Follow-up of 50 children after posterior urethral valve management in Al-Azhar University Hospitals

Objective: This study was performed to assess the various clinical presentations, complications, and surgical management, as well as follow-up, of patients with posterior urethral valve (PUV).Patients and methods: This is a prospective descriptive analysis of the data of 50 patients with PUVs of different age reviewed. Serum creatinine levels, clinical examination, abdominopelvic ultrasound, and magnetic resonance urography were performed, and the diagnosis was confirmedby voiding cystourethrography. The patients were divided into two categories: primary intervention and surgical intervention.Results: A total of 50 boys with a mean age at diagnosis of 100 ±15 days were included in this work. The most common presentation in patients managed by valve ablation was difficult micturition (60%), whereas in patients managed by initial vesicostomy the most common presentation was febrile urinary tract infection (67%). Vesicoureteral reflux presented in 61.2% and hydronephrosis in 82.6%, whereas complications occurred in three (6%) children. Mortality occurred in five (10%) patients. Postoperative improvement of hydronephrosis grade in both categories is not appreciably different.Conclusion: Urinary drainage using small catheters or nasogastric tube in the early days of infancy followed by valve ablation is the best treatment modality in PUV.Keywords: children, outcome, posterior urethral valve, urinary drainage valve ablation, vesicostom

Maltooligosaccharide Chemosensation by Intestinal Enteroendocrine L-Cells Regulates the Endogenous Release of Gut Hormones and Contributes to Weight Management in Vivo

As obesity has become one of the most prevalent metabolic diseases, and diabetes mellitus has become the seventh leading causes of death in the United States, alternative food/nutrition-based approaches to tackle obesity that are both efficacious and cost effective are in high demand. Since starch and its derived products are the principal dietary supply of glucose, strategies of using slowly digestible starch to achieve moderated glycemic response and prolonged glucose delivery, as well as to locationally digest starch into the ileum, have shown successful results such as moderation of insulinemia and reducing food intake in obese animals. An important regulator of appetite suppression is the neuroendocrine system of the gut-brain axis. Glucagon-like peptide-1 (GLP-1), oxyntomodulin (OXM), and peptide YY (PYY) are the main anorexigenic peptide products of the intestinal enterendocrine L-cells that regulate postprandial insulin levels as well as satiety signals. The stimulation of the enteroendocrine L-cells throughout the gastrointestinal tract through glucose, fatty acids and proteins has been extensively studied and confirmed. However, the stimulatory effect of complex dietary carbohydrates on L-cells is not described. In this dissertation, we investigated the in vitro intestinal cell chemosensation of L-cells to α-amylase starch digestion products, named maltooligosaccharides (MOS), and in the possible application of using slowly digestible starch delivery of MOS in vivo. In Chapter II of this dissertation, we reported a significantly higher stimulatory effect of MOS on GLP-1 and OXM secretion compared to glucose in mouse and human L-cells, respectively. Additionally, maltotriose enhanced the relative expression of the gastrointestinal peptide, cholecystokinin. Moreover, MOS exhibited protective effects on barrier function and monolayer integrity of intestinal epithelial cells. In Chapters III and IV, we performed a multiomics approach where transcriptomic analysis and global protein profiling of mouse L-cells treated with different types of MOS showed that the carbohydrates exhibit their effects through the induction of exocytosis of GLP-1- or OXMcontaining vesicles and not through a positive regulation of the proglucagon gene expression. It is suggested that MOS induce higher secretion, but not higher synthesis, of the proglucagon gene products. In addition, maltotriose treatment downregulated the relative expression of the glucotoxicity marker, thioredoxin-interacting protein, and upregulated the relative expression of tight junction proteins supporting a role of MOS in barrier function integrity. Translating the in vitro findings into an in vivoapplication that is beneficial for human health required the use of controllable tool for the delivery of MOS throughout the small intestine for sensing by a higher number of L-cells. Slowly digestible starch (SDS), compared to rapidly digestible starch, provided such a tool. For this purpose, we used alginate-entrapped SDS microspheres that digest distally into the ileum to examine the role of SDS in the intervention and prevention of obesity in C57BL/6J diet-induced obese (DIO) and lean mice models. Results showed that 20% SDS in low-fat diets significantly improved weight loss and food intake reduction in DIO mice converted to low-fat diet for 12 weeks. Similarly, 15% SDS in high-fat diets showed significant reduction in body fat percent and significant increase in lean body mass as well as considerable reduction in weight gain rate and food intake in lean mice fed on 45% of calories high-fat diet. Immunohistochemistry of small intestine of mice in both the intervention and prevention studies revealed an even and thorough distribution of GLP-1 positive L-cells

Measurement of the Strategic Performance of Hospitality in the Kingdom of Saudi Arabia: a balanced scorecard Approach (BSC)

In this paper, we planned to realize the marketing managers’ perceptions through their perception of Strategic Performance Dimension of view and the Balanced scorecard (BSC) technique for the Measurement of the Strategic Performance.The respondents in this study were a group of Marketing managers working in the Hospitality Sector (Experiences in number of years) of Madina, Saudi Arabia Hospitality. It has been observed trough literature and a limited Marketing Managers’ survey that only financial perspective measures are used with objectives. Balanced Score Card (BSC) enables to measure objectives across four perspectives: (1) the financial perspective, (2) the customer perspective, (3) the internal business process perspective, and (4) the learning and growth perspective. Hypothesis is formulated about the relationship between perception of managers about the Dimension of view and the Balanced Score Card (BSC) and the years of Experience. We also designed a questionnaire that was distributed to a population of 130 Marketing managers in the field of Hospitality. The year of study was 2011, with Marketing managers’ survey instruments that measure Balanced Score Card Dimension. The result of the study shows that there are significant differences between the three types of Hospitality Marketing managers’ (Experience in number of years:1-3years, 3-6years, more than 6years). After discussing the findings, some policy implications are suggested for the Hospitality, as well to practitioners seeking an understanding of a practical managerial tool. Limitations of the study are highlighted and further research discussions are suggested

Assessment of the blood eosinophil count in different grades of nasal polyps

Abstract Background Blood eosinophil count is significantly correlated with eosinophil infiltration in the nasal polyps; so, it could be a good marker for the nasal polyp eosinophilic inflammation. Objective Assessment of different peripheral eosinophil counts in different nasal polyps grading in allergic rhinitis patients. Methods A study was applied to 160 patients with allergic rhinitis (AR). Computed tomography (CT) was done preoperative then nasal polyps grading was assessed by nasal endoscopy. Peripheral eosinophil counts were checked in a blood sample for all patients. Then, a statistical analysis of the data was done. Results The study included 160 patients. Within 54 AR patients with no nasal polypi, eosinophil counts ranged between 0.001 × 103 μl and 0.907 × 103 μl with a mean of 0.2399 (SD = 0.2153). While within 106 patients with nasal polyps, eosinophil counts ranged between 0.05 × 103 μl and 14.7 × 103 μl with a mean of 1.6645 (SD = 3.06) with a significant difference (p = 0.0008, t = 3.418). The eosinophil counts were statistically significantly more in advanced grades of the nasal polyps (p < 0.0001, F = 9248). Conclusion Measuring peripheral eosinophil counts is simple, low cost, safe, and directly proportionate with different grades of nasal polyps. It can be used as a reliable marker to predict the severity of nasal polyps and consequently predict the prognosis of sinus disease and quality of life

Effect of coconut oil on growth performance, carcass criteria, liver and kidney functions, antioxidants and immunity, and lipid profile of broilers

Abstract The aim of this study is to evaluate the beneficial effects of coconut essential oil on growth performance, carcass criteria, antioxidant status, and immune response of broiler chicks. A total of 192 un-sexed 7-days broiler chicks were divided into six treatment sets with four copies of 8 chicks per set. The groups were as follows: (1) basal diet (without additive), (2) basal diet plus 0.5 ml coconut essential oil/kg, (3) basal diet plus 1 ml coconut essential oil/kg, (4) basal diet plus 1.5 ml coconut essential oil/kg, (5) basal diet plus 2 ml coconut essential oil/kg and (6) basal diet plus 2.5 ml coconut essential oil/kg. The results showed that the most prevalent compound in coconut oil is 6-Octadecenoic acid (oleic acid) representing 46.44% followed 2(3H)-Furanone, dihydro-5-pentyl- (CAS) (11.36%), Hexadecanoic acid (CAS) (4.71%), and vanillin (2.53%). Dietary 1 and 1.5 ml of coconut oil improved significantly the body weight and gain of broiler chickens. Dietary supplementation of 1 ml of coconut oil improved significantly liver function compared to control and other treatment groups. The supplementation with 1 ml coconut oil significantly reduced TG and VLDL compared to control and other treatment groups, while no significant differences in TC, HDL, and LDL due to dietary coconut oil. The present findings showed that dietary coconut oil with 1 and 1.5 ml/kg feed improved significantly antioxidants status through increased antioxidant enzymes like SOD and GSH while decreasing significantly MDA levels compared to control and other treatment groups. Therefore, it was concluded that the diets of broiler chickens could be fortified with coconut oil with 1 or 1.5 ml to improve the growth, feed utilization, and antioxidant status of broiler chickens