Right mini-thoracotomy versus median sternotomy for mitral valve replacement

Background: The advantages of minimally invasive mitral valve surgery over the conventional approach is still debated. This study aimed to evaluate early outcomes after mitral valve replacement (MVR) using the right mini-thoracotomy (RMT) versus median sternotomy (MS). Methods: We prospectively included 60 patients who had MVR from May 2015 to June 2017. We classified patients into two groups; Group A (n= 30) had RMT, and Group B (n= 30) had MS. Postoperative pain score, wound satisfaction, and clinical and echocardiographic outcomes were compared between both groups. Results: The mean age was 39.90 ± 12.34 years in Group A and 45.75 ± 13.10 years in Group B (p= 0.08). Preoperative and echocardiographic data showed no statistical significance difference between the groups. Group A had longer aortic cross-clamp (118.85 ± 40.56 vs. 70.75 ± 24.81 minutes, p<0.001) and cardiopulmonary bypass times (186.70 ± 67.44 vs. 104.65 ± 42.60 minutes, p<0.001).  Group B had more blood loss (565 ± 344.3 vs. 241.5 ±89.16 ml/24 hours, p<0.001). The median pain score was 1 (range: 1- 3) in Group A and 4 (2- 8) in Group B (p<0.001), and the median wound satisfaction was 1.5 (1- 4) in Group A and 4 (1- 7) in Group B (p<0.001).  Wound infection occurred in 1 (3.3%) patient in Group A and 6 (20%) patients in Group B (p=0.04). Conclusion: Mitral valve replacement through the right mini-thoracotomy could be a safe alternative to median sternotomy. The right mini-thoracotomy was associated with longer operative times but better pain and wound satisfaction scores and lower wound infection

Quality of life among asthmatic children in Zagazig University Hospitals

Background: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) is one of the most widely used instruments for measuring health-related QOL in children with asthma.Objective: to evaluate health-related quality of life (HRQOL) in children with bronchial asthma to identify the most important determinants adversely affecting their QOL.Patients and methods: This study was conducted on 72 asthmatic children over six months period. They were recruited from The Outpatient Clinic of Pediatrics Pulmonology Unit, Zagazig University Hospitals. All study patients were subjected to complete history taking, clinical examination, determination of level of asthma symptom control and filling PAQLQ.Results: About 58% of patients had partially controlled asthma and one quarter of them had well controlled asthma (Symptoms domain was the most affected domain ranged from 3 to 5.2 with mean 4.056). There was statistically significant relation between sex and physical, emotional and overall score of PQLQ. There was statistically significant relation between residence & social class and QOL scores. There was statistically significant relation between BMI and QOL scoresConclusion: Asthma significantly adversely affects the QOL of the affected children. Control of the main determinants of QOL scores might improve the QOL of these patients

Evaluation of health-related quality of life and muscular strength in children with beta thalassemia major

Background: Thalassemia is an inherited blood disorder that requires repeated blood transfusions and chelation regimes. This may lead to restrictions in physical activities, social participation as well as decreased muscle strength.Aim: The aim of this study was to evaluate the health-related quality of life (HRQoL), muscular strength and pain in children with β-thalassemia major.Patients and method: One hundred and twenty children (60 with β-thalassemia major and 60 age-matched healthy) were participated in a cross-sectional study from both sexes (57 girls and 63 boys) with ages ranging from two to twelve years. HRQoL (physical, emotional, social and school functioning), muscular strength and pain were evaluated for all children by using the pediatric quality of life inventoryTM (PedsQLTM) 4.0 generic core scale, hand-held dynamometer and visual analogue scale (VAS) respectively.Results: Children with β-thalassemia major showed a significant decrease in all domains of health-related quality of life and handgrip strength with a significant increase in VAS score (p ≤ 0.0001).Conclusions: The study concluded that thalassemia as a chronic disease has a negative impact on HRQoL and muscle strength of children in different age group.Keywords: Beta thalassemia, Quality of life, Handgrip strength, childre

Affecting Factors Titanium Oxide of Nanoparticles for the Electrical Effect on Insulation Resistance of the Transformer Oil

In most cases, The electrical insulation of the transformer oil will be exposed to different internal problems, such as short circuit , over voltage, over load, over excitation and etcetera. The insulation of transformer will be sever decreased into minimum value. This requires some treatments of oil liquid ,such as refining or replacing the damaged oil with a new, which is a very expensive process. In this paper, the Insulation Resistance (IR) of transformer oil will be enhanced by using nanoparticles NPs. Titanium oxide (TiO2) one of them, which will be used in this experiment. The (NPs) improve the insulation, physical and chemical properties of transformer oil. The breakdown voltage will be tested for pure oil and after the addition (TiO2) according to IEC standard methods. The results of this study indicated that addition of TiO2 in certain quantities of pure oils can be affected the Insulation Resistance (IR) and electrical breakdown voltage. A comparative study was conducted to identify the effects of using nanoparticles in pure transformer oils to ensure their effect on electrical Insulation Resistance (IR). The results are indicated an increasing in the breakdown voltage and the dissipation factor of the transformer oil, thus results using nanoparticles oil higher than pure oil

Long-term protection of hepatitis B vaccination among Egyptian children

Background: Hepatitis B Vaccination is the most effective way to prevent transmission of hepatitis B virus (HBV). Objective: to detect the long-term immunogenicity of the vaccine in Egyptian children after five and ten years of vaccination. Methods: Two hundreds healthy children were recruited. They were divided into two groups according to their age. Group A included 100 child, around 6 years old, vaccinated 5 years ago. Group `B` included 100 child, around 11 years old, vaccinated 10 years ago. Hepatitis B surface antibody (HBsAb) titre was tested, booster dose of the vaccine was given to children whose HBsAb was < 10 mIU/ml, then one and half month later, they were retested for HBsAb to evaluate the response. Results: Both groups had a wide range of HBsAb (2-1000 mlU/ml), and there was a significant difference in the level of the two groups. Our data proves the decline of antibody titre with time. In group A, 19 children needed a booster dose, 14 of them were vaccinated, and 10 were retested after one and half month. The results showed that 9 (90%) responded by increased level of HBsAb, with six (66.6%) showing an adequate response. In group B, 52 children had antibody titre < 10, 48 of them were vaccinated and 34 were retested one and half months later. Two out of the 34 did not respond and 32 (94.2%) responded by an increase in the antibody titre. Of those who responded, 19 had adequate response (HBsAb ≥ 100) and 13 had hypo-response (HBsAb = 10 -100). Eighty percent (80%) of boys versus 51.7% of girls responded adequately. Conclusion: Hepatitis B vaccine is an effective and successful way for preventing HBV infection. No need for booster dose at least for 5 years after vaccination .Keywords: HBV- HB vaccine- long term immunityEgypt J Pediatr Allergy Immunol 2011;9(1):35-4

Anti-Obesity Evaluation of Averrhoa carambola L. Leaves and Assessment of Its Polyphenols as Potential α-Glucosidase Inhibitors

Averrhoa carambola L. is reported for its anti-obese and anti-diabetic activities. The present study aimed to investigate its aqueous methanol leaf extract (CLL) in vivo anti-obese activity along with the isolation and identification of bioactive compounds and their in vitro α-glucosidase inhibition assessment. CLL improved all obesity complications and exhibited significant activity in an obese rat model. Fourteen compounds, including four flavone glycosides (1–4) and ten dihydrochalcone glycosides (5–12), were isolated and identified using spectroscopic techniques. New compounds identified in planta included (1) apigenin 6-C-(2-deoxy-β-D-galactopyranoside)-7-O-β-D-quinovopyranoside, (8) phloretin 3′-C-(2-O-(E)-cinnamoyl-3-O-β-D-fucopyranosyl-4-O-acetyl)-β-D-fucopyranosyl-6′-O-β-D fucopyranosyl-(1/2)-α-L arabinofuranoside, (11a) phloretin3′-C-(2-O-(E)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside, (11b) phloretin3′-C-(2-O-(Z)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside. Carambolaside M (5), carambolaside Ia (6), carambolaside J (7), carambolaside I (9), carambolaside P (10a), carambolaside O (10b), and carambolaside Q (12), which are reported for the first time from A. carambola L. leaves, whereas luteolin 6-C-α-L-rhamnopyranosyl-(1-2)-β-D-fucopyranoside (2), apigenin 6-C-β-D-galactopyranoside (3), and apigenin 6-C-α-L-rhamnopyranosyl-(1-2)-β-L-fucopyranoside (4) are isolated for the first time from Family. Oxalidaceae. In vitro α-glucosidase inhibitory activity revealed the potential efficacy of flavone glycosides, viz., 1, 2, 3, and 4 as antidiabetic agents. In contrast, dihydrochalcone glycosides (5–11) showed weak activity, except for compound 12, which showed relatively strong activity

FOXP3 Polymorphism and Susceptibility to Pediatric Acute Lymphocytic Leukemia (ALL): A Preliminary Data

FOXP3 (forkhead box P3) polymorphism is associated with many inflammatory diseases and cancers. Acute lymphoblastic leukemia (ALL) is the most common type of pediatric malignancies.This study was designed to investigate the impact of FOXP3 (-3279C/A and -2383C/T) gene polymorphism on the susceptibility of Egyptian children to ALL. A total of 128 subjects with ALL and 124 healthy controls were enrolled in this study. Genotyping of FOXP3 (-3279C/A and -2383C/T) were performed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). There was a significant increase (P<0.01) in FOXP3 (-3279CC) genotype, while FOXP3 -3279CA genotype was significantly decreased in ALL patients compared to controls. Insignificant change in FOXP3 (-2383C/T) genotypes was demonstrated between both groups. FOXP3 (-2383CC) genotype was significantly decreased (p<0.05) in treatment responders compared to non-responders and a significant increased (p<0.05) in relapsed patients comparing to the non-relapsed group. Taken together, our pilot study pointed to the potential role of FOXP3 (-3279C/A) gene polymorphisms in Egyptian children ALL susceptibility. An additional prospective large scale study should be carried out to support our findings

Missed cleavage opportunities by FEN1 lead to Okazaki fragment maturation via the long-flap pathway.

RNA-DNA hybrid primers synthesized by low fidelity DNA polymerase α to initiate eukaryotic lagging strand synthesis must be removed efficiently during Okazaki fragment (OF) maturation to complete DNA replication. In this process, each OF primer is displaced and the resulting 5'-single-stranded flap is cleaved by structure-specific 5'-nucleases, mainly Flap Endonuclease 1 (FEN1), to generate a ligatable nick. At least two models have been proposed to describe primer removal, namely short- and long-flap pathways that involve FEN1 or FEN1 along with Replication Protein A (RPA) and Dna2 helicase/nuclease, respectively. We addressed the question of pathway choice by studying the kinetic mechanism of FEN1 action on short- and long-flap DNA substrates. Using single molecule FRET and rapid quench-flow bulk cleavage assays, we showed that unlike short-flap substrates, which are bound, bent and cleaved within the first encounter between FEN1 and DNA, long-flap substrates can escape cleavage even after DNA binding and bending. Notably, FEN1 can access both substrates in the presence of RPA, but bending and cleavage of long-flap DNA is specifically inhibited. We propose that FEN1 attempts to process both short and long flaps, but occasional missed cleavage of the latter allows RPA binding and triggers the long-flap OF maturation pathway

Dynamic structure mediates halophilic adaptation of a DNA polymerase from the deep-sea brines of the Red Sea.

The deep-sea brines of the Red Sea are remote and unexplored environments characterized by high temperatures, anoxic water, and elevated concentrations of salt and heavy metals. This environment provides a rare system to study the interplay between halophilic and thermophilic adaptation in biologic macromolecules. The present article reports the first DNA polymerase with halophilic and thermophilic features. Biochemical and structural analysis by Raman and circular dichroism spectroscopy showed that the charge distribution on the protein's surface mediates the structural balance between stability for thermal adaptation and flexibility for counteracting the salt-induced rigid and nonfunctional hydrophobic packing. Salt bridge interactions via increased negative and positive charges contribute to structural stability. Salt tolerance, conversely, is mediated by a dynamic structure that becomes more fixed and functional with increasing salt concentration. We propose that repulsive forces among excess negative charges, in addition to a high percentage of negatively charged random coils, mediate this structural dynamism. This knowledge enabled us to engineer a halophilic version of Thermococcus kodakarensis DNA polymerase.-Takahashi, M., Takahashi, E., Joudeh, L. I., Marini, M., Das, G., Elshenawy, M. M., Akal, A., Sakashita, K., Alam, I., Tehseen, M., Sobhy, M. A., Stingl, U., Merzaban, J. S., Di Fabrizio, E., Hamdan, S. M. Dynamic structure mediates halophilic adaptation of a DNA polymerase from the deep-sea brines of the Red Sea