Homocysteine, folic acid and vitamin B12 levels in serum of epileptic children

AbstractThe relationship between increased homocysteine (Hcy) level and epileptic seizure remains controversial in human, despite a growing evidence of the pro-convulsive effect of the hyperhomocysteinemia (HHcy) observed in the animal studies. The mechanism of this association with epileptogenesis has not been clearly understood, although there is emerging evidence to support the unfavorable effects of some anti-epileptic drugs (AEDs) on the plasma homocysteine (Hcy) concentrations. The aim of this study was to uncover the relationship between the levels of homocysteine (Hcy), the cofactors involved in its metabolism as folic acid and vitamin B12 and anti-epileptic drugs (AEDs) in epileptic patients. Serum level of homocysteine (Hcy), folic acid and vitamin B12 was measured in 60 patients with idiopathic epilepsy; and its level was compared to 30 healthy children serving as control group. No significant difference was found regarding the plasma homocysteine (Hcy) levels between patients (both receiving anti-epileptics and non anti-epileptic drug users) and controls. Epileptic patients on polytherapy showed higher mean serum levels of homocysteine (Hcy) and lower mean serum levels of folic acid compared to those on monotherapy. However, the mean serum levels of homocysteine (Hcy), vitamin B12 and folic acid showed non significant differences between patients using valproic acid (VPA) or carbamazepine (CBZ). Duration of AED therapy showed a significant positive correlation with mean serum levels of homocysteine (Hcy) and a significant negative correlation with mean serum levels of folic acid. To conclude; AEDs upset the homeostatic balance of homocysteine (Hcy) and its cofactors and cause abnormalities in their serum levels

Evaluation of Homocysteine, Folic Acid and Vitamin B12 Levels among Egyptian Children with Idiopathic Epilepsy

Objective: To evaluate relationship between homocysteine (Hcy), folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control.Patient and Methods: The study included 60 patients with idiopathic epilepsy and thirty non-epileptic children of the same age and sex served as controls. All cases were subjected to physical and neurological examination and electroencephalogram (EEG). Serum level of folic acid, homocysteine (Hcy) and vitamin B12 were done for both epileptic patients and controls. Non parametric test, one way ANOVA and Pearson’s correlation were used for analysis of data.Result: 44 patients (73.3%) had generalized epilepsy and the remaining patients had partial epilepsy (simple or complex). 37 patients (61.6%) were in grade I, 3 patients (5 %) were in grade II and the remaining 20 patients (33.3 %) were in grade III epilepsy. Vitamin B12 was significantly higher in epileptic patients. Duration of anti-epileptic drug treatment was correlated significantly to folic acid and Hcy level.Conclusion: antiepileptic drugs might upset the homeostatic balance of Hcy and its cofactors and cause abnormalities of their serum levels. The duration of anti-epileptic drug treatment was related to decrease of folic acid and increase in homocysteine levels

COMPARATIVE ADVANTAGE AND COMPETITIVENESS OF EGYPTIAN EXPORTS OF DATES IN THE WORLD MARKETS

The study aimed at measuring competitiveness of Egyptian exports of dates based on indicators Econometric Analysis and indicators of competitiveness.  The important results of this study are: 1-     Indonesia is ranked first in the import of Egyptian dates, amounting is about 31.9%, followed by the state of Morocco with about 24.6%, then the State of Malaysia, Lebanon, Jordan, Turkey, Syria, Germany with rates about 20.9%, 3.8%, 3.6%, 2.9%, 2.3%, 0.99% respectively of total imports. 2-     Egypt has a competitive advantage compared to the rate of penetration of Egyptian exports of dates for the most important international markets in the state of Morocco, followed by Indonesia, Malaysia, and Lebanon respectively. 3-     Egypt has also a competitive advantage in the export price of dates for each of Tunisia, Saudi Arabia and Algeria among the most important countries in the world. 4-      Calculating the geographic concentration of date’s commodity coefficient shows that it is almost close to zero, which suggests that there is a problem in Egyptian exports of dates, despite the fact that Egypt is classified as the first country worldwide in its production. 5-     A ten percent change in the comparative advantage of the phenomenon of Egyptian exports of dates leads to a change in the same direction to the amount of Egyptian exports target of 11.7% . 6-     The study predicts an increase in the quantity and value of Egyptian exports targeted from about 32.9 thousand tons, 41.9 million dollars in 2017 to 38.2 thousand tons, 48.9 million dollars in 2020.   Recommendations   1-    The paper recommends that a production map should be made to determine different consumer tastes in importing countries. 2-    Opening export areas of dates in competitive countries such as the state of Tunisia, Saudi Arabia and Algeria specially where Egypt has a competitive price advantage over these countries. 3-    Reviewing the export policy in general and the policy of exporting dates in particular to support Egypt’s competitive status in the Arab and international markets specially that the rest of the competitive countries in exporting dates had a competitive price advantage compared to Egypt. 4-    Studying both of the Lebanese and Turkish markets to re-open them for Egyptian date exports since these specific markets show a significant lack of Egyptian date exports. 5-    Increasing the competitiveness of dates in the international markets and maintaining the markets in which Egypt has a competitive edge for its exports of dates such as Indonesia and Morocco. 6-    Determining in general the most important kinds of dates that competitive countries exports

EVALUATION FOR DRYING UNITS AND PACKING DATES IN SIWA OASIS

ABSTRACT   The date industry in Egypt in general and in Siwa Oasis in particular has an important economic position in the food industries sector, where the value of manufactured products amounted to about 41.5 billion pounds, representing about 15.7% of the total value of production of food industries to about 263.8 billion pounds during 2017.   The research aims to   In general, the research aims to identify the feasibility of investing in the activities of the units and drying and filling dates in Siwa Oasis by studying the criteria of financial and economic evaluation of these projects to identify the financial and economic feasibility.   The results showed drying units and packing date is the small capacity, and the large capacity in Siwa Oasis is as follows   - The possibility of expanding the establishment of drying units and packing dates in the small and large capacity for Siwa Oasis, where 160 workers on average, while the average wage per day for the worker about 345 pounds, 295.5 pounds respectively during the season 2018/ 2019. - The average value of Net Present Value worth was 12.99 million pound, 29.94 million pound respectively, accordinat to the Internal Rate of Return, it reached about 55.5% and 73.5% respectively, which is intended to be higher than the opportunity cost available in the community, for capital investment of about 16.25%. - The Pay Back Period rate for these units was about 1.6 years, and the rate of Benfit to the cost indicated a value greater than the correct one for all date drying units and packing in Siwa Oasis.   Which indicates the possibility of expanding the development and establishment of date drying units and packing in Siwa Oasis according to the criteria used in the study, which emphasizes the safety of investment and efficiency of customization in the date drying units and packing to provide new employment opportunities and promote the employment of women and increase the value of agricultural production and income in the oasis, The negative effects of the research are increasing the monopoly of owners of these units and work to reduce the prices of dates and oasis and reduce the incomes of agricultural producers.    The recommendations of the research can be summarized as follows   - Training and raising the skills of those involved in the anufacturing process. - Control the export of dates, which indicates the maintenance of the reputation of the dates of the Siwa in particular, and dates in Egypt in general. - Provide financial support by the Ministry of Industry and Trade, which indicates the purchase of sorting machines. - Provide financial support by the Ministry of Agriculture and Land Reclamation to provide the bags necessary for the process of curving, which indicates to improve the qualities of the product, which encourages the increase of exports. - Preparation of a database and information for agricultural statistics and data on drying units and packing dates and complementary industries

Fragmentation of Ventricular Extrasystoles: A Potential New Electrocardiographic Window to Uncover Patients at Risk

Fragmented QRS (fQRS) is a marker of conduction block due to myocardial scar that presents in electrocardiography (ECG) as an additional one or more R wave (R\u27) or notching in the S wave nadir in contiguous leads. However, fQRS description on premature ventricular contractions (PVCs) has not been previously described. We describe a case of a 67-year-old male with a past medical history of prediabetes, hypertension and coronary artery disease who presented after an ophthalmic procedure with asymptomatic PVCs and episodes of bigeminy. Initial ECG showed an isolated fQRS in V2. However, during PVCs significant extrasystoles fragmentation was seen in other coronary territories. Upon reviewing his most recent cardiac catheterization, it showed a 40% ostial and 70% distal left anterior descending stenosis with a mid-segment patent stent, 95% first diagonal stenosis and totally occluded proximal right coronary artery. Identification of diffuse fQRS known to be associated with myocardial scar, sustained arrhythmic events and sudden cardiac death, particularly when seen in the inferior leads, became extremely relevant in our patient. We noted that ejection fraction reduction from 52% to 34% on his last coronary intervention was crucial to decide if an implantable cardioverter-defibrillator would be needed. PVC fragmentation might be a new ECG marker that could uncover both scar and arrhythmia potential in patients at risk of adverse cardiac events

Correlates of parental stress and psychopathology in pediatric epilepsy

Background: Chronic conditions like epilepsy in a child can affect his/her entire family. The failure of the family members to adapt adequately to the unique demands of this childhood chronic illness can be considered as an important risk factor for development of psychopathology. Objectives: The objectives of this study were to study the profile of parenting stress in parents of children with epilepsy and its correlates; and, to examine the correlates of psychopathology in these children. Material and Methods: Twenty three epileptic children and their families were subjected to Parenting Stress Index (PSI), Scores for indices such as The Children′s Depression Inventory (CDI), Benton Visual Retention test, Spence anxiety scale for children, The Child Behavior Checklist (CBCL) and Wechsler Intelligence Scale for Children were calculated. Results: Mean verbal and performance IQ score was 94, while the mean total IQ score was 95. Mean scores for all Wechsler IQ Scores as well as Benton Visual retention test were within the average range. Means for total internalizing CBCL t scores (M, Mean=70; Standard Deviation, SD=4.4), total externalizing CBCL t scores (M=60, SD=9.6), and total behavior problems CBCL t scores (M=67, SD=5.2) were above the standard cut off levels of 65 for clinical behavioral problems. Mean score on CDI was 42 ± 2. Scores of the PSI equal to or higher than 85 th percentile were considered pathologically high. Conclusion: The results of our study indicated that pediatric patients with epilepsy, specifically with intractable cases, are correlated with high levels of parental stress

Splenic Abscess: A Rare Complication of the UVC in Newborn

Splenic abscess is one of the rarest complications of the UVC in a newborn and it is hypothesized that it could be due to an infection or trauma caused by a catheter. The case that is being reported presented with abdominal distension and recurrent desaturation with suspicion of neonatal sepsis versus necrotizing enterocolitis. However, the final diagnosis was splenic abscess as a complication of an inappropriate UVC insertion which was discovered by abdominal ultrasound. The patient was given broad spectrum antibiotics empirically and the symptoms were resolved without any surgical intervention. Such cases and controlled studies need to be reported in order to identify further causes and risk factors associated with splenic abscess in a patient with UVC which can eventually help us adopt preventive strategies to avoid such complications

Novel transport delay problem solutions for gas plant inlet pressure control

The process of transferring the natural gas from the gas well to the gas separation plant encountered some delay time depending on the distance between this well and the factory, the cross section of the transport line, the geometry of this transport line, the well pressure and others. To control the factory inlet pressure by controlling the choke valve existing at the well head, the delay time makes the traditional control systems to fail. In this framework we aim to solve this problem by presenting a novel controller design and delay modeling technique. The presented technique is compared to the previous control system design and delay approximation techniques

Assessing the hepatoprotective effects of hesperidin on liver-associated disorders in albino rats with experimentally induced obesity and type II diabetes: A histological and biochemical study

Introduction: Hesperidin (HSP) has multiple beneficial effects in verities of clinical situations including type 2 diabetes mellitus (T2DM). Aim: Determination of curative effects of HSP on the liver in T2DM rats through biochemical and histopathological studies. Methods: Animals. Fifty rats were enrolled. 10 rats were fed a normal diet (control group), and the remaining 40 rats received a high-fat diet (HFD) for 8 weeks. The HFD-fed rats were grouped into Group II: 10 rats, and Group III: 10 rats received HSP 100 mg/kg. Group IV: 10 rats received a single dose of streptozotocin (STZ), 30 mg/kg, and Group V: 10 rats received STZ and HSP. Body weight, Blood glucose, insulin level, liver enzymes, lipid profile, oxidative stress, TNF-α, NF-κB, and liver biopsy were estimated. Results: there is improvement in the histological profile of the steatosis in HFD-fed rats treated with HSP either in group III or in group V (received STZ) along with amelioration in blood glucose, insulin, liver enzymes, lipid profile, oxidative profile, TNF-α, and NF-κB. Conclusion: HSP in this STZ model revealed an improvement in steatosis, biochemical markers, and histologic findings. By studying these factors, we expected to identify the prospective targets for intervention that could help improve outcomes for individuals with obesity and diabetes-related liver diseases