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Background: Vitiligo is an acquired depigmented skin disorder. It has a genetic and autoimmune background. Human beta defensin-1(HBD-1) plus its gene polymorphism were linked to some autoimmune disorders. Objectives: To elucidate the possible role of HBD-1 in the pathogenesis of non-segmental vitiligo (NSV) through evaluation of HBD-1 serum levels and its single nucleotide polymorphism (SNP) in patients having NSV, in addition, to correlating the results with the extent of vitiligo in those patients. Methods: A current case-control study included 50 patients having NSV and 50 controls. The authors used Vitiligo Area Scoring Index (VASI) score to assess vitiligo severity and laboratory investigations to assess serum HBD-1 level using ELISA and defensin-beta1 (DEFB1) SNP using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: There were significantly lower HBD-1 serum levels in NSV cases than in controls (p < 0.001). There was a significant predominance of GG DEFB1 genotype and G allele in NSV patients in comparison to controls (p < 0.001). The levels of serum HBD-1 and DEFB1 genotypes were not associated or correlated significantly with any of the personal and clinical parameters of vitiligo patients. Study limitations: The small sample size. Conclusions: DEFB1 gene polymorphism (GG genotype and G allele) may modulate vitiligo risk and contribute to vitiligo development in Egyptian populations. Decreased circulating HBD-1 levels might have an active role in vitiligo etiopathogenesis that could be mediated through its possible anti-inflammatory effects.

Background: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the airways associated with airway narrowing with airflow obstruction leading to difficulty in breathing impair daily activity and cause poor quality of life. Patients and methods: Fifty patients whom diagnosed with COPD are divided into two groups, 1st control group includes 25 patients assigned to receive conventional therapy of Formoterol fumarate 12 microgram inhaler twice daily, and 2nd interventional group also includes 25 patients assigned to receive conventional therapy with (300 mg/ 2 times daily) sublingual glutathione for two months. Saint George respiratory questionnaire (SGRQ) were measured before and after first and second months after treatment in both study groups. Aim of the study: This study was object to assess the changes in quality of life by using SGRQ following sublingual glutathione supplements therapy in COPD patients. Results and conclusion: After two months treatment , the mean values of SGRQ showed a significant increase compared to pre-treatment levels in both groups (P

Advance care planning (ACP) is a useful tool that benefits adult patients, care providers, and surrogate decision makers, through providing opportunities for patients to consider, express, and formalize their beliefs, preferences, and wishes pertaining to decisions regarding future medical care at a time when they retain decision-making capacity. Early and timely consideration of ACP discussions is paramount in Huntington’s disease (HD) given the potential challenges in ascertaining decision-making capacity in the advanced stages of the disease. ACP helps to empower and extend patient autonomy, providing clinicians and surrogate decision makers with reassurance that management is consistent with a patient’s expressed wishes. Regular follow up is vital to establish consistency of decisions and wishes. We outline the framework of the dedicated ACP clinic integrated within our HD service to highlight the importance of a patient-centred and tailored care plan that fulfils the patient’s expressed goals, preferences, and values.

Reconciliation of transactions between multiple parties is a time-consuming process. This paper presents a new conceptual framework that may lower costs and shorten the reconciliation time. The proposed framework recommends recording transactions on the blockchain before populating the transacting parties’ respective enterprise resource planning (ERP) systems, which will be the source of a single truth. This information flow will result in all involved parties having access to the same transaction details. Further, the paper presents a technical feasibility demonstration with two examples, where all involved parties are executing transaction details on the blockchain after meeting the governing smart contract constraints using their digital wallets. The new conceptual framework has been specifically designed to create one truth for all parties involved in a transaction that in turn may eliminate what is perceived to be unnecessary redundancy in current accounting systems.

Background Despite being a well-described intervention, the optimal anatomical approach to perform a stellate ganglion block (SGB) has been disputed. We compared the subfascial and extrafascial ultrasound-guided (USG) SGB. Methods A randomised clinical trial was conducted, consisting of 50 patients in two groups. Group I received SGB via the subfascial approach while Group II received an SGB via the extrafascial approach. The primary endpoint was successful sympathetic blockade (as indicated by a measured temperature rise of ≥2°C). Secondary endpoints included analgesic efficiency (extent of early onset of pain relief as indicated by >50% improvement in Visual Analogue Scale (VAS) score at 300’s post-procedure); occurrence of Horner’s syndrome; extent of local anaesthetic distribution; and adverse events. Results The mean increase in sympathetic blockade was significantly higher in the subfascial group (2.6 ± 0.6°C; p = .003). Analgesic efficacy was also significantly higher in the subfascial group ( p < .001). The difference in the average dermatomal spread of local anaesthetic down to T2 and up to C4 between the groups was also statistically significant ( p = .021 and p = .019, respectively). Conclusions The degree of temperature rise, pain relief and occurrence of Horner's syndrome were higher in the subfascial than the extrafascial group. The subfascial approach to SGB, with a limited volume of local anaesthetic agent, is a more reliable technique when compared to the extrafascial approach.

يهدف هذا البحث لبيان مشروعية الوقف على تطبيقات الذكاء الاصطناعي بدراسة شرعية، بعد بيان ماهية الذكاء الاصطناعي، بحكم أنَّه الثورة المرتقبة في عالم المعلومات والتكنولوجيا، كما يهدف لبيان ضوابط مشروعية الوقف على تطبيقات الذكاء الاصطناعي ومجالاته، وبيان تصور مقاصدي لأولويات الوقف على تطبيقات الذكاء الاصطناعي. ومشكلة البحث الرئيسة تتمثل في ماهية الحكم الشرعي للوقف على التطبيقات الذكية وضوابطه وأولوياته. وقد اتبع الباحث المنهج الاستقرائي التحليلي، وتوصل لعدة نتائج لعل من أبرزها: أنَّ الوقف على تطبيقات الذكاء الاصطناعي مشروع، ويشهد له عموم نصوص الشريعة، وعموم كلام الفقهاء في الوقف وميادينه، وما قرره الباحث من أنَّ ميادين الوقف اجتهادية، وليست توقيفية، ومنها: أنَّ للوقف على تطبيقات الذكاء الاصطناعي ضوابط، أهمها: أنَّ كل تطبيق لا يحقق مصلحة شرعية لا يوقف عليه، وألا يعود الوقف على هذه التطبيقات بالضرر على الفرد أو المجتمع، ووجوب مراعاة الجانب الأخلاقي في هذا النوع من الوقف. وفي الأخير جعل الباحث أولويات في الوقف على تطبيقات الذكاء الاصطناعي، حتى تحقق مقاصد الشريعة، وحتى لا يهتم بالمفضول ويترك الفاضل

يهدف هذا البحث لبيان مشروعية الوقف على تطبيقات الذكاء الاصطناعي بدراسة شرعية، بعد بيان ماهية الذكاء الاصطناعي، بحكم أنَّه الثورة المرتقبة في عالم المعلومات والتكنولوجيا، كما يهدف لبيان ضوابط مشروعية الوقف على تطبيقات الذكاء الاصطناعي ومجالاته، وبيان تصور مقاصدي لأولويات الوقف على تطبيقات الذكاء الاصطناعي. ومشكلة البحث الرئيسة تتمثل في ماهية الحكم الشرعي للوقف على التطبيقات الذكية وضوابطه وأولوياته. وقد اتبع الباحث المنهج الاستقرائي التحليلي، وتوصل لعدة نتائج لعل من أبرزها: أنَّ الوقف على تطبيقات الذكاء الاصطناعي مشروع، ويشهد له عموم نصوص الشريعة، وعموم كلام الفقهاء في الوقف وميادينه، وما قرره الباحث من أنَّ ميادين الوقف اجتهادية، وليست توقيفية، ومنها: أنَّ للوقف على تطبيقات الذكاء الاصطناعي ضوابط، أهمها: أنَّ كل تطبيق لا يحقق مصلحة شرعية لا يوقف عليه، وألا يعود الوقف على هذه التطبيقات بالضرر على الفرد أو المجتمع، ووجوب مراعاة الجانب الأخلاقي في هذا النوع من الوقف. وفي الأخير جعل الباحث أولويات في الوقف على تطبيقات الذكاء الاصطناعي، حتى تحقق مقاصد الشريعة، وحتى لا يهتم بالمفضول ويترك الفاضل. الكلمات المفتاحية: الوقف، تطبيقات الذكاء الاصطناعي، المقاصد، التوقيف، الاجتهاد، ضوابط.

Background and objective: Oral health is one of the essential elements of the overall health status of the people. Dental hygiene and dental diseases concern to have a major public health problem. The aim of this study was to know the proportion self-perception of dental problems and their relation with the socio-demographic characteristics among female students at intermediate governmental schools in Abha. Methods: A cross-sectional study was conducted among girls students of two intermediate government schools of Abha city during October 2016 to April 2017 academic year by using self-administered questionnaire and informed verbal consent was obtained, using simple random sampling techniques for choosing 400 students. Results: Mean age of the students was 12.30±1.82, 163(41%) of students were 12-13 years of age and 200(50%) from 1st year of intermediate scholastic year. Almost all students belong to nuclear family system and 64%lived in rented houses. Working status of father and mothers was 94% and 53% respectively, 88% family’s monthly income >10000 SAR/per month, 203 (51%) fathers and 171 (43%) mothers had secondary school or higher education. Illiteracy was 13% among fathers and 19% among mothers. The proportion of self-perceived dental problems was 43% among students, malocclusion of teeth was most frequent while bad smell was the least frequent complaints among all dental problems. Only 38% of the students were considering dental problem as a serious problem. Dental problems were found to have significantly (P value

Objectives: Sternoclavicular joint (SCJ) dislocation is uncommon but dangerous. Redislocation frequently occurs after manual reduction due to the torn ligaments of the joint with a high-energy injury, which is often the case. Reconstruction of the SCJ is recommended to avoid poor efficacy of conservative treatment and decreasing quality of life in the patient due to progressive pain limiting the movement of the shoulder girdle. Our study aimed to evaluate the efficacy, safety, and patient satisfaction using a high-strength non-absorbable tape suture to reconstruct the anterior SCJ dislocation. Methods: This study included ten patients (Nine males and one female) who presented with acute anterior dislocation of the SCJ (six on the right and four on the left side). Our patients’ average age was 40.1 years (18–52 years), with 12 months on average follow-up (9–18 months). Four patients had isolated anterior SCJ dislocation, while the others had associated injuries. Results: All patients had excellent functional and satisfactory outcomes and returned to the pre-injury activity level. No intraoperative or major post-operative complications were recorded, and no injuries to near structures or wound problems were noted. The mean improvement of physical function measured by the American shoulder and elbow score was 24.59, which increased from 68.11 ± 3.72 preoperatively to 92.70 ± 3.54 postoperatively. Conclusion: The technique of open reconstruction of anterior SCJ dislocation using high-strength nonabsorbable tape sutures is recommended because it gave us excellent results regarding the safety, functional outcome, patient satisfaction, and avoidance of other surgical site morbidities.

Enhancing Transmission Control Protocol (TCP) performance is one of the key solutions for improving the performance of modern wireless communication networks. It is a highly dependable protocol for communication between network hosts based on an internet protocol (IP). It uses packet sequence numbering and acknowledgment (ACK) packets to ensure that data is recoverable in the event of problems like data loss, and corruption. Loss-based Congestion Control (CC) algorithms overreact and underperform in the presence of rapid channel oscillations, resulting in buffer bloat and significant delays. The goal of this paper is to develop an efficient congestion control mechanism for the new TCP agent Newreno over the fifth generation (5G) network, as well as to improve the increment and decrement strategy for adjusting the congestion window (cwnd) during the congestion avoidance phase, It also fast adapts to the current network requirements and adjusts the transmission rate accordingly. TCP enhancements can improve performance under dynamic traffic loads and over long product channels with high bandwidth. As a result, when such a TCP congestion control mechanism is improved, the network’s throughput increases, and low packet losses, and delay are reduced.

يهدف البحث إلى بيان الإطار النظري لظاهرة غسل الأموال بتعريفها وبيان مراحلها وأساليبها والأنماط الجرمية لها، كما يهدف البحث أيضاً إلى تقويم الإجراءات الرقابية للبنك المركزي في المؤسسات المالية للحد من عمليات غسل الأموال فضلا عن الإجراءات المتبعة في البنك المركزي للحد من هذه الظاهرة، وتحقيقاً لأهداف البحث ووصولاً لأفضل الأساليب والطرائق لمعالجة مشكلة البحث تم اعتماد المنهج الاستنباطي وذلك بالاستفادة من البحوث والدراسات وتوظيفها لا نجاز الجانب النظري من البحث الحالي. أما بالنسبة للجانب العملي فإنه تم اعتماد المنهج الاستقرائي والتحليلي، فقد تم إعداد قائمة استقصاء لبيان دور البنك المركزي في مكافحة غسل الأموال. وتوصل البحث إلى جملة من الاستنتاجات والتوصيات ويتمثل أهم استنتاج للبحث بأخذ البنك المركزي العراقي مسؤولياته في إجراءات الامتثال لغسل الأموال على محمل الجد عن طريق اعداد من التعليمات والارشادات والقوانين تطبق على كافة المؤسسات المالية ومتابعه تطبيق هذا القوانين وتعليمات وتحديد العقوبات الصارمة في حالة مخالفة في تطبيق أو عدم التطبيق، وتتمثل أهم توصية بزيادة اعداد موظفي الامتثال بما يتناسب مع العمل المصرفي وعرض جميع التقارير التي تصدر من قسم مكافحة غسل الأموال على مراقب الامتثال، وزيادة متابعة لإجراءات المصرف في التحفظ على الأموال المستخدمة في ارتكاب جريمة غسل الأموال وكيفية وتمويله.