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Duplex Ultrasonography of the Carotid Arteries, in Sickle Cell Disease Children: The Relation to Disease Types and Hematological Parameters

Gihan Yousef Ali1 MD^1, Essam-Eldin Ahmed Abdelbary MD², Waleed Albu-A1i MD1^3, Eglal Hussein Al-Gohary MD³

1-       Pediatric  department, Sohag College of medicine, Sohag University, Eygpt

2-       Radiology department, Sohag College of medicine, Sohag University, Eygpt.

3-       Pediatric department college of Medicine KFU, KSA.

email: jhakeem11@yahoo.com

Abstract: Background: The role of trans-cranial Doppler to detect asymptomatic children who are at increased risk to develop stroke is considered as an evolution in the sickle cell disease (SCD)-related brain injury managment. This work aims to detect the role of trans-cranial and extra-cranial Doppler of carotid arteries in children with SCD and its relation to hematological parameters. Patients & Method: This prospective observational study carried out in the polyclinic health center of King Feisal University, Al-Ahasa, KSA, in a period from 2011 to 2013. It included 72 patients known to have SCD. Their mean age was (8±3.7yrs). They were (32) males (40) females. Velocities in the carotid arteries measured by both intracranial & extra-cranial duplex ultrasonography. Results: High time Average Maximum Mean Velocity (TAMMV) (>190m/s) was detected in 5.4%.Where 62.3% had average flow (<90m/s) and 26.3% had blood flow between 90-190 cm/s. There was significant correlation between the TAMMV, Peak Systolic Velocity (PSV) and Peak Diastolic Velocity (PDV) in both right and left carotid arteries in intracranial and extra-cranial Duplex. Blood flow velocities between intracranial Middle cerebral artery (MCA) and extra cranial proximal internal Carotid artery (pICA) showed significant positive correlation between their TAMMV(r: 0.938 & P< 0.001). It also positively correlated with PSV and PDV. TAMMV was positively correlated with WBCs count, Platelets and Reticulocyte %. Blood flow velocities were more in patients with SCD than those with SCD-thalassemia. Conclusion: Duplex Ultrasonography detected a considerable percentage of children who were at increased blood flow velocities. Extracrainal Duplex of proximal internal carotid artery considered as sensitive and easy method to detect these children.

[Gihan Yousef Ali1, Essam-Eldin Ahmed Abdelbary, Waleed Albu-A1i, Eglal Hussein Al-Gohary. Duplex Ultrasonography of the Carotid Arteries, in Sickle Cell Disease Children: The Relation to Disease Types and Hematological Parameters. J Am Sci 2014;10(8):1-7]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 1. doi:10.7537/marsjas100814.01

Key Words: Duplex ultrasonography, Carotid arteries, Sickle cell disease, Children.

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Hematological characteristics in Sudanese adult with sickle cell disease in Khartoum state

Mahmoud M. Elgari¹, Huda Adwa Ahmed², Mohammed Siddig Younis³, Hisham Ali Waggiallah³

¹ Department of Medical Laboratory Technology, College of Medical Applied Science Taibah University, Almadina Almonawwarah, Saudi Arabia

² Department of Hematology, College of Medical laboratory Science- Sudan University of Science and Technology - Khartoum-Sudan.

³ Department of Medical Laboratory Technology, College of Medical Applied Science Taibah University, Almadina Almonawwarah, Saudi Arabia

Hishamwagg30@hotmail.com

Abstract: Sickle cell anemia (SCA) is a major cause of morbidity and mortality and affect hematological profile, a case control study conducted at national health laboratory in Khartoum state in period between 14 December 2011 to 20 November 2012, 80 patients with Sickle cell anemia (SCA) were enrolled, blood samples were collected in EDTA containers from each individual, Automated Cell Counter; Sysmex 21 was used to determine complete blood counts including blood cell indices, hemoglobin electrophoresis apparatus was used to estimate sickle cell genotypes using cellulose acetate alkaline electrophoresis technique. The frequency distribution of sickle cell phenotypes of study group on basis of hemoglobin electrophoresis were SS 29(36.2%), AS 49(61.2%), SC 1(1.3%), SF 1(1.3%). The mean hemoglobin concentration, mean packed cell volume, mean cell volume (MCV), mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC) were 9.2 ± 3.2 gm/dl, 30.2 ± 9.2%, 76.6 ± 7.9/fl, 23.2 ± 3.0/pg, 30.1 ± 2.3gm/dl. Significant lower hemoglobin (p value <0.05), The mean TWBC, RBC and platelet counts were 11.1 x 109/L ± 8.6, 3.9 x 1012/L ± 1.3, 450 x 109/L ± 15.8, significant higher TWBC and lower RBC counts of p value <0.05 for both. the findings indicates for moderate to severe anemia.

[Elgari M M, Ahmed H A, Younis M S, Waggiallah H A. Hematological Characteristics in Sudanese adult with sickle cell disease in Khartoum state. J Am Sci 2014;10(8):8-11]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 2. doi:10.7537/marsjas100814.02

Keywords: Hematological characteristics, Sickle cell, anemia.

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Evaluation of Ultra-low Drip Irrigation and Relationship between Moisture and Salts in Soil and Peach (pruns perssica) Yield

Omima M. El-sayed¹ and Mohamed E. El-Hagarey²

¹ Plant production Dept., Desert Research Center, DRC, Egypt

²Soil Conservation and Water Resources Dept., Desert Research Center, Egypt

elhagarey@gmail.com

Abstract: Research study was carried out for two successive seasons 2012 and 2013 on seven years old Florida prince peach trees (Purnus perseca L.) budded on Nemagard rootstock. The experiment was conducted at the experimental farm, Modern reclamation lands, Situated at Bader City, South Al-Tahrir, Al-Beharia Governorate, Egypt. Peach trees (seven years) were planted at 5 x 4 m² in sandy soil, this investigation aimed to study the effect of irrigation using four techniques of drip irrigation systems: Gr surface drip (SD) 4 l/h., Gr subsurface drip (SSD), surface ultra-low drip (SUD) 1.0 l/h, and subsurface ultra-low drip (SSUD) under three amounts of applied water (60, 80, 100% of calculated applied water called T₁, T₂ and T₃) on yield, fruit quality and some leaf parameters peach trees. The obtained results indicated that, the amount of applied water for T₂ under SUD irrigation system gave the best effect on tree yield and fruit quality, except fruit volume, fruit length, T.S.S. and total acidity % where the highest significant values where obtained with T₂ under SD irrigation systems. On the other hand, yield, fruit weight and T.S.S. recorded the highest significant values with T₃ under SSUD. Moreover, the same treatment increased leaf area and total chlorophyll contents, as well as mineral content (N, P and K) in both seasons. In the first season, the recommended water treatment and system that gave the highest yield is (T₂ and T₃) under (SUD) irrigation systems, so the irrigation water saving for SUD irrigation systems and water treatment T2 was 20%, while at the second season, the interaction between the two studied factors, proved that (T₃) with the (SSD) and (T₂ and T₃) with (SSUD) had the highest significant values. So the best irrigation water save was 20% for T2 under all of SUD and SSUD irrigation system, on the other hand, T₁ under SUD irrigation system in both of first and second years saved irrigation water by 40%. The greatest value of soil moisture content was concentrated at the depths of 40-60 and 60-80 cm specially, at 10 and 18 hours after irrigation finish process, and this increasing the deep-percolation (effective root zone for peach was 60 cm) and so water loss increased and irrigation system efficiency was reduced. Distribution of SSUD moisture contents was more ideal than SD in X, Y, and Z directions. Soil moisture content of SSUD is higher than SUD irrigation systems due to the water loss by evaporation at subsurface drip irrigation that was less than the SUD irrigation system. The higher salt concentration distribution at the upper soil layer 0- 40 cm was under SUD and SSUD irrigation while under SD and SSD irrigation systems the higher salt concentration was distributed at the lower soil layer 40- 80 cm. The (SUD) had highest significant value. Concerning irrigation treatments, (T₂ and T₃) gave the highest insignificant value. The interaction between the two studied factors revealed that treatment of (T₂ and T₃) with (SUD) irrigation system had the highest significant value in the first season. In the second season, concerning irrigation systems, insignificant of yield, regarding amounts of water applied, (T₃) gave the highest yield. The interaction between the two studied factors, proved that (T₃) with the (SSD) and (T₂ and T₃) with (SSUD) had the highest significant values.

[Omima M. El-sayed and Mohamed E. El-Hagarey. Evaluation of Ultra-low Drip Irrigation and Relationship between Moisture and Salts in Soil and Peach (pruns perssica) Yield. J Am Sci 2014;10(8):12-28]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 3. doi:10.7537/marsjas100814.03

Keywords: Ultra low flow, drip irrigation, moisture distribution, salts, water-save, peach trees, water use efficiency, fruit quality, yield.

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Experiences of Jordanian Mothers and Fathers of Children with Cancer

Ahmad Saifan¹, Rami Masa’Deh¹, Carol Hall², Jacqueline Collier³

¹ Applied Science Private University/School of Nursing, Amman/Jordan

² University of Nottingham/School of Nursing, Midwifery & Physiotherapy, Nottingham/UK

³ University of East Anglia/School of Allied Health Professions, Norwich, UK

r_masadeh@asu.edu.jo

Abstract: Previous studies investigating psychological stress of parents of a child with cancer have shown inconsistent findings about parental perceived stress whose children have cancer and most of these studies were established in Western communities (with none in the Arab world). Additionally, the majority of published research focused on mothers. Therefore, the aim of this study is to explore perceived stress in mothers and fathers (couples) parenting a child with cancer in Jordan. Such an exploration may contribute to the existing literature and improve overall family survivorship experiences following childhood cancer in Jordan. This qualitative study used semi-structured interviews of 12 mothers and 12 fathers parenting a child with cancer in Jordan. Parents of children of various cancer diagnoses were interviewed and the ages of children were between six months and 14 years. Most mothers admitted that being with the ill child most of the time and therefore away from other healthy children, relatives and friends was the main cause of stress. However, most fathers said that employment status and financial burden were their main causes of stress after their child’s health status. Most of the interviewed couples commented that they were sharing the life situation with their partners, helping and supporting each other to overcome the challenges. Results of this study highlight the importance of recognizing the psychological needs of Jordanian mothers and fathers of a child with cancer not only at the time of diagnosis but also during the cancer journey.

[Ahmad Saifan, Rami Masa’Deh, Carol Hall, Jacqueline Collier. Experiences of Jordanian Mothers and Fathers of Children with Cancer. J Am Sci 2014;10(8):29-39]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 4. doi:10.7537/marsjas100814.04

Keywords: mother; father; parent; child; cancer; stress.

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The Impact of hemodialysis and continuous peritoneal dialysis on lipoprotein(a) concentration and Apolipoprotein(a) Phenotypes in Patients with End Stage Renal Disease

Ahmed Mohammed Ahmed¹, Bader Eldien H. Elabid², Abdelrahman Abdelwahab Rhmtallah³, Hussein Yousif Eledum⁴, Akram H. Awadalla⁵, Hisham Ali Waggiallah¹

¹Department of Medical Laboratories technology - College of Applied Medical Sciences - Taibah University - Almadinah Almunawarah - Kingdom of Saudi Arabia.

E-mail: ahmedlab1@hotmail.com

²Clinical chemistry department (clinical pathology) - College of Medical Laboratory Science - University of Science and Technology – Khartoum – Sudan.

³Saudi Red Crescent – Almadinah Almunawarah branch – Kingdom of Saudi Arabia.

⁴Department of Mathematics (Biostatistics) – College of Science – Taibah University – Almadinah Almunawarah – Kingdom of Saudi Arabia.

⁵Kordofan University - Faculty of Medicine & Health Sciences - College of Medical Laboratory – El-Obeid - Sudan.

Abstract: Back ground: Elevated the concentration of lipoprotein(a) [lp(a)] and apolipoprotein(a) [apo(a)] phenotypes are an independent risk factor for coronary heart disease (CHD). Aim: investigation of lp(a) levels and apo(a) phenotypes in relation to coronary heart disease (CHD) and the effect of dialysis on serum lipoprotein(a) concentration according to apo(a) phenotype in patients with end-stage renal disease (ESRD). Patients and methods: This is a case control study among patients attending hospitals and medical dialysis centers in Khartoum capital of the Sudan in March 2011. There were 60 normal healthy subjects (controls), 34 hemodialysis (HD) patients and 29 continuous peritoneal dialysis (CPD) patients. Lipid profiles, Lp(a), and apo(a) phenotypes were determined. Results: The frequencies of the subjects with apo(a) phenotypes of high molecular weight (HMW) only, including S4, or S5 or null type were 96.3% of control, 98.2% of HD patients, and 93% of CPD patients. The frequent apo(a) phenotypes in patients consisted of S4, S4S5, S5, and S5S5 isoforms. There were significant different when compared mean levels of Lp(a) concentration between HD and CPD patients and controls [36±8.0 mg/dL; 38±9.0 mg/dL and 18±2.0 mg/dL respectively P<0.05]. The levels of total cholesterol and LDL cholesterol and ApoB levels were higher in CPD patients compared to HD patients. The levels of serum albumin was significantly higher in controls than in HD and CPD patients [4.4±0.3g/L; 4.0±0.4g/L 3.2±0.7g/dL respectively, P<0.05]. Conclusion: In (ESRD) patients the levels Lp(a) was increased mainly in CPD patients compared to HD patients and control subjects for common apo(a) phenotypes, which may contribute to the frequent cardiovascular.

[Ahmed Mohammed Ahmed, Bader Eldien H. Elabid, Abdelrahman Abdelwahab Rhmtallah, Hussein Yousif Eledum, Akram H. Awadalla Hisham Ali Waggiallah. The Impact of hemodialysis and continuous peritoneal dialysis on lipoprotein(a) concentration and Apolipoprotein(a) Phenotypes in Patients with End Stage Renal Disease. J Am Sci 2014;10(8):40-45]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 5. doi:10.7537/marsjas100814.05

Keywords: Hemodialysis (HD), continuous peritoneal dialysis (CPD), apo(a) high molecular weight (HMW) phenotypes.

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Improving Time Performance in Construction Projects: Perspective of Contractor

Aftab Hameed Memon, Nadzirah Roslan, Noor Yasmin Zainun

Faculty of Civil and Environmental Engineering, University Tun Hussein Onn Malaysia

aftabm78@hotmail.com

Abstract: Malaysian construction sector has not escaped from the problem of time overrun. Huge numbers of construction projects are experiencing this important issue of overrun in time nationwide. This might be because of poor project management. Thus; it is very important to develop a proper time management system. Further, due to the uniqueness of construction projects, it is also imperative to propose various possible improvement methods which can be applied in various projects according to prevail conditions. Hence, this study aims to study several methods to help the construction players in reducing time overrun problem. For this, a total of 89 gathered samples collected through survey in Peninsular Malaysia were analyzed using statistical software SPSS v21.0 with the Kendall’s concordance test. The findings of this study revealed that top improving method for controlling time are proper planning of work, committed leadership and management, close monitoring, send clear and complete message to the worker to ensure effective communication, and hire skilled workers to achieve good progress. Overall, this study has suggested 13 improvement methods for reducing the occurrence of time overrun in Malaysian construction industry. These finding will assist practitioner to prepare the effective strategies for achieving successful completion of the projects.

[Memon AH, Roslan N, Zainun NY. Improving Time Performance in Construction Projects: Perspective of Contractor. J Am Sci 2014;10(8):46-50]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 6. doi:10.7537/marsjas100814.06

Keywords: Time performance; construction; contractors; improvement method.

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Doppler Ultrasound Study of Fetal Middle Cerebral Artery and Renal Artery in Cases with Idiopathic Hydraminos

Refaat Ibrahim El-Shimy M.D.,Samia Mohamad Eid, M.D., Khattab Abd-Elhalim Omar Khattab, M.D., Shoroq Mohamed El Beshbeshy, Msc.

Department of Obstetrics & Gynecology, Al-Azhar University, Damietta, Egypt

eidsamia@yahoo.com

Abstract: Background: Adverse perinatal outcomes in patients with polyhydramnios have been associated with congenital fetal anomalies in numerous studies. Perinatal morbidity and mortality rates also significantly increase. The etiologic factors of polyhydramnios are varied and may include maternal and fetal conditions such as congenital anomalies, diabetes mellitus, isoimmunization, multiple gestations, and placental. But the cause of polyhydramnios remains idiopathic in most cases (60%). Ratios of the fetal Doppler parameters provide the clearest evidence of deterioration in the fetal condition, there is a controversy regarding the value of middle cerebral artery Doppler ultrasound as a single parameter in assessing the fetal wellbeing. However a combination of multiple fetal vessels Doppler study as umbilical, aorta, renal and middle cerebral artery may be more accurate. Methods: Group1 (Control): This group consisted of 50 pregnant women with no polyhydramnios. Group 2 (study): This group consisted of 50 pregnant women complicated by idiopathic polyhydramnios (amniotic fluid index ≥ 24cm). We were do Doppler US study of fetal vessels including umbilical, descending thoracic aorta, renal artery (RA) and MCA. Peak systolic volume of the MCA and renal artery and RA/MCA pulsatile index were done. Results: There was significant increase in the mean PI of both umbilical artery and fetal descending aorta (0.76-0.98) and (1.55-2.34) respectively in the cases of polyhydraminos if compared with the controls. The mean PSV of both the UA and fetal descending aorta was reduced below accepted reference values for gestation (40.13--68.47) and (69.03—144.2) respectively in the cases of poly-hydraminos denoting brain sparing in case of hypoxia when compared with the controls. Conclusions: Middle cerebral artery pulatility index Doppler velocimetry is considered more valid for prediction of the fetal outcome compared with the renal artery. Middle cerebral artery has the highest negative predictive value (87.9%) than the renal artery (80%). Therefore middle cerebral artery Doppler indices may be useful in identifying those fetuses not likely to have a major perinatal outcome. Our preliminary results suggest that RA/MCA ratio may be a predictor of fetal outcome.

[Samia Mohamad Eid, Refaat Ibrahim El-Shimy, Khattab Abd-Elhalim Omar Khattab, Shoroq Mohamed El Beshbeshy. Doppler Ultrasound Study of Fetal Middle Cerebral Artery and Renal Artery in Cases with Idiopathic Hydraminos. J Am Sci 2014;10(8):51-58]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 7. doi:10.7537/marsjas100814.07

Key words: Idiopathic Hydraminos; Fetal Doppler Ultrasound; Outcome.

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Effect of dietary fats on the development of insulin resistance in relation to PPARγ activation and leptin concentration in rats

Doaa Nader Al-Jada, Mousa Numan Ahmad

Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan

doaa.jada@yahoo.com

Abstract: Insulin resistance usually precedes the onset of type 2 diabetes. Therefore, studying factors that may influence the development of insulin resistance and their mechanisms of action is of huge importance. The aim of the present study was to investigate the effect of dietary fat type on the development of insulin resistance in relation to PPARγ activation and leptin concentration. Male Sprague–Dawley rats were assigned into maize starch-fed or fructose-fed group. The rats consumed diets containing olive oil, maize oil or sheep tallow for 10 weeks. Serum glucose, insulin and leptin concentrations were then determined. HOMA-IR was calculated as an index of insulin resistance. PPARγ activation was assessed using a PPRE-based ELISA system. Sheep tallow produced the highest HOMA-IR in the maize starch-fed group. In the fructose-fed group, rats consuming olive oil were the only rats to show significantly higher HOMA-IR and insulin concentration compared to the maize starch-fed group. Neither PPARγ activation nor leptin concentration was affected by dietary fat type. In conclusion, dietary fat type, in the maize starch-fed group, altered insulin resistance by mechanisms independent of affecting PPARγ activation or leptin concentration with sheep tallow showing a deleterious effect.

[Al-Jada DN, Ahmad MN. Effect of dietary fats on the development of insulin resistance in relation to PPARγ activation and leptin concentration in rats. J Am Sci 2014;10(8):59-66]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 8. doi:10.7537/marsjas100814.08

Keywords: Dietary fats; PPARγ activation; Leptin; HOMA-IR; High-fructose diet; Transcription factors; Adipocytokines; Rats

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Serum fetuin-A “a biomarker of arterial stiffness”; its relation to carotid intima media thickness in chronic kidney disease Patients

Hassan Abdelhady¹, Yassin Salah Yassin¹, Walid Mohammed Fathy², Ahmed Ragheb Tawfik¹ and Amira I. S. Ahmed¹

¹Department of Internal Medicine Faculty of Medicine - Menufia University- Egypt

²Department of Clinical Pathology Faculty of Medicine - Menufia University- Egypt

kandeel5m@yahoo.com

Abstract: Objective: The aim of this study was to study the association between serum fetuin-A level as a biomarker for arterial stiffness and carotid intima media thickness (CIMT) in chronic kidney disease patients (CKD). Background: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in CKD patients. Serum fetuin-A is a natural calcification inhibitor. Its deficiency leads to vascular calcifications and arterial stiffness. Methods: This study included forty patients with CKD, divided into 2 groups, twenty patients (12 males and 8 females) on hemodialysis therapy (H.D.) and the other twenty patients (11 males and 9 females) on conservative therapy. All the studied patients and 10 healthy control subjects were subjected to the following: through history taking and complete clinical examination, laboratory investigations: Complete Blood Count (CBC), kidney function tests (Urea & Creatinine), estimated creatinine clearance (eCCr), serum calcium & phosphorus levels, serum sodium, potassium levels, fasting blood glucose, 2 hours post prandial blood glucose, lipid profile including total cholesterol and triglycerides, liver function tests (total bilirubin, serum albumin, prothrombin time), serum fetuin-A: measured by ELISA, CIMT measured through ultrasonographic examination of carotid arteries. Results: Serum fetuin-A significantly negatively correlated with CIMT in both H.D. and conservative groups of patients with arterial stiffness, also serum fetuin-A significantly negatively correlated with serum creatinine, blood urea and positively significantly correlated with estimated glomerular filteration rate (eGFR). The mean value of serum fetuin-A is significantly reduced in the H.D. group patients compared to other two groups. The mean value of CIMT is higher in the H.D. group patients compared to other two groups. Conclusion: Serum fetuin-A is significantly reduced in CKD patients (both on conservative and H.D. therapy) with more reduction in H.D patients than in patients on conservative therapy.

[Hassan Abdelhady, Yassin Salah Yassin, Walid Mohammed Fathy, Ahmed Ragheb Tawfik and Amira I. S. Ahmed. Serum fetuin-A “a biomarker of arterial stiffness”; its relation to carotid intima media thickness in chronic kidney disease Patients. J Am Sci 2014;10(8):67-73]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 9. doi:10.7537/marsjas100814.09

Key words: Arterial stiffness, Carotid intima media thickness, Chronic kidney disease, Cardiovascular calcification, Hemodialysis, Serum fetuin-A.

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Effect of gender on some plasma biochemical parameters of sheep from Southern Al Jabal Al Akhdar in Libya

Mabruka Saleh. Sitmo

Department of Physiology and Biochemistry, Faculty of Veterinary Medicine, Omar Al Mukhtar University, Al Baida/ Libya.

mabruka_sitmo@hotmail.com

Abstract: The aim of the present study was to determine some biochemical parameters in plasma of sheep (less than 12 months) from Sulunta province in Al Jabal Al Akhdar district and to investigate the effect of gender on these biochemical parameters. Blood samples were collected from 21 males and 17 females and their plasma biochemical parameters were determined. The results revealed variation in blood urea nitrogen and low density lipoprotein (LDL) concentrations (P≤ 0.05) between females and males, whereas the effect of gender on all other plasma parameters examined; i.e. total bilirubin, triglycerides, cholesterol, plasma proteins (total protein, albumin, globulin) creatinine, alkaline phosphatase (ALP), aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), sodium (Na), potassium (K), chloride (Cl), high density lipoprotein (HDL), and very low density lipoprotein (VLDL) was not statistically significant (P> 0.05).

 [Mabruka Saleh. Sitmo. Effect of gender on some plasma biochemical parameters of sheep from Southern Al Jabal Al Akhdar in Libya. J Am Sci 2014;10(8):74-77]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 10. doi:10.7537/marsjas100814.10

Key words: sheep plasma, biochemical parameters, gender.

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Management of Early Post LASIK Ectasia by using Corneal Collagen Cross-Linking

Abdalla M. Elamin MD.

Ophthalmology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt

Abstract: Purpose: To study the results of corneal collagen cross-linking (CXL) in management of early ectasia after LASIK.Patients and Methods: Twenty-two eyes of 15 patients with postoperative ectasia after LASIK (22 eyes) were included with a mean age of 26±6 years at the time of treatment and a mean follow-up of 12 months (range, 9–15 months).All patients treated with CXL for progressive ectasia after LASIK. Best corrected visual acuity (BCVA), maximum keratometry readings (K_max), minimum radius of curvature (R_min), and corneal topography indices were assessed in this study. Results: Ninety five percent of BCVA postoperatively are equal to preoperatively BCVA or gained 1 or more lines.Mean BCVA before CXL was 0.6 units, which improved to a mean of 0.3 units (P<0.002). Best corrected visual acuity improved 1 line or more in 14 cases and remained unchanged in 7 patients. Mean K_max after CXL of 51.3±4.2 diopters (D) was significantly lower (P<0.003) than mean pre-CXL K_max of 51.9±5.1 D. The R_min after CXL was increased significantly (P = 0.005), whereas the index of surface variance (P = 0.04), the index of vertical asymmetry (P = 0.05), the keratoconus index (P = 0.04), and the central keratoconus index (P = 0.017) were reduced significantly. Conclusions: Corneal ectasia is a serious vision-threatening complication of laser in situ keratomileusis (LASIK). It is associated with progressive corneal steepening, an increase in myopia and astigmatism, and decrease in visual acuity. Ectasia after LASIK can be arrested by CXL with stabilization of BCVA Cross linking should be performed in patients with progressive post LASIK keratectasia as early as possible to prevent a further deterioration.

[Abdalla M. Elamin. Management of Early Post LASIK Ectasia by using Corneal Collagen Cross-Linking. J Am Sci 2014;10(8):78-82]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 11. doi:10.7537/marsjas100814.11

Keyword: Post LASIK ectasia. CXL.

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Bone Mineral Density and Calcium Status in Children with β-Thalassemia

Fathy Khaleel Nawar¹, Gamal A. Alkheshen², Hesham S. Hamoud³ Shereif H. Abdrahman.¹ Mohamed M.

Abd Elmohsen¹ and Magdy F. Ahamad¹

Departments of ¹Pediatrics, ²Clinical Pathology and ³Rheumatology   Faculty of Medicine, Al Azhar University, Cairo, Egypt

drabdelmohsen@hotmail.com

Abstract: Background: Thalasssmia is one of the most common single gene disorders. It is widely distributed in the Mediterranean region .In spite of the improved treatment of the hematologic disorder and its complications, β-thalassemia patients exhibit an unbalance in bone mineral turnover with increased resorptive rates and suppression of osteoblast activity, resulting in diminished bone mineral density (BMD) more evident in the lumbar spine. Objectives: In this work we attempted to delineate calcium status and bone mineral density in a group of transfusion dependent Egyptian β-thalassemic patients of both sexes. Patients and methods: This study was cross sectional study. It included 50 cases diagnosed as ß- thalassemia major. The patients were selected by simple randomization from the pediatric hematology units of Al Azhar University Hospitals, as well as 15 healthy children included as a control group. For each (patients and control) bone mineral density (BMD) had been measured by the Dual Energy X-ray Absorption (DEXA) method for total body and lumber spines. Serum calcium, phosphorous and alkaline phosphatase were measured. Results: Serum Calcium was lower (P<0.001), the alkaline phosphatase was higher (P ˂0.000) when compared to controls. The Mean Total BMD values in patients with thalassemia were significantly reduced in comparison with that of controls (Z- score: -1.5 ± 1.2 and -0.2 ± 0.9) respectively P <0.001.. In patients with thalassemia LBD were significantly reduced in comparison with that of control (Z-score: -2.4 ±1.7and -0.1 ±1) respectively P <0.001; Conclusion: Decreased mineral density is frequent in β-Thalassemic patients. The sequalae of osteoporosis, especially vertebral and long bone fractures, represent a major cause of morbidity in these patients. Bone mineral density should be done annually for follow up and early detection of bone status in patients with thalassemia.

[Fathy Khaleel Nawar, Gamal A. Alkheshen, Hesham S. Hamoud Shereif H. Abdrahman.Mohamed M.  Abd Elmohsen and Magdy F. Ahamad. Bone Mineral Density and Calcium Status in Children with β-Thalassemia. J Am Sci 2014;10(8):83-89]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 12. doi:10.7537/marsjas100814.12

Keywords: β-thalassemia - Bone Mineral Density

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Nosocomial Device Related Infections inside Intensive Care Units and Inhibitory Effect of Reserpine on Ciprofloxacin Resistance among Clinical Isolates of Acinetobacter Baumannii

Hamido M. Hefny¹, Meshal Alhomod¹, Mohammed S. Alhussaini¹, and Mounir M. Salem²

¹Department of Clinical Laboratory Sciences, College of Applied MedicalSciences, Shaqra University, Kingdom of Saudi Arabia.

²Department of Pharmaceutics (MMSB), Kayyali Chair for Pharmaceutical Industries, College of Pharmacy, King Saud University, Kingdom of Saudi Arabia.

malhussaini@su.edu.sa; 00966569506939

Abstract: The goal of this research is to investigate the prevalence of nosocomial device related infections (DRIs) and to study the resistance mechanisms of nosocomial microorganisms to antibiotics, as well as to evaluate the effect of reserpine as efflux pump inhibitor (EPI) among ciprofloxacin resistant A. Baumanniithat was meropenem resistant. Patients are admitted to intensive care units (ICUs) due to some medical problems which require medical intervention using medical devices which contribute to the incidence of nosocomial infection. One hundred and ninety eight infected cases hospitalized in some Kingdom of Saudi Arabia hospitals from November 2011 to January 2013. A total of 255 isolates were recovered from198 different cases from many sources as sputum, endotracheal tube (ETT), central venous catheter (CVC),central venous pressure (CVP), nasogastric tube (NGT), cerebrospinal fluid (CSF), eye, nose, urine, pus, bedsore, blood, surgical drain and surgical wound. Microbiological identification revealed that (31.20%) of isolates were Gram positive and (68.80%) were Gram negative. In this study 141 nosocomially infected cases that were device and undevice related examined for occurrence of device related infections (DRIs), these cases revealed 157 bacterial isolates. The rate of DRI was (47.77%) and the rate of undevice related infection was (52.23%). Susceptibility to ciprofloxacin and meropenem for A. Baumannii isolates was done by Kirby Bauer disc diffusion method. Also minimum inhibitory concentration (MIC) for ciprofloxacin was determined in presence and absence of 25mg/L reserpine by microtitre broth dilution method. Antimicrobial resistance is a serious problem inside ICUs, among the mechanisms of resistance to antimicrobial agents is the efflux pump system. The growing number and rapid increase in antibiotic resistant Acinetobacter isolates to β- lactam antibiotics and carbapenems has prompted us to investigate the resistance mechanisms among A. Baumannii isolates. It was found that 0.00% of meropenem resistant A. Baumannii (MRAB) isolates were carbapenemase producer by Modified Hodge test (MHT), 100% were Metallo β -lactamase (MBL) producers by EDTA disc synergy test (EDST) and 52% were AmpC by β-lactamase AmpC producers. Detection of potential resistance to ciprofloxacin among MRAB isolates was done by efflux pump test using reserpine as EPI, this test revealed that 76% of MRAB isolates had efflux pump which confer complete or partial resistance to ciprofloxacin. This study demonstrated that EDTA disc synergy test seems to be a better method for detection Carbapenemases than MHT as well as AmpC β-lactamase was a contributory factor for carbapenem resistance among isolates of MRAB, also reserpine was inhibitor for efflux pump which was responsible for ciprofloxacin resistance. Presence reserpine with ciprofloxacin decrease the MIC four folds and one fold in 56% and 20% of MRAB isolate respectively, on the other hand the MIC of (24%) of MRAB isolates were not affected by the presence of reserpine.

[Hamido M. Hefny, Meshal Alhomod, Mohammed S. Alhussaini and Mounir M. Salem. Nosocomial Device Related Infections inside Intensive Care Units and Inhibitory Effect of Reserpine on Ciprofloxacin Resistance among Clinical Isolates of Acinetobacter Baumannii. J Am Sci 2014;10(8):90-99]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 13. doi:10.7537/marsjas100814.13

Key words: Nosocomial infections, Intensive care units, Reserpine, A. Baumannii

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Withdraw

doi:10.7537/marsjas100814.14

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NDVI Threshold Classification for Detecting Vegetation Cover in Damietta Governorate, Egypt

M. I. El-Gammal¹, R. R. Ali² and R. M. Abou Samra¹

¹Environmental Science Department, Faculty of Science, Damietta University, Egypt

² Soils and Water Use Department, National Research Centre, Cairo, Egypt

rasha.mohamed67@yahoo.com

Abstract: The aim of this study is to detect vegetation cover change at Damietta governorate by using remote sensing technique. To fulfill this objective, three Landsat images (path 176, row 038) acquired in 1987 (TM), 2004 (ETM+) and 2013 (Landsat-8) were used to map the land cover and monitor NDVI over the investigated area. The threshold NDVI classification analysis revealed three vegetation cover groups including no plant cover, weak plants and healthy plants, which were designated in an increasing order of vegetation vigor. Vegetation cover revealed significant spatial and temporal changes. There was a general decrease in vegetation cover indicating a trend of degradation of the ecosystem. The spatial pattern in the classified images showed that the "healthy plants" had decreased in the 1987-2013 period, by 19.1% and by 10.1% in the 2004- 2013 period.

[M. I. El-Gammal, R. R. Ali and R. M. Abou Samra. NDVI Threshold Classification for Detecting Vegetation Cover in Damietta Governorate, Egypt. J Am Sci 2014;10(8):108-113]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 15. doi:10.7537/marsjas100814.15

Keywords: NDVI, remote sensing, land cover, Damietta Governorate, Egypt

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The Diagnosis, Intervention and Treatment of ADHD. A Critical Review

Mohaned Abed

Program of Educational Graduate Studies, King Abdulaziz University, P.O. Box: 80200, Jeddah 21589, Kingdom of Saudi Arabia

mabed@kau.edu.sa

Abstract: Numerous studies on ADHD and its symptoms in children have been published over a vast number of literature; however, the perception of the condition frequently alters, and thus, it is difficult to determine a universally-accepted, accurate concept for ADHD, which in turn can assist assessment and diagnosis of ADHD. Although disciplines are in agreement that the diagnosis of ADHD can be made utilising the DSM-IV-TR as a sensibly-reliable and valid method of assessing children with ADHD, common practice between the disciplines in the case of identification of ADHD still varies considerably. The clinical guidelines presented by the American Academy of Pediatrics (AAP) and American Academy of Child & Adolescent Psychiatry (AACAP) present a method which allows a health professional to complete the procedure and to also validate a systematic assessment and diagnosis of ADHD utilising the DSM-IV-TR, thus allowing them to directly manage ADHD children. However, this paper tends to believe that the diagnosis of this disorder should be based on valid processes which are supported by empirical investigation evidence.

[Abed M. The Diagnosis, Intervention and Treatment of ADHD. A Critical Review. J Am Sci 2014;10(8):114-129]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 16. doi:10.7537/marsjas100814.16

Keywords: ADHD; Diagnosis; Intervention; Treatment

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Vascular Endothelial Growth Factor in Gingival Tissues of Diabetic and Healthy Periodontal Patients

Ghada Bassiouny ^1, Hajar Alayed ² and Tahani Alsalman ²

¹ Department of Periodontology & Oral Medicine, Collage of Dentistry, Qassim University, KSA& faculty of Dentistry, Alexandria University, Egypt

² undergraduate students, Collage of Dentistry, Qassim University, KSA

dr.ghada.bassiouny@qudent.org

Abstract: Background: Vascular endothelial growth factor (VEGF) played an important role in the development of chronic inflammatory diseases. In diabetes mellitus VEGF plays a major role in diabetic microangiopathy and causes an increased angiogenic response. Recently VEGF has attracted attention as a potential inducer of periodontal disease progression. On that account, the aim of this study was to evaluate VEGF expression in healthy versus diabetic periodontally diseased patients. Subjects and methods: Twenty-Four subjects were participated in this study. They were divided equally into three groups: group I non diabetic, none periodontally affected subjects (controls); group II periodontally affected patients (P); and group III periodontally affected type II diabetic patients (DP). All participants were evaluated clinically and histologically by the use of monoclonal antibodies (anti-VEGF) for immunohistochemical expression of VEGF in gingival tissues. Results: The three studied groups demonstrated a statistically significant difference in respect to the clinical parameters of periodontal disease. Histologically, both experimental groups expressed significantly increased level of VEGF when compared to controls. Moreover, the expression of VEGF was higher in DP group than P group. However, this increase was not significant.  Conclusion: VEGF overexpression in diabetic patients with periodontitis depicts the primary role in promoting the extravasation of inflammatory cells, suggesting a useful antiangiogenic therapy for management of chronic periodontitis.

 [Ghada Bassiouny ^, Hajar Alayed  and Tahani Alsalman. Vascular Endothelial Growth Factor in Gingival Tissues of Diabetic and Healthy Periodontal Patients. J Am Sci 2014;10(8):130-135]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 17. doi:10.7537/marsjas100814.17

Key words: Chronic periodontitis; diabetes mellitus; immunohistochemistry; vascular endothelial growth factor.

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Role of Doppler Ultrasound and Peripheral Angiography (as a Diagnostic Modality of Atherosclerosis) in Combination with Conventional Atherosclerosis Risk Factors in Coronary Artery Disease Prediction

Hussein Montaser Roshdy and Yaser G. Abish

Department of Diagnostic Radiology, Al-Azhar Faculty of Medicine (Boys, Cairo)

Husseinmontaser@yahoo.com

Abstract: Introduction: Atherosclerosis is a generalized disease; the presence of the disease at one site increases the frequency of symptomatic and asymptomatic disease at another. The conventional risk factors of smoking, hypertension, hyperlipidemia, insulin resistance and diabetes, physical activity, and obesity are correlated to systemic vascular disorders. Preclinical markers of atherosclerosis enable identification of individuals in whom the atherosclerotic process is already present. Consequently, in recent years, research on atherosclerosis has been mainly focused towards identifying markers of early preclinical atherosclerosis. The most frequently studied are circulating markers and markers of early arterial wall alteration such as arterial wall thickening. Purpose: was to identify the value of Doppler ultrasound and peripheral angiography (as a diagnostic modality of atherosclerosis) in combination with conventional atherosclerosis risk factors in coronary artery disease prediction. Material and methods: The study included one hundred patients with suspected or proven CAD; non invasive parameters such as, arterial duplex, carotid intima-media thickness, ankle-brachial index were done. Invasive investigations such as peripheral angiography (PA) and coronary angiography were done. Result: The study included one hundred patients, the mean age was 57.40 ± 6.32 years (ranged from 35-70 years), seventy five patients were males (75%). Forty seven patients (47%) were diabetic, seventy seven patients (77%) were hypertensive, sixty two patients (62%) were smoker, seventy one patients (71%) were dyslipedemic, forty six patients (46%) had an elevated serum cholesterol, forty four patients (44%) had an elevated serum triglycerides, forty three patients (43%) had an elevated serum LDL, thirty five patients (35%) had positive family history. Conclusion: nonconventional markers for atherosclerosis such as CIMT and/or ankle-brachial index (ABI) may be useful in providing a predictive value for CAD. Combination of more than one measurement (specially the nonconventional markers) were more effective than the use of a single measurement for predicting cardiovascular events.

[Hussein Montaser Roshdy and Yaser G. Abish. Role of Doppler Ultrasound and Peripheral Angiography (as a Diagnostic Modality of Atherosclerosis) in Combination with Conventional Atherosclerosis Risk Factors in Coronary Artery Disease Prediction. J Am Sci 2014;10(8):136-142]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 18. doi:10.7537/marsjas100814.18

Key Words: Carotid intima-media thickness, coronary artery disease, ankle-brachial index, peripheral arterial disease.

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Lexical Based Semantic Orientation of Online Customer Reviews and Blogs

Aurangzeb khan¹, Khairullah khan¹, Shakeel Ahmad², Fazal Masood Kundi², Irum Tareen², Muhammad Zubair Asghar²

¹Institute of Engineering and Computing Sciences, University Of Science and Technology Bannu, Pakistan.

²Institute of Computing and Information Technology, Gomal University D. I. khan, Pakistan.

zubair@gu.edu.pk

Abstract: Rapid increase in internet users along with growing power of online review sites and social media has given birth to sentiment analysis or opinion mining, which aims at determining what other people think and comment. Sentiments or Opinions contain public generated content about products, services, policies and politics. People are usually interested to seek positive and negative opinions containing likes and dislikes, shared by users for features of particular product or service. This paper proposed sentence-level lexical based domain independent sentiment classification method for different types of data such as reviews and blogs. The proposed method is based on general lexicons i.e. WordNet, SentiWordNet and user defined lexical dictionaries for semantic orientation. The relations and glosses of these dictionaries provide solution to the domain portability problem. The method performs better than word and text level corpus based machine learning methods for semantic orientation. The results show the proposed method performs better as it shows precision of 87% and 83% at document and sentence levels respectively for online comments.

[Aurangzeb khan, Khairullah khan, Shakeel Ahmad, Fazal Masood Kundi, Irum Tareen, Muhammad Zubair Asghar. Lexical Based Semantic Orientation of Online Customer Reviews and Blogs. J Am Sci 2014;10(8):143-147]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 19. doi:10.7537/marsjas100814.19

Keywords: sentiment analysis, opinion mining, classification, semantic orientation

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Shunt Capacitance for a Practical 110 kV System

A. H. Almasoud

EE Dept., Faculty of Engineering, King Abdulaziz University, Jeddah, Saudi Arabia, P.O. Box 80204, Jeddah 21589

Email: amasoud@kau.edu.sa

Abstract: It is well known that shunt capacitance is both socially and economically beneficial to power system network. These devices reduce the apparent power (S) which is produced by generators allowing more customers to be served and increasing the income of electrical companies. Shunt compensation units have to be connected to carefully selected substations to result in a high degree of reactive power compensation. This can be done by several methods, such as the Genetic Algorithm (GA), Hybrid of GA or Trial and Error heuristic method. In this paper, we present a comparison of the three algorithms to determine the amount of savings that can be achieved by each algorithm. The system under investigation is a real 110 kV system, operating in the Western Region of Saudi Arabia, and the results reflect experimental data on this system.

[Almasoud A.H. Shunt Capacitance for a Practical 110 kV System. J Am Sci 2014;10(8):148-154]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 20. doi:10.7537/marsjas100814.20

Keywords: shunt capacitance, reactive compensation, 110 kV, substation, saving, Saudi Arabia

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Software Design of Photovoltaic Grid-Connected Power Plants

A. H. Almasoud & Hatim M. Gandayh

Electrical and Computer Engineering Department King Abdulaziz University, Jeddah, Saudi Arabia

Email: amasoud@kau.edu.sa

Abstract: It is aimed to construct software to aid the design of photovoltaic grid-connected (PVGC) power plants at suitable locations in Saudi Arabia with high solar radiation that are not in the area of sand dunes or shifting sands. These power plants should cover 15% of the expected load by 2020 and support conventional power generation during peak loads. PVGC software was built with Microsoft Visual Basic to assist in the design. The results show that adding 11273.25 MW of solar energy in the Saudi Arabia grid would save 3581151 ton of CO₂, 62869 ton of SO₂, and 42375 ton of NO_x emissions. The tariff of PVGC power plants in this design varied between 0.45 and 0.72 Saudi riyal/kWh. Solar radiation is the most significant factor in the design of PVGC plants. Accordingly, Saudi Arabia should be ready to add PVGC to its network by 2020 to support conventional generation and meet increasing power demands.

[A. H. Almasoud & Hatim M. Gandayh. Software Design of Photovoltaic Grid-Connected Power Plants. J Am Sci 2014;10(8):155-162]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 21. doi:10.7537/marsjas100814.21

Keywords: PVGC software, solar energy, conventional generation, solar radiation, Saudi Arabia.

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Cytokine profile in patients with concurrent Schistosoma mansoni infection with Helicobacter pylori associated chronic gastritis

Gouda M. A. ¹; Nassef N. ²; Sharaf S. A. ¹; Saad A.E. ¹; Sahar S. ¹and Zaghla  H.E. ¹

Departments of ¹Medical Parasitology National Liver Institute and ²Faculty of Medicine Menoufiya University, Egypt. ahmedyoussef4880@yahoo.com.

Abstract: The response of the host to parasitic infections represents a complex interaction between non specific inflammatory mechanisms and specific immunologically adaptive events. The type of effector mechanisms involved depends on the type of organism. Schistosoma mansoni infection is characterized by a strong T-helper type 2 (Th2) cell-associated immune response. However, bacterial infection is associated with induction of Th1 immune response. Few data are available about the immune response of cases infected with combined Helicobacter pylori (H. pylori) and schistosomiasis. Thus, the investigation of the cytokine pattern in patients coinfected with both H. pylori and schistosomiasis was our rationale. This study included four patient groups: Group I included 24 patients infected with chronic schistosomiasis alone, Group II included 24patients infected with H. pylori alone, Group III included 24 healthy control individuals with matched age and sex and Group IV patients with chronic H. pylori and schistosomiasis. Serum levels of IFN-gamma, interleukin (IL)-4were measured in all groups by enzyme-linked immunosorbent assay. The results showed that the patients infected with H. pylori had significantly higher serum levels of IFN-gamma compared with the controls and the patients with schistosomiasis and coinfection (P < 0.001). On the other hand, serum levels of IL-4 were significantly higher in patients with schistosomiasis and coinfection compared with the control group and with the H. pylori patients. Schistosomiasis appeared to induce a Th2 cytokine profile, with increase in serum levels of IL-4, even in the presence of H. pylori coinfection. In conclusion, schistosomiasis may down regulate the stimulatory effect of H. pylori on Th1 cytokines.

[Gouda M. A.; Nassef N.; Sharaf S. A.; Saad A.E.; Sahar S. and Zaghla H.E. Cytokine profile in patients with concurrent Schistosoma mansoni infection with Helicobacter pylori associated chronic gastritis. J Am Sci 2014; 10(8):163-168]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 22. doi:10.7537/marsjas100814.22

Key words: cytokines, Schistosomiasis and H. Pylori.

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Role of Parasitic Infections in Patients with Obstructive Jaundice in National Liver Institute (N.L.I)

Menoufiya University

Shafey D. A.; Nassef N.; Sharaf S. A.; Saad A.E.; Selim S. and Saleh S.M.

Departments of Medical Parasitology National Liver Institute and Faculty of Medicine ²Menoufiya University, Egypt.

alrowad_2005@yahoo.com

Abstract: Obstructive jaundice is a surgical problem where there is blockage of the bile duct due to many causes as biliary stones, biliary strictures, cancer head of pancreas and also parasites can cause obstruction either by direct obstruction of the duct by the worms or the parasites act as a nidus for stone formation. The aim of the present study was to evaluate the role of various parasitic infections in patients with obstructive jaundice. This study was conducted on 110 patients with obstructive jaundice chosen from the ERCP unit (Endoscopic Retrograde Cholangio Pancreatography) National Liver Institute. All patients were subjected to clinical examination, urine and stool examination. ERCP to diagnose and treat the causes of obstruction, eosinophilic count, liver functions and viral markers. IHAT was done to diagnose bilharziasis, fascioliasis and hydatidosis. Rectal snip to diagnose S.mansoni. ERCP in the current study revealed five cases of parasites inside the bile duct (two cases of live Fasciola worm, two cases of hydatid sand resulting from rupture hydatid cyst and one case of live Ascaris worm). IHAT (Indirect Haemagglutination Test) revealed 42 positive cases for bilharziasis, 2 positive cases for hydatidosis and 8 positive cases for facioliasis. Stool examination was positive in 5 cases of bilharziasis, 2 cases of fascioliasis and 18 cases of ascariasis. Rectal snip was positive for S. mansoni in 13 cases. Eosinophilia was reported in 57.1% of bilharzial patients, 100% of hydatid patients, 62.5% of fascioliasis patients and in 72.2% of ascariasis patients. Alkaline phosphatase level was > 115 IU/L in 91% of patients, GGT was >85 IU/L in 86% of cases and direct bilirubin was >2 mg/dl in 82% of cases. From the present study it was concluded that many parasites may be a cause of obstruction of the bile duct either by direct obstruction of the duct as in case of biliary parasites or act as a nidus for stone formation.

[Shafey D.A.; Nassef N.; Sharaf S. A.; Saad A.E.; Selim S. and Saleh S.M. Role of Parasitic Infections in Patients with Obstructive Jaundice in National Liver Institute (N.L.I). J Am Sci 2014;10(8):169-173]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 23. doi:10.7537/marsjas100814.23

Key words: obstructive jaundice, ERCP, biliary parasites.

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Management Time and Effort of the Domestic Workers in the Light of Saudi Labor Regulation

S. M. A. Ba-Sabreen

College of Home Economics, King Abdul Aziz University, KSA

 dr.sakeena@live.com

Abstract: A large proportion of domestic workers, especially in developing countries, the administration of ILO agreed in the session 301 (March 2008) to place an item on decent work for domestic workers on the agenda of the International Labor Conference, 99 (2010) with the aim of developing labor standards. Domestic work is one of the oldest and most important occupations for millions of women around the world. The list of the domestic workers and the like issued on 7-9-1434 A. H by the decision of the Council of Ministers No. (310). Research aims to study how to manage the family's time and effort of the housekeeper in the light of the employment regulations, and learn about the social and economic factors in relation to family-style management of domestic worker to help families the investing in their human resources. Also, to educate families about their rights and duties in the light of the employment regulations. Distribution (30) an electronic questionnaire on household Saudi in Jeddah following an official contract identified with the domestic worker, based on the descriptive analytical. The most important result was that the Saudi families have a high level management time and effort working in light of its commitment to the application of the regulation on labor. As well as. The household in the sample of women with a university degree and with age from 35 to 45 years and unemployed "homemakers" who were the best in the management of working time and effort home. One of the most important recommendations to continue making specialized scientific studies on the effects of the use of household labor on family and children and disseminating the results to decision-makers (Executive-Legislative). So that the results of such studies and research reference to decisions and amend legislation that meet the interests of the younger family.

[S. M. A. Ba-Sabreen. Management Time and Effort of the Domestic Workers in the Light of Saudi Labor Regulation. J Am Sci 2014;10(8):174-182]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 24. doi:10.7537/marsjas100814.24

Keywords: worker; developing country; employment; labor; family

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Role of Tempol on Redox System and Lipid Peroxidation in Gamma Irradiated Rats

E.M.Kamal El-Dein and Abd El Rahman N.A

Rad. Biol. Dept., Nat.Cent. for Rad. Res. and Technol.(NCRRT)

Saeed.soliman@ymail.com

Abstract: The present study was designed to evaluate the potential efficacy of tempol a superoxide dismutase mimetic agent against redox imbalance and cytotoxicity induced by protracted exposure to gamma rays. Tempol was orally administered to Sprague Dawley male albino rats via intragastric intubation (40 mg / Kg body wt /day) for 7 days before exposure to gamma-rays and continued during the whole period of irradiation processing. Whole body γ- rays was delivered at 3 doses of 2 Gy increment every week up to total cumulative dose of (6 Gy) in 3 weeks. The results obtained showed increased level of lipid peroxides contents and xanthine oxidase (XO) activity in irradiated animal groups with concomitant depletion in the level of reduced glutathione (GSH) and activities of superoxide dismutase (SOD), Catalase (CAT) and glutathione peroxidase (GSH-Px). Administration of tempol has significantly lowered the level of lipid peroxidation and enhanced the antioxidant status of irradiated animals. It could be concluded that tempol exerts a protective effect against radiation-induced cytotoxicity by modulating the extent of peroxidation and augmenting antioxidant defence system.

[E.M.Kamal El-Dein – Abd El Rahman N.A. Role of Tempol on Redox System and Lipid Peroxidation in Gamma Irradiated Rats. J Am Sci 2014;10(8):183-190]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 25. doi:10.7537/marsjas100814.25

Key Words: Gamma-rays, Tempol, Lipid peroxidation, redox balance, rats

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Hair and Follicles Characteristics during Summer and Autumn Seasons of Shami Goat Raised in North Sinai

Helal, A. and Hekal, S. A.

Department of wool Production and Technology, Animal and Poultry Production Division, Desert Research Centre, Al-Matareya, Cairo, Egypt

ahelal_drc@yahoo.com

Abstract: This study aims to investigate the difference s of Shami goat fibers and follicles in summer and autumn seasons. Outer coat fibers had average fiber diameter of63.2 µm with medullated fibers represent50.2% of total fibers and medulla occupied about 42.5 % of total fiber diameter. Fibers with diameter below 50 µm represent 31% of total fibers and this percent is too high and allude to the ability Shami hair to be added with wool blend to produce yarns. Inner fibers had 18 µm of average fiber diameter with average length of 0.86 cm at the end of autumn season. Significant differences were found between all follicles measurements between summer and autumn seasons. Similar ratios found between external diameter of both primary and secondary follicles to each other in the same season and the same ratio of each follicle type from autumn to summer reflect the harmony and symmetrical relationship between the primary and secondary follicles. The differences between outer and inner root sheath during studied seasons were also discussed.

[Helal, A. and Hekal, S.A. Hair and Follicles Characteristics during Summer and Autumn Seasons of Shami Goat Raised in North Sinai. J Am Sci 2014;10(8):191-198]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 26. doi:10.7537/marsjas100814.26

Key words: Hair, Follicles Characteristics, Summer and Autumn Seasons, Shami Goat, North Sinai.

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Refractive change after YAG laser anterior capsulotomy in capsular phimosis syndrome

Abd Elmagid M.Tag Eldin

Department of Ophthalmology, Faculty of Medicine Al-Azhar University, Egypt

abdotag@hotmail.com

Abstract: Aim of the Work: To measure the refractive change after YAG laser capsulotomy in cases of capsular phimosis after cataract surgery and IOL implantation. Site of the Study: University hospitals "Alhussein Hospital and Sayed Galal University Hospital" Cairo, Egypt. Design: Prospective randomized masked clinical trial. Methods: 16 eye of 16 pts with capsular phimosis after phacoemulsification and in the bag IOL implantation, the eyes undergone refractive assessment using autorefractometer and the refraction is calculated as a spherical equivalent before, one day and one month after YAG laser capsulotomy. Results: the mean and standard deviation of spherical equivalent of the 16 eyes of 16 patients included in the study before and after the YAG laser intervention. The result was 4.33929±2.97361 before YAG laser capsulotomy and 1.94643±0.86702 one day and 1.875±0.80209 one month after yag laser capsulotomy. There was a significant change of refraction between before and one day after the YAG with p value of 0.00766, and there was no significant change between one day and one month after the YAG with p value of 0.82276 . Conclusion: There is a significant change of the spherical equivalent of post operative refractive error due to capsular phimosis one day after treatment with YAG laser capsulotomy and no further significant change after one month later.

[Abd Elmagid M.Tag Eldin. Refractive change after YAG laser  anterior capsulotomy in capsular phimosis syndrome. J Am Sci 2014;10(8):199-201]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 27. doi:10.7537/marsjas100814.27

Key words: Refractive change, YAG laser anterior capsulotomy, capsular phimosis syndrome.

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Feasibility of Completing Radiofrequency Catheter Ablation of Typical Atrioventricular Nodal Reentrant Tachycardia Using the Ablation Catheter Only

Hatem Abdlateif Kholieif¹, Tarek Basiouny¹, Mohamed Karim¹, Mansour Mostafa¹ and Mohammed Abdo Ali²

¹ Cardiology department, Al-Azhar University, Cairo, Egypt

² Health insurance Hospital, Cairo, Egypt

Abstract: Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of regular SVT. Typical slow fast form of AVNRT comprises 85% of all AVNRT. The diagnosis of this form of AVNRT requires exclusion of alternative mechanisms; these include atypical form of AVNRT, AV re-entry using a retrograde accessory pathway and atrial tachycardia. Many electrophysiological characteristics can differentiate typical form of AVNRT from these types of tachycardias, this includes an intracardiac VA interval during the tachycardia ≤ 65msec (an interval measured from the surface QRS to A wave of HRA). Diagnosis and ablation of this form of AVNRT requires use of multiple catheters. The aim of this study was to use the previous electrophysiological characteristics to try to demonstrate the ability of ablating typical AVNRT using only the ablation catheter. Patients and methods: Our study comprised patients with documented narrow QRS complexes SVT referred for electrophysiological study and RFA in our institute. Inclusion criteria were: absence of manifested WPW syndrome in surface ECG, atrial flutter or fibrillation and presence of an intracardiac RA interval during the tachycardia ≤ 65msec. Results: 15 patients fulfilled the criteria for typical AVNRT. The slow AVN pathway was successfully ablated in 14 out of 15 patients (93%) without complication. Only one patient required the use of multiple catheter technique. Conclusion: It is possible to diagnose and ablate typical form of AVNRT using the ablation catheter only with high success rate and low risk of complications.

[Hatem Abdlateif Kholieif, Tarek Basiouny, Mohamed Karim, Mansour Mostafa and Mohammed Abdo Ali. Feasibility of Completing Radiofrequency Catheter Ablation of Typical Atrioventricular Nodal Reentrant Tachycardia Using the Ablation Catheter Only. J Am Sci 2014;10(8):202-208]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 28. doi:10.7537/marsjas100814.28

Key words: Radiofrequency catheter ablation, typical atrio-ventricular nodal reentrant tachycardia, single catheter.

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The Effect of Probiotics Supplementation on Fecal Calprotectin as an Early Marker of Neonatal Enteropathy

Mohamed S El Frargy, Azza M. Hassan

Departments of Pediatrics * and Microbiology & Immunology, Faculty of Medicine, Tanta University, Egypt

farargy2009@hotmail.com

Abstract. Objectives. Evaluationof the effect of probiotic supplementation on fecal calprotectin levels which was tested as an early marker of necrotizing enterocolitis (NEC) and sepsis in neonates. Patients and Methods. A prospective, double blind, randomized, controlled clinical trial was conducted in 30 neonates who were examined for fecal calprotectin (FCP) levels. neonates are divided into two groups, the group I consisted of 15 neonates who were given probiotics (Probiotics group) and group II consisted of 15 neonates who were not given probiotics(non-probiotic group), both groups were followed up and observed until reach full feeding for the occurrence of necrotizing enterocolitis (NEC), feeding intolerance and sepsis. Results. FCP levels were higher in neonates of group II (non-probiotics group) than neonates of group I (Probiotics group) after 2 weeks of probiotic supplementation in neonates of group I (190.5+ 86.9 versus 38.4 + 32.2) and significant Correlation between the level of FCP and Enteropathy in group I showing + ve correlation and p-value<0.05 with p-value is (0.029,0.024,0.019) at the onset of research and after 1 wk and after 2 wks respectively and Cutoff point of the FCP on which enteropathy occurred was 482 μg/g. Conclusions. The use of probiotics in neonates could decrease the incidence of NEC and sepsis and FCP could be used as an early predictor of NEC in neonates for early prevention and treatment with better prognosis and outcome

[Mohamed S El Frargy, Azza M. Hassan. The Effect of Probiotics Supplementation on Fecal Calprotectin as an Early Marker of Neonatal Enteropathy. J Am Sci 2014;10(8):209-213]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 29.doi:10.7537/marsjas100814.29

Keyword: probiotics, calprotectin, neonates, enteropathy.

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Atelectasis and alveolar recruitment maneuvers in acute lung injury.

Khaled M Abo El eneen, Ayman A Radi, Ahmed A Abd El Aziz and Wael s Abd elwadood

Department of Anesthesia, Faculty of Medicine, Menofyia University, Egypt.

waelsss@live.com

Abstract: Objective: Review alveolar recruitment maneuvers in acute lung injury. Study selection: Systematic reviews that addressed alveolar recruitment maneuvers in acute lung injury. Data Extraction: Special search was done at midline with key words (recruitment maneuvers) in the title of papers; extraction was made, including assessment of quality and validity of papers that met with the prior criteria that describe review. Data synthesis: The main result of the review. Each study was reviewed independently; obtained data is rebuilt in new language according to the need of the researcher and arranged in topics through the article. Recent Findings: If the future of ARDS treatment lies in improvements in the management of multiorgan failure, then the pharmacological approach to treating lung injury may change. For example, reducing pathological fibrosis may be possible when more is understood about the regulation of collagen turnover in the normal and injured lung. This may enhance the repair of the alveolar epithelial cell barrier, the clearance of intra-alveolar exudate, and the normal turnover and function of surfactant. Conclusions: Assessing the efficacy of RM on oxygenation only is largely insufficient and the complete evaluation, as for any ventilatory strategy in ARDS, must consider the effects on hemodynamics, lung recruitment, over distension, stress and strain, and biotrauma associated with RM are both at the lung level (VILI) and at the systemic level.

[Khaled M Abo El eneen , Ayman A Radi, Ahmed A Abd El Aziz and Wael s Abd elwadood. Atelectasis and alveolar recruitment maneuvers in acute lung injury. J Am Sci 2014;10(8):214-220]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 30.doi:10.7537/marsjas100814.30

Key words: ARDS, alveolar recruitment, respiratory failure.

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Dimensionality Invariant Similarity Measure

Ahmad B. A. Hassanat

IT Department, Mutah University, Mutah – Karak, Jordan, 61710

ahmad.hassanat@gmail.com

Abstract: This paper presents a new similarity measure to be used for general tasks including supervised learning, which is represented by the K-nearest neighbor classifier (KNN). The proposed similarity measure is invariant to large differences in some dimensions in the feature space. The proposed metric is proved mathematically to be a metric. To test its viability for different applications, the KNN used the proposed metric for classifying test examples chosen from a number of real datasets. Compared to some other well known metrics, the experimental results show that the proposed metric is a promising distance measure for the KNN classifier with strong potential for a wide range of applications.

[Hassanat B. A. Dimensionality Invariant Similarity Measure. J Am Sci 2014;10(8):221-226]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 31.doi:10.7537/marsjas100814.31

Keywords: metric, similarity measure, KNN, supervised learning, machine learning.

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Posterior Lumbar Inter-body fusion with pedicle and screw fixation Guided by spinal Neuronavigation for the Treatment of Spondylolithesis. Advantage and disadvantage.

Mahmoud Farid B. A And Omar Abdelhay Eldanasory.

Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

faridneuro@yahoo.com

Abstract: Background: To assess accuracy, time efficiency, safety, and outcome of using the neuronavigation system in posterior lumbar inter-body and pedicle screws fixation. Methods: This is a retrospective study which has been done between May 2009 and may2011. During this period, there were 20 cases with lytic or degenerative Spondylolithesis, which required posterior interbody and pedicle screws fixation. Pedicle screws were placed utilizing the image-guidance system in all 20 patients. The accuracy of screw placement was assessed by intraoperative neurophysiological monitoring, assisted fluoroscopy, postoperative computerized tomography, x rays and clinical follow up after 6 weeks 3, 6, 9 and 12 months. Conclusion: The accuracy of pedicle screws placement using neuronavigation was better than using fluoroscopy with reduction of fixation complications as implant failure, pedicle cortex violation, and neural injury. Navigated minimal invasive cases had faster recovery and shorter hospital stay because of less muscle retraction and less tissue damage.

[Mahmoud Farid B. A.; Omar Abdelhay Eldanasory. Posterior Lumbar Inter-body fusion with pedicle and screw fixation Guided by spinal Neuronavigation for the Treatment of Spondylolithesis. Advantage and disadvantage. J Am Sci 2014;10(8):227-233]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 32.doi:10.7537/marsjas100814.32

Key Words: navigated, posterior lumbar interbody fixation, Radicular pain, Spondylolisthesis.

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Effect of Green Tea Extract on Experimentally Induced Lung Fibrosis in Adult Male Albino Rat

Fatma A. El-Safti, Ahmed S. Zolfakar, Neveen M. El-Sherif and Aliaa S.A. Alafify

Anatomy and Embryology Department, Faculty of Medicine, Menoufiya University

elraya2011@yahoo.com

Abstract: Background: Bleomycin is an antineoplastic agent used in the chemotherapy of different types of cancer. Its toxic effect has been utilized advantageously in experimental models to cause lung injury leading to oxidant induced inflammatory and fibrotic lesions. Objectives: The aim of this study was to determine the effect of green tea extract on the bleomycin induced lung fibrosis in adult male albino rats. Methods: This study was carried out on thirty male adult albino rats. The animals were divided into four groups, control group (I) consisted of ten rats divided into two subgroups five rats for each group. Green tea extract group (II) consisted of five rats. Lung fibrosis induction group (III) by bleomycin was consisted of five rats. Bleomycin and green tea extract group (IV) consisted of ten rats divided into two subgroups five rats for each one, subgroup IVa received green tea extract two weeks before bleomycin induction and was continued with bleomycin injection for four weeks to identify its protective role, subgroup IVb received green tea extract with the start of bleomycin injection for four weeks and continued addition two weeks to identify its therapeutic role. Rats were subjected to histological, immunohistochemical, morphometrical, genetical and statistical analysis. Results: Lung fibrosis showed marked accumulation of inflammatory cells, degeneration of lung alveolia, bronchiole and pulmonary arteriole with wide area of hemorrhage, hemosiderosis, excess collagen deposition. Immunohistochemical study showed, strong positive immunoreaction to inducible nitric oxide synthase and tumor necrosis factor alpha. Lung fibrosis was greatly reversed by addition of green tea extract. Conclusion: Lung fibrosis model greatly improved by addition of green tea extract, more prominent in its protective role. Recommendations: This results open the way to important applications in humans, where it could be recommended that patients receiving bleomycin or human being highly exposure to air pollutions should take green tea extract which is orally safe and inexpensive or at least drink green tea daily in a regular manner as a life style in order to reduce the affection of the lung with inflammation and fibrosis.

[Fatma A. El-Safti, Ahmed S. Zolfakar, Neveen M. El-Sherif and Aliaa S.A. Alafify. Effect of Green Tea Extract on Experimentally Induced Lung Fibrosis in Adult Male Albino Rat. J Am Sci 2014;10(8):234-247]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 33.doi:10.7537/marsjas100814.33

Keywords: Department of anatomy and embryology, bleomycin, green tea extract, fibrosis, lung.

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Anterior Chamber Fluctuation and Its Effect on Macular Thickness in Uncomplicated Phacoemulsification

Mohamed khedr

Ophthalmology department, Faculty of Medicine- Al -Azhar University, Cairo, Egypt

Abstract: Purpose: To study the effect of intraoperative abnormal anterior chamber fluctuation on central macular thickness in uncomplicated phacoemulsification. Methods: Twenty eight eyes for 28 patients were included, who underwent  phacoemulsification, cases with abnormal intraoperative anterior chamber fluctuation were selected, central macular thickness using optical coherence tomography was estimated preoperative and one week postoperative. Results: there were statistically non-significant difference in central macular thickness between preoperative and postoperative OCT measures where P=0.295 .Only four eyes develop subclinical increase in macular thickness that represent 14.1% .There is high significant improvement of visual acuity postoperative where P=1.58 Conclusion: Abnormal anterior chamber fluctuation in uncomplicated phacoemulsification has no effect on central macular thickness early postoperative.

[Mohamed khedr. Anterior Chamber Fluctuation and Its Effect on Macular Thickness in Uncomplicated Phacoemulsification. J Am Sci 2014;10(8):248-251]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 34.doi:10.7537/marsjas100814.34

Keywords: Anterior; Chamber; Fluctuation; Macular; Thickness; Phacoemulsification

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Diagnostic Performance of High definition 64-slice MDCTA in Post Operative Cardiothoracic Complications in Patients after Open Heart Surgery

Ibrahim Mostafa Helmy, Mohammed Mostafa Sayed Mostafa ¹ and Osama E. Arafa²

Ministry of Health Hospital and Faculty of Medicine, Al-Azhar University, Radiodiagnosis Departments (Egypt)¹ and Ministry of Health Hospital, State of Kuwait Cardiothoracic Surgery Department ²

dr_mohamed_mos@yahoo.com

Abstract: Purpose: To evaluate diagnostic value of HD 64-slice MDCTA in various post-operative cardiothoracic complications in patients after open heart surgery. Material and methods: This study included 40 patients with post-operative cardiothoracic complications after open heart surgery (35 males and 5 females) with their ages ranged between 39-60 years (50 years mean age). Post operative symptoms form first to 60 days. All cases underwent HD 64-slice MDCTA. Invasive coronary angio (ICA) was performed only for post CABGS. Results: The findings were nine patients (22.5 %) show total occlusion of CABGs at proximal anastomosis, two patients (5%) show total occlusion of CABGs at distal anastomosis, one patient (2.5%) cannot evaluated due to clip-artifacts and one patient (2.5%) native vessel cannot evaluated due to advanced atherosclerosis. Three patients (7.5%) show localized pericardial hematoma, two patients (5%) show pulmonary embolism, five patients (12.5 %) show pericardial effusion, seven patients (17.5 %) show pleural effusion, three patients (7.5%) show chest wall infection, four patients (10%) show pneumonia, one patient (2.5%) shows pseudoaneurism of left ventricle, one patient (2.5%) shows postoperative myocardial infarction and one patient (2.5%) shows aneurysm at the re-implanted coronary artery after Bentall procedure. Conclusion: HD 64-slice MDCTA is non-invasive technique which shows to be effective in diagnosis most of the post operative cardiothoracic complications and gaining more grants in difficult clinical situations.

[Ibrahim Mostafa Helmy, Mohammed Mostafa Sayed Mostafa and Osama E. Arafa. Diagnostic Performance of High definition 64-slice MDCTA in Post Operative Cardiothoracic Complications in Patients after Open Heart Surgery. J Am Sci 2014;10(8):252-261]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 35.doi:10.7537/marsjas100814.35

Key Words: HD 64-slice (High definition) and MDCTA (Multidetector computed tomography angiography). Coronary artery bypass grafts (CABGs).

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Perioperative glycemic control

Ayman A Radi MD*, Nagwa M Doha MD*, Wafiya R Mahdy and Mohamed Hamdin Mandor M.B.B.Ch**

* Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Menofyia University.

**Nasr city insurance hospital Cairo.

drmohammadhamdinmandor@yahoo.com

Abstract: Objective: Review perioperative glycemic control. Data Sources: medical text books, medical journals, medical websites which have updated researches with key words (glycemic control) in the title of the paper.  Study selection: Systematic reviews that addressed perioperative glycemic control. Data Extraction: Special search was done at midline with key words (glycemic control) in the title of papers; extraction was made, including assessment of quality and validity of papers that met with the prior criteria that describe review. Data synthesis: The main result of the review. Each study was reviewed independently; obtained data is rebuilt in new language according to the need of the researcher and arranged in topics through the article. Recent Findings: Compared to hyperglycemia due to diabetes, stress induced hyperglycemia is a particular challenge in inpatient care, as its prevalence and natural history are not well defined and its occurrence is unpredictable and often unanticipated by providers. Higher mortality was noted in patients without diabetes requiring insulin compared to patients with known diabetes suggesting that stress hyperglycemia may represent a different pathophysiology and natural history than in patients with known diabetes. Optimization of the patient’s preoperative medications and the use of insulin infusions, as well as surgical and anesthetic technique, are important factors for achieving desirable perioperative blood glucose control. Minimizing blood glucose variability during surgery should be part of the glycemic control strategy. Advances in real-time glucose monitoring may benefit hospitalized diabetic and nondiabetic patients.  Conclusions: Balancing the risks of hypoglycemia against the known benefits in morbidity and mortality is the goal, and, although intensive glycemic control continues to be standard of care, current consensus guidelines recommend less stringent glycemic goals, typically between 80-150 mg/dL.

[Ayman A Radi, Nagwa M Doha, Wafiya R Mahdy and Mohamed Hamdin Mandor. Perioperative glycemic control. J Am Sci 2014;10(8):262-266]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 36.doi:10.7537/marsjas100814.36

Key words: DM, perioperative hyperglycemia, glycemic control.

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