Off versus On pump coronary artery bypass grafting; a single-center experience

Background: The debate about on-pump vs. off-pump coronary artery bypass grafting (CABG) continues. The present study compared the short-term outcomes after off-pump vs. on-pump CABG. Methods: The study was conducted on 67 patients who underwent CABG from 2021 to 2022. Patients were divided into two groups according to the CABG technique. Group 1 included 33 patients who underwent off-pump CABG, and Group 2 included 34 patients who underwent on-pump CABG. The study outcomes were operative time, hospital complications, and mortality. Results: On-pump patients were significantly older than off-pump patients (64.78±7.12 vs. 59.09±6.29; p= 0.004). There were no differences in comorbidities, presenting symptoms, or ejection fraction between groups. Operative time was significantly shorter in off-pump patients (227.47±13.73 vs. 321.12±27.49; p< 0.001). Blood transfusion was lower in off-pump patients (1.06± 0.311 vs. 1.79± 0.25; p< 0.001). Bleeding was lower in off-pump patients (0.81±0.13 vs. 0.91±0.20 ml, p= 0.01). Off-pump patients had significantly shorter ICU (3.5±2.6 vs. 4.9±4.7; p<0.001) and hospital stay (7.6±4.8 vs. 9.5±6.1; p<0.001). No patient had reexploration for bleeding, wound infection, or mortality in our series. One patient had renal impairment in the on-pump group (p>0.99). Conclusion: Off-pump and on-pump CABG seem to be safe approaches for managing coronary artery disease in our institution. Off-pump could be superior to on-pump CABG regarding shorter ICU and hospital stay. Studies with data from a large number of patients are recommended

Comparison of two surgical approaches for the treatment of atrial septal defects

Background: Cardiac surgery has adopted less invasive procedures in the last two decades, aiming to reduce surgical insult and achieve early patient recovery. The present study compared median sternotomy and minimally invasive techniques for managing atrial septal defects. Methods: The current study is a prospective cohort comparative study that included 67 patients randomly divided into two groups. Group A included 34 patients with median sternotomy; their ages ranged from 2 to 40 years (mean± SD 36.12±7.3 years). Group B (n= 33) underwent minimally invasive surgery, and their ages ranged from 21 to 46 years (mean± SD 32.09±7.35). Results: Minimally invasive patients had fewer blood transfusions (1.06±0.24 vs. 1.79±0.25 units, P<0.001), less pain on the second day (3.73±0.72 vs. 7.94±1.01, P<0.001) and fifth day (2.09±0.52 vs. 5.38±.49, P<0.001) of the operation, and a shorter duration of hospital stay (4.85±0.75 vs. 6.38±0.78 days, P<0.001) than median sternotomy patients. Wound infection was reported in three cases with minimally invasive surgery, while nine patients had wound infection with median sternotomy. However, both groups had no reported mortality after two months of follow-up. Conclusion: Atrial septal defect closure with minimally invasive approaches could be safe with low morbidity, a fast recovery phase, and the ability to restore normal activities

<i>In vitro</i> evaluation of physicochemical-dependent effects of polymeric nanoparticles on their cellular uptake and co-localization using pulmonary calu-3 cell lines.

ObjectiveThe study evaluated physicochemical properties of eight different polymeric nanoparticles (NPs) and their interaction with lung barrier and their suitability for pulmonary drug delivery.MethodsEight physiochemically different NPs were fabricated from Poly lactic-co-glycolic acid (PLGA, PL) and Poly glycerol adipate-co-ω-pentadecalactone (PGA-co-PDL, PG) via emulsification-solvent evaporation. Pulmonary barrier integrity was investigated in vitro using Calu-3 under air-liquid interface. NPs internalization was investigated using a group of pharmacological inhibitors with subsequent microscopic visual confirmation.ResultsEight NPs were successfully formulated from two polymers using emulsion-solvent evaporation; 200, 500 and 800 nm, negatively-charged and positively-charged. All different NPs did not alter tight junctions and PG NPs showed similar behavior to PL NPs, indicating its suitability for pulmonary drug delivery. Active endocytosis uptake mechanisms with physicochemical dependent manner were observed. In addition, NPs internalization and co-localization with lysosomes were visually confirmed indicating their vesicular transport.ConclusionPG and PL NPs had shown no or low harmful effects on the barrier integrity, and with effective internalization and vesicular transport, thus, prospectively can be designed for pulmonary delivery applications

Carriers for the Targeted Delivery of Aerosolized Macromolecules for Pulmonary Pathologies.

INTRODUCTION: Macromolecules with unique effects and potency are increasingly being considered for application in lung pathologies. Numerous delivery strategies for these macromolecules through the lung, have been investigated to improve the targeting and overall efficacy. Areas covered: Targeting approaches from delivery devices, formulation strategies and specific targets are discussed. Expert opinion: Although macromolecules are a heterogeneous group of molecules, a number of strategies have been investigated at the macro, micro and nanoscopic scale for the delivery of macromolecules to specific sites and cells of lung tissues. Targeted approaches are already in use at the macroscopic scale through inhalation devices and formulations, but targeting strategies at the micro and nanoscopic scale are still in the laboratory stage. The combination of controlling lung deposition and targeting after deposition, through a combination of targeting strategies could be the future direction for the treatment of lung pathologies through the pulmonary route

Mental health stigma and internship nursing students’ attitudes toward seeking professional psychological help: a cross-sectional study

Abstract Background Self-stigma and negative attitudes toward mental illness have been identified as significant barriers that hinder individuals from seeking psychological assistance, leading to adverse consequences in their lives. Aim This study aimed to assess mental health stigma and internship nursing students’ attitudes toward seeking professional help. Methods A cross-sectional design was conducted in the current study including a purposive sample of 228 participants of internship nursing students using a Socio-demographic data sheet, Self-Stigma of Seeking Help scale (SSOSH), and Attitude toward seeking professional psychological help scale (ATSPPH). The data acquisition period spanned from August to November 2022. Results This study revealed significant insights into the attitudes of internship nursing students toward seeking professional psychological help. Gender emerged as a notable factor, with males exhibiting higher levels of self-stigma compared to females (mean = 2.872). Attitudes towards seeking professional help varied significantly based on age, gender, residence, and marital status. Specifically, participants aged 23 years, females, rural residents, and married individuals demonstrated the highest Mean scores reflecting attitudes that lean more positively towards seeking help. Furthermore, a significant negative correlation (r = -0.372, p < 0.01) was observed between self-stigma and attitudes toward seeking professional help. Conclusion This study concluded that more than three-fifths of internship nursing students hadn’t stigma towards seeking professional psychological help while the vast majority had a positive attitude towards seeking professional psychological help. However, the majority of students reported that financial barriers, specifically the high cost of therapy, prevent them from seeking psychological help. This highlights the need for more affordable mental health services for this population

Lipolytic Postbiotic from Lactobacillus paracasei Manages Metabolic Syndrome in Albino Wistar Rats

The current study investigates the capacity of a lipolytic Lactobacillus paracasei postbiotic as a possible regulator for lipid metabolism by targeting metabolic syndrome as a possibly safer anti-obesity and Anti-dyslipidemia agent replacing atorvastatin (ATOR) and other drugs with proven or suspected health hazards. The high DPPH (1,1-diphenyl-2-picrylhydrazyl) and ABTS [2,2&prime;-azino-bis (3-ethyl benzothiazoline-6-sulphonic acid)] scavenging activity and high activities of antioxidant enzyme such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-px) of the Lactobacillus paracasei postbiotic (cell-free extract), coupled with considerable lipolytic activity, may support its action against metabolic syndrome. Lactobacillus paracasei isolate was obtained from an Egyptian cheese sample, identified and used for preparing the postbiotic. The postbiotic was characterized and administered to high-fat diet (HFD) albino rats (100 and 200 mg kg&minus;1) for nine weeks, as compared to atorvastatin (ATOR; 10 mg kg&minus;1). The postbiotic could correct the disruption in lipid metabolism and antioxidant enzymes in HFD rats more effectively than ATOR. The two levels of the postbiotic (100 and 200 mg kg&minus;1) reduced total serum lipids by 29% and 34% and serum triglyceride by 32&ndash;45% of the positive control level, compared to only 25% and 35% in ATOR&rsquo;s case, respectively. Both ATOR and the postbiotic (200 mg kg&minus;1) equally decreased total serum cholesterol by about 40% and 39%, while equally raising HDL levels by 28% and 30% of the positive control. The postbiotic counteracted HFD-induced body weight increases more effectively than ATOR without affecting liver and kidney functions or liver histopathology, at the optimal dose of each. The postbiotic is a safer substitute for ATOR in treating metabolic syndrome

Water Pollution Detection System Based on Fish Gills as a Biomarker

AbstractThis article presents an automatic system for assessing water quality based on fish gills microscopic images. As fish gills are a good biomarker for assessing water quality, the proposed system uses fish gills microscopic images in order to detect water pollution. The proposed system consists of three phases; namely pre-processing, feature extraction, and classification phases. Since the shape is the main characteristic of fish gills microscopic images, the proposed system uses shape feature based on edge detection and wavelets transform for classifying the water-quality degree. Furthermore, it implemented Principal Components Analysis (PCA) along with Support Vector Machines (SVMs) algorithms for feature extraction and water quality degree classification. The datasets used for experiments were constructed based on real sample images for fish gills. Training dataset is divided into four classes representing the different histopathological changes and the corresponding water quality degrees. Experimental results showed that the proposed classification system has obtained water quality classification accuracy of 95.41%, using the SVMs linear kernel function and 10-fold cross validation with 37 images per class for training

Awareness, knowledge, attitude, and skills of telemedicine among mental healthcare providers

Abstract Background Telemedicine plays a vital role in patient-centered healthcare delivery in the diagnosis, management, and development of future treatment plans for chronic diseases. Results This study revealed that attitude toward telemedicine was high among the studied mental healthcare providers, while it was average among the other studied variables (awareness, knowledge, and skills). Psychiatrists had a high percentage in the studied variables (awareness, attitude, knowledge, and skills). There were statistically significant differences in the dimensions of the telemedicine questionnaire according to age, profession, and academic degree. There was a statistically significant relation between the levels of awareness, knowledge, and attitude toward telemedicine. Conclusions This study concluded that the studied mental healthcare providers had high attitudes while the other studied variables (awareness, knowledge, and skills) were average. Psychiatrists had a high percentage in the studied variables (awareness, attitude, knowledge, and skills), followed by psychologists, while nurses had the lowest level in all studied variables

Chlamydia species in free-living Cattle Egret (Bubulcus ibis) and Hoopoe (Upupa epops) in Egypt

Little information is available on the presence of chlamydia infection in wildlife. This study was conducted to assess the occurrence of chlamydiae in asymptomatic birds from two species of wild birds (Cattle Egret and Hoopoe) in Egypt. In the present study Chlamydiaceae was analyzed using Giemsa stain, Giménez stain, fluorescent antibody test (FAT) and PCR. The results of these techniques were compared with CFT for detecting Chlamydia psittaci antibodies among the examined birds. The results reveal that 96.4%, 81.8%, 89.1%, 80.0% and 58.2% of the examined samples were positive for chlamydiosis using PCR, Giemsa stain, Giménez stain, FA, and CFT respectively among Hoopoe. The percentages were 90.6%, 77.4%, 83.0%, 75.5% and 66.0% respectively for the previous tests among Cattle Egret birds. The results suggest that Cattle Egret and Hoopoe may be reservoir of Chlamydiaceae species and thus shed the organisms in their excreta. The shedding of chlamydiae by free living birds in Egypt may expose humans that come in contact with these birds to zoonotic risks

Antimicrobial resistance and mecA characterization of methicillin-susceptible S. aureus and non-S. aureus of beef meat origin in Egypt

Methicillin-resistant Staphylococcus aureus (MRSA) have been found in various farm animal species throughout the world. Yet, methicillin-susceptible S. aureus (MSSA), methicillin-susceptible non-S. aureus (MS-NSA) and methicillin-resistant non-S. aureus (MR-NSA) were not investigated. Therefore, we persued to determine the diversity in theirphenotypic virulence assay, phenotypic antimicrobial resistance profile and molecular characterisation in one of the food chains in Egypt. Samples were collected during 2013 from beef meat at retail. Twenty seven isolates comprising five species (S. hyicus, S. aureus, S. schleiferi subsp. coagulans, S. intermedius and S. lentus) were characterized for their antibiotic resistance phenotypic profile and antibiotic resistance genes (mecA, cfr, gyrA, gyrB and grlA). Out of the 27 Staphylococcus isolates only one isolate was resistant to the 12 antibiotics representing nine classes. Raw beef meat sold across the Great Cairo zone, contains 66.7% of MRS, with highest prevalence was reported in S. aureus (66.7%), while the MRS non-S. aureus strains constituted 66.7% from which S. hyicus (60%), S. intermedius (33.3%), S. schleiferi subsp. coagulans (100%) and S. lentus (100%) were MRS. Seven S. aureus, six S. hyicus, four S. schleiferi subsp. coagulans, three S. intermedius and one S. lentus isolates although being resistant to oxacillin yet, 11/27 (40.7%) carried the mecA gene. At the same time, the cfr gene was present in 2 of the nine S. aureus isolates, and totally undetectable in S. hyicus, S. schleiferi subsp. coagulans, S. intermedius and S. lentus. Although global researches largely focused into MRSA and MR-NSA in animals on pigs, the analysis of our results stipulates that buffaloes and cattle could be MRSA dispersers and that this theme is not specific to pigs. Detection of MSSA virulence determinants is a must, as although oxacillin resistance may be absent yet, the MSSA may carry the virulence determinants which could be a source of perilous S. aureus for the human community