Swelling Soil Stabilized with Sand

This paper presents the study of swelling soil and its recurrent volume changes with the variation of moisture content. This soil has a unique shrink-swell behavior which changes along with variation in soil water content reducing the strength that can damage a structure. Controlling the swelling potential of soil is one of the important criteria to the civil engineers. Several attempts are being made all over the world to improve the swell-shrink phenomenon of swelling soil. The present paper attempts to study the improvement of the swelling soil with EPS geofoam layer and with sand as a layer and as soil-sand mixture. Various tests have been performed such as sieve analysis, standard proctor test, Atterberg limits, one- dimensional oedometer, and free swell index. in the laboratory on both natural and treated soil. These tests were performed at the geotechnical engineering research laboratory, Tanta University. From the obtained results of the experimental testing program, it is observed that the engineering properties of the swelling soil are improved effectively and the swelling pressure is substantially reduced, as the percent of sand increased. From the obtained results, it was found that adding sand could considerably decrease the swelling pressure of the tested soil from 520 kN/m2 to nearly 320 kN/m2

Laparoscopic management of pediatric and adolescent patients with intra-abdominal complications of ventriculoperitoneal shunt

Background/purpose: Ventriculoperitoneal (VP) shunt is the most common operative procedure performed in the treatment of hydrocephalus. The aim of this procedure is to drain CSF from the ventricles to the peritoneal cavity, thus to decrease the intracranial pressure. Numerous complications as a result of this technique are reported in the literature and are most commonly located around the peritoneal end of the shunt tube. The standard approach for management is laparotomy and correction of the complication. This approach, although solves the problem, causes the formation of adhesions, which are also not devoid of consequences. The aim of this study is to present our experience and outline the role of laparoscopy in the management of intraabdominal complications of VP shunt in pediatric and adolescent patients.Patients and Methods: Over a period of 4 years, 14 patients were managed and recruited in this study. All patients were presented with recurrent abdominal signs and symptoms or elevated intracranial pressure. All patients were managed laparoscopically according to the final diagnosis.Results: Fourteen patients (9 men and 5 women) with abdominal complications of VP shunt catheter were managed. Their ages at operation were ranged from 10 months to 15 years. All patients were investigated, diagnosed and managed laporoscopically. The median operative time of the laparoscopic procedure varied according to the diagnosis. It was 120 minutes in pseudocysts, 45 minutes in recurrent congenital inguinal hernias, 100 minutes in adhesive intestinal obstruction and 35 minutes in subcutaneous cyst and 30 minutes in umbilical fistula. Follow up period extended for 24 months after the procedure and all patients had complete resolution of their presenting abdominal or neurological symptoms. The length of the postoperative hospital stay ranged from one day in recurrent congenital hernias up to 4 days in the other procedures. There were no intra- or postoperative complications related to the laparoscopic technique.Conclusion: Laparoscopic is a very useful diagnostic and therapeutic tool in dealing with intra-abdominal complications of VP shunt with high safety and an excellent outcome.Keywords: hydrocephalus, laparoscopic management, ventriculoperitoneal shun

Detection of A2142G, A2142C and A2143G clarithromycin mutations in Helicobacter pylori in Alexandria University Pediatric Hospital

Background: Helicobacter pylori (H. pylori)colonizes the stomach and affect almost 50% of the world’s population. Clarithromycin is considered a cornerstone for H. pylori treatment. Emergence of clarithromycin resistance (CLR-R) has played a major role in failure of H. pylori eradication both in adults and children.  Clarithromycin resistance is mostly due to mutations in 23S rRNA gene: A2142G, A2142C, and A2143G. The aim of the current study is to determine the prevalence of CLR-R among H. pylori infected children with prior clarithromycin treatment. Materials and Methods: Multiple endoscopic gastric biopsies were collected from 50 H. pylori infected children after cessation of clarithromycin-based treatment. Samples were subjected to histopathological examinations, rapid urease test (RUT) and simultaneous molecular detection of H. pylori infection as well as CLR-R by multiplex Real-Time polymerase chain reaction (PCR). Results: Histopathological examinations and RUT revealed H. pylori in 74% and 92% of samples respectively. Molecular detection of CLR-R showed that 62.5% positive H. pylori cases were not harboring any of the tested mutations, while 25% harbored 2143A-G single mutation. Double mutations (2142A-C and 2143A-G) were detected in only 4 cases. Statistical significant correlation existed between both RUT and PCR results as well as between histopathological findings and PCR test results. Conclusions: A combination of histopathogy, RUT and multiplex PCR procedures offers a real benefit in the simultaneous diagnosis of H. pylori infection along with clarithromycin resistance status. Other mechanisms of clarithromycin resistance need to be investigated to explain treatment failure in absence of the previously detected mutations

Modified Dismembered Technique of Laparoscopic Transperitoneal Pyeloplasty in Children

Background: Laparoscopic pyeloplasty in children gained more and more popularity over the past two decades. However, it remains technically challenging with the most steps of the procedure are ureteric spatulation, DJ insertion, and intracorporeal anastomosis. Many modifications have been proposed to address these issues. In this article, we present our surgical approach to laparoscopic transperitoneal modified dismembered pyeloplasty highlighting some tips to make it easy. Objectives: This study was conducted to evaluate the outcomes of laparoscopic management of ureteropelvic junction obstruction children. Patients and Methods: This was a prospective study carried out on patients who presented with UPJO to our center from May 2019 to October 2021. All the cases underwent laparoscopic transperitoneal modified dismembered pyeloplasty where complete dismembering is deferred after the ureteropelvic anastomosis to prevent ureteral torsion and to use the redundant pelvis as a handle for ureteric manipulation. We used 3 simple techniques for antegrade insertion of DJ. Results: The study included 25 patients (19 males and 6 females) The mean age at operation was 30.88 ± 27.48 months. The mean time needed for the anastomosis was 80 minutes while the mean total operative time was 155 minutes. No conversion was needed. Apart from 2 cases, all other patients showed significant improvement of the degree of hydronephrosis and renal split function. Conclusion: The described modifications facilitated performing the procedure rendering laparoscopic pyeloplasty to be a less demanding and much easier procedure than the conventional technique

Attitude of Syrian students toward GAD patients: An online cross-sectional study

Generalized Anxiety Disorder (GAD) is a prevalent condition and a significant cause of mental disability and poor quality of life. People with GAD have chronic worrying, restlessness, and discrimination from the general public; Little is known about the stigmatizing attitudes toward people with GAD among Syrian students. The questionnaires contained demographic data about age, gender, social status, personal stigma toward GAD scale, perceived stigma toward GAD scale, social distance with those with GAD, the participants' usual source of their knowledge about GAD, helpful interventions, and supporting information. A total of 1,370 replies were collected, but only 1,358 were used for analysis as 12 participants declined to complete the survey. About 44.1% of participants agreed that people with GAD could snap out of the problem, most of them being females (32.4% of the total population). Compared to medical students, more non-medical students (7.1% of the total population) believed that anxiety is a sign of personal weakness. This study demonstrated that Syrian college students showed a high level of stigmatizing and socially distancing attitudes toward people with GAD, particularly female and non-medical students

A multinational cross-sectional study on the awareness and concerns of healthcare providers toward monkeypox and the promotion of the monkeypox vaccination

BackgroundThe aim of this study was to explore potential healthcare workers' (HCWs) concerns about the monkeypox virus in order to create practical solutions to manage this disease.MethodsOnline cross-sectional research was conducted in 11 Arabic countries (Egypt, Saudi Arabia, Yemen, Syria, Libya, Algeria, Tunisia, Iraq, Palestine, Jordan, and Sudan) from 2 August 2022 to 28 December 2022.ResultsApproximately 82% of respondents felt the need to acquire further information. The acceptability of the vaccine against monkeypox has been indicated by more than half of the participants (54.5%). Furthermore, we state that 45% of the participants are knowledgeable about the monkeypox virus, and 53.1% of the participants have never been affected with COVID-19 before are more worried about COVID-19 than about monkeypox. Participants diagnosed with COVID-19 were 0.63 times less likely to worry about monkeypox than those who were not diagnosed with COVID-19. A greater willingness to get the monkeypox vaccination was seen among the age group 21–30 years (42.4%) compared to the other age groups.ConclusionMost healthcare professionals have a moderate knowledge of the monkeypox virus. Furthermore, they demonstrated a low willingness to get the vaccination against the monkeypox virus