A Survey of the Vitamin and Mineral Content in Milk from Yaks Raised at Different Altitudes

In this study, the content of vitamins and of toxic and beneficial (macro- and micro-) minerals in milk from yaks raised at different altitudes (3,215, 4,340, and 5,410 m) was investigated. For comparison, the components in cow’s milk were also measured. At higher altitudes, a significant ( P < 0.05 ) increase in vitamin A and vitamin E was observed in the yak’s milk, whereas the opposite was observed for vitamin B1 and vitamin B2. No significant statistical difference in vitamin C, Ca, P, Na, K, and Mg concentrations was observed in milk from yaks raised at different altitudes. The concentrations of Zn in milk from yaks raised at different altitudes showed no statistical difference, whereas the Mn and Fe concentrations in milk from yaks raised at 3,215 m were lower than those raised at higher altitudes. The concentrations of Pb and Cd in yak’s milk did not exceed the maximum permissible concentrations (Codex Alimentarius Commission), whereas their concentrations were higher in milk from yaks raised at 3,215 m than at higher altitudes. These findings indicated that the contents of vitamins and minerals in yak milk varied in different altitudes.

Validation of Pre-/Post-TACE-Predict Models among Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization

This study attempted to validate the prognostic performance of the proposed Pre- and Post-TACE (transarterial chemoembolization)-Predict models, in comparison with other models for prognostication. One-hundred-and-eighty-seven patients with HCC who underwent TACE were recruited. Regarding overall survival (OS), the predictive performance of the Pre-TACE-Predict model (one-year integrated area under the curve (iAUC) 0.685 (95% confidence interval (CI) 0.593–0.772)) was better than that of the Post-TACE-Predict model (iAUC 0.659 (95% CI 0.580–0.742)). However, there was no significant statistical difference between two models at any time point. For comparison between models using pre-treatment factors, the modified hepatoma arterial embolization prognostic (mHAP)-II model demonstrated significantly better predictive performance at one year (iAUC 0.767 (95% CI 0.683–0.847)) compared with Pre-TACE-Predict. For comparison between models using first TACE response, the SNACOR model was significantly more predictive at one year (iAUC 0.778 (95% CI 0.687–0.866) vs. 0.659 (95% CI 0.580–0.742), respectively) and three years (iAUC 0.707 (95% CI 0.646–0.770) vs. 0.624 (95% CI 0.564–0.688), respectively) than the Post-TACE-Predict model. mHAP-II and SNACOR may be preferred over the Pre- and Post-TACE-Predict models, respectively, considering their similar or better performance and the ease of application.

Delta Variant SARS-CoV-2 infections in pediatric cases during the second wave in India

The aim of this study was to identify the SARS-CoV-2 lineages circulating in the pediatric population of India during the second wave of the pandemic. Clinical and demographic details linked with the nasopharyngeal/oropharyngeal swabs (NPS/OPS) collected from SARS-CoV-2 cases (n=583) aged 0-18 year and tested positive by real-time RT-PCR were retrieved from March to June 2021.Symptoms were reported among 37.2% of patients and 14.8% reported to be hospitalized. The E gene CT value had significant statistical difference at the point of sample collection when compared to that observed in the sequencing laboratory. Out of these 512 sequences 372 were VOCs, 51 were VOIs. Most common lineages observed were Delta, followed by Kappa, Alpha and B.1.36, seen in 65.82%, 9.96%, 6.83% and 4.68%, respectively in the study population. Overall, it was observed that Delta strain was the leading cause of SARS-CoV-2 infection in Indian children during the second wave of the pandemic. We emphasize on the need of continuous genomic surveillance in SARS-CoV-2 infection even amongst children.

EFFCIENCY OF TELEREHABILITATION ON PAIN AND FORWARD HEAD POSTURE AMONG STUDENTS WITH NONSPECIFIC NECK PAIN IN PANDEMIC SITUATION – A QUASI EXPERIMENTALSTUDY

INTRODUCTION: The neck pain and forward head posture are the most prevailing condition among the college students due to increased smart phone usage and causes activity limitation. At current situation providing rehabilitation via face to face increases the risk of spread of the pandemic(COVID 19). The deep neck flexor strengthening and ergonomic correction via telerehabilitation improves the functional activity among college students and limits the spread of disease. MATREIALS AND METHODOLGY: Subjects with (n=15), who fulfil the screening criteria were given the exercise protocol that is deep neck flexor strengthening and ergonomic correction via telerehabilitation mode for a period of 4 weeks and the outcome measures included neck pain and forward head posture. RESULT: There is a significant statistical difference between pre test and post test values of pain and forward head posture. CONCLUSION: Telerehabilitation platform provides a greater efficiency for treating pain and forward head posture among college students in pandemic situation.

A Novel Autophagy-Related Marker for Improved Differential Diagnosis of Rheumatoid Arthritis and Osteoarthritis

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two most common rheumatic diseases in the world. Although there are standard methods for the diagnosis of both RA and OA, the differentials in some cases are poor. With deepening research, the role of autophagy in maintaining cell homeostasis and thus enabling cells adapt to external environments has become increasingly prominent. Both RA and OA, two diseases with inherent differences in pathogenesis, gradually show differences in autophagy levels. Our study therefore aims to further understand differences in pathogenesis of RA and OA through in-depth studies of autophagy in RA and OA. We also define appropriate autophagy-related markers as recognition indicators. Differences in autophagy levels between RA and OA were found based on analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) and single-sample gene set enrichment (ssGSEA). These differences were mainly caused by 134 differentially expressed genes (DEGs). In two autophagy-related genes, CXCR4 and SERPINA1, there existed significant statistical difference between RA and OA. An autophagy related index (ARI) was thus successfully constructed based on CXCR4 and SERPINA by binary logistic regression of the generalized linear regression (GLR) algorithm. Pearson analysis indicated that the expression of CXCR4, SERPINA1, and ARI were closely correlated with autophagy scores and immune infiltration. Moreover, ARI showed high disease identification through receiver operating characteristic (ROC) analysis (AUCtesting cohort = 0.956, AUCtraining cohort = 0.867). These results were then verified in GSE12021 independent cohort. In conclusion, ARI associated with autophagy and immune infiltration was successfully constructed for accurately identifying OA and RA. The index, thus, has great potential in clinical applications.

The effect of Hyoscine Butylbromide on the rate of vaginal delivery in cases of secondary arrest of cervical dilatation: A rondomized controlled clinical trial

Background For decades, health providers have worked to manage labor actively and safely, with the goal of shortening the duration of painful labor. Reduction of cesarean sections and maternal complication is also an important aspect of labor management. Antispasmodic are commonly administrating during labor in both developing and developed countries, although there is a paucity of scientific reports validating this. Hyoscine butylbromide is an effective antispasmodic drug. Therefore, We aim to assess efficacy of Hyoscine butylbromide on rate of vaginal delivery in cases of 2ry arrest of cervical dilatation. Objective To assess whether the intravenous injection of hyoscine butylbromide is effective in progress of labor in which cases with 2ry arrest of cervical dilatation. Patients and Methods The study included 100 pregnant women (PG, P1, P2, P3) conducted at Ain Shams University Maternity Hospital, the inclusion Criteria were: term uncomplicated singleton pregnancy in a spontaneous active labor, with cephalic presentation. The patient must be free from any medical disorder associated with pregnancy and free from any obstetric complication. Cases were subdivided into 2 groups: Study group: 50 patients received 40mg iv Hyoscine Butylbromide (as Buscopan 20mg\mrl) when the cervix &gt;4cm dilated and was &gt;50% effaced. Control group: 50 patients received 2ml saline as placebo. Results Significant increase in vaginal delivery rate (72%) in Hyoscine group; compared to Saline group (52%); with significant statistical difference (p = 0.04). Highly significant decrease in 1st and 2nd stage labor time in Hyoscine group; compared to Saline group; with highly significant statistical difference (p &lt; 0.05 respectively). These results observed without significant difference as regards 3rd stage labor time and postpartum hemorrhage (p &gt; 0.05), APGAR score and NICU admission (p &gt; 0.05). Conclusion From the current study we can conclude that HBB 40 mg is safe and effective in increasing vaginal delivary rate in cases of 2ry arrest of 12 dilatation. It is effective in decreasing first and second stage of labor. It has no maternal or neonatal adverse effect. It is easy and available.

Comparative Study between Lichtenstein Repair and Trans Abdominal Pre Peritoneal Repair of Inguinal Hernia (TAPP)

Background Inguinal hernia repair is one of the most widely performed surgical procedure. Among the techniques used, the open Lichtenstein repair is still the most widely performed. However, in the last decade there has been an increased interest in the laparoscopic approach for inguinal hernia repair, mainly represented as the trans-abdominal pre- peritoneal (TAPP) technique. As described in recent studies, TAPP approach entails the benefits of minimally invasive surgery, such as less pain and early recovery. Objective s: This study aims to compare between lichtenstein repair of inguinal hernia and trans-abdominal pre-peritoneal repair of inguinal hernia (TAPP) as regard their hospital stay, cost, intra-operative & post-operative complications and short term recurrence. Patients and Methods Our study was carried out on (50) male patients with inguinal hernia, 25 patients underwent laparoscopic TAPP repair and 25 patients underwent open Lichtenstein repair. We found a highly significant difference of laparoscopic TAPP Repair in decreasing post-operative pain than in open repair. Results Comparative study between the 2 groups revealed non-significant difference as regards age and sex of the patients. Comparative study between the 2 groups revealed non-significant difference as regards all socio-demographic data. Comparative study between the 2 groups revealed non-significant difference as regards type and side of hernia. Comparative study between the 2 groups revealed; highly significant increase in operative duration in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in post-operative pain score and post-operative hospital stay; in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in intra-operative complications in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Conclusion Our study showed that laparoscopic TAPP approach for inguinal hernia repair reduces early post-operative pain. Furthermore, it is related to less complications, although it takes a longer operative time and higher cost.

Usage of Dermal Substitutes for Hand Coverage and Reconstruction

Background Hand coverage and reconstruction gives a challenge for plastic surgery. In this study we introduce a method for hand coverage and reconstruction by dermal substitutes which easy and simple to use. Objectives The aim of this study is to know the versatility of dermal substitutes in reconstruction & coverage of complex hand defects. Patients and Methods This was a cohort study conducted on 20 patients with hand tissue loss; to evaluate the versatility of dermal substitutes in reconstruction & coverage of complex hand defects. Patients attending El Helmeia armed forces hospital (plastic and reconstructive department) & Ain shams university hospital with follow up duration up to 6 months. All patients had clean wound & complex hand defects with exposed tendon and/or bone, Defects post trauma and after tumour excision and Post burn hypertrophic scars, keloid or contractures. Results We found that; the mean age of all patients was (23.5 ± 8.82) years. Regarding gender of the patients, the majority (80%) of patients were males; while (20%) were females. Regarding side of raw area; (55%) of patients had Rt-sided raw area, and (45%) had Lt-sided raw area. Regarding site of raw area; (20%) of patients had Finger-tip raw area, (20%) had Palm raw area, (10%) had Volar surface of little and ring raw area, (10%) had Volar surface of little finger raw area, (25%) had Dorsum raw area, (10%) had Dorsum of lateral 4 fingers raw area, while (5%) had Dorsum of middle finger raw area. Regarding Etiology of raw area; (70%) of raw areas caused by Trauma, (15%) caused after burn keloid removal, (10%) caused after burn contracture, and (5%) caused by donor site. Regarding Intervention data; (50%) of patients used Integra dermal substitute; and (50%) used Pelnac dermal substitute. Regarding follow up data; the average Time of removal was (3.65 ± 0.49) weeks, and the average Time for follow up was (3.25 ± 1.12) months. Comparative study between 20 hand tissue loss patients revealed; highly significant increase in Post-operative STSG satisfaction rate (70%); with highly significant statistical difference (p &lt; 0.01), highly significant increase in Post-operative STSG good movement (80%); with highly significant statistical difference (p &lt; 0.01). Conclusion The use of dermal substitutes cons gives an alternative reconstructive option for managing extended skin avulsion injuries of the upper extremity; it reduces postoperative immobilization, minimizes donor site morbidity and provides good functional and esthetic results in a single surgical procedure.

Effect of Intravenous Dexamethasone on the Duration of Labor Induction: A Randomized Controlled Trial

Background Induction of labor is one of the most common interventions practiced in modern obstetrics. In the developed World, the ability to induce labor has contributed to the reduction in maternal and perinatal mortality and morbidity. Aim of the work to establish whether Dexamethasone plays a role in shorting the duration interval between initiation of labor induction and beginning of true contraction of labor in post-term pregnancy, so shorting the duration of labor. Patients and Methods This randomized controlled trial study was conducted in the labor ward of Ain Shams University Maternity Hospital on one hundred thirty five pregnant women with full term pregnancy divided into the following: Group I (Dexamethasone group) injected with 2 ml (8 mg) of the product (dexamethasone) 4 hours before initiation of labor induction and Group II (Control group) received 2 ml saline (as a placebo). Results There was a non-significant statistical difference between the two studied groups as regards the age, gestational age on admission, body mass index (BMI), Bishop Score, mode of delivery and Apgar score. There was a high significant statistical difference between the two studied groups as regards Induction- delivery interval, induction-contraction, contraction – delivery interval were shorter in cases of study than control. Conclusion From the above data we can conclude that the intravenous administration of dexamethasone appear to shorten labor duration.

The role of magnetic resonance imaging in the assessment of acromial morphology in association with rotator cuff tear

Background: The pathogenesis of rotator cuff tear (RCT) remains controversial. The acromion portion ofthe scapula and its morphology may be attributable for a variety of shoulder disorders such as RCT. Patients and Methods: This was a retrospective study that included 40 patients divided into two groups; a group with RCT included 20 patients and a control group with no RCT included the other 20 patients. 19 were males and 21 females, their age 20-69 years old with a mean age of 45. Cases were selected from the PACS system of the Radiology department of Ain Shams University Hospital. Statistical data analysis was done using IBM SPSS software package version 20.0. (Armonk, NY: IBM Corp) Results: The study revealed that Type Il acromion was encountered in most of the male patients (42.1%) and type Ill acromion was encountered in most of the female patients (42.9%) while type IV acromion was less frequently seen among males and females (5% & 0%) respectively. It also revealed that Type Ill is mostly encountered in RCT (50%); 58% of full-thickness tear and 37% of partial thickness tear. while type I is less frequently associated with a partial tear or full thickness tear (8%) for each. Acromion type Ill was the commonest type of acromion found between the patients of the case group with a significant statistical difference found between the case and control groups (P value: 0.006). However, type I acromion was the commonest acromion type found between the control group with also a significant statistical difference (P value: 0.011). Conclusion: Type Ill acromion may be a risk factor leading to rotator cuff tear. This may help guide therapy in patients with shoulder pain and findings suggesting type Ill acromion shape Keywords acromion shapes, magnetic resonance imaging, rotator cuff tear