Comparison between caudal levobupivacaine versus levobupivacaine–nalbuphine for postoperative analgesia in children undergoing hernia repair: A randomized controlled double blind study

AbstractObjectivesCaudal analgesia is widely used in children; the aim of this trial was to evaluate the efficacy of adding nalbuphine to local anesthetic in pediatric patients undergoing hernia repair.Patients and methodsThis randomized double-blind controlled trial was done in department of anesthesia, Cairo University hospitals, and 40 patients with ASA physical status classification I–II, aged 2–7years were enrolled in this study and randomly assigned into 2 groups; group L received caudal levobupivacaine 1ml/kg with concentration of 0.25% and group LN received caudal 0.125% levobupivacaine with volume of 1ml/kg plus 0.2mg/kg nalbuphine. Pain was evaluated immediately after emergence (FLACC 0h), after 1h in the PACU, after 2, 3, 4, 5, 6 and 12h by the FLACC pain score (Face, Leg, Activity, Crying, Consolability). First time of rescue analgesic, total dose of rescue analgesic and side effects were observed for 12h.ResultsFLACC pain scores were much less in LN group compared to L group (p value<0.001) after the second hour. The first time for postoperative analgesic requirement was significantly longer in LN group (384±23.1min) compared to L group (202.20±23.42min) (p value>0.001). The total dose of postoperative supplementary analgesia (intravenous paracetamol infusion) in the first 12h was significantly lower in LN group (200.5±65.5mg) in comparison with L group (355.25±69.9mg) (P<0.05).ConclusionsCombining caudal anesthesia using levobupivacaine and nalbuphine provided prolonged time of analgesia with no reported side effects

The Predictive Ability of Cognitive Motivation, Optimism and Pessimism of Academic Procrastination

The study aimed for revealing the cognitive motivation, and where the study sample leads to optimism and pessimism, and it aimed for showing the female students’, at Prince Sattam Bin Abdul-Aziz University, ability of cognitive motivation, optimism, and pessimism of academic procrastination. The study sample consisted of 421 students from the faculty of education, who had been chosen by the available way. For achieving the study goals, the two researchers improved the scales of the cognitive motivation and the academic procrastination; they also extracted their sincerity and constancy indications. In addition, the study results indicated that the cognitive motivation level was high, and that sample’s individuals tended to be more optimistic than pessimistic. Also, it showed that the cognitive motivation is more influential in predicting the academic procrastination. Hence, the regression coefficient reached (0.240), which is a statistical function. On the other hand, optimism’s and pessimism’s ability of predicting the academic procrastination took the second position with a regression coefficient of (0.135). Accordingly, the study recommended to study the academic procrastination and its relation to other variables, and to study it in different environment rather than the university one. Moreover, the study recommended to create awareness programs and guidance publications in order to reduce the phenomenon of the academic procrastination as much as possible. And, for optimism and pessimism, the study recommended to construct educational centers for the youth, males and female, that improves their skills and abilities, and that connect them to the society to communicate with it in order to break their solitude, which causes pessimism. Key Words: Cognitive Motivation, Optimism and Pessimism, Academic procrastination

Management for failed back surgery syndrome: three-in-one procedure versus percutaneous spinal fixation alone

Objectives: To evaluate the short-term outcome of a 3-in-1 procedure including percutaneous facet radiofrequency, percutaneous spinal fixation and steroid with hyaluronidase enzyme injection versus percutaneous spinal fixation alone for cases with failed back surgery syndrome (FBSS).Patients and methods: The study included 50 patients who had had previous spinal surgery since a mean duration of 39.7 ± 8.5 months and developed recurrent back pain since a mean duration of 10 ± 2.1 months. Patients were randomly allocated into two groups; group A underwent percutaneous spinal fixation only and group B underwent the 3-in-1 procedure. Outcome was evaluated at the end of six months postoperatively (PO) using a pain numeric rating scale (NRS), the Oswestry Disability Index (ODI) and Odom’s criteria for evaluation of surgical outcome with evaluation of patients’ satisfaction by outcome.Results: All patients showed progressive decrease of NRS pain and ODI scores compared with preoperative scores. However, patients in group B showed significantly lower postoperative NRS pain scores and ODI with significantly higher frequency of patients having had &gt; 50% reduction of both scores compared with patients in group A. PO analgesic consumption rate in both groups was significantly lower than the preoperative rate with a significant reduction of mean total scoring compared with preoperative scoring. The frequency of patients who found the provided therapeutic procedure satisfactory and its outcome good-to excellent was significantly higher among patients in group B compared with group A.Conclusion: Short-term outcomes of the applied 3-in-1 procedure are promising for improvement of symptoms secondary to FBSS and may ultimately prove to be recommended as the therapeutic modality for such a challenging clinical problem.Keywords: failed spinal surgery, percutaneous facet radiofrequency, percutaneous spinal fixatio

The Predictive Ability of Social Anxiety within Internet Addiction among University Students

The study aimed to identify the predictive ability of social anxiety in Internet addiction among university students, by relying on the relational descriptive approach. The study sample consisted of (462) male and female students from the Faculty of Educational Sciences at the Hashemite University who were selected through the available random method and were assessed by the social anxiety scale and the Internet addiction scale prepared by Young (1997) which was modified by Widyanto and McMurran (2004) after confirming the appropriateness of its psychometric properties. The study results found that social anxiety level and Internet addiction level were high among the study sample and indicated a statically significant correlation at level (0.01) between the social anxiety level and the level of Internet addiction, which indicates that the higher the social anxiety level, the higher the internet addiction level and that social anxiety works as a predictor of the internet addiction. Results also indicated a nonexistence of statistically significant differences in the social anxiety level as well as the level of Internet addiction due to gender. The current study recommended the activation of students’ counseling services for students within the university and society as a whole to train them on controlling and self-control, which reduce the social anxiety and increase the university's interest about Internet addiction phenomenon in addition to holding awareness programs to help solve problems of this phenomenon

Risk Factors Associated with Mild Cognitive Impairment аmong Apparently Healthy People and the Role of MicroRNAs

BACKGROUND: Mild cognitive impairment (MCI) is a stage between the expected cognitive decline of normal ageing and the serious decline of dementia. AIM: To identify risk factors and role of miRNAs associated with mild cognitive impairment (MCI) among employees. SUBJECTS AND METHOD: A cross-sectional study was carried out on 186 employees aged between 40 and 65 years. Cognitive function was evaluated using ACEIII, MoCA, and Quick cognitive tests. Medical history and lifestyle were assessed. Family 132 &amp; 134 miRNA expressions were assessed by real-time PCR. RESULTS: MCI was detected among 14 / 186 (7.5%). miRNA 132 expression was the only significant miRNAs to detect MCI with low sensitivity and specificity (70%). The logistic analysis revealed that higher miRNA132 expressions, low monthly intake of; vegetables, unroasted nuts, low education and higher ALT levels were predicting factors for MCI with AOR 1.1 (1.01-3.3), 1.2 (1.04-1.43), 0.8 (0.8-0.98), 2.7 (1.9-7.4) and 1.6 (1.1-2.3) respectively. CONCLUSION: MiRNAs expression showed low sensitivity and specificity in detecting MCI; only miRNA 132 might be used. Several modifiable factors seem to reduce the risk of MCI

Incommensurate One-Dimensional Fluctuations in YBa₂Cu₃O₆.₉₃

A novel neutron scattering technique has been utilized to discover one-dimensional fluctuations with a very sharply defined modulation period of 16.65 Å along the b(a) direction in YBa2Cu3O6.93. The fluctuations are found to be absent in the reduced oxygen compound YBa2Cu3O6.15. The wave vector of the fluctuations is consistent with accepted values of 2kF for the Cu-O chains

Osteoprotegerin, soluble receptor activator nuclear factor-κB ligand, nuclear factor kappa B and intestinal trefoil factor 3 are promising biomarkers in diagnosis and follow- up inflammatory bowel disease patients

Background: Inflammatory bowel disease (IBD) is a condition in which the gastrointestinal system becomes inflamed for no apparent reason. Its incidence increased during the last few decades. As a result, it's critical to understand how to validate a clinical diagnosis and monitor any progress using a simple procedure. Osteoprotegerin (OPG), which interacts with RANKL, regulates RANK/RANKL signaling. OPG is a decoy receptor for soluble receptor activator of nuclear factor-B ligand (sRANKL), which stimulates nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and the healing trefoil factor 3 (TFF3), which could be employed as in the diagnosis and follow-up of IBD patients, biomarkers are used. Objectives: The aim of the current work was to evaluate the role of RANKL (sRANKL), OPG, NF-κB , and TFF3 in in the diagnosis of active IBD. Subjects and methods: Thirty-five newly diagnosed untreated IBD patients and thirty-five healthy controls were included in this study. Patients were then given particular treatment either in the form of cortisone, mesalamin, immunotherapy or infliximab and immunotherapy for 3 months and attend for second visit. OPG, sRANKL, NF-κB and TFF3 levels were estimated by ELISA method using commercial kits in patients before and after treatment and healthy control. Results: Patients with IBD had significantly increased levels of OPG, sRANKL, NF-B, and TFF3 than healthy controls (P =0.0001). After 3 months of treatment, patients' levels of NF-B and TFF3 were significantly lower (p = 0.0001 and 0.03, respectively). Conclusion: The biomarkers OPG, sRANKL, NF-κB , and TFF3 show promise in the diagnosis of active IBD. The decrease in NF-κB and TFF3 following treatment suggests that be used as biomarkers to track disease activity and treatment effectiveness

Catechol-O-Methyltransferase Expression and 2-Methoxyestradiol Affect Microtubule Dynamics and Modify Steroid Receptor Signaling in Leiomyoma Cells

CONTEXT: Development of optimal medicinal treatments of uterine leiomyomas represents a significant challenge. 2-Methoxyestradiol (2ME) is an endogenous estrogen metabolite formed by sequential action of CYP450s and catechol-O-methyltransferase (COMT). Our previous study demonstrated that 2ME is a potent antiproliferative, proapoptotic, antiangiogenic, and collagen synthesis inhibitor in human leiomyomas cells (huLM). OBJECTIVES: Our objectives were to investigate whether COMT expression, by the virtue of 2ME formation, affects the growth of huLM, and to explore the cellular and molecular mechanisms whereby COMT expression or treatment with 2ME affect these cells. RESULTS: Our data demonstrated that E(2)-induced proliferation was less pronounced in cells over-expressing COMT or treated with 2ME (500 nM). This effect on cell proliferation was associated with microtubules stabilization and diminution of estrogen receptor alpha (ERalpha) and progesterone receptor (PR) transcriptional activities, due to shifts in their subcellular localization and sequestration in the cytoplasm. In addition, COMT over expression or treatment with 2ME reduced the expression of hypoxia-inducible factor -1alpha (HIF-1 alpha) and the basal level as well as TNF-alpha-induced aromatase (CYP19) expression. CONCLUSIONS: COMT over expression or treatment with 2ME stabilize microtubules, ameliorates E(2)-induced proliferation, inhibits ERalpha and PR signaling, and reduces HIF-1 alpha and CYP19 expression in human uterine leiomyoma cells. Thus, microtubules are a candidate target for treatment of uterine leiomyomas. In addition, the naturally occurring microtubule-targeting agent 2ME represents a potential new therapeutic for uterine leiomyomas

Tumour Necrosis Factor-Alpha affects Estrogen Metabolic Pathways in Breast Cancer Cells

Abstract: The purpose of this study is to investigate the effect of the proinflammatory cytokine Tumor necrosis factor-alpha (TNF-α) on estrogen metabolic pathways in MCF-7, a breast cancer cell line. This aims to add to our understanding of the relationship between inflammation and breast carcinogenesis. MCF-7 cells where thus treated with different concentrations of TNF-α and different techniques were employed to assess its effect on the estrogen metabolic pathways: Capillary liquid chromatography/mass spectrometry (LC/MS) analysis was used for quantitative measurement of estrogens and estrogen metabolites (EM). High performance liquid chromatography (HPLC) was used for the analysis of estrogen-DNA adduct levels. Reporter gene assay, Real time reverse transcription polymerase chain reaction (real time RT-PCR) and Western blot analysis, were used to assess the expression of estrogen-metabolizing genes and enzymes. Our results indicated that compared to controls, TNF-α significantly increased the total EM (P&lt;0.05) and decreased the estrone (E1) / 17-β estradiol (E2) ratio (P&lt;0.05). Moreover, it significantly altered the expression of genes and enzymes involved in E2 activation and deactivation pathways e.g. Cytochrome P-450 1A1 (CYP1A1), Cytochrome P-450 1B1 (CYP1B1), Catechol-O-methyl transferase (COMT) and Nicotinamide adenine dinucleotide phosphate-quinone oxidoreductase 1 (NQO1). In addition, there were increased levels (P&lt;0.05) of some catechol estrogens e.g. 4-hydroxy-estrone (4-OHE1) and 2-hydroxyestradiol (2-OHE2) with decreased levels of methylated catechols e.g. 2-methoxy estradiol (2-MeOE2) (P&lt;0.05). DNA adducts especially 4-OHE1-[2]-1-N3 Adenine was significantly increased (P&lt;0.05). It can thus be concluded that TNF-α directs the estrogen metabolism into more hormonally active and carcinogenic products in MCF-7. This may implicate a new possible explanation for inflammation associated breast cancer