Current Review of Medical Research in Developing Countries: A Case Study from Egypt

It is amazing to see how medical science has progressed. Medical research is now cross-national and cross-cultural, the relentless progress of globalization poses complex ethical questions for those wishing to do medical research in developing countries. In developing countries, poverty, endemic diseases, and a low level of investment in health care systems influence both the ease of performing and the selection of trials that can benefit the people of the countries. In this chapter, we present an overview of medical research situation in developing countries with critique of different clinical trials that was conducted in Egypt after review. Egypt has 41 universities and 94 health related medical schools. There are 24 faculties of medicine with up to 34 departments in each. Clinical research is an essential mandate for getting Master, Doctorate Degrees, and for promotion of faculty members. In Egypt, the Profession Ethics Regulations issued by the Ministry of Health (MOH) No. 238/2003 was endorsed and maintained in Law 71/2009. Beside these regulations, more than 56 Institutional Review Board (IRB) have been registered. The Egyptian Network of Research Ethics Committees (ENREC) was created in 2008. Yet, in the absence of robust legislative constraints, there is no clear way to avoid violations. Our experience in Tanta Faculty of Medicine is also highlighted in this chapter

Comparison of actions and resistances in different building design codes

AbstractStructural design codes of different countries provide engineers with data and procedures for design of the various structural components. Building design codes from USA, Europe, and Egypt are considered. Comparisons of the provisions for actions (loads), and for the resistance (strength) of sections in flexural and compressive axial loading are carried out. Several parameters are considered including variable actions for occupancy and different material strengths. The comparison is made considering both concrete and steel structures. Issues and consequences of mixing actions from one code and resistance from another code are also discussed

Soluble Triggering Receptor Expressed on Myeloid Cells-1 as a marker to differentiate septic from aseptic meningitis in children: comparison with procalcitonin and C-reactive protein

Background: Differentiating between septic and aseptic meningitis remains a challenge. Procalcitonin (PCT) was suggested by many researchers as a sensitive marker for early diagnosis of septic meningitis but with varying discriminative power. Triggering receptor expressed on myeloid cells-1 (TREM-1), a neutrophil and monocyte receptor, is up-regulated during infection with potential role during sepsis. Objectives: The aim of this study was to evaluate the diagnostic accuracy of soluble TREM-1 in comparison to PCT and C-reactive protein (CRP) in early diagnosis of septic meningitis and its usefulness to distinguish between septic and aseptic meningitis in children. Study design: Fifty-one children aged 2 to 162 months identified as possible cases of meningitis were included in this case control study. Beside Gram staining, cultures of blood and cerebrospinal fluid (CSF) and latex agglutination test of CSF, CRP, serum PCT and soluble TREM-1 (sTREM-1) measurement was done on admission, and after 48-72 hours of treatment. Results: Septic meningitis was diagnosed in 16 (44%) of the studied cases. Although patients with septic meningitis had a significant increase in serum sTREM-1 and PCT levels at the time of admission (median, 25.2 ng/ml and 79.1ng/ml, respectively) in comparison with patients with aseptic meningitis (4.6 ng/ml and 0.7 ng/ml, respectively) and control group (4.1 ng/ml and 0.3 ng/ml, respectively) (p < 0.0001), sTREM-1 showed significantly higher sensitivity (93.7%) and specificity (94.3%) in the early prediction of sepsis with an area under the Receiver Operator Characteristic (ROC) curve (95% CI) of 0.94 (0.84 - 0.99) at a cutoff value of 12.4 ng/ml. Moreover, sTREM-1 but not PCT or CRP concentration was significantly lower (P=0.007) at admission in patients with poor outcome than in those with good prognosis. Conclusions: Both serum PCT and sTREM-1 are valuable in early distinguishing septic from aseptic meningitis in children but with markedly higher diagnostic discriminatory power for sTREM-1. Moreover, sTREM-1 has a significant value in predicting the prognosis of cases with septic meningitis. Keywords: Soluble Triggering Receptor Expressed on Myeloid Cells-1 – Procalcitonin- C-Reactive Protein - Septic meningitisEgypt J Pediatr Allergy Immunol 2011;9(2):77-8

β-Sitosterol Glucoside-Loaded Nanosystem Ameliorates Insulin Resistance and Oxidative Stress in Streptozotocin-Induced Diabetic Rats

β-Sitosterol glucoside (SG), isolated from Senecio petasitis (Family Asteraceae), was loaded in self-nanoemulsifying drug delivery systems (SEDDS) in a trial to enhance its solubility and biological effect. Various co-surfactants were tested to prepare a successful SEDDS. The selected SG-loaded SEDDS had a droplet size of 134 ± 15.2 nm with a homogenous distribution (polydispersity index 0.296 ± 0.02). It also demonstrated a significant augmentation of SG in vitro release by 4-fold compared to the free drug suspension. The in vivo insulin sensitivity and antidiabetic effect of the prepared SG-loaded SEDDS were further assessed in streptozotocin-induced hyperglycemic rats. The hypoglycemic effect of SG-loaded nanosystem was evidenced by decreased serum glucose and insulin by 63.22% and 53.11%, respectively. Homeostasis model assessment-insulin resistance (HOMA-IR) index demonstrated a significant reduction by 5.4-fold in the diabetic group treated by SG-loaded nanosystem and exhibited reduced glucagon level by 40.85%. In addition, treatment with SG-loaded nanosystem significantly decreased serum MDA (malondialdehyde) and increased catalase levels by 38.31% and 64.45%, respectively. Histopathological investigations also supported the protective effect of SG-loaded nanosystem on the pancreas. The promising ability of SG-loaded nanosystem to ameliorate insulin resistance, protect against oxidative stress, and restore pancreatic β-cell secretory function warrants its inclusion in further studies during diabetes progression

Pilot Experimental Tests on Punching Shear Strength of Flat Plates Reinforced with Stirrups Punching Shear Reinforcement

Flat plates are favor structure systems usually used in parking garages and high-rise buildings due to its simplicity for construction. However, flat plates have some inherent structural problems, due to high shear stress surrounding the supporting columns which cause a catastrophic brittle type of failure called "Punching Shear Failure". Several solutions are used to avoid punching shear failure, including the use of drop panels or punching shear reinforcement. The latter is being a more sophisticated solution from the structural ductility, the architectural and the economical point of view. This study aims at investigating the effect of stirrups as shear reinforcement in enhancing the punching strength of interior slab-column connections. A total of four full-scale interior slab-column connections were tested up to failure. All slabs had a side length of 1700 mm and 160 mm thickness with 200 mm x 200 mm square column. The test parameters were the presence of shear reinforcement and stirrups concentration around the supporting column. The test results showed that the distribution of stirrups over the critical punching shear zone was an efficient solution to enhance not only the punching shear capacity but also the ductility of the connection. Furthermore, the concentrating of stirrups shear reinforcement in the vicinity of the column for the tested slabs increases the punching shear capacity by 13 % compared to the uniform distribution at same amount of shear reinforcement

Pilot Experimental Tests on Punching Shear Strength of Flat Plates Reinforced with Stirrups Punching Shear Reinforcement

Flat plates are favor structure systems usually used in parking garages and high-rise buildings due to its simplicity for construction. However, flat plates have some inherent structural problems, due to high shear stress surrounding the supporting columns which cause a catastrophic brittle type of failure called "Punching Shear Failure". Several solutions are used to avoid punching shear failure, including the use of drop panels or punching shear reinforcement. The latter is being a more sophisticated solution from the structural ductility, the architectural and the economical point of view. This study aims at investigating the effect of stirrups as shear reinforcement in enhancing the punching strength of interior slab-column connections. A total of four full-scale interior slab-column connections were tested up to failure. All slabs had a side length of 1700 mm and 160 mm thickness with 200 mm x 200 mm square column. The test parameters were the presence of shear reinforcement and stirrups concentration around the supporting column. The test results showed that the distribution of stirrups over the critical punching shear zone was an efficient solution to enhance not only the punching shear capacity but also the ductility of the connection. Furthermore, the concentrating of stirrups shear reinforcement in the vicinity of the column for the tested slabs increases the punching shear capacity by 13 % compared to the uniform distribution at same amount of shear reinforcement

Dynamic MR-Mammography as the best method for diagnosis of invasive lobular breast carcinoma: A retrospective study

AbstractAim of the studyIt is a retrospective study aiming to provide diagnostic characterization of ILC in Dynamic MR-Mammography and to compare its diagnostic performance to mammography and ultrasonography.Material and MethodA total of 56 cases of ILC were selected in retrospective review of mammography, ultrasonography and Dynamic MRM of 420 patients with invasive breast cancer.ResultsAsymmetric density was the commonest mammography finding and the measured sensitivity of mammography in detecting ILC was 87.5% (9/56 FN).The most common US manifestation of ILC was focal shadowing without a discrete mass and its sensitivity in detecting ILC was 84.9% (10/56 FN). At MR imaging, the most common manifestation of ILC was a solitary irregular or angular mass with speculated or ill-defined margins (33.9%of cases [n=19]).The measured sensitivity is 96.5% (2/56 FN). Additional data such as those affected the patient management including the presence of multifocal or multicentric disease, chest wall involvement and contralateral breast cancer were encountered in 48.2% of cases [n=27]. ILC has a tendency to demonstrate delayed maximum enhancement with washout exhibited by only a minority of lesions (21.4% [n=12]).ConclusionMR imaging has proved to be superior to mammography and US in the detection and management of ILC. It provides useful information for further management and pre-surgical planning

Different Materials Used as Denture Retainers and Their Colour Stability

BACKGROUND: Retainers are of great importance for the longevity of the prosthetic removable partial denture during various functions especially the esthetic one. The key of successful clasp selection is to select a direct retainer that will control tipping and torquing forces on the abutment teeth, provide retention against reasonable dislodging forces and are compatible with both tooth and tissue contour together with the aesthetic desire of the patient. AIM: This study aims to compare different clasp material to enhance the choice of the clasp based on the aesthetic point of view. METHODS: The colour evaluation of the tested materials had been evaluated by computer aided technique with digital camera with 3 Mega Pixels of resolution. RESULTS: In the current research, the technique of colour evaluation was carried out to compare different clasp materials to enhance the choice of the clasp based on the aesthetic point of view. Most commonly, Removable Partial Denture (RPD) retainers are fabricated identically from the metal framework’s alloy as Cobalt Chromium (CoCr) alloy although it is unaesthetic. This esthetic problem has been overcome by other methods and by utilising different materials, these included covering the retainers with tooth-coloured acrylic resin, as well as the introduction of esthetic materials as; Thermoplastic Acetal, Versacryl, and Thermopress. CONCLUSION: It has been concluded that the non-metallic Acetal resin clasp shows superior physical properties regarding colour stability

Preparation of Polyfunctionally Substituted Pyridine-2(1H) thione Derivatives as Precursors to Bicycles and Polycycles

Reaction of acetylacetone with 1 mole of dimethylformamide dimethyl acetal (DMFDMA) affords enamine 2a which react with cyanothioacetamide to give pyridinethione 3a. Pyridinethione 3a reacts with methyl iodide, halogenated compounds, aromatic aldehyde and malononitrile / elemental sulfur to yiled compounds 7-10 respectively. Reactions of thioether (7) in ethanolic K2CO3, 1 mole DMFDMA and 4-(dimethylamino) benzaldehyde gave compounds (11, 13, 14) respectively. Enaminone (12) can be prepared by reaction of compound (11) with DMFDMA. Also, compounds (13) and (14) can be obtained by reaction of compounds (3a) and (9a) with 2 mole of DMFDMA and methyl iodide respectively. Reactions of enaminone (9) with hydrazine hydrate and cyanothioacetamide gave compounds (11) and (12) respectively. Malononitrile dimmer when reacted with chalcones (9a), (14) and enaminone (12), (13) gave bipyridyl (15), (16) and (19a,b) respectively. Bipyridyl (15) can be converted to (16) by methylation using methyl iodide. Reactions of thienopyridine (8) with DMFDMA and sodium nitrite in acetic acid gave tricyclic compounds (20) and (21) respectively. Finally, reactions of (21a) with malononitrile / elemental sulfur and DMFDMA gave compounds (22) and (23) respectively