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The present study aimed to clarify the alternations in alpha-fetoprotein (AFP), phosphorus (Ph), calcium (Ca), and metabolic hormones (Growth hormones (GH), insulin, and thyroid gland hormones) in singleton, twin, and triplet pregnancy in goats. Animals were examined for pregnancy ultrasonographically during mid-pregnancy (6-14 weeks of gestation), and were classified conferring to litter size into singleton (n =55), twin (n=25) and triple (n=6) pregnancy, and non-pregnant status (n=64). Blood samples (5 ml) were collected before ultrasound examination and serum was separated for analysis of alpha-fetoprotein, phosphorus, calcium, and GH, insulin, T3, and T4. The current data showed that the fetal numbers markedly influenced AFP, Ph, Ca, GH, insulin, T3 levels, but did not affect T4 and Ph/Ca ratio. AFP levels were higher in twin (P< 0.05) and triple (P< 0.001) bearing does than in non-pregnant does (56.00±5.00 and 87.00±1.90 vs 3.80±.051 ng/ml). Phosphorus and Ca levels declined with pregnancy, with the substantial decreased in multiple feti compared with non-pregnant does. Growth hormone imminently raised in twine and triple fetuses than non-pregnant does. Insulin levels elevated in triple compared to non- pregnant and singleton (P< 0.005). Serum free T3 levels were lower in single and twin bearing does than non-pregnancy. In conclusion, fetal number markedly influenced the dam metabolic profile and mineral homostatis through altering AFP and metabolic hormones levels during pregnancy in goats.

This study aimed to (1) identify the status of reproductive tract of repeat-breeder heifers (RBH) ultrasonography, as well as (2) determinethe variations in steroid hormones, oxidative stress biomarkers, and cell-free RNA in serum.These culled animals from400 heifers at the breeding stationwere examined ultrasonography, and whole blood samples were collected. Theultrasonic diagnosed heifers as paraovarian cyst (POC, n=18) associated with genital pathological conditionswere compared with groups of control heifers at follicular(n=6), luteal (n=6), and early pregnant (n=10). The POC appeared as anechoic circumscribed masses located nearby, but separated from the ovary. Follicular number, corpus luteum size, serum cell-free RNA, and ovarian steroids were not affected by POC, although dominant follicle size tended to be lower (P= 0.069)in POC withCL absence (POC-CL). Heifers with POC-CLhad lower MDA levels than pregnant ones. Buffaloes that had POC in the presence of CL (POC+CL) were found to have higher SOD activity than luteal and pregnant cases. Total serum proteinslevels recorded lower valuesin POC+CL compared to that in follicular phase. There was a significant positive relationship between POCsize, and GPx activity and CL size, but negative correlations with dominate follicles size. The POC might interfere with ovarian function, via alterations in antioxidant levels.

Background: Cryptosporidium parvum is a protozoan parasite of medical and veterinary importance that causes neonatal diarrhea in many vertebrate hosts. In this study, we evaluated the efficacy of an affinity-purified antigen as a C. parvum vaccine candidate using ileal and liver tissues of experimentally infected neonatal mice by immunohistochemical profiling and immune scoring of CD4, CD8, Caspase-3, and nuclear factor kappa B (NF-κB). This vaccine was prepared from the C. parvum oocyst antigen using immunoaffinity chromatography with cyanogen bromide-activated Sepharose-4B beads. Thirty neonatal mice were divided into three groups (10 mice/group): (1) nonimmunized noninfected, (2) nonimmunized infected (using gastric tubes with a single dose of 1×105 of C. parvum oocysts in 250 µl PBS solution 1 h before a meal) and (3) immunized (twice with 40 µg/kg of purified C. parvum antigen at 2-week intervals and then infected with 1×105 C. parvum oocysts simultaneously with the second group). After euthanizing the animals on the 10th day, post-infection, their ileal and liver tissues were collected and prepared for immunohistochemistry (IHC) staining to detect CD4, CD8, Caspase-3, and NF-κB levels, which are indicators for T helper cells, cytotoxic T cells, apoptosis, and inflammation, respectively. Results: The IHC results showed that CD4, CD8, Caspase-3, and NF-κB antibodies varied significantly (P <0.001) in both organs in all the groups. We also recorded high CD4 levels and low CD8 antibodies in the nonimmunized noninfected mice tissues, while the opposite was observed in the nonimmunized infected mice tissues. In the immunized infected mice, the CD4 level was higher than CD8 in both organs. While the Caspase-3 levels were higher in the ileal tissue of nonimmunized infected than immunized infected mice ileal tissues, the reverse was seen in the liver tissues of both groups. Furthermore, NF-κB expression was higher in the liver tissues of nonimmunized infected mice than in immunized infected mice tissues. Therefore, the IHC results and immune-scoring program revealed a significant difference (P <0.001) in the CD4, CD8, Caspase-3, and NF-κB antibody levels in both ileal and liver tissues of all mice groups, which might be necessary for immunomodulation in these tissues. Conclusions: The improvement observed in the immunized infected mice suggests that this vaccine candidate might protect against cryptosporidiosis.

Fresh semen from fifty bulls was evaluated for ejaculate volume, individual motility, concentration, lives sperm and abnormalities as well as acrosome integrity. Bulls were classified according to semen motility into two groups; good and poor. DNA was extracted from semen of both groups, then the PCR followed by single-strand conformation polymorphism (SSCP) techniques were performed for mutation detection in gonadotropin releasing hormone receptor (GnRHR) gene through multiple sequence alignment. The results showed that the percentages of sperm motility, sperm concentration and live sperm, were significantly higher in good than poor semen quality bulls. However, semen volume, percentage of acrosome integrity and abnormalities did not differ between good and poor. The PCR amplification of 240-bp fragment and the results of SSCP appeared a genetic polymorphism with two patterns. Pattern I was seen in all good bulls, with incidence of 100%. Pattern II appeared only in poor semen quality bulls with a frequency of 31.25%. The sequence analysis of the PCR product for the two patterns showed two single nucleotide polymorphisms (SNPs) as a transversion base substitution mutation at positions 20 (T/A) and 193 (A/T). The GnRHR gene could be used as a genetic marker related to semen quality in buffalo due to the good semen bulls had a unique pattern.

Introduction Restless Sleep Disorder (RSD) is characterized by frequent nocturnal movements of large muscle groups or a complaint of restless sleep by observers with associated daytime dysfunction.1 RSD, like other movement disorders of sleep, is associated with low iron stores.2 Children with RSD have increased NREM sleep instability and a propensity for parasomnia.2 No reports to date have demonstrated the use of iron therapy for parasomnia in patients with RSD. Furthermore, studies are limited in very young children with this disorder as they currently fall outside proposed diagnostic criteria.1 Report of Cases: A 2 year-old male presented to the sleep clinic with parental complaints of nightly sleep initiation and maintenance difficulty, mild snoring, restless sleep, episodes of sleepwalking and night terrors multiple times per week. Symptoms worsened over 6 months and were associated with daytime irritability and behavioral problems. Sleep quality measures assessed progress between visits: the PROMIS Sleep Disturbance (PROMIS SD) and Sleep Related Impairment (PROMIS SRI). Serum ferritin was initially 20ug/L. Polysmnogram demonstrated no significant sleep related breathing disorder, a large muscle group movement index of 14, periodic limb movement index of 3. Initial treatment included oral iron therapy, scheduled awakenings, and hypnotic dose melatonin. The sleep psychologist addressed limit setting and negative sleep associations with improved insomnia symptoms but parasomnia and restless sleep continued. The parent noted reduction in both movements and parasomnia frequency after one month of iron therapy. After a 3 month period on treatment, the parent reported complete cessation of the parasomnia, drastic reduction in restlessness, and near resolution of insomnia. Sleep quality measure PROMIS SD improved by 11, demonstrating reduced sleep disturbance. PROMIS SRI did not change. Ferritin level increased to 47ug/L. Conclusion RSD in a very young child with NREM parasomnia responded to oral iron therapy improving overall sleep quality. This case demonstrates the relationship between relative iron deficiency, RSD and associated parasomnia. Support (If Any) 1. DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder(RSD).SleepMed.2020;75:335-340. 2. Leung W, Singh I, McWilliams S, Stockler S, Ipsiroglu OS. Iron deficiency and sleep - A scoping review. SleepMedRev.2020;51:101274

Cryptosporidium is an apicomplexan parasite of human and animals and is considered as an important co-factor in neonatal diarrhea. In this study, an explant culture was used as an in vitro model of buffalo intestine to evaluate the effect of Moringa leaves extract on Cryptosporidium parvum (C. parvum) oocysts using light and scanning electron microscopy and measuring IFN-γ, IL-12 and IL-14 in the culture supernatants. C. parvum oocysts were collected from naturally-infected calf feces, isolated, excysted and then co-inoculated with ileal tissue explants culture medium. The prepared Moringa leaves extract was then introduced to the infected tissues in the concentrations of 100 mg/ml and 300 mg/ml. After 24 h, tissues were collected and processed for light and scanning electron microscopy. Also, culture supernatants were collected for cytokines measurement. C. parvum parasitophorous vacuoles were found attached to the surface of tissue in Cryptosporidium-infected ileal tissue explants. High magnification imaging of ileal tissue explants using scanning electron microscopy showed that Moringa leaves extracts had a great effect on Cryptosporidium-infected ileal tissue explants. There was a high significant (P

Objective: To evaluate the teratogenic effects of clarithromycin on developing rabbit.Design: Randomized controlled study.Animals: Twenty one female New Zealand rabbits. Procedure: The pregnant female rabbits (21) were allocated into 4 groups. Control group (G1) (6 rabbits) received placebo. Other groups received clarithromycin (at a dose of 30 mg/kg b.wt orally) for ten days during the first stage (group2, n=6), the second stage (group3, n=6) or the third stage (group 4, n=3) of pregnancy. Three rabbits from each group were slaughtered on 20th and 30th days of pregnancy. Teratogenic effects were evaluated morphologically and histopathologically. Results: The therapeutic dose of clarithromycin exhibited morphological malformations, significant decrease (P≤0.05) in viable foeti mean, the mean values of the body weight and the fetal crown-rump length. However there was significant increase (P≤0.05) in dead foeti, fetal resorption rate, pre and post-implantation death in different stages of pregnancy. Visceral fetal abnormalities revealed dilatation of lateral ventricles of brain, thickening of the ventricular wall of the heart, and slight unilateral or bilateral widening of the renal pelvis. Skeleton fetal malformations showed incomplete ossification of 5th sternipri with absence of last ribs. Histopathological examination confirm teratogenic effects of clarithromycin. Conclusion and clinical relevance: The use of clarithromycin during pregnancy should be prohibited.

So far the intimate link between serum microRNA (miRNA) and uterine inflammation in mares is unknown. We aimed (I) to investigate expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 (II) and to measure concentrations of interleukin 6 (IL-6), and prostaglandins (PGF2α and PGE2) in serum of mares with healthy and abnormal uterine status (endometritis). This study was conducted on 80 Arabian mares: young (4–7 years), and old (8–14 years). Mares were divided into 48 sub-fertile (endometritis) and 32 fertile (control) at stud farms. Serum was collected for measuring IL-6, PGF2α, and PGE2, as well as miRNA isolation and qRT-PCR. Concentrations of IL-6, PGE2, and PGF2α were higher in mares with endometritis compared to control. Age of mares had a remarkable effect on IL-6, PGE2, and PGF2α concentrations. Relative abundance of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 was higher in both young and old mares with endometritis. We noticed that eca-miR-155, eca-miR-223, eca-miR-200a, and eca-miR-205 revealed higher expression level in old than young mares with endometritis. This is the first study that has revealed the changes in cell free miRNA and serum inflammatory mediators during endometritis, and these findings could be used for a better understanding the pathophysiology mechanisms of endometritis in equine.

Background: So far the intimate link between serum microRNA (miRNA) and uterine inflammation in mares is unknown. We aimed (I) to investigate the expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 (II) and to measure the concentrations of interleukin 6 (IL-6), and prostaglandins (PGF2α& PGE2) in serum of Arabian mares with healthy and abnormal uterine status (endometritis).Methods and Results: This study was conducted on 80 Arabian mares; young (4-7 years), and old (8-14 years). These animals were divided into 48 sub-fertile including 16 young and 32 old mares suspected of endometritis and 32 fertile as control (24 young and 8 old) at stud farms. Serum samples were collected for measuring IL-6, PGF2α, and PGE2 concentrations, as well as serum miRNA isolation and qRT-PCR. Serum concentrations of IL-6, PGE2, and PGF2α were higher (P≤0.001) in mares with endometritis (young and old) compared to the control ones. Age of mares had a remarkable effect(0.001≤P≤0.01) onIL-6, PGE2, and PGF2αconcentrations. The relative abundance of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 was higher (P≤0.001) in both young and old mares with endometritis. We noticed that eca-miR-155, eca-miR-223, eca-miR-200a, and eca-miR-205 revealed higher (0.001≤P≤0.01) expression level in old than young mares with endometritis. Conclusions: To the best of our knowledge, this is the first study revealed that serum miRNA and serum inflammatory mediators (IL-6, PGE2, and PGF2α) could be used as non-invasive gold standard biomarkers, and therefore might be served as an important additional diagnostic tool for endometritis in Arabian mares.

STUDY OBJECTIVES: Because existing data investigating obstructive sleep apnea (OSA) and insulin resistance (IR) are inconsistent, we examine OSA and IR in a pediatric obesity clinic. METHODS: Children (2–18 years) in the obesity clinic (2013–2017) undergoing polysomnography (PSG), anthropometric measurements, and fasting laboratory tests were included. Linear regression assessed OSA defined by the obstructive apnea-hypopnea index (oAHI) with the homeostatic model assessment of insulin resistance (HOMA-IR). Secondary aims assessed oxygen desaturation index (ODI) and age interactions with HOMA-IR. Logistic regression models and receiver operating characteristic analysis were performed to investigate optimal oAHI and ODI cutoffs relative to HOMA-IR ≥ 3. RESULTS: Eighty children were included (mean age, 11.4 ± 4.0 years; 56% female; 46% Caucasian; median body mass index [BMI], 34.6 kg/m(2) [interquartile ratio, 29.9–40.1], median BMI z-score, 2.5 [interquartile ratio, 2.3–2.8); 46% with oAHI ≥ 5 events/h. HOMA-IR was higher in the OSA group (oAHI ≥ 5 events/h): 5 vs 3.8 (P = .034). After adjustment for sex, race, and BMI z-score, oAHI ≥ 5 events/h retained significance with HOMA-IR (P = .041). HOMA-IR increased in older children (age ≥ 12 years) when adjusting for waist circumference z-score and waist-height ratio (statistical interaction, P = .020 and .034, respectively). Receiver operating characteristic showed optimal cut points of oAHI and ODI for predicting significant IR 4.9 (area under the curve, 0.70; 95% confidence interval, 0.57–0.83; sensitivity, 0.76; specificity, 0.66) and 4.6 (area under the curve, 0.68; 95% confidence interval, 0.55–0.80; sensitivity, 0.70; specificity, 0.67), respectively. CONCLUSIONS: In a clinic-based pediatric cohort with obesity, OSA is associated with increased IR even after adjusting for confounders including obesity defined by the BMI z-score. Age ≥ 12 years was associated with AHI relative to IR after adjustment for waist circumference z-score and waist-height ratio. Significant IR could be discriminated by oAHI ≥ 4.9 with moderate sensitivity/specificity. Future studies are needed to verify these findings. CITATION: Siriwat R, Wang L, Shah V, Mehra R, Ibrahim S. Obstructive sleep apnea and insulin resistance in children with obesity. J Clin Sleep Med. 2020;16(7):1081–1090.

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.

Ameloblastic carcinoma (AC) is an extremely rare malignant odontogenic tumour arising from odontogenic epithelium. It was classified into primary type and secondary type. A previous study revealed that primary ameloblastic carcinoma cases were associated with more favourable prognosis than secondary cases. The aim of the present work was: to report the clinical, histopathological, immunohistochemical, and ploidy status, and therapeutic details of four cases of primary AC, and to review the literature with regard to clinical, follow-up, prognosis, histopathological, and immunohistochemical information of primary AC. The Medline database was searched using the term ameloblastic carcinoma and primary type. The review of English literature revealed that primary ameloblastic carcinoma favours the posterior mandible with profound male predilection and appears as an ill-defined radiolucency. Metastasis and invasion are more likely to occur in maxillary cases. The treatment of choice is wide surgical resection with or without cervical lymph node dissection. Adjuvant postoperative radiotherapy is beneficial in incomplete resection cases and advanced soft tissue invasion. The most specific diagnostic methods of AC, as concluded from review, are α-SMA in epithelial cells in conjunction with Ki-67 index value and SPF more than 11.5%.

This preliminary study investigated the tolerability and efficacy of a novel mattress technology-the Sound-To-Sleep (STS) system-in the treatment of sleep problems in children with autism.After screening, 45 children, ages 2.5 to 12.9 years, were randomized to order of mattress technology use (On-Off vs. Off-On). Treatment conditions (On vs. Off) lasted two weeks with immediate crossover. Tolerability, including study discontinuation and parent-report of mattress tolerance and ease of use, was tracked throughout the study. Efficacy assessments were obtained at baseline, prior to crossover, and end of study and included measures of autism traits, other psychopathology symptoms, sensory abnormalities, communication difficulties, quality of life, sleep diary parameters, and single-blinded actigraphy-derived sleep parameters. Statistical analyses evaluated differences in tolerability and efficacy when the STS system was on versus off.STS system use was well tolerated (n = 2, 4.4% dropout) and resulted in parent-reported sleep quality improvements (STS off mean = 4.3, 95% CI = 4.05-4.54 vs. on mean = 4.9, 95%CI = 4.67-5.14). The technology was described by parents as very easy to use and child tolerance was rated as good. Parent-diary outcomes indicated improvements in falling asleep and reduced daytime challenging behavior. Actigraphy-derived sleep parameters indicated improved sleep duration and sleep efficiency. Improvements in child and family quality of life were identified on parent questionnaires.A future large sample phase 2 trial of the STS system is warranted and would benefit from extended study duration, an objective primary efficacy outcome, and careful attention to methodological issues that promote compliance with the intervention and study procedures.

This chapter describes a case of alternating leg muscle activation (ALMA) followed by discussion of this condition and the related hypnagogic foot tremor (HFT). HFT and ALMA are benign sleep-related movements of unknown etiology, typically found incidentally on polysomnography. Both HFT and ALMA are characterized by bursts of tibialis anterior activity occurring in sequences with an inter-burst interval shorter than found in periodic limb movements in sleep. There is no specific treatment for HFT and ALMA. Rather, treatment should focus on the other comorbid sleep disorders such as obstructive sleep apnea, as HFT and ALMA motor activity associated with respiratory events may be responsive to positive airway pressure therapy. In this chapter the diagnostic criteria and clinical features are summarized, and polysomnographic tracings and video samples are provided.

This chapter illustrates the impact of sleep disorders in pregnancy by demonstrating a case of obstructive sleep apnea (OSA) associated with preeclampsia. Maternal-fetal health complications are well documented in association with maternal OSA. OSA in pregnancy is a risk for preeclampsia, eclampsia, gestational hypertension, and gestational diabetes mellitus. A growing body of literature supports the importance of detection and diagnosis of OSA in pregnant women. Pregnancy-related complications may be mitigated by OSA treatment. Treatment with continuous PAP therapy is well tolerated in pregnancy and can be offered during pregnancy. Further investigation is needed to understand the effects of treatment on outcomes in pregnancy.

The patient presented in this chapter had uncontrolled obstructive sleep apnea (OSA) and was intolerant of positive airway pressure (PAP). Previous conservative and surgical interventions failed. The patient was successfully treated with maxillomandibular advancement (MMA) surgery. Although many patients benefit from first-line therapy with PAP for OSA, some are intolerant of PAP and require discussion of alternative treatments. Maxillofacial surgical approaches are an option for the treatment of OSA in patients whose craniofacial anatomy is anatomically appropriate. With MMA, patients can achieve significant improvement and in many cases can achieve cure of OSA. Multiple studies support the benefits of MMA in those who are candidates for this treatment.

Introduction Narcolepsy is a central disorder of hypersomnia with a bimodal peak incidence at ages 15 and 35. Onset in early childhood has been reported, but rarely under the age of 5. We present a case of Narcolepsy Type 1 in a 2.5-year-old with dropping spells. Report of case(s) A 2.5-year-old African American healthy male presented with acute onset sudden drops, unsteady gait, and staring spells. These episodes lasted a few seconds, occurred multiple times a day, and were associated with eye fluttering and dysarthric speech. History was notable for increased daytime sleep/sleep attacks, disrupted nocturnal sleep with confusional arousals, nightmares and sleepwalking, weight gain and mood instability with aggressive behavior. No preceding head injury or illness. Physical examination demonstrated frequent atonic episodes with loss of deep tendon reflexes. A clinical suspicion of myoclonic/atonic epilepsy prompted video- electroencephalogram (EEG) which showed frequent bursts of generalized intermittent slowing representative of NREM 1 sleep lasting several seconds. Magnetic resonance imaging of the brain and infectious workup was unremarkable. Cerebrospinal fluid (CSF) Orexin was Conclusion This case demonstrates an unusual presentation of Narcolepsy Type 1 in a toddler initially thought to have epilepsy. Video-EEG and low CSF orexin led to the diagnosis. His age, severity of cataplexy, mood changes, and parental concerns made treatment challenging. Furthermore, this case highlights the importance of early recognition of Narcolepsy in young children to provide appropriate treatment during critical developmental stages. Support (if any)

Maize is the one of important crops in Egypt. Aflatoxins (AFs) are the foremost cancer present compounds by Aspergillus flavus (A. flavus) and cause health risks to human and animals. This study aimed to suppression of aflatoxins production by A. flavus by using different concentrations of natural substances (carnation oil, lemongrass oil, propolis and beewax) and chemical substances (salicylic acid and potassium sorbate) on maize grains. The strains of A. flavus were isolated from local maize grains on Potato Dextrose Agar (PDA) and detect its ability of aflatoxins production on coconut agar media. Samples (100g) of sterilized maize grains were treated individually with different concentration of carnation oil, lemongrass oil, salicylic acid and potassium sorbate (0.25, 0.5, 1.0, 2.0, 4.0 and 6.0%) and at concentration 1% and 4% for propolis and beeswax each, then inoculated with A. flavus and stored for 30 days at 28±2˚C. AFs reduction was determined by using High Performance liquid Chromatography (HPLC). All the tested substances had active effect in inhibition of AFs production by A. flavus in stored maize grains. The production of Aflatoxin B1 and B2 (AFB1 and AFB2) was decreased to about 93% and 99% at concentration of 0.25% carnation oil. Lemongrass oil almost completely inhibited AFB1and AFB2 production (99.12% - 99.98% and 99.98% -99.99%, respectively) at concentration of 2% - 6%. Potassium sorbate and salicylic acid (0.25%- 6%) that were significantly effective controlling aflatoxins production on maize grains compared with control. While, the propolis and beewax found to be the most active to protect maize grains against fungi. Natural substances, carnation oil, lemongrass oil, beewax and propolis had higher active effect at low concentration on aflatoxin production more than salicylic acid and more safe for human used.

RESUMO: O principal objetivo deste estudo é obter um conjunto de informações sobre o setor público do sistema de saúde mental no Egito, usando o WHO-AIMS. A obtenção destas informações, pela primeira vez no país, pode ajudar-nos a melhorar o sistema de saúde mental, permitindo uma avaliação inicial para acompanhar a mudança. Estas informações serão ainda úteis para o acompanhamento da implementação do plano de reforma, das políticas e de outras acções de saúde mental, incluindo as que são desenvolvidas nos serviços psiquiátricos gerais e especializados, e as que dizem respeito ao desenvolvimento de recursos humanos, ao financiamento de serviços de saúde mental, à investigação, à melhoria da qualidade e da promoção da saúde mental e às campanhas de consciencialização pública.. Os dados para este estudo foram colhidos em 2017 e referem-se ao ano de 2016. O Egito tem um plano e uma legislação de saúde mental. O financiamento é maioritariamente destinado ao funcionamento dos serviços, à formação de profissionais e à disponibilização da medicação essencial. O tratamento, incluindo a disponibilização de drogas psicotrópicas, é fornecido gratuitamente pelo governo nos serviços de internamento e no tratamento ambulatório. Este estudo sobre o sistema de saúde mental representa uma nova abordagem no país que se concentra na análise geográfica para medir a disponibilidade e a prestação de cuidados de saúde à população, podendo contribuir para uma melhor distribuição dos recursos. Os maiores desafios incluem o facto do Plano de Saúde Mental no Egito ser aplicado nos hospitais de saúde mental afiliados ao Ministério da Saúde (setores governamental e privado), mas não nos hospitais universitários e nos hospitais militares. O facto da equipa do Ministério (Secretaria Geral de Saúde Mental e do Tratamento das Dependências), responsável pela implementação, ser reduzida face aos padrões internacionais, é outro desafio. No entanto, esta equipa continua a disponibilizar formação contínua para os profissionais. Deverá existir uma melhoria dos programas de reabilitação na comunidade, que permitirá suportar os planos para a alta as pessoas com doenças mentais, facilitando a integração na comunidade e a continuidade de cuidados. ABSTRACT: The main goal of this study is to collect information about the governmental sector of mental health system in Egypt using the WHO-AIMS. Collecting this information for the first time in the country can help us improve the mental health system and provide a baseline for monitoring the change. It will also be useful to monitor progress in implementing reform plan, policies and mental health act, providing general and specialized Psychiatric services, monitor the human resource development, and mental health services financing, research, quality improvement, promotion of mental health and public awareness campaigns. Data for this study was collected in 2017 and based on the year 2016. Egypt has a mental health plan and mental health legislation should be regulates the services. Treatment, including the supply of psychotropic drugs is provided free by the government for inpatient and outpatient clinics. Explore of mental health services represents a type of new study that focuses on spatial analysis to measure the availability and delivery of health care to the population, and how to allocate resources. Current Mental Health act in Egypt applied on mental health hospitals affiliated to Ministry of Health (Governmental and Private sectors) but not applied on University Hospitals and Military Hospitals. The Numbers of all the health team is still less than the international standards; however General Secretariat of Mental Health and Addiction Treatment provide continuous training for mental health providers. There should be an improvement in the rehabilitation programs in the community that help discharged patients to merge normally in the community and post discharges follow up.

Background: Nitric oxide (NO) is a potent vasodilator synthesized by the vascular endothelium. It has been reported that endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphism is associated with coronary artery disease (CAD). Methodology: In this study, we investigated Glu298Asp eNOS polymorphism and serum NO in a group of 146 age-matched male subjects; 77 patients with coronary artery disease (CAD) classified according to the severity of coronary insufficiency and 69 normal male controls. Results: The obtained frequencies of the eNOS Glu298Asp genotypes for the CAD subjects were GG (54.5%), GT (31.20%), and TT (14.3%). The allele distributions of G and T were 70.1 and 29.9%, respectively. In the control group, the genotype frequencies were 53.6% for GG, 36.2% for GT, and 10.2% for TT, and the frequencies of the G and T alleles were 71.7% and 28.3%, respectively. There were no significant differences in genotype and allele frequencies between the CAD patients and the control group. The mean serum NO levels in CAD patients was significantly higher than that of healthy subjects (p=0.0139). Conclusion: No significant association was detected when CAD severity, genotypes and NO serum levels were correlated.