into account. The interaction between reduction factor and the reduced period of vibration is studied, and it is found that values of maximum period of vibration can be used as an alternative method to calculate the inelastic base shear value without taking reduction factors in consideration

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

A Comparative study between Different Treatment Modalities of Floating Knee Jnjury At Aswan University Hospital

Purpose: The study aimed at presenting a comparison between the modalities of treatment different of floating knee injury at Aswan University Hospital.  Materials and Methods:  This study is a prospective study including all of our 20 cases of floating knee injuries who were treated utilizing various treatment modalities at Aswan University Hospital between December 2018 and September 2019 with a follow-up period of 12 months  Results: Based on the data analysis,  nailing is a better modality in floating knee injury (especially with diaphyseal long bone). Moreover, plating is a good choice for distal fractures, the external fixator is considered a choice for limb saving(as in popliteal ischemia, open fractures(OG3), and compartment syndrome).  Conclusion: Management of floating knee injury is critical as floating knee injury is not like other fractures. Floating knee injuries are serious injuries with a high rate of complications. Besides being caused by high-energy trauma with extensive skeletal and soft tissue damage, they are also associated with potentially life-threatening injuries of the head, chest, and abdomen. There are multiple controversies in surgical management starting from choosing suitable fixation for each patient according to variable conditions.  Floating knee injury remains a challenging orthopedic problem in which regaining good knee function outcome is a major concern. Stable osteosynthesis to achieve rigid fixation and early mobilization should always be attempted

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

Blood Pressure and Blood Pressure Deficits as Predictors of Acute Kidney Injury in Vasopressor Dependent Patients Post Cardiovascular Surgery

BACKGROUND: Acute kidney injury (AKI) is a common and serious post-operative complication following cardiovascular surgery. AIM: The aim of the study was to evaluate the value of blood pressure and blood pressure deficits as predictors of AKI in post cardiovascular surgery vasopressors’ dependent patients. METHODS: A prospective observational, single center study, conducted on 100 patients requiring vasopressor support for more than 4 h after cardiovascular surgery. All included patients were subjected to the measurements of three or more systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) readings from the ward charts before surgery and the mean of these measures was calculated, was recorded and pre-operative systolic perfusion pressure (SPP), diastolic perfusion pressure (DPP), and mean perfusion pressure (MPP) were calculated. A vasopressor-associated average values for hemodynamic pressure-related parameters (SAP, DAP, MAP, CVP, SPP, DPP, and MPP) were calculated on the 1st 24 h after admission. The percent deficit in post-operative average parameters in relation to pre-operative parameters was determined as % parameter deficit. RESULTS: The pre-operative SAP, DAP, MAP, SPP, DPP, and MPP were significantly higher in the non-AKI compared to AKI patients while pre-operative central venous pressure (CVP) was significantly higher in AKI patients. The post-operative DAP, MAP, DPP, and MPP were also higher in non-AKI and the post-operative CVP was lower in non-AKI compared to AKI patients. CONCLUSIONS: This study concluded that the relative decrease in the perfusion pressures could be significant predictors of AKI after cardiovascular surgery in vasopressor dependent patients. The higher pre- or post-operative CVP or its relative decrease after cardiac surgery was seen also to be associated with higher incidence of AKI