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Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis

Mona Hosny Abdel Salam¹, Reem Jan Farid², Mostafa Abdelnassier Abdelgawad¹ and Marwa Salim Youssef Ismail³

¹Internal Medicine Department, Faculty of Medicine, Ain Shams University, Egypt.

² Clinical Pathology Department, Faculty of Medicine, Cairo University, Egypt.

³Central Hospital of Bassioun / Gharbea Governorate, Ministry of Health Egypt.

salamhosnymona2015@gmail.com; drmona_abdelsalam@med.asu.edu.eg

Abstract: Vascular access dysfunction in hemodialysis patients has been correlated to low serum vitamin D level in previous studies. Vitamin D deficiency and hepatitis C virus infection have been linked to endothelial cell dysfunction, promoting inflammatory cascade.30 negative - & 30 positive - hepatitis C virus patients on prevalent hemodialysis in Ain Shams University Hospitals, were enrolled in the study. All patients had access blood flow < 800 ml / min. For all patients we performed: complete physical examination, complete blood count, serum ferritin, ESR 1^st and 2^nd hours, CRP, blood urea, serum creatinine, serum albumin, total and direct bilirubin, alanine transferase, aspartate transferase, prothrombin time, International Normalized Ratio, serum calcium and phosphorus, and serum intact parathyroid hormone. Previous laboratory tests were performed using conventional methods within our hospitals laboratories. Serum vitamin Dlevel was measured by Enzyme Linked Immunosorbent Assay. Access blood flow was measured by Duplex Ultrasound. Vitamin D serum level was < 20 ng/ml within negative and positive groups with no significant difference between them. Vascular access flow was significantly lower within positive patients. Parathyroid hormone, Phosphorus, Prothrombin time, International Normalized Ratio, Alanine - and Aspartate - transferase were significantly higher within positive patients. We deduced that Vitamin D level < 20ng /ml was associated with reduced vascular access blood flow < 800 ml / min, with much more reduced access flow within hepatitis C virus positive patients.

[Mona Hosny Abdel Salam, Reem Jan Farid, Mostafa Abdelnassier Abdelgawad and Marwa Salim Youssef Ismail. Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis. J Am Sci 2020;16(1):1-6]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 1. doi:10.7537/marsjas160120.01.

Key Words: Hemodialysis – vitamin D – HCV – Vascular access blood flow

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Lung Ultrasound in Rapid Diagnosis of Acute Respiratory Disorders in Critically Ill Children

Yomna Gaber Elfeky (MSc)¹, Khaled Talaat Abu-Eala (MD)¹, Omar Ahmed Hassanein (MD)² and Ahmed Mohamed Abd Elrazik (MD) ¹

¹ Pediatric Department, Faculty of Medicine, Tanta University, Egypt

² Radiology Department, Faculty of Medicine, Tanta University, Egypt

yomna199@yahoo.com

Abstract: Background: Lung ultrasound (LUS) has moved from its traditional role in diagnosing pleural effusions and masses, to diagnosing pulmonary parenchyma as a real time method used in emergency. The aim of the work was to evaluate the impact of LUS in rapid diagnosis of acute respiratory disorders in critically ill children. Patients and Methods: This prospective cohort study was carried out in pediatric intensive care unit on 120 critically ill children and equally divided into three groups (n=40); group I: suffered from acute respiratory disorders and ventilated, group II: suffered from acute respiratory disorders and not ventilated, group III: suffered from non-respiratory disorder. LUS was performed by a single operator then CXR in all studied cases. Multislice chest computed tomography (CT) was performed on only 80 cases (as the other cases couldn’t be transferred). Results: There was insignificant difference among the three groups in mortality and length of stay. Regarding PRISM III score, there was a significant increase in groups I and III compared to group II. Regarding CPIS score, there was a significant increase in group I compared to group III, otherwise, there were insignificant differences among the three groups. Regarding SOFA score, there was a significant increase in group I compared to the groups II and III in the 1^st, 2^nd, 3^rd and 4^th day and in group III compared to group II in the 2^nd, 3^rd days. LUS showed 89.22% sensitivity and 66.67% specificity, while CXR showed 56.86% sensitivity and 72.22% specificity and chest CT showed 93.20%sensitivity and 44.44 %specificity. LUS was a good diagnostic tool which agrees well with the final diagnosis. Conclusion: LUS was superior to CXR and slightly inferior to CT chest in diagnosing acute chest disease but the hazards of mobilization of critically ill patients and of radiation exposure and time-consuming make LUS is the best diagnostic tool in emergency.

[Yomna Gaber Elfeky, Khaled Talaat Abu-Eala, Omar Ahmed Hassanein and Ahmed Mohamed Abd Elrazik. Lung Ultrasound in Rapid Diagnosis of Acute Respiratory Disorders in Critically Ill Children. J Am Sci 2020;16(1):7-14]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 2. doi:10.7537/marsjas160120.02.

Keywords: Lung ultrasound, acute respiratory disorders, critically ill children

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Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus: Systematic Review & Meta-analysis

Prof. Dr. Khalid Abdullah Elfiky¹, Prof. Dr. Ahmed Mohamed Elbadawy², Dr. Khaled Rezk Abd-Elaziz², Mohamed Salah Eldesoky Abdelhady¹

¹General Surgery Department, Faculty of Medicine- Ain Shams University, Cairo, Egypt

²Plastic & Reconstructive & Maxillofacial surgery, Faculty of Medicine- Ain Shams University, Cairo, Egypt

msalah23592@gmail.com

Abstract: Diabetic foot ulcers are among the most common complications of patients who have diabetes mellitus which is not well controlled. The standard practices in diabetic foot ulcers management include surgical debridement, dressings to facilitate a moist wound environment and exudate control, wound off-loading, vascular assessment, and infection and glycemic control. Among adjuvant methods that appear to accelerate wound healing, negative-pressure wound therapy (NPWT) seems to be particularly effective in diabetic foot ulcerations. NPWT involves the use of a device that is connected to the wound bed through a special set and generates a negative pressure. We conducted the present systematic review and meta-analysis in order to assess the short-term efficacy and safety data of NPWT use in patients with diabetes mellitus and concomitant neuropathic foot wounds. In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar from their inception till March 2019. The search retrieved 1542 unique records. We then retained 58 potentially eligible records for full-texts screening. Finally, 11 RCTs (No. of patients = 972) were included in the present systematic review and meta-analysis. In the present systematic review and meta-analysis, the average age of the patients within the included studies was > 50 years old and the average BMI was around 30kg/m². In terms of ulcer characteristics, calcaneal dorsal or plantar foot ulcer was the most common site of ulceration within the included studies. In the present study, the overall effect estimates favoured NPWT over conventional care for complete healing of the ulcer (RR 1.38, 95% CI [1.21 – 1.58]; P <0.001), reduction of time healing (MD -8.07, 95% CI [-13.7 – -2.45]; P =0.005), reduction of ulcer depth (MD -40.83, 95% CI [-45.65 – -36]; P <0.001), and reduction of ulcer area (MD -12.19, 95% CI [-15.87 – -8.5]; P <0.001). In addition, six studies reported the rates of amputation. The overall effect estimates favoured NPWT over conventional care for amputation (RR 0.49, 95% CI [0.32 – 0.76]; P <0.001).

[Khalid Abdullah Elfiky, Ahmed Mohamed Elbadawy, Khaled Rezk Abd-Elaziz, Mohamed Salah Eldesoky Abdelhady. Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus: Systematic Review & Meta-analysis. J Am Sci 2020;16(1):15-25]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 3. doi:10.7537/marsjas160120.03.

Keywords: Negative; pressure; therapy; foot; wound; people; diabetes mellitus; Systematic Review; Meta-analysis

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Prepare Amodel for Enhance the Efficiency of the Product Development Processes in Small and Medium Garment Factories

Prof. Dr. Maged Mohamed Kamal; Prof. Dr. Nesreen Nasr El din and Rawan Ragaa Ragab

Department of Apparel, Faculty of Applied Arts, Helwan University, Egypt.

rawanragaa7@gmail.com

Abstract: Research summary: This research aims at both: 1- Setting tariffs for small and medium-sized factories and their differences, and knowing the different criteria for defining these factories/identifying the steps of the garment product industry/"stages of clothing production"/knowledge of technology and its role in the garment industry and types of technology and classification. 2- Develop a model to raise the efficiency of product development processes for pre-production fun (sample production stage) and analyze the components of this model, for application within small and medium garment factories through: * Study the constraints and problems facing small and medium-sized factories and the apparent lack of performance of product development processes for the sample production phase.* Study of large factories in the stage of product development for pre-production fun, and know the scientific foundations underlying the production process in these factories and technological developments in the sampling phase, and therefore the sound scientific steps that serve and work to raise the efficiency of this stage. *Work a sophisticated model that can be applied to suit small and medium-sized factories to raise efficiency and improve the quality of the pre-production of the sample section. *The application of the model that was developed within a number of small and medium factories was implemented: A- Apply the model inside a small factory for children's ready-made clothes and take the number 1 sample and take measurements of the sample before applying the model and the result after applying the model. B- Apply the model inside an average factory for children's ready-made clothes and take the number 1 sample and take measurements for the production stages of the sample before and after the application of the model. C- Apply the model inside an intermediate factory for women's pajamas and take 1 sample and take measurements of the production stages of the sample before applying the model and after applying the model. 3. Demonstrate how important it is to apply the model to pre-production (sample production) and a development cycle in both "time reduction, quality improvement, efficiency increase, cost reduction."" 4- Clarify the details of the model used in the development in small and medium factories for the production of samples and a two-part configuration (sample production order model + technical file containing sample production details). 5. There are some differences in the model used for small factories from that used for medium-sized factories, and that is the difference in the use of certain technological technologies to suit the capabilities of small factories not to apply this technology. 6- The model was applied to several samples in several different factories and to clarify the difference and the role of the model in influencing the production stage of the eye of the eye (design and patron, cut, printing, embroidery and operation).

[Maged Mohamed kamal; Nesreen Nasr El din and Rawan Ragaa Ragab. Prepare Amodel for Enhance the Efficiency of the Product Development Processes in Small and Medium Garment Factories. J Am Sci 2020;16(1):26-44]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 4. doi:10.7537/marsjas160120.04.

Keywords: Small and medium factories - sample production development - preparing a model for development - management of the development of clothing product - technological innovation for product development.

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Comparative Study between Breast Conserving Surgery and Modified Radical Mastectomy in Management of Triple Negative Breast Cancer

Amr H Afifi, MD

General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

dr_amrhamed1984@yahoo.com

Abstract: Background: Breast cancer is the most common cancer in women around the world. Modified radical mastectomy (MRM) is a radical procedure of surgery usually used in the treatment of breast cancer. Breast conserving surgery (BCS) and radiotherapy have been shown to provide similar local control and survival rates to radical procedures in the surgical treatment of early breast cancer. Patients with breast cancer are managed using clinical, histological parameters, hormone receptors like Estrogen, Progesterone, and human epidermal growth factor receptors and radiological investigations. Objective: The aim of this study is to assess and compare the oncologic and cosmetic outcomes of breast conserving surgery (BCS) and Modified Radical Mastectomy (MRM) regarding in triple-negative breast cancer patients. Patients and Methods: This retrospective study included 20 breast cancer patients presented in many hospitals in Egypt divided into two groups, breast conserving surgery group, and modified radical mastectomy group. Inclusion criteria have proven histopathology of early (stage I-II) breast cancer, a triple-negative receptors test (Estrogen receptor, Progesterone receptor and Human epidermal growth factor receptor 2 (HER2)) and with no other lesions in the same or contralateral breast. Exclusion criteria: patients with advanced breast cancer, medically unfit for surgery, patient with a past history of breast cancer and patients with contraindication of BCS or radiation. Results: We investigated Overall Survival (OS) in patients with Triple-negative breast cancer (TNBC) treated with mastectomy compared with those receiving BCS, patients with BCS had better survival than patients with mastectomy. Multivariate analysis revealed an excellent survival rated in the BCS group comparing to the mastectomy group. Conclusion: our results reported superior overall survival in the BCS group compared to mastectomy. Patients managed using mastectomy suffered from cosmetic impairments, worse outcomes and an avoidable deterioration in quality life during the surgical decision-making process. Therefore, we recommend BCS is a preferable line of management in patients with TNBC tumors when given adequate adjuvant treatment.

[Amr H Afifi. Comparative Study between Breast Conserving Surgery and Modified Radical Mastectomy in Management of Triple Negative Breast Cancer. J Am Sci 2020;16(1):45-52]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 5. doi:10.7537/marsjas160120.05.

Keywords: Comparative Study; Breast; Conserving; Surgery; Modified Radical Mastectomy; Management; Triple Negative Breast Cancer

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J Am Sci 2020;16(1):53-63. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 6.

withdrawn 

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Numerical Analysis of Improving the Structural Resistance during Earthquake Using Skirted Foundation

W. R. Azzam¹ and M. N. El Siragy²

¹Professor of Geotechnical Engineering, Faculty of Engineering, Tanta University, Egypt.

² Lecture of Geotechnical Engineering, Faculty of Engineering, 6 October University, Egypt

siragy2000@yahoo.com

Abstract: Structural skirts were used to implement in the marine structures and wind turbines to reduce settlement and increase the bearing capacity. Consequently, the installation of the skirts on the buildings undertake to seismic load showed that the efficiency of the skirts were improved the seismic response of foundation under displacement, acceleration, excess pore water pressure and shear strain. In addition to, improve the structure response to earthquakes. Earthquake is the most reason of structure hazards, Therefore, extensive investigation to safeguard buildings and foundation from disintegrate has been done using different techniques. The main notions of this paper are investigating the influence of skirted techniques for the foundation to enhance the durability and the serviceability of superstructure. The influence of the raising the sub-grade stiffness by skirts system on the foundation and structure steadiness through a seismic force are studied. Numerical finite element model for the analysis is investigated to simulate the earthquake effect and the skirt existence. A reinforced concrete building consists of 4 stories its foundation is a raft simulated by 2D model in case of using skirts and without using skirts. In the present study, a 2D plain strain PLAXIS program, (dynamic version) is set. The models for the problem under investigation are run at variety of skirt embedment lengths beneath the raft base. Nodal displacement and element strains are studied for the foundation in case of skirt system and with no skirting and different points along the building are also monitored. Another model for simulating the direct effect of the earthquake on the structure is presented using SAP 2000 to study the damage effect and how the skirted system reduce the possibility of the structure failure. The paper outcomes stated a noticeable efficacy in the structural stability of the building because of the confinement influence and increasing sub-grade stiffness. The usage skirts techniques can adjust and reduce the under-laying behavior. Accordingly, the mounting of the base stiffness can vary and reduce the horizontal deformation of the structure besides decreasing the induced staining action on the building elements. This mechanism of the skirting is considered to be an effective technique to amplify the stability of the inertia, enhance the movement resistance stiffness of the structure through the seismic wave, and decrease the building acceleration.

[W. R. Azzam¹ and M. N. El Siragy. Numerical Analysis of Improving the Structural Resistance During Earthquake Using Skirted Foundation. J Am Sci 2020;16(1):64-74]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 7. doi:10.7537/marsjas160120.07.

Key Word: Structural skirts, lateral confinement, displacement, acceleration, excess pore water pressure and shear strain

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Assessment of sexual Dysfunctions after Colorectal Surgery

Emad M Elsageer M.D., Tarek Youssef¹, M.D., MRCS, Abdelfattah Saleh Abdelfattah Abozaid MD, Sherif Abdel Halim^1,2, M.D., MRCS

Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract: Introduction: Before the discovery of the Total Mesorectal Excision (TME), the incidence of post-operative sexual dysfunction was 40-60%. Sexual dysfunctions remain a recognized complication in spite of adoption of autonomic nerve preserving techniques in TME. Aim of the work: The aim of this research is to assess the incidence of sexual dysfunctions following rectal or colonic surgery. Patients and methods: The study included (137) patients who underwent colorectal surgeries for benign and malignant diseases obtained from a retrospective patient database performed in Ain Shams and Minia University hospitals by using validated questionnaires. The Brief Sexual Function Index was used to assess male sexual function, while Female sexual function was assessed by the Female Sexual Function Inventory. Results: Age is a predisposing factor for sexual dysfunctions in males; type of operation doesn’t significantly affect sexual functions with a trend toward more severe symptoms after the abdomino-perineal resection (APR). Patients who received long course neo-adjuvant (chemoradiotherapy) reported significantly more problems with the sexual drive. In female only APR affect sexual functions. We concluded that the domain specific score for sexual drive tend to be significant worse after APR. Conclusion Preservation of the autonomic nerve is of major importance, particularly in low rectal resection to avoid sexual dysfunction. Neo-adjuvant CRT is the risk factors for sexual dysfunction in male patients.

Emad M Elsageer, Tarek Youssef, Abdelfattah Saleh Abdelfattah Abozaid, Sherif Abdel Halim. Assessment of sexual Dysfunctions after Colorectal Surgery. J Am Sci 2020;16(1):75-83]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 8. doi:10.7537/marsjas160120.08.

Keywords: Rectum Surgery, Total Mesorectal Excision, sexual dysfunction, neo-adjuvant chemo-radiation, hypogastric nerve plexus.

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Influence of Ballooning on Textured Yarns Finishing properties

Amr E. Allam

Textile dyeing, printing and finishing Department, Faculty of Applied Arts, Helwan University, Cairo, Egypt

amreaallam@yahoo.com

Abstract: At the University of Manchester, a new texturing machine was designed and set to produce textured both Polyester and Polyamide yarns. The purposely built machine was a new method for producing bulk textured yarns using false twist process. Compared to commercial machines, friction disc been replaced by a water jet to apply twist. Steam heater also is used to maintain the needed heat energy to allow high speed texturing. Ballooning is been part of such process, especially at high speeds. Examining such physical phenomena happening with the processed yarn showed it can influence the physical properties of the finished produced polyester yarn.

[Amr E. Allam. Influence of Ballooning on Textured Yarns Finishing properties. J Am Sci 2020;16(1):84-88]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 9. doi:10.7537/marsjas160120.09.

Keywords: Influence; Ballooning; Textured Yarns; Finishing; properties

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The Association between Right Ventricular Free Wall Strain and Exercise Capacity in Healthy Individuals Compared To Heart Failure Reduced Ejection Fraction Patients

Mohamed Magdy Abdelrazik Edries, Prof. Dr. Mohamed Osama Fathy Ayed, Dr. Aly Aly Ramzy

Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Mohamed.m345@yahoo.com

Abstract: Aim of study: To assess functional capacity in HFrEF patients as well as healthy individuals using RV free wall strain. Methods: This prospective cohort study was conducted on fifty patients scheduled for routine echocardiographic examination. All patients were evaluated by history taking and clinical examination, exercise ECG test, laboratory investigations and echocardiographic examination including RV assessment with speckle tracking. Patients were divided into two equal groups; one for healthy individuals and another for heart failure patients. Results: Patients in group A (healthy individuals) were younger than group B. There is significant difference in clinical parameters on initial assessment as the resting and maximal exercise heart rate, blood pressure were lower in group A. while exercise time and METs achieved were higher in the same group. Conventional echocardiographic measurements of RV were lower in group A, while FAC and TAPSE were significantly higher in the same group. RV and LV global longitudinal strain were significantly increased in group A (-21.12 ±3.45 vs. -14.53 ±1.93, p value <0.001) and (-27.86 ±1.13 vs. -19.86 ±4.34, p value <0.001) respectively. By correlation of RVGLS to other parameters, we found significant positive correlation with age, RV diastolic and systolic areas, RV-MPI, tricuspid E∕A ratio, and LVGLS. Finally, we found significant negative correlation with METs, Exercise time, TAPSE, FAC. Conclusion: RV strain is independently associated with functional capacity in compensated heart failure patients as well as healthy individuals. RV function should be regarded as an important factor for exercise capacity.

[Mohamed Magdy Abdelrazik Edries, Mohamed Osama Fathy Ayed, Aly Aly Ramzy. The Association between Right Ventricular Free Wall Strain and Exercise Capacity in Healthy Individuals Compared To Heart Failure Reduced Ejection Fraction Patients. J Am Sci 2020;16(1):89-94]. ISSN 1545-1003 (print); ISSN 2375-7264 (online). http://www.jofamericanscience.org. 10. doi:10.7537/marsjas160120.10.

Key words: Functional capacity, Right ventricular function, heart failure with reduced ejection fraction

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