Median sternotomy in penetrating cardiac trauma , does it make a difference ?

Background: Studies comparing the outcomes of left lateral thoracotomy and median sternotomy in the management of penetrating cardiac trauma in the Egyptian setting are lacking, which motivated us to conduct the current study. This study aimed to compare the perioperative and short-term outcomes between median sternotomy and left anterior thoracotomy in the management of patients with penetrating cardiac injuries. Methods: A total of 40 patients with penetrating cardiac trauma were included: 34 were males (85%), and 6 were females (15%). The mean age was 35.00 ± 10.83 years. Patients were allocated into two groups: Group A (n= 20) was managed with median sternotomy, and Group B (n= 20) was managed with left lateral thoracotomy. The study outcomes included operative time, intraoperative blood loss, postoperative pain score, duration of mechanical ventilation, length of ICU stay, postoperative complications and mortality. Results: The right ventricle was the most common injury site (60% vs. 50%, p= 0.619 in Groups A and B, respectively). Left lateral thoracotomy was associated with longer operation times [3750 (1500 – 6000) vs. 185 (70 - 260) mins, p= 0.002]. Left lateral thoracotomy patients had longer ICU stays [5 (2 – 7) vs. 3 (2 – 5) days, p= 0.004] and hospital stays [7 (4 – 12) vs. 5 (4 – 7) days, p= 0.001]. There were no differences in wound infection, pericardial effusion, or mortality between the groups. The pain score was lower in the median sternotomy group postoperatively from day 2 to day 7. Conclusion: Median sternotomy was associated with a significant decrease in operation time, blood loss, pain score, duration of ICU stay, and hospitalization period. The median sternotomy approach could be preferred over the thoracotomy approach in patients with penetrating cardiac injury

Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients

Between 2002 and 2007, fifty elderly patients with displaced femoral neck fractures were treated with hip replacement at Emergency Hospital, Mansoura University. Patients were randomly selected, 25 patients had either cemented or cementless bipolar prosthesis, and another 25 patients had either cemented or cementless fixed-head prosthesis. There were 34 women and 16 men with an average age of 63.5 years (range between 55 and 72 years). All patients were followed up both clinically and radiologically for an average 4.4 years (range between 2 and 6 years). At the final follow-up, the average Harris hip score among the bipolar group was 92 points (range between 72 and 97 points), while the fixed-head group was 84 points (range between 65 and 95 points). Radiologically, joint space narrowing more than 2 mm was found in only 8% (2 patients) among the bipolar group, and in 28% (7 patients) of the fixed-head group. Through the follow-up period, total hip replacement was needed in two cases of the bipolar group and seven cases of the fixed-head group. Bipolar hemiarthroplasty offered a better range of movement with less pain and more stability than the fixed-head hemiarthroplasty in elderly patients with displaced femoral neck fractures

Management Of Subtrochanteric Femoral Fractures Using Proximal Femoral Nail

Background: Fractures of the proximal femur are a big challenge in traumatology. Rapid strides in implant and instrumentations in quest of ideal fixation of subtrochanteric femoral fractures have made various options available. Objective: The present study aims to study the role of standard proximal femoral nail (PFN) in the management of these fractures. This study aimed to evaluate the results of treatment of subtrochanteric femoral fractures using PFN. Patients and methods: This prospective study conducted at Orthopedic Department, Zagazig University Hospital, from November 2020 to July 2021. It included 24 patients, complaining of closed subtrochanteric fractures treated with PFN (Gamma intramedullary nail). The age ranged from 23 to 87 years (with mean 54.21 years), 13 of them were males and 11 females. Road traffic accident (RTA) represented the most common mechanism of injury in 10 patients (41.7%) while fall down represented (37.5%) in 9 patients, and fall from height in 5 patients (20.8%). Results: there was statistically significant difference in HHS among patients with different age groups, mechanism of injury and presence of diabetes mellitus (DM) as associated condition. Statistically there was significant correlation between type of reduction and diabetes mellitus with Harris hip score. Conclusion: This study concluded that the Gamma nail is an excellent choice in treatment of subtrochanteric fractures as it has many advantages as allowing for early functional exercise and full weight-bearing of the affected limb, shortening the duration of operation, high rotation stability, small wounds and minimizing blood loss along with risk of infectio

A UV-Spectrophotmetric Chemometric Method for the Simultaneous Determination of Sulfadoxine and Pyrimethamine in Tablets

In the present study, a simple, inexpensive, precise and accurate uv-spectrophotometric method based on chemometrics, has been developed for the simultaneous determination of sulfadoxine and pyrimethamine in tablet formulation. The % recoveries obtained were 99.7% ± 0.9 and 101.5% ± 0.8 for sulfadoxine and pyrimethamine, respectively. The developed method has been compared to USP-HPLC method with regard to accuracy and precision. The calculated F-ratio and the (t) statistics indicate that there is no significant difference at 5% level with regard to precision and accuracy between the proposed and the USP methods. Moreover, the developed method is simple, cost-effective, and less time-consuming. Accordingly, it can be used advantageously in routine quality control of sulfadoxine and pyrimethamine in tablet formulation

Knowledge, Prevention, and Practice of Heat Strokes Among the Public in United Arab Emirates (UAE)

Background: Heat stroke is a predictable and preventable occurrence. Public awareness of the condition and preventative practices are essential in hot and humid regions. This study aims to assess the level of awareness (knowledge, prevention, and management) of heat stroke among United Arab Emirates (UAE) residents. Methods: This is a survey-based study of knowledge and practices of heat stroke in a random sample of adults (?18 years) in four different cities in the UAE. Each correct answer was equal to one point, and total and average scores were calculated, with the average score used as the cutoff point. Multivariate logistic regression was used to identify factors associated with below-average awareness. Results: A total of 402 people participated in the study, with an average age of 33±12 years, and 48.5% were female. Only 1 person achieved a perfect score, and 0.7%, 10%, and 17.7% achieved above-average scores in knowledge, practices, and management, respectively. Seven percent of participants had never heard of a heat stroke. A third of participants (32%) were unaware that severe heat strokes could lead to death. Males are at a higher risk of having a poor level of knowledge (Odds ratio [OR]=1.65; 95% confidence interval [95%CI]=1.10-2.47). The older the population, the poorer the knowledge of heat stroke was (OR=1.39, 95%CI=1.03–1.89). Conclusion: The results of this study show that a huge proportion of the population in the UAE does not have sufficient knowledge about heat stroke, its prevention, and management. Governmental institutes should increase awareness of heat stroke

TIFL Games in the Arab world:How the Baby Olympics is used as a pathway for sport promotion and Olympic education?

In the Middle East and North African (MENA) region, the Arabic term ‘tifl’ is used to refer to both baby and child. The aim of this research study was to understand the motives of the National Olympic Committees (NOCs) of the MENA region to invest, organise and promote the ‘Tifl Games’, also known as ‘Baby Olympics’. The toddlers compete for the ultimate prize in various sport events which try to embody the core Olympic values of excellence, respect and friendship. The situational analysis methodology based on qualitative data after the digital review of the events was utilised for the study. The NOCs of the MENA region were observed through the official websites, social media channels (YouTube, Facebook, Instagram, LinkedIn, and Twitter), news and digital reports. The results show that the opportunity to develop consumer engagement and future talent identification are the main reasons for the organisation of the events. The existence of misconceptions in the MENA region regarding the practise of sports by toddlers was also highlighted in this study. The lack of elite athletes or high-performance sports programmes opened a new door to promote the message of Olympism for the youth generation. The conclusions alert that it is necessary to avoid the precocious training or competition in early age stages. Unconventional training regimes coupled with the inhumane treatment the young athletes are subjected to shed light on the great lengths some countries are willing to go to claim supremacy in the sporting arena. The ‘Tifl Games’ are an excellent opportunity for sport participation, sport promotion and Olympic education in a region with a deficit of sport for development though care should be taken by the NOCs to protect the human rights, adhere to the child protection policy and avoid exploitation of the young athletes

Dentatin isolated from Clausena excavata induces apoptosis in MCF-7 cellsthrough the intrinsic pathway with involvement of NF-kB signalling andG0/G1 cell cycle arrest : a bioassay-guided approach

Ethnopharmacological relevance: Clausena excavata Burm. f. has been used in folk medicines in eastern Thailand for the treatment of cancer. Materials and methods: To investigate the apoptosis mechanism, we isolated dentatin (DTN) from this plant using a bioassay-guided approach. DTN-induced cytotoxicity was observed with the MTT assay. Acridine orange/propidium iodide staining was used to detect cells in early apoptosis and high content screening (HCS) to observe nuclear condensation, cell permeability, mitochondrial membrane potential (MMP) and cytochrome c release. Apoptosis was confirmed with a clonogenic assay, DNA laddering and caspase 3/7 and 9 assays. Reactive oxygen species (ROS) formation, Bcl-2 and Bax expression, and cell cycle arrest were also investigated. The involvement of nuclear factor-kappa B (NF-kB) was analysed with the HCS assay. Results: A significant increase in chromatin condensation in the cell nucleus was observed by fluorescence analysis. Apoptosis was confirmed by the reduced number of colonies in the clonogenic assay and the increased number of cellular DNA breaks in treated cells observed as a DNA ladder. Treatment of MCF-7 cells with DTN encouraged apoptosis with cell death-transducing signals that reduced MMP by down-regulation of Bcl-2 and up-regulation of Bax, triggering cytochrome c release from the mitochondria to the cytosol. The released cytochrome c triggered the activation of caspase 9 followed by the executioner caspase 3/7. DTN treatment significantly arrested MCF-7 cells at the G0/G1 phase (po0.05) and ROS was significantly elevated. Moreover, DTN significantly blocked the induced translocation of NF-kB from cytoplasm to nucleus. Conclusion: Together, the results demonstrated that the DTN isolated from Clausena excavata inhibited the proliferation of MCF-7 cells, leading to cell cycle arrest and programmed cell death, which was confirmed to occur through the mitochondrial pathway with involvement of the NF-kB signalling pathway

Diosgenin alleviates D-galactose-induced oxidative stress in rats’ brain and liver targeting aging and apoptotic marker genes

The theory of aging is primarily concerned with oxidative stress caused by an imbalance in reactive oxygen species generation and cellular antioxidants. To alleviate the oxidative stress, we investigated the protective effect of diosgenin (DSG) for D-galactose (D-gal) using 20 and 40 mg of DSG/kg/day/orally for 42 days. The findings showed that D-gal caused brain and liver oxidative injuries by upregulating aging and oxidative markers. To counteract the oxidative stress caused by D-gal, DSG upregulated glutathione peroxidase-1, superoxide dismutase-1, and glutathione S-transferase-α. DSG also diminished the expression of p53, p21, Bcl-2-associated X protein, caspase-3, and mammalian target of rapamycin in brain and liver, as well as the build-up of β-galactosidase. DSG, in a dose-dependent manner, decreased the oxidative aging effects of D-gal in brain and liver tissues through targeting of aging and apoptotic marker genes. Finally, it should be noted that consuming DSG supplements is a suggesting natural preventative agent that may counteract aging and preserve health through improvement of body antioxidant status and control aging associated inflammation and cellular apoptosis

Pathological, microscopic, and molecular diagnosis of paratuberculosis/John’s disease in naturally infected dromedary camel (Camelus dromedarius)

Background and Aim: Paratuberculosis (PTB) or John’s disease is a chronic disease of ruminants impeding the reproduction and productivity of the livestock sector worldwide. Since there is a lack of pathological studies explaining the nature and development of the disease in camels, this study aimed to highlight the anatomopathological changes of PTB in camels, which may help in verifying and validating some diagnostic tests used to detect the etiology of the disease in camel tissues. Materials and Methods: In August 2017, at Alselaa border’s Veterinary Clinic of Al Dhafra Region, Western Abu Dhabi, UAE, one imported culled she-camel of 2 years old was subjected to clinical, microscopic, and anatomopathological investigations along with real-time quantitative polymerase chain reaction (q-PCR) to confirm the infection and correlate between clinical signs and pathological lesions of the PTB in dromedary camels. Results: Clinically, typical clinical signs compliant with the pathognomonic gross and histologic lesions of PTB were seen in naturally infected dromedary camel. As presumptive diagnosis microscopically, acid-fast coccobacillus bacterium clumps were demonstrated in direct fecal smears as well as in scraped mucosal and crushed mesenteric lymph node films, and in histopathological sections prepared from a necropsied animal and stained by Ziehl-Neelsen stain. Free and intracellular acid-fast clump phagosomes were further confirmed as Mycobacterium avium subsp. paratuberculosis by q-PCR. Conclusion: Clinical signs and pathological lesions of paratuberculosis in a dromedary camel were found to be similar to those of the other susceptible hosts