Skeletonized versus pedicled left internal mammary artery harvesting and risk of sternal wound infection after coronary artery bypass surgery

Background: The left internal mammary artery (LIMA) is the gold standard conduit for coronary artery bypass grafting (CABG). There are two harvesting methods, either pedicled or skeletonized. The choice of any technique must consider its complication profile, especially sternal wound infections (SWI). This study aims to evaluate and compare the occurrence of SWI after pedicled and skeletonized LIMA harvesting techniques for CABG. Methods: This prospective observational study included 300 patients who had CABG between 2016 and 2019. We included patients who had pedicled LIMA (n=200) in group 1 and who had skeletonized LIMA (n=100) in group 2. All patients completed a follow-up period of 3 months after CABG. The evaluation during follow-up included: sternal instability, signs of wound infection, temperature, the microbiological study of wound discharge, and chest computed tomography scan. Results: There was no significant differences in age (p = 0.20), male to female ratio (p = 0.43), body mass index (p = 0.12), NYHA I/II (p = 0.50), diabetes mellitus (p = 0.28), ejection  fraction (p= 0.14), and EuroSCORE II (p= 0.09) between groups. No significant difference in cardiopulmonary bypass time (p = 0.24), and cross-clamp time (p= 0.19) between groups. There was a significant increase in the total operating time in skeletonized LIMA group (212.77±75.25 min vs. 190.78±55 minutes, p= 0.004). Skeletonized LIMA was significantly associated lower incidence of SWI than that with pedicled LIMA (4% vs 15.5%, p= 0.003), and non-significantly lower incidence of deep SWI (1% vs 4.5%, p= 0.11). The risk factors for SWI in patients who had pedicled IMA were obesity (OR: 13.06, 95%CI: 3.98-42.89), diabetes mellitus (OR: 10.51, 95%CI: 2.35-46.84), and excessive diathermy (OR: 12.62, 95%CI: 3.93-40.54). Conclusion: Obesity, diabetes, and the use of excessive diathermy for hemostasis may increase the risk of sternal wound infection with pedicled LIMA harvest compared to skeletonized LIMA in patients undergoing CABG

Right coronary artery severe stenosis as a predictor of new onset atrial fibrillation after coronary artery bypass surgery

Background: post-operative Atrial fibrillation (POAF) commonly occurs in patients undergoing cardiac surgeries including Coronary artery bypass grafting (CABG). Role of right coronary artery (RCA) stenosis in developing POAF after CABG is not settled yet. Objective: This retrospective study aimed to assess severe RCA stenotic lesion (70% or more narrowing) as a predisposing factor for POAF, in patients undergoing on-pump CABG, whether the RCA was grafted or not. Patients and methods: A total of 100 patients who underwent on-pump CABG in xxxx Hospitals and xxxx Hospitals between January 2022 and June 2022 were divided into two groups: Group (A) had severe right coronary artery disease, and Group (B) did not have severe right coronary artery disease. Following the operation, all patients were examined daily for electrocardiogram (ECG) alterations until they were discharged. Results: The mean age of the included patients was 52.6 (± 3), and 55 % of them were females. The mean Left ventricular ejection fraction was 56 (± 5). Incidence of atrial fibrillation was significantly higher in patients with severe RCA stenosis compared to those without severe RCA stenosis; p= 0.001 (68% vs 34%) denoting positive correlation between significant RCA stenosis and POAF; r=0.340, p=0.001. Conclusion: Severe RCA stenosis is one of the predictors of developing AF after CABG

Video-assisted Minimally Invasive Mitral Valve Surgery versus Conventional Mitral Surgery in Rheumatic Patients

Background: Minimally invasive mitral valve surgery became an attractive option because of its cosmetic advantages over the conventional approach. The superiority of the minimally invasive approach regarding other aspects is still debatable. The aim of our study was to determine the potential benefits of minimally invasive mitral valve replacement with intraoperative video assistance over conventional surgery. Methods: This is a single-center prospective cohort study that included 60 patients with rheumatic heart disease who underwent mitral valve replacement. Patients were divided into two groups: group (A) included patients who had conventional sternotomy (n= 30), and group (B) included patients who had video-assisted minimally invasive mitral valve replacement (n= 30). Intraoperative and postoperative outcomes were compared between both groups. Results: Mortality occurred in one patient in the group (A). Cardiopulmonary bypass time was 118.93 ± 29.84 minutes vs. 64.73 ± 19.16 minutes in group B and A respectively (p< 0.001), and ischemic time was 102.27 ± 30.03 minutes vs. 53.67± 18.46 minutes in group B and A respectively (P < 0.001). Ventilation time was 2.77± 2.27 vs. 6.28 ± 4.48 hours in group B and A respectively (p< 0.001) and blood transfusion was 0.50 ± 0.63 vs. 2.83 ± 1.34 units in group B and A respectively (p< 0.001).  ICU stay was 1.73 ± 0.64 days in the group (B) vs. 4.47 ± 0.94 days in group A (p< 0.001). Postoperative bleeding was 353.33 ± 146.77 ml in the group (B) vs. 841.67 ± 302.03 ml in group A (p <0.001). No conversion to full sternotomy was reported in group B. In group (B), two cases (6.6%) required re-exploration for bleeding vs. four cases (13.2%) in group (A) (p=0.67). The hospital stay was 6.13 ± 1.59 days in the group (B) vs. 13.27 ± 7.62 days in group A (p< 0.001). Four cases (13.3%) developed mediastinitis in group A and in the group (B), there was one case of acute right lower limb embolic ischemia. Conclusion: Video-assisted minimally invasive mitral operations could be a safe alternative to conventional sternotomy with the potential of lesser morbidity and earlier hospital discharge

An Exploration of Leadership Styles and Motivation in Egyptian Business Organizations

Leadership styles can have a profound impact on employee motivation and performance. The changing global business landscape has drawn much attention to transformational leadership as an approach that addresses the demands of organizations in this complex environment. The purpose of this qualitative grounded theory study was to understand the nature of employee motivation with regard to leadership styles and the role of transformational leadership in Egyptian business organizations. Seventeen Egyptian professionals were recruited through a combination of e-mail and telephone procedures and were interviewed regarding their experiences with organizational leaders; their perception of the ideal organizational leader; their feelings about the tenets of transformational leadership theory; and how leadership styles influence their job performance, job satisfaction, and the achievement of their career related goals. Data were analyzed and emerging patterns and themes were established, such as participants holding largely negative views regarding the majority of leadership behaviors and employee motivation techniques they presently experience and being very receptive to the majority of aspects of transformational leadership. These patterns and themes culminated in the development of a theory for the ideal leadership style for Egyptian employees. The study yielded information that can make it easier to lead and motivate employees in Egyptian business organizations, and increase the ability of Egyptian organizations to effect positive social change by way of leadership practices that allow organizational stakeholders to enjoy the positive impact on society of organizations that are better led, more productive, and more focused on a greater sense of social wellness

A Proposed Framework for Automated Evaluation of Architectural Spatial Configurations Using Fuzzy Logic Approach

Architectural spatial layout configurations are the result of a complex design process aiming at managing the most advantageous location of all spaces with certain objectives and constraints. In the presence of broadening the scope of understanding spatial phenomenon, its role, and its composition in scope of various programmatic, ideological, formal, and engineering aspects, embedded in a complex theoretical background. The aspect of evaluation is the least apparent and there are significant limitations to what can be achieved there. This paper is aiming at evaluating functionality (such as quality of space, use, Access, adjacency, non-adjacency, proximity etc.), build quality (such as performance, efficiency, cost, etc.), impact (such as user performance, internal quality, urban, social, and cultural integration, etc.), indication of the quality of the architectural space design and the quality of the layout configuration. To achieve this research goal, we devised all possible spatial relation, affecting these qualities, as inputs for a given architectural space using descriptive rule blocks. We define this fuzzy logic system for residential spaces that's been blended into a layout to evaluate the layout configuration. We define all input variables, output variables, and fuzzy sets, and present space-space relations using membership functions. The paper proposes a framework based on fuzzy logic approach for automated evaluation of architectural spatial layout configurations

EFFECT OF COMPOST AND NPK WITH BIOFERTILIZERS ON GROWTH AND ESSENTIAL OIL PRODUCTION OF LEMONGRASS (CYMBOPOGON CITRATUS)

A field experiment was carried out at the Nursery of Fac. Agric., Minia Univ. during the two successive seasons of 2011/2012 and 2012/2013 to explore the effect of three compost levels (0, 4 and 8 ton/fed) and four mineral NPK/biofertilization treatments on vegetative growth and essential oil of lemongrass plants. Obtained results proved that vegetative growth characters (plant height, number of tillers/plant, fresh and dry weights of leaves/fed and essential oil percent and yield per fed were considerably augmented due to the use of both low and high compost levels, with the high one (8 ton/fed) being much more effective. Concerning mineral/biofertilization treatments, both 100% NPK and 75% NPK  + E.M. + yeast treatments out grew the other two treatments (75% NPK + E.M. and 75% NPK + yeast) in producing higher values of growth and essential oil parameters. The best overall results were obtained when lemongrass plants were supplied with compost at the level of 8 ton/fed and fertilized with 75% NPK combined with E.M. and yeast

RESPONSE OF CUMIN PLANT TO SOME ORGANIC, BIOFERTILIZATION AND ANTIOXIDANT TREATMENTS II. ESSENTIAL OIL PRODUCTION AND CHEMICAL CONSTITUENTS

The effect of farmyard manure (FYM) at 10, 15 and 20 m3/fed. Effective microorganisms (E.M.) and/or vitamin E or vit. B1 treatments on oil production (essential oil % and essential oil yield/plant and /fed) and chemical components (photosynthetic pigments content and NPK %) were investigated during 2015/2016 and 2016/2017 at Samalot region (El-Byaho village) - Minia Governorate and Laboratory of ornamental plants, Fac. of Agric., Minia Univ. All treatments of FYM statistically increased oil production as well as chemical components as compared with control. The high level of FYM was more effective in this concern. The treatments of E.M. + vit. B1 followed by E.M. + vit. E, then mineral NPK (full dose) gave the best results in increasing all previous traits. Supplying cumin plants with FYM at 20 m3/fed. in combination with E.M. + vitamins (B1 or E) or FYM at 15 m3/fed. plus E.M. + vit. B1 resulted overall the highest values of the previous traits

RESPONSE OF CUMIN PLANT TO SOME ORGANIC, BIOFERTILIZATION AND ANTIOXIDANT TREATMENTS I. VEGETATIVE GROWTH AND FRUITS YIELD

The effect of farmyard manure (FYM) at 10, 15 and 20 m3/fed E.M. and/or vitamin E or vit. B1 treatments on vegetative growth (plant height, number of branches/plant and dry weight of herb/plant), yield (number of umbels/plant, fruit yield/plant and /fed) of cumin plant were investigated during 2015/2016 and 2016/2017 at Samalot region (El-Byaho village) - Minia Governorate and Laboratory of Ornamental Plants, Fac. of Agric., Minia Univ. All treatments of FYM statistically increased vegetative growth characters and fruit yield as compared with control. The high level of FYM was the most effective in this concern. The treatments of E.M. + vit. B1 followed by E.M. + vit. E, then mineral NPK (full dose) were the best results in increasing all the previous traits. Supplying cumin plants with FYM at 20 m3/fed in combination with E.M. + vitamins (B1 or E) or FYM at 15 m3/fed plus E.M. + vit. B1 resulted overall the highest values of the previous traits

Chicory abrogates oxidative stress, inflammation and caspase-dependent apoptosis in acute hepatic injury model induced by acetaminophen in rats

In this study the protective effect of chicory leaves hydroalcoholic extract (CIE) against acute liver injury induced by a single dose of acetaminophen (700 mg/kg, i.p.) was investigated in rats. The CIE and silymarin treatment (standard reference) were given in a dose of (100 mg/kg, p.o.) for 3 days before and at 1 and 12 h following acetaminophen administration. Treatment with CIE significantly reduced the levels of serum ALT, AST, alkaline phosphatase, bilirubin, total cholesterol, triglycerides, urea, creatinine, TNF-α and hepatic contents of malondialdehyde (MDA), nitric oxide, caspase-3 and hydroxyproline, with significant increases in serum total protein, albumin, HDL- cholesterol and hepatic activities of reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) as compared with the acetaminophen group. The histopathological alterations mediated by acetaminophen were ameliorated by CIE. It was concluded that CIE protects rat liver against acetaminophen hepatotoxicity, most probably through abrogation of oxidative stress, inflammation and caspase-3 dependent apoptosis

The International Natural Product Sciences Taskforce (INPST) and the power of Twitter networking exemplified through #INPST hashtag analysis

Background: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools. Methods: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST. Results and Conclusion: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events