Clinical significance and treatment of striae gravidarum during pregnancy: a review article

Abdominal stretch marks found during pregnancy may be indicative of poor skin elasticity. One who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during vaginal delivery. Striae gravidarum (SG) is a common phenomenon of stretch marks observed during pregnancy that may be an indicator of poor skin elasticity. The type and amount of collagen in connective tissue are considered to determine the individual’s elastic index. The skin surface is made up of a complex network of crossing thin lines. The two-dimensional relationship between primary and secondary lines determines the skin texture and its grade of irregularity. SG is caused by changes in the structural connective tissue due to a hormonal elect on the alignment and reduced elastin and fibrillin in the dermis. Severity scoring of SG was observed using the numerical scoring system of Atwal. This score provides a rank based on observation of four areas in which SG is most commonly observed (abdomen, hips, buttocks, and breast)

Tamoxifen for treatment of abnormal uterine bleeding in etonorgstrel implant users: a randomized clinical trial

Background: The current study aims to compare the use of tamoxifen and oral contraceptive pills in women using implanon and complain with irregular uterine bleeding.Methods: Women attended family planning clinic using implanon presented by bleeding were invited to participate in the study. They were randomized into two groups: Group A: 100 women received Tamoxifen 10 mg twice daily for 10 days taken at the onset of an episode of bleeding or spotting episode. Group B: 100 women received Combined oral contraceptive pills (microcept) once daily for 21 days take at the onset of an episode of bleeding or spotting episode.Results: No difference regarding the baseline criteria of both groups. No difference between both groups regarding the duration of irregular bleeding in the implanon users (p=0.090). Additionally, the number of bleeding days and spotting in the last month was similar in both groups (p=0.554). The percentage of women who stopped bleeding during the period of treatment is 84% in the tamoxifen group and 92% in the COCs group, but the COCs needs longer treatment time, where the mean of days required to stop bleeding is 5.03±1.8 days in the tamoxifen group and 6.5±2.5 in the COCs group. Headache and nausea were the most prominent adverse effects found in the COCs group (p=0.000).Conclusions: Oral administration of tamoxifen 10 mg twice daily for 10 days is effective on stopping bleeding attacks in implanon users

Predictors of Long Covid 19 Syndrome

Background: Symptoms of covid persist in most cases with development of a multisystem syndrome called long covid syndrome.Objective: The aim of the work was to evaluate symptoms that persist after the acute stage of the disease in a cohort of patients with confirmed or suspected COVID 19 and to define the predictors for long COVID syndrome.Patients and method: This retrospective study involved 164 patients with previously confirmed or highly suspected COVID 19 and still attending to the post covid outpatient clinic in El-Minia University Chest Hospital complaining from persistence of symptoms or for regular follow up. Their data was obtained from their previous medical reports. Results: Post Covid 19 symptoms were found in about 86 % of the studied patients with 42.7% reported neuropsychiatric symptoms and 26.8% reported respiratory symptoms. The most common reported symptoms in nonsevere cases were the anxiety disorders (18.9%), followed by chronic fatigue and neuropathy (15.2%), while chronic dyspnea in 9.8% mostly in severe cases, while vertigo and headache in 9.1%, musculoskeletal symptoms in 6.1% and skin lesions in 3.7%.Conclusion: It could be concluded that persistence of symptoms is very common after acute Covid 19 infection. Chronic dyspnea was reported more frequently in severe cases while anxiety reported mostly by patients with mild disease

Risk Factors Associated With Hip Fractures among Adult People in Babylon City, Iraq

BACKGROUND: The fractures of hip joint considered as a serious problem in public health in the medical and socioeconomic issues, the incidence of the fracture neck femur is significantly increased with the increment of general population life span. AIM: The goal of this study is to highlight and focus on the most important risk factor for the hip fractures in our Babylon society, and to improve our understanding of the medical and social aspects of these predisposing factors. PATIENTS AND METHODS: A case-control study of older adults (above 60 years old). The study was done on tow samples. First, one consisting of 75 cases those having fracture neck femur considered as cases, and second sample as a control group, consisting of 150 people as a healthy control group having no fracture. A pre-tested questionnaire was prepared to collect data from both samples; the questionnaire included demographic data and information about potential risk factors of hip fracture. RESULTS: Most of the people in the study samples in both groups were, married women, housekeepers, illiterate and from urban dwellers. There was highly significant association between case-control groups regarding, Continuous using of medication such as cortisone which was found to be a potential risk factor of hip fracture (Unadjusted OR = 3.636), low income was positively associated risk factor of hip fracture in this study (OR = 2.377), low milk intake, low sun exposure, tobacco smoking were positively associated with this health problem (OR = 1.794), while physical exercise was protective factor (OR = 0.489). CONCLUSION: The highest risk factors associated with increased occurrence of hip fracture were using cortisone, Osteoporosis, tobacco smoking, consuming soft drinks, and less exposure to sunlight

An efficient electric charged particles optimization algorithm for numerical optimization and optimal estimation of photovoltaic models

The electric charged particles optimization (ECPO) technique is inspired by the interaction (exerted forces) between electrically charged particles. A developed version of ECPO called MECPO is suggested in this article to enhance the capability of searching and balancing the exploitation and exploration phases of the conventional ECPO. To let the search agent jumps out from the local optimum and avoid stagnation in the local optimum in the proposed MECPO, three different strategies in the interaction between ECPs are modified in conjunction with the conventional ECPO. Therefore, the convergence rate is enhanced and reaches rapidly to the optimal solution. To evaluate the effectiveness of the MECPO, it is executed on the test functions of the CEC’17. Furthermore, the MECPO technique is suggested to estimate the parameters of different photovoltaic models, such as the single-diode model (SDM), the double-diode model (DDM), and the triple-diode model (TDM). The simulation results illustrate the validation and effectiveness of MECPO in extracting parameters from photovoltaic models

Supplementation of Saussurea costus root alleviates sodium nitrite-induced hepatorenal toxicity by modulating metabolic profile, inflammation, and apoptosis

Sodium nitrite (NaNO2) is a widely used food ingredient, although excessive concentrations can pose potential health risks. In the present study, we evaluated the deterioration effects of NaNO2 additives on hematology, metabolic profile, liver function, and kidney function of male Wistar rats. We further explored the therapeutic potential of supplementation with S. costus root ethanolic extract (SCREE) to improve NaNO2-induced hepatorenal toxicity. In this regard, 65 adult male rats were divided into eight groups; Group 1: control, Groups 2, 3, and 4 received SCREE in 200, 400, and 600 mg/kg body weight, respectively, Group 5: NaNO2 (6.5 mg/kg body weight), Groups 6, 7 and 8 received NaNO2 (6.5 mg/kg body weight) in combination with SCREE (200, 400, and 600 mg/kg body weight), respectively. Our results revealed that the NaNO2-treated group shows a significant change in deterioration in body and organ weights, hematological parameters, lipid profile, and hepatorenal dysfunction, as well as immunohistochemical and histopathological alterations. Furthermore, the NaNO2-treated group demonstrated a considerable increase in the expression of TNF-α cytokine and tumor suppressor gene P53 in the kidney and liver, while a significant reduction was detected in the anti-inflammatory cytokine IL-4 and the apoptosis suppressor gene BCL-2, compared to the control group. Interestingly, SCREE administration demonstrated the ability to significantly alleviate the toxic effects of NaNO2 and improve liver function in a dose-dependent manner, including hematological parameters, lipid profile, and modulation of histopathological architecture. Additionally, SCREE exhibited the ability to modulate the expression levels of inflammatory cytokines and apoptotic genes in the liver and kidney. The phytochemical analysis revealed a wide set of primary metabolites in SCREE, including phenolics, flavonoids, vitamins, alkaloids, saponins and tannins, while the untargeted UPLC/T-TOF–MS/MS analysis identified 183 metabolites in both positive and negative ionization modes. Together, our findings establish the potential of SCREE in mitigating the toxic effects of NaNO2 by modulating metabolic, inflammatory, and apoptosis. Together, this study underscores the promise of SCREE as a potential natural food detoxifying additive to counteract the harmful impacts of sodium nitrite.Peer Reviewe

Appraisal on the Wound Healing Potential of Deverra tortuosa DC. and Deverra triradiata Hochst Essential Oil Nanoemulsion Topical Preparation

Deverra tortuosa (Desf.) DC. and Deverra. triradiata Hochst. ex Bioss are perennial desert shrubs widely used traditionally for many purposes and they are characteristic for their essential oil. The objective of the present study was to investigate the in vivo wound healing activity of the essential oil (EO) of D. tortuosa and D. triradiata through their encapsulation into nanoemulsion. EO nanoemulsion was prepared using an aqueous phase titration method, and nanoemulsion zones were identified through the construction of phase diagrams. The EO was prepared by hydrodistillation (HD), microwave-assisted hydrodistillation (MAHD), and supercritical fluid extraction (SFE) and analyzed using GC/MS. D. tortuosa oil is rich in the non-oxygenated compound, representing 74.54, 73.02, and 41.19% in HD, MADH, and SFE, respectively, and sabinene represents the major monoterpene hydrocarbons. Moreover, D. triradiata is rich in oxygenated compounds being 69.77, 52.87, and 61.69% in HD, MADH, and SFE, respectively, with elemicin and myristicin as major phenylpropanoids. Topical application of the nanoemulsion of D. tortuosa and D. triradiata (1% or 2%) exhibited nearly 100% wound contraction and complete healing at day 16. Moreover, they exhibit significant antioxidant and anti-inflammatory effects and a significant increase in growth factors and hydroxyproline levels. Histopathological examination exhibited complete re-epithelialization accompanied by activated hair follicles and abundant collagen fibers, especially at a concentration of 2%. Therefore, the incorporation of the two Deverra species into nanoemulsion could professionally endorse different stages of wound healing

On the Performance of a Photonic Reconfigurable Electromagnetic Band Gap Antenna Array for 5G Applications

In this paper, a reconfigurable Multiple-Input Multiple-Output (MIMO) antenna array is presented for 5G portable devices. The proposed array consists of four radiating elements and an Electromagnetic Band Gap (EBG) structure. Planar monopole radiating elements are employed in the array with Coplanar Waveguide Ports (CWPs). Each CWP is grounded on one side to a reflecting L-shaped structure that has an effect of improving the antenna’s directivity. It is shown that by inductively connecting Minkowski fractal structure of 1 st order to the radiating element, the impedance matching is improved that results in enhancement in the array’s bandwidth performance. The EBG structure is used to provide the isolation between antenna elements in the MIMO array. The fractal structure is connected to the L-shaped reflector through four photosensitive light dependent resistor (LDR) switches. The effect of various LDR switching configurations on the performance of the antenna is investigated. The proposed array provides a novel performance in terms of S-parameters with enhancements in the radiation properties. Such enhancements are achieved with low separation gaps between antenna elements (about λ o /16 at 3.5 GHz). It is shown that the array’s operational bands centered at 3.5 GHz and 4.65 GHz can be selected by activating certain LDR switches. The electromagnetic exposure of the array on the human body is investigated by determining the specific absorption rate (SAR). It is found that the proposed antenna shows lower SAR values compared to other antennas reported in literature. With the proposed EBG structure, the gain of the array is increased 7.5 dB (from -3.5 dBi to +4 dBi) at 3.5 GHz and by 14.3 dB (from -8.7 dBi to + 5.6 dBi) at 4.65 GHz. The average radiation efficiency between 3.5 GHz and 5.5 GHz increased by 42% from 20% to 62%. Excellent radiation characteristics of the EBG the array makes it suitable for 5G portable devices such as tablets

On the performance of a photonic reconfigurable electromagnetic band gap antenna array for 5G applications

In this paper, a reconfigurable Multiple-Input Multiple-Output (MIMO) antenna array is presented for 5G portable devices. The proposed array consists of four radiating elements and an Electromagnetic Band Gap (EBG) structure. Planar monopole radiating elements are employed in the array with Coplanar Waveguide Ports (CWPs). Each CWP is grounded on one side to a reflecting L-shaped structure that has an effect of improving the antenna’s directivity. It is shown that by inductively connecting Minkowski fractal structure of 1st order to the radiating element, the impedance matching is improved that results in enhancement in the array’s bandwidth performance. The EBG structure is used to provide the isolation between antenna elements in the MIMO array. The fractal structure is connected to the L-shaped reflector through four photosensitive light dependent resistor (LDR) switches. The effect of various LDR switching configurations on the performance of the antenna is investigated. The proposed array provides a novel performance in terms of S-parameters with enhancements in the radiation properties. Such enhancements are achieved with low separation gaps between antenna elements (about λo/16 at 3.5 GHz). It is shown that the array’s operational bands centered at 3.5 GHz and 4.65 GHz can be selected by activating certain LDR switches. The electromagnetic exposure of the array on the human body is investigated by determining the specific absorption rate (SAR). It is found that the proposed antenna shows lower SAR values compared to other antennas reported in literature. With the proposed EBG structure, the gain of the array is increased 7.5 dB (from -3.5 dBi to +4 dBi) at 3.5 GHz and by 14.3 dB (from -8.7 dBi to + 5.6 dBi) at 4.65 GHz. The average radiation efficiency between 3.5 GHz and 5.5 GHz increased by 42% from 20% to 62%. Excellent radiation characteristics of the EBG the array makes it suitable for 5G portable devices such as tablets

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