Search

Gastrointestinal perforation is a significant injury that originates mainly from gastrointestinal ulcers. It is associated with a high rate of morbidity and mortality. The height of the column of the air under the diaphragm can be used to estimate the amount of peritoneal soiling due to viscus perforation. This study aimed to determine the correlation between this estimate and the incidence of morbidity and mortality.To achieve this aim, a prospective cohort study was conducted on 83 patients at Kasr al ainy hospital who, between March 2021 and March 2022, presented to the emergency department with free air under the diaphragm at chest X-ray and required surgical intervention for a perforated viscus. For each case, the amount of peritoneal soiling and the amount of air under the diaphragm as determined by a chest X-ray were recorded.The mean air under the diaphragm in a plain erect chest X-ray was 1.78 ± 1.92 cm, and the mean amount of peritoneal soiling was 1201.83 ± 948.99 CC. There are positive correlations between the amount of air under the diaphragm as shown on an X-ray and the size of the perforation (p = 0.034), the amount of peritoneal soiling (p = 0.003), and the mortality (p = 0.013).There was a statistically significant correlation between air under the diaphragm according to X-ray and the amount of peritoneal soiling in patients with a perforated viscus. This measure can be used as a sensitive tool to predict morbidity and mortality as more free air in the chest X-ray is associated with significant mortality. These results may enhance the decision making using sensitive and available tool of diagnosis.

Background: Presently, non-operative management of penetrating abdominal stab injuries has been standardized in several trauma centers. This strategy has appromising outcome conserving decreasing morbidity. Aim of the work: This study aimed to assess the safety and feasibility of SNOM of patients having penetrating abdominal stab injuries not indicating emergent laparotomy and to identify a protocol for selection of patient candidates for non-operative management in a tertiary care hospital in Egypt. Patients & Methods: This is a prospective study that involved patients who presented to the casualty department of Kasr Elainy teaching Hospital, in the period from August 2018 to August 2020, for management of a penetrating abdominal Stab injuries. Fully conscious, haemodynimacally stable patients were included. Eligible patients were allocated to either SNOM group or immediate operative management (IOM) group. Results: SNOM group included64 patients and IOM group included 40 patients. The age of the patients ranged from 16 to 49 years with a mean of 33±6.8 years, and the majority were males (99%). SNOM failed in 4/69 patients (5.7%) who required delayed laparotomy for peritonitis (2 cases) and HB drop and haemodynamic instability (2 cases). In IOM group, only 3 cases had therapeutic laparotomies (7.3%). The remaining cases had unnecessary laparotomies (92.7%). Statistically significant higher LOS was seen in SNOM group (p

Research on fiber-reinforced shotcrete (FRS) for rock supports in tunneling and mining is increasing. This study used a novel approach based on scientometric analysis of FRS's bibliographic data to determine its essential components. The potential of manual review articles to link together previously isolated areas of the literature is limited. Knowledge mapping, co-citations, and co-occurrence analysis are the most challenging parts of current research. The information needed to complete the study was retrieved from the Scopus search engine. Important publishing sources, keyword analysis, writers that have the most contribution in terms of citations and publications, the most-cited articles, and the regions most actively engaged in FRS research were identified throughout the data review process. Moreover, the need for FRS and the major constraints associated with their usage were discussed. In addition to its applications in tunneling and mining, FRS can also be used for refractory linings, soil stabilization, structural restorations, and the construction of river barriers, swimming pools, shell structures, domes, and even buildings. The key barriers to employing FRS are the corrosion of fibers, high expense, and uniform fiber dispersion. Using recycled fibers, particularly from discarded tires, coating fibers with zinc/brass/copper, and employing the layer procedure, on the other hand, are superior approaches to addressing these issues. Moreover, with increased concerns about the sustainability of construction materials, efforts need to be carried out for the creation of sustainable FRS by using waste materials. The scientific description and quantitative assessment of regions and scientists might help academics build collaborative projects and disseminate new ideas and methods.

Objective: Serum calcium levels often decrease during acute illness in patients with an intact calcium-regulating system. However, the dynamics of serum calcium levels in hospitalized pati...

Breast cancer (BC) contributes to 30% of all women suffering from cancer in the US. Despite enhanced survival rates and recovery rates, pathogenic mutation discovery remains indispensable for early detection and prognosis. BRCA1 pathogenic mutations increase the chance of BC to 55% by the age of 70. A crucial mechanism of mutations is affecting protein-protein interaction. BRCA1 interacts with the BARD1 protein forming a complex that contributes to DNA repair and plays a vital role in tumor suppression. In this study, we aimed to investigate mutations that contribute to the dysfunction of BRCA1 protein through sequencing and computational analysis and their impact on the active site interacting with BRCA1 associated Ring Domain 1 (BRAD1) of BRCA1, and hence its beneficial role in BC prognosis. Herein, we represent a study on 48 BC patients sequenced using Devyser BRCA NGS kit, according to the manufacturer’s instructions. The reagent kit V2, 500 Cycles PE, on the Illumina MiSeq System. Using the Illumina MiSeq System to detect pathogenic mutations. Bioinformatics analysis was carried out for variant calling and different databases, such as ClinVar and BIC, were searched to identify the novel mutations. P2RANK software was used to identify and confirm the active site protein sequences. For BRCA1, we studied three missense mutations present in the ring domain of the protein interacting with BRAD1. We used PDBsum server to retrieve protein structures predicted by the Artificial Intelligence (AI)-based AlphaFold software. Structures were further confirmed using Ramachandran plot. We used Dynamut server to study the stability and structural variability due to mutations. Docking was carried out using HDock software and significant poses were sorted out based on their RMSD values. For BRCA1, Cys47Ser and Cys39Arg caused destabilization of the protein represented as Gibb’s energy by -2.257 kcal/mol and -0.318 kcal/mol respectively. On the other hand, Cys39Tyr caused the stabilization of protein by 0.247 kcal/mol. The effect of mutations on rigidity was determined in terms of vibrational entropy where Cys47Ser caused an increase of protein flexibility with the energy of 0.262 kcal.mol−1.K−1. Cys39Arg and Cys39Tyr decreased the flexibility of the protein and caused rigidity by -0.164 kcal.mol−1.K−1 and -0.371 kcal.mol−1.K−1 respectively. In, conclusion, investigating the three selected pathogenic mutations showed a clear impact on the structure of the protein favored different types of bonds in the active site that may alter the interaction between BRCA1 and BARD1. This study has a beneficial role to investigate the impact of BRCA1 mutations on the structural stability of the protein and thereby the risk of BC development Citation Format: Yahia Ahmad Yahia, Nasra F. Abdel Fattah, Marwa A. Abdel Wahed, Fatma S S Hafez, Sara HA Arwa, Samah A. Loutfy. Novel pathogenic mutations in BRCA1 gene that may influence the interaction of BRCA1 protein with BARD1 protein in breast cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 868.

Background: The presence of defects in native umbilical in adults and its use as laparoscopic first entry site is poorly documented. It would likely be a safer method than the Veress needle and direct trocar insertion. This work aimed to report the prevalence and size of native umbilical defects, and their relationship with gender, age and body mass index. Methods: In 160 consecutive laparoscopic operations, a trans-umbilical incision was made and a defect at its base was looked for. When found, the defect was measured and used as the first port entry site. Relationships of presence of native defects and their sizes in relation to gender, age and BMI were analyzed. Results: The prevalence of a native defect in this series was 90%. Its presence had no relation with gender, age or BMI. Its size, however, positively correlated with age and BMI. No complications were related to the defect’s use for first laparoscopic entry site. Conclusion: A native umbilical defect is present in 90% of adults. Whenever present, it is recommended for use as the first port entry site by an open technique. This method is simple and safe and avoids unnecessarily inducing another defect. Keywords: Laparoscopy, Open technique, Access, Native defect, Umbilical defect

Spectrophotometric determination of hydroxymethylfurfural (HMF) based on p-toluidine as a reagent has been studied. The absorption intensities were measured at a wavelength range of 250 to 500 nm to record the absorption spectra before and after reaction with the HMF. The solution response was obtained at pH 3. The concentration of HMF was 5 × 10-3M, whereas for p-toluidine was 8 × 10-3M .The relative standard deviation (R.S.D.) of reproducibility was 3.33% when concentration of p-toluidine 3 × 10-3M was used .The photostability was found to be good with 1.9 %. M was used . The photostability was found to be good with 1.9 %.

Medico-legal tasks are not exclusive to forensic medical experts –any physician may face medico-legal issues in his career. Hence, the practice of medicine requires education in legal issues. In Saudi Arabia, there are 30 universities with medical colleges, but we do not know how they teach undergraduate forensic medicine and medico-legal issues. The aim of this study was to discover undergraduate training courses in forensic medicine in Saudi universities. We conducted a cross-sectional study involving all colleges of medicine in Saudi Arabia. A structured, self-administered questionnaire containing 13 items relating to the undergraduate forensic medicine course was distributed. Out of a total of 30 universities, 27 universities responded. Of these 27 universities, 16 (59.26%) teach forensic medicine to undergraduate medical students, and 11 (40.74%) do not teach forensic medicine in their undergraduate curriculum. Of the 27 universities that responded, none has a department of forensic medicine. Eleven universities that do not teach forensic medicine have no forensic medicine unit/division or faculty at all. Forensic medicine belongs to the pathology department in 11 universities, while it belongs to different departments in five universities. There is variation in teaching methods, years where the course is taught and length of the course. Practical and morgue visits take place in 7/16 (43.8%) universities, while 9/16 (56.3%) universities only teach the theoretical aspects of forensic medicine. All 16 universities teach forensic medicine only to medical students and do not teach it to students in other colleges such as dentistry and nursing.