Carnitine deficiency and oxidative stress provoke cardiotoxicity in an ifosfamide-induced Fanconi Syndrome rat model

In addition to hemorrhagic cystitis, Fanconi Syndrome is a serious clinical side effect during ifosfamide (IFO) therapy. Fanconi syndrome is a generalized dysfunction of the proximal tubule which is characterized by excessive urinary excretion of glucose, phosphate, bicarbonate, amino acids and other solutes excreted by this segment of the nephron including L-carnitine. Carnitine is essential cofactor for β-oxidation of long-chain fatty acids in the myocardium. IFO therapy is associated with increased urinary carnitine excretion with subsequent secondary deficiency of the molecule. Cardiac abnormalities in IFO-treated cancer patients were reported as isolated clinical cases. This study examined whether carnitine deficiency and oxidative stress, secondary to Fanconi Syndrome, provoke IFO-induced cardiomyopathy as well as exploring if carnitine supplementation using Propionyl-L-carnitine (PLC) could offer protection against this toxicity. In the current study, an animal model of carnitine deficiency was developed in rats by D-carnitine-mildronate treatment Adult male Wistar albino rats were assigned to one of six treatment groups: the first three groups were injected intraperitoneally with normal saline, D-carnitine (DC, 250 mg/kg/day) combined with mildronate (MD, 200 mg/kg/day) and PLC (250 mg/kg/day), respectively, for 10 successive days. The 4th, 5th and 6th groups were injected with the same doses of normal saline, DC-MD and PLC, respectively for 5 successive days before and 5 days concomitant with IFO (50 mg/kg/day). IFO significantly increased serum creatinine, blood urea nitrogen (BUN), urinary carnitine excretion and clearance, creatine phosphokinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), intramitochondrial acetyl-CoA/CoA-SH and thiobarbituric acid reactive substances (TBARS) in cardiac tissues and significantly decreased adenosine triphosphate (ATP) and total carnitine and reduced glutathione (GSH) content in cardiac tissues. In carnitine-depleted rats, IFO induced dramatic increase in serum creatinine, BUN, CK-MB, LDH, carnitine clearance and intramitochondrial acetyl-CoA/CoA-SH, as well as progressive reduction in total carnitine and ATP in cardiac tissues. Interestingly, PLC supplementation completely reversed the biochemical changes-induced by IFO to the control values. In conclusion, data from the present study suggest that: Carnitine deficiency and oxidative stress, secondary to Fanconi Syndrome, constitute risk factors and should be viewed as mechanisms during development of IFO-induced cardiotoxicity. Carnitine supplementation, using PLC, prevents the development of IFO-induced cardiotoxicity through antioxidant signalling and improving mitochondrial function

Public Evaluation of Speed Humps Performance and Effectiveness

In Egypt, it is believed that speed humps are the cheapest and best solutions to reduce vehicles speed and thus reduce the number of potential accidents. Due to the lack of specifications in Egypt that govern the installation of speed humps, they were spread randomly and with different dimensions without adequate studies. Consequently, this practice can cause adverse effects on the road users and the surrounding environment. For this purpose, a questionnaire was designed to discuss the different effects of using speed humps in Kafr El-Sheikh city as a typical model in the Egyptian cities. To verify that the questionnaire is appropriate for the intended task, it was evaluated by 30 respondents aged 18 years and over. After the trial process, the required corrections were made to the proposed form of the questionnaire. Then, final questionnaires were distributed and 1000 responses were collected from all road users, whether they were pedestrians, drivers, owners of vehicles or vehicle repairmen by using face-to-face interviews. The responses were analysed using SPSS program. The results reflected that the installation of speed humps contributed greatly to reduce vehicles speed, the flow of traffic and accidents rate. On the other hand, the results proved that humps also contribute significantly to the environmental pollution, damage to the pavement and vehicles especially when they are poorly designed and located. The majority of respondents attributed the random spread of the speed humps to the weakness of the authorities in law enforcement and the prevention of the installation of new humps without authorization. Finally, with the widespread use of speed humps and with the exception of the positive impact on traffic safety, it also has negative impacts on both the economy and the environment. Finally, the use of speed humps can cause many harmful effects to the neighbourhood, if there no strict control on its installation process. Unless specifications and some standards should be strictly followed, other means of traffic calming measures should be considered

Evaluation of Testicular Blood Flow and Ultrasonographic Measurements in Rams with Emphasis on Laterality

The current study aimed to measure the testicular ultrasonographic dimensions (length, width, thickness and volume) as well as spectral Doppler indices (resistive index and pulsatility index) of testicular artery, and to investigate the possible differences between the paired testes based on testicular dimensions and blood flow Doppler indices. Five Awassi rams of normal fertility, with a body weight 50-65 kg and aged 3-5 years were subjected to testicular ultrasound examination for testicular dimensions and pulsed-wave Doppler, twice monthly for five consecutive months. The testicular volume of the left testis (69.34±6.66 mm3) was higher than the right testis (66.85±5.46 mm3). Testicular thickness was significantly affected by the laterality of the testes (P<0.05). Doppler measures for RI (resistive index) as well as pulsatility index (PI) were slightly higher (P>0.05) in the right testicular artery rather than the left one. In conclusion, the testicular ultrasound measures and Doppler flow indices varied between the paired right and left testes in mature rams. In addition, the blood flow indices are highly correlated in the testicular artery of rams

Impact of Road Humps on the Pavement Surface Condition

In order to fight against over-speeding, the government and people in Egypt resorted to the installation of speed humps without adequate studies. On this basis, speed humps became widespread in most of the Egyptian roads in a semi-random way. It has been observed that the pavement condition of the roads has deteriorated in the vicinity of these humps. For impact assessment of speed humps on the pavement condition index (PCI), three roads link Kafr El-Sheikh city with three major towns in Kafr El-Sheikh governorate were selected to conduct PCI survey. The results indicated that the presence of speed humps contributes greatly to reduce the pavement condition index (PCI) values. It should be mentioned that the average reduction in PCI values ranged between 15% and 22% due to the presence of speed humps. Also, the most frequently observed distress on the pavement sections including humps considered for the selected roads was Raveling and Rutting. Accordingly, to avoid the pavement defects at the locations where the speed humps are installed, it is proposed to study the structural section of the road in the vicinity of the speed hump to resist the braking force and speed reduction effect

Impact of Tactile Stimulation on Neurobehavioral Development of Premature Infants in Assiut City

Objective: To assess impact of tactile stimulation on neurobehavioral development of premature infants in Assiut City. Design: Quasi-experimental research design. Setting: The study was conducted in the Neonatal Intensive Care Unit at Assiut University Children Hospital, Assiut General Hospital, Health Insurance Hospital (El-Mabarah Hospital) and El-Eyman for Gynecology and Obstetric Hospital. Subjects: The study subjects included a convenient sample of 50 premature infants divided into study or control groups and they were matched with gestational age and birth weight. Tool: Brazelton Neonatal Behavioral Assessment Scale is used to assess neurobehavioral development of infants from birth to two months of age. Method: Premature infants divided into two groups; (a) study group who receiving tactile stimulation (b) control group who receiving routine hospital care only. Neurobehavioral development using Brazelton’s Neonatal Behavior Assessment Scale (NBAS) was assessed at initial contact and after 5 days of intervention and on discharge. Results: showed that the premature infants of the study had better neurobehavioral development than those in the control group with statistical significant differences were found between the study and the control groups Conclusion: It was concluded from the findings of the current study that premature infants who received tactile stimulation had better neurobehavioral development than those who didn’t receive it and had only the hospital routine care. Keywords: Tactile stimulation, neurobehavioral development, premature infant

A Comparative Study of Opinions and Practices of Egyptian and Saudi Mothers Regarding Weaning Process

The aim of the study was to compare mothers’ opinion and practice regarding infant weaning in two Arab countries Saudi Arabia and Egypt. A comparative descriptive, non-experimental design was adopted in the current study.  Participants in the present study were a convenient sample of a 400 participants, 200 from Riyadh, Saudi Arabia and 200 from Cairo, Egypt Data was collected from different shopping malls in Riyadh and from outpatient of Cairo University, New Pediatric Hospital. Data were collected using a questionnaire developed by the researchers. The questionnaire have three parts: Part 1: Socio demographic data for the mothers. Part 2: Mothers Opinions about the weaning, Part 3: Mothers practices of weaning. The mothers who are working are more in Cairo than in Riyadh. A greater number of mothers were little educated in Cairo. The main source of information about weaning were family and relatives who represented the highest percentage in both countries. Breast milk insufficiency was the main reason given for the cessation of breastfeeding across the two countries. 12% of the children in Cairo had allergy problems after starting weaning process in contrast to 21.5% of the Riyadh children. Almost all these parameters were significantly different between the two countries. The current study revealed that the practices of feeding and weaning are different between the two countries. Majority of weaning happen suddenly in both countries and allergy might happen due to this sudden weaning practices. Teaching the parents about the proper weaning process and ways of introducing the new food could prevent further feeding difficulties and this responsibility lies on the shoulders of health care providers in both countries. Keywords: Opinion weaning, Breastfeedin

EFFECT OF IRON OVERLOAD AND IRON CHELATORS ON ANTI-MÜLLERIAN HORMONE LEVEL IN EGYPTIAN FEMALE PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA

Objective: This work aims to determine the effect of iron overload on serum anti-müllerian hormone (AMH) levels in females subjected to transfusion-dependent β-thalassemia by measuring serum ferritin and to investigate the effects of iron chelation therapy including oral deferiprone and subcutaneous deferoxamine in the management of transfusion-related iron overload together with reproductive function.Methods: 90 female patients with thalassemia major (TM), thalassemia intermedia (TI) and thalassemia minor (T minor) were selected to investigate AMH by ELISA and ferritin by IRMA.Results: Serum AMH level was lower in female patients with transfusion dependent β-thalassemia than in T minor also, Ferritin was 25 fold more in TM compared to T minor (3088.0±2497.6 ng/ml vs. 120.3±36.2 ng/ml). There was significant negative correlation of AMH with ferritin in TM (r =-0.949; P<0.001*), in TI (r =-0.378; P =0.039*) and in T minor (r =-0.754; P<0.001*). The iron chelator, deferoxamine had significantly higher ferritin and lower AMH in TM and TI than deferiprone.Conclusion: the results demonstrated that females with TM and TI were found to have lower serum AMH levels than T minor and inversely related to the serum ferritin levels in all thalassemic groups. Also, it demonstrated that deferiprone was more efficient than deferoxamine in removing excess iron and reduced the deleterious effect of excess iron to the reproductive system, which leads to fertility preservation of female patients with transfusion–dependent β-thalassemia.Keywords: Anti-müllerian hormone, Ferritin, Iron overload, β-thalassemia, Deferoxamine, Deferiprone

New Algorithm for Drawings of 3-Planar Graphs

Graphs arise in a natural way in many applications, together with the need to be drawn. Except for very small instances, drawing a graph by hand becomes a very complex task, which must be performed by automatic tools. The field of graph drawing is concerned with finding algorithms to draw graph in an aesthetically pleasant way, based upon a certain number of aesthetic criteria that define what a good drawing, (synonyms: diagrams, pictures, layouts), of a graph should be. This problem can be found in many such as in the computer networks, data networks, class inter-relationship diagrams in object oriented databases and object oriented programs, visual programming interfaces, database design systems, software engineering…etc. Given a plane graph G, we wish to find a drawing of G in the plane such that the vertices of G are represented as grid points, and the edges are represented as straight-line segments between their endpoints without any edge-intersection. Such drawings are called planar straight-line drawings of G. An additional objective is to minimize the area of the rectangular grid in which G is drawn. In this paper we introduce a new algorithms that finds an embedding of 3-planar graph. Keywords: 3- Planar Graph; Graph Drawing; drawing on grid

EXTRACTION, ISOLATION, AND CHARACTERIZATION OF BIOACTIVE COMPOUNDS AND ESSENTIAL OIL FROM SYZYGIUM JAMBOS

Objectives: Over the past few decades, phenolic compounds become important due to it has been associated with protection against different diseasesand sensory point of vision. Hence, at the present study, there has been a growing interest to carry out structural elucidation and characterization ofthe pure isolates from Syzygium jambos.Methods: S. jambos dried powder leaves were extracted by soaking in 85% methanol solvent at room temperature 25±2°C. The antioxidative activityof the isolates was assessed according to 2,2'-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging and phosphomolybdenum assays.Results: A total of 8 compounds were isolated from the n-butanol extract of S. jambos (Family Myrtaceae) plant, they were identified as quercetin-3-O-rutinoside (1), prenylbenzoic acid 4-β-D-glucoside (2), morolic acid 3-O-caffeate (3), 5,4'-dihydroxy, 7-methoxy, 6-methyl-flavone (4),3,4,5-trihydroxybenzoic acid (5), quercetin (6), isoetin-7-O-β-D-glucopyranoside (7), and (4'-hydroxy-3'-methoxyphenol-β-D-[6-O-(4â€-hydroxy-3â€,5â€-dimethoxylbenzoate)] glucopyranoside) (8). Compounds 5 and 6 showed the most radical scavengers among the tested compounds with SC50 values of5.50 and 4.30 μg/ml, respectively, compared to ascorbic acid as standard and the total antioxidant capacity (TAC) values of 605.0 and 680.59 mg ascorbicacid equivalent/g compound, respectively. In vitro antimicrobial activities of the isolated compounds were tested using disc agar plate method againstfour pathogenic microbial strains including Gram-positive, Gram-negative bacteria and yeast with inhibition zones from 9 to 19 mm. Gas chromatographymassspectrometry analysis for the essential oil provides twenty four identified components representing 92% of its total oil composition.Conclusion: The results supported that S. jambos could be attributed to sources of natural antioxidant and antimicrobial applications

Implementation and Evaluation of Antimicrobial Stewardship Program in Medical ICU in Cairo University Specialized Pediatric Hospital

BACKGROUND: High antibiotics use in pediatric intensive care units (PICUs) results in antibiotic resistance, the unfavorable clinical outcome of patients, increase the length of hospital stay, and drug expenditure. AIM: This study aimed at setting clinical guidelines customized according to local diseases epidemiology and local cumulative antimicrobial susceptibility, implementing, and evaluating the Antimicrobial Stewardship Program (ASP) effect in; optimizing antibiotics use, decreasing antibiotics expenditure, decreasing the length of therapy and stay in hospitals, and improving patients’ clinical outcomes. METHODS: A prospective study was conducted at a PICU of the Specialized Pediatric Hospital, Cairo University. Facility-specific guidelines were set, and the ASP was implemented and evaluated through the following indicators; adherence of physicians to the guidelines, ASP recommendations and acceptance of them, the rate of mortality, length of stay, drug costs, antibiotics days of therapy, and length of therapy. RESULTS: The adherence to the ASP guidelines was positively correlated to the patient’s clinical outcome (p = 0.018). In post ASP period, the average length of stay and the length of therapy significantly decreased (p = 0.047, p = 0.001, respectively), the rate of adherence to the ASP guidelines was (91.9%), the days of therapy of ceftazidime, ceftriaxone, and amikacin decreased significantly (p = 0.041, p = 0.026, p = 0.004, respectively). The most common ASP recommendation was drug schedule/frequency change (26.1%) followed by drug discontinuation (17.8%) and the most common antibiotic required intervention was ampicillin-sulbactam (21.6%). CONCLUSION: The antimicrobial stewardship is very effective in optimizing antibiotics use and leads to favorable outcomes in terms of decreased length of therapy, hospital stay, and mortality rate of the patients