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Aim: The aim of this study was to assess the prevalence of micro- and macrovascular disease in Egyptian patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Methods: The study included 161 Egyptian patients with DM and PAD (91.3% had type 2 DM and 67.1% were females). Mean diabetes duration was 14.2 ± 5.2 years. Full history, clinical and fundus examination as well as laboratory investigations were done. PAD was diagnosed through assessment of ankle/brachial index (ABI) by Doppler ultrasonography. Results: ABI was 1.3 in 66.5% of patients. A significant positive correlation was found between abnormal ABI and diabetes duration, ischemic heart disease (IHD), diabetic retinopathy and neuropathy, foot ulcers, elevated blood pressure (BP), creatinine, urine albumin/creatinine ratio (ACR) and triglycerides and a significant negative correlation with HDL. Multivariate regression analysis revealed that the independent predictors for PAD in patients with ABI< 0.9 were neuropathy, creatinine, triglyceride, LDL, urine ACR and low HDL, and in patients with ABI >1.3 were IHD, neuropathy, elevated diastolic BP and triglyceride. Conclusion: The risk of micro- and macrovascular disease is high in Egyptian patients with diabetes and PAD. Early diagnosis and good control of risk factors could reduce PAD progression.

Objective: Hypothyroidism is associated with an increased risk of atherosclerosis. Pulse wave velocity (PWV) is an index of arterial wall stiffness widely used for noninvasive assessment of early atherosclerosis. We assessed PWV in Egyptian patients with hypothyroidism. Methods: The study included 100 Egyptian females aged 18 to 55 years. They were classified into three groups: group I, 40 women with overt hypothyroidism; group II, 40 women with subclinical hypothyroidism; and group III, 20 euthyroid women as a control group. The three groups were age matched. Doppler ultrasonography was used to calculate the heart-femoral PWV. Results: PWV was significantly higher in women with overt and subclinical hypothyroidism as compared with the control group (9.55 ± 1.81 m/s and 9.30 ± 1.28 m/s, respectively vs. 7.82 ± 2.14 m/s; P

We describe changes in pulmonary function measures across time in Duchenne muscular dystrophy patients treated with glucocorticoids (GCs) 1 year compared to GC naïve patients in the Cooperative International Research Group Duchenne Natural History Study, a multicenter prospective cohort study. 397 participants underwent 2799 pulmonary function assessments over a period up to 10 years. Fifty-three GC naïve participants ( 1 month exposure) were compared to 322 subjects with 1 year cumulative GC treatment. Forced vital capacity (FVC), peak expiratory flow rate (PEFr), maximal inspiratory and expiratory pressures were performed and calculated as a percent predicted (%p). GC treatment slowed the rate of pulmonary decline as measured by FVC%p, in patients aged 7-9.9 years. GC treatment slowed 12 and 24-month progression of percent predicted spirometry to a greater degree in those with baseline FVC%p from 80-34%. GC treatment resulted in higher peak absolute FVC and PEFr values with later onset of decline. Progression to an absolute FVC 1 liter was delayed by GC treatment. Patients who reached a FVC below 1 L were 4.1 times more likely to die (p = 0.017). Long-term glucocorticoid treatment slows pulmonary disease progression in Duchenne dystrophy throughout the lifespan.

Hypothyroidism is associated with increased risk of atherosclerosis. We assessed carotid intima-media thickness (CIMT), as a marker of atherosclerosis, and endothelial function in patients with hypothyroidism. We included 70 female patients with hypothyroidism in the study, 40 patients with overt and 30 patients with subclinical hypothyroidism. Forty, age- and sex-matched, subjects with normal thyroid functions were also included as a control group. CIMT was measured using high-resolution color-coded Doppler ultrasonography. Endothelial function was assessed by measuring the percent of change in blood flow following heat-mediated vasodilation using laser Doppler flowmetry. CIMT was significantly higher in patients with overt and subclinical hypothyroidism as compared with the control group (0.7 ± 0.2 and 0.6 ± 0.2 mm respectively vs 0.45 ± 0.07 mm,P P P = 0.014). CIMT negatively correlated with percent of change in blood flow following heat-mediated vasodilation in patients with overt and subclinical hypothyroidism (P

Brucellosis is highly contagious bacterial zoonoses affecting a wide range of domesticated and wild animals. In this study, Brucella (B.) abortus bv 1 was identified in uterine discharge of apparently healthy bitch and queen with open pyometra housed on a cattle farm. This study highlights the role of dogs and cats as symptomatic carriers and reservoirs for Brucella. To the best of our knowledge, this study represents the first report of feline infection with B. abortus bv 1 globally. These pet animals may contaminate the environment and infect both livestock and humans. Surveillance and control programmes of brucellosis have to include eradication of the disease in dogs, cats and companion animals.

OBJECTIVE We investigated the correlation between the severity of diabetic retinopathy (DR) and carotid intima media thickness (IMT) as a marker of atherosclerosis in patients with type 2 diabetes. METHODS The study group consisted of 140 normotensive Egyptian patients (68 males and 72 females) with type 2 diabetes and DR. Carotid IMT was evaluated using high-resolution B-mode ultrasonography. DR was assessed and graded using colored fundus photography and fundus fluorescein angiography, as either nonproliferative DR (NPDR) or proliferative DR (PDR). RESULTS Carotid IMT was greater in patients with PDR compared to those with NPDR (1.094 ± 0.142 mm vs. 0.842 ± 0.134 mm; P

This summary presents a practical exchange of experience for some typical RE funded projects in Egypt. This experience is extended to cover different areas of Renewable Energy applications including PV, Thermal, and Wind Energy systems.

OBJECTIVE Carotid atherosclerotic lesions have been described more frequently in patients with diabetes and microvascular disease than in those with uncomplicated diabetes. In this study, we investigated the role of blood pressure as a risk factor of diabetic retinopathy in normotensive patients with type 2 diabetes. We also assessed the correlation of carotid intima-media thickness with both blood pressure and diabetic retinopathy. METHODS The study group consisted of 140 normotensive patients (68 males and 72 females) with type 2 diabetes and diabetic retinopathy. Carotid intima-media thickness was evaluated using high-resolution B-mode ultrasonography. Diabetic retinopathy was assessed and graded, using colored fundus photography and fundus fluorescein angiography, as either non-proliferative or proliferative. RESULTS Patients with proliferative diabetic retinopathy showed a higher systolic and diastolic blood pressure (p

This study evaluated the various growth parameters among patients presenting with chronic diarrhea and highlight the most common causes of chronic diarrhea among a sample of Egyptian infants and children. This cross-sectional study included 146 patients with chronic diarrhea. They were 87 males and 59 females, with age ranging between 2 and 198 months and a mean age of 27.3 +/- 34.5 months. Each patient was subjected to medical history taking including age of onset and duration of diarrhea, consistency of stools, presence of blood and mucus, vomiting with or without hematemesis, fever, allergic manifestations and family history of atopy. Dietetic history included milk feeding during the first 6 months and age of weaning and age of introduction of cow's milk products. Anthropometric measurements included weight and height and weight for height were assessed and z-scores were calculated using software WHO anthro v3.2.2. Laboratory investigations included stool analysis and culture, CBC and all other investigations necessary for diagnosis of the definite cause including RAST for specific IgE against cow's milk proteins, serology for celiac disease (anti-gliadin and anti tTG), Breath hydrogen test, endoscopy (colonoscopy or esophago-gastrodudenoscopy) and histopathologic assessment of endoscopic biopsies. CMA was diagnosed on basis of withdrawal and open re-challenge technique. Causes included chronic infections (40.4%), CMA (34.9%), celiac disease (10.3%), inflammatory bowel disease (6.8%) and lactose intolerance (3.4%). Rare causes were chronic non-specific diarrhea (1.3%), cystic fibrosis (0.7%), post-surgery short bowel syndrome (0.7%), neuroblastoma (0.7%) and IBS (0.7%).78.7% of patients enrolled in the study had a low WFA z-score (< -2), 75% had low length for age z-score (

Aim We assessed the correlation between plasma adiponectin levels and carotid intima media thickness (IMT), as a marker of atherosclerosis, in non-obese patients with type 2 diabetes. Methods The study group included 112 (60 males and 52 females) non-obese Egyptian patients with type 2 diabetes. Fasting plasma adiponectin was measured using ELISA technique. Carotid IMT was assessed using high-resolution color- coded Doppler ultrasonography. Forty age, sex and weight matched normal Egyptian subjects were included in the study as a control group. Results A non-significant inverse correlation was found between plasma adiponectin levels and carotid IMT in the study group (p = 0.054). Multiple regression analysis revealed that plasma adiponectin was not a determinant of carotid IMT in the study group (p = 0.061). Conclusion The inverse relation between plasma adiponectin and carotid IMT in type 2 diabetes could be explained, at least partially, by obesity.

We evaluated the renal vascular indices in children and adolescents with sickle cell disease (SCD) using Doppler ultrasonography. We also assessed the renal hemodynamics alterations in patients with homozygous SCD and sickle beta-thalassemia (sickle β-thalassemia). We studied 75 patients (age range = 3-20 years; M = 9.95 ± 4.15) with SCD: 42 patients suffering from homozygous SCD and 33 patients diagnosed with sickle β-thalassemia. Thirty, age- and sex-matched, normal subjects were also included as a control group. Both patients and control groups had Doppler assessment of pulsatility (PI) and resistivity (RI) indices of main renal, segmental, interlobar, and arcuate arteries. Both PIs and RIs were significantly higher in SCD patients, compared with the control group. Among patients, PIs and RIs in the main renal, segmental, interlobar, and arcuate arteries were significantly higher in patients with homozygous SCD as compared with those with sickle β-thalassemia ( p values

Objectives The study was designed to evaluate the efficacy, safety, and tolerability of the ketogenic diet (KD) whether classic 4:1 formula or the modified Atkins diet (MAD) in intractable childhood epilepsy. Patients and methods Anthropometric measurements and serum lipid profile were measured upon enrollment and after 3 and 6 months in 40 patients with symptomatic intractable epilepsy. Fifteen were given MAD diet, ten were kept on classic 4:1 ketogenic liquid formula, and the rest were allowed to eat as desired. Results The liquid ketogenic formula group showed significantly higher body mass index compared with those who did not receive KD after 6 months. The lipid profile of KD patients was within normal limits for age and sex during the study period. The rate of change of frequency and severity of seizures showed best improvement in ketogenic liquid formula patients followed by the MAD group than the patients on anti-epileptic medications alone. Conclusion The KD whether classic 4:1 or MAD is a tolerable, safe, and effective adjuvant therapy for intractable symptomatic childhood epilepsy with limited adverse effects on the growth parameters and accepted changes in the lipid profile. The liquid ketogenic formula patients showed better growth pattern and significantly more seizure control.

In this paper, a new classification approach combining support vector machine with scatter search approach for hepatitis disease diagnosis is presented, called 3SVM. The scatter search approach is used to find near optimal values of SVM parameters and its kernel parameters. The hepatitis dataset is obtained from UCI. Experimental results and comparisons prove that the 3SVM gives better outcomes and has a competitive performance relative to other published methods found in literature, where the average accuracy rate obtained is 98.75%.

Background and Study Aims : Recently, tissue adhesive material has been used to improve the initial control of bleeding from huge esophagogastric varices, and to prevent them from rebleeding, in contrast to the conventional sclerotherapy. The present study assessed the value of the combined use of the tissue adhesive substance : N-butyl-2-cyanoacrylate and ethanolamine oleate 5% for management of bleeding esophagogastric varices. Patients and Methods : One hundred and fourteen patients with documented active variceal bleeding at the time of endoscopy were alternatively randomized into two groups. The combined therapy group included 58 patients who underwent injection using both cyanoacrylate for large esophageal and gastric varices and a sclerosant agent for remaining varices. The sclerosis, or control, group included 56 patients, who underwent injection with ethanolamine oleate. Results : This study proved the value of the combined therapy for the initial control of all bleeders (the follow-up period ranged from 12 to 32 months). In the sclerosis group, failure of the initial control of bleeding was reported in two cases (3.6%). Recurrent bleeding occurred in 8.6% in the combined therapy group compared to 25 % in the sclerosis group (p 0.05). Conclusion : The combined use of tissue adhesive and sclerosant materials seems to be the best plan for rapid eradication of esophagogastric varices within a short time, requiring the lowest number of injection sessions and involving minor complications and low mortality.

Brucellosis is an endemic disease in Egypt among humans and animals. Accurate estimates of disease prevalence are the cornerstone to apply and study the efficiency of any control program. In this study, a cross sectional study was carried out at one area of the Nile Delta with high livestock density; Kafrelsheikh district to study the disease prevalence in cattle and humans. A total of 149 milk samples randomly collected from cattle in this district were tested using ELISA against Brucella spp. antibodies. The prevalence of brucellosis was estimated at 7% (95% CI: 2.9 – 11.1%). The within village seroprevalence was ranged from 0% to 46.5%. About half of the visited villages had at least one infected cattle; 44.8% (95% CI: 13.0 % – 75.9%). There is a positive strong correlation (> 0.7) between the prevalence of brucellosis among sheep and cattle on village flock level (P < 0.02). In humans, the prevalence of Brucella was estimated at 1.25% (95%CI: 0% – 3.45%) in Kafrelsheikh district. Hospital-based incidence rate of human brucellosis at the governorate level was 0.54/100000 population; 0.75/100000 population for male and 0.38/100000 population for females. Half of the reported human cases with brucellosis in the governorate have no contact with animals, while 35.7% of them owned a seropositive animal in their households. Continuous integrated surveillance at human-animal interface, revising the current national control program in animals with suggestion of vaccination to be in place, restriction of raw milk marketing and enhancement of public health education regarding brucellosis risks are recommended measures to reduce brucellosis prevalence among human and animal population of the study region.

This paper explores and exchanges the experience gained from four different joint European projects directed mainly to the field of Mechatronics and funded by Tempus (Trans-European Mobility Program for University Studies) with about 3 millions €. These Mechatronics projects are based on consortium activities of EU-Egyptian and Jordanian partnership at different higher education levels including undergraduates and postgraduates programs. For successful outcomes of these projects the partnership also comprises other industrial and NGO's partners to reach practical higher educational Mechatronics programs complying with the real need for the industry and communities at the third party countries in Egypt and Jordan. In line with the objective of this paper, the author will demonstrate the typical features, difficulties, expected outcomes, replication, sustainability and the disseminations role in the W projects that are designed to benefit the Middle East partners and neighbor countries.

Support Vector Machine (SVM) is a popular data classification method with many diverse applications. SVM has many parameters, which have significant influences on the performance of SVM classifier. In this paper, a Scatter Search approach is used to find near optimal values of the SVM parameters and its kernel parameters. The proposed method integrates a scatter search approach with support vector machine using three different kernel functions, shortly (3SVM). To evaluate the performance of the proposed method, 4 benchmark datasets are used. Experiments and comparisons prove that the 3SVM is a promising approach and has a competitive performance relative to some other published methods.

Support Vector Machines (SVMs) are a popular data classification method with many diverse applications. The SVMs performance depends on choice a suitable kernel function for a given problem. Using an appropriate kernel; the data are transform into a space with higher dimension in which they are separable by an hyperplane. A major challenges of SVMs are how to select an appropriate kernel and how to find near optimal values of its parameters. Usually a single kernel is used by most studies, but the real world applications may required a combination of multiple kernels. In this paper, a new method called, weighted powered kernels for data classification is proposed. The proposed method combined three kernels to produce a new combined kernel (WPK). The method used Scatter Search approach to find near optimal values of weights, alphas and kernels parameters which associated with each kernel. To evaluate the performance of the proposed method, 11 benchmark are used. Experiments and comparisons prove that the method given acceptable outcomes and has a competitive performance relative to a single kernel and some other published methods.

This paper present a novel method for matching the wind farm with wind turbine generating units from the view point of site data and generator parameters. The paper focuses on selecting wind generator turbine parameters' in order to optimize the generated energy while maximizing the utilization of the wind power available at the location. The study presents an improvement to the site performance by identifying the best turbine parameters that should be erected at the selected site to maximize the power generation. The new method depends on introducing the new ranking parameter ‘Turbine Selection Index (TSI)’ that helps to match wind turbine with site data. For every wind site, TSI locates a unique point, at which the turbine develops its maximum performance characteristic and hence the optimal turbine parameters which match that can be located. The new method is applied for identifying the optimum wind turbine generator parameters for the wind farm promising sites in Egypt. The new method outstand old methods in the capital cost of generating units.

This paper presents an optimization controller for three-phase induction motor. In this controller, Multi Objective Particle Swarm Optimization MOPSO is implemented to tackle all the conflicting goals that define the problem. This paper deals with two conflicting objective functions. These conflicting functions are: 1. Maximize the efficiency of the drive system, and 2. Maximize the power factor of the induction motor. The proposed technique are based on the principle that the flux level in a machine can be adjusted to give the trade-off solution of maximum efficiency and maximum power factor for a given value of speed and load torque. The optimum flux levels are function of the machine load and speed requirements. Simulation results show that considerable efficiency and power factor improvements are achieved using MOPSO when compared with the Field Oriented Control (FOC) and Constant Voltage to Frequency Ratio Control (CVFRC).

This paper presents the application of PSO for losses and operating cost minimization control in the induction motor drives. In this paper, Maximum Efficiency Strategy for induction motor speed control is proposed. The proposed technique is based on the principle that the flux level in a machine can be adjusted to give maximum efficiency for a given value of speed and load torque. The main advantages of the proposed technique are; its simple structure and its straightforward verification of maximum efficiency of induction motor for a given load torque and rotor speed. As will be demonstrated, PSO is so efficient in finding the optimum operating machine's flux level. The optimum flux level is a function of the machine load and speed requirements. Simulation results show that a considerable energy and cost savings is achieved in comparison the proposed strategies with the field oriented control and the conventional methods of operation under the condition of constant voltage to frequency ratio.

This paper presents the application of neural network based on PSO for losses and operating cost minimization control in the induction motor drives. In this paper, four strategies for induction motor speed control are proposed. Those four strategies are based on PSO and called maximum efficiency strategy, minimum stator current strategy, maximum power factor strategy, and maximum weighted cost strategy. The proposed technique is based on the principle that the flux level in a machine can be adjusted to give the minimum amount of losses and minimum operating cost for a given value of speed and load torque. The main advantages of the proposed technique are; its simple structure and its straightforward maximization of induction motor efficiency and its operating cost for a given load torque. As will be demonstrated, PSO is so efficient in finding the optimum operating machine's flux level. The optimum flux level is a function of the machine load and speed requirements. Simulation results show that a considerable energy and cost savings is achieved in comparison with the conventional method of operation under the condition of constant voltage to frequency ratio and field oriented control.

This paper presents an application of the neuro-fuzzy modeling to analyze the time series of solar activity, as measured through the relative Wolf number. The neuro-fuzzy structure will be optimized based on the linear adapted genetic algorithm with controlling population size (LAGA-POP). First, the dimension of the time series characteristic attractor is obtained based on the smallest Regularity Criterion (RC) and the neuro-fuzzy modeling. Second, after describing the neuro-fuzzy structure and optimizing its parameters based on LAGA-POP, the performance of the present approach in forecasting yearly sunspot numbers is favorably compared to that of other published methods. Finally, the comparison predictions for the remaining part of the 22nd and the whole 23rd cycle of solar activity are presented.

This in turn will improve efficiency in reading.Acknowledgements: This program was supported through National Institute of Health (NIH) grant 4R44DK091964. 850 Prospective Blinded Study of a Magnetically Guided Gastric Capsule As Compared to Conventional Gastroscopy in Patients With Upper Abdominal Complaints Naoki Hosoe*, Haruhiko Ogata, Kazuo Ohtsuka, Noriyuki Ogata, Keiichi Ikeda, Hiroyuki Aihara, Ulrike W. Denzer, Geoffroy Vanbiervliet, Bilal Hotayt, Mohamed H. Abdel-Hamid, Michel Greff, Toshifumi Hibi, Shin-Ei Kudo, Hisao Tajiri, Thomas RoSch, Xavier HeButerne, Jean-Francois Rey School of Medicine, Keio University, Tokyo, Japan; Showa University, Northern Yokohama Hospital, Yokohama, Japan; University Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan; The Jikei University School of Medicine, Tokyo, Japan; Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Gastroenterology, Centre Hospitalier Universitaire de Nice, NIce, France; Institut Arnault Tzanck, NIce, France Background and aims Upper GI endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. A simpler filter tests such as capsule endoscopy would be helpful, but current passive capsules do not provide adequate gastric visualization. The current study evaluates a magnetically guided capsule endoscopy (MGCE) in patients with routine indications for gastroscopy. Methods Symptomatic patients from two French centers underwent subsequent MGCE and conventional gastroscopy, performed independently of each other and primarily in a blinded fashion; final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was the accuracy (sensitivity/specificity) of MGCE for the diagnosis of major gastric lesions calculated on a patient basis, defined as those requiring conventional gastroscopy for biopsy or removal. Secondary outcomes were detection of minor lesions, factors influencing accuracy and complications. Results Of 214 eligible patients, 189 patients were included (105 male, 84 female, mean age 53 years); MGCE was performed by 9 examiners, conventional gastroscopy by 6. 23 major lesions were finally diagnosed in 21 patients. With a specificity of 94.1% (CI 89-97), MGCE sensitivity was only 61.9% (CI 34.5-77) and did not correlate with lesion localization, gastric luminal visibility, examiner case volume, or examination time (OR 0.715, p 0.03). Of the remaining patients (n 168), 94% had minor lesions, mostly diffuse and multiple; MGCE made a correct diagnosis in 88.1% (CI 82.2-92.6) of cases with a sensitivity of 89.2% (CI 83.3-93.6) and a specificity of 70.0% (CI 34.8-93.3); of confounding factors, only proximal location of findings was found to be significant. On subsequent interviews, patients preferred MGCE to conventional gastroscopy (VAS 1.17 (95% CI 1.11-1.23) vs. 1.67 (95%CI 1.55-1.79); p 0.001) and unequivocally favored MGCE (100%) for repeated examination. Conclusions In a prospective and strictly blinded study design, MGCE shows insufficient sensitivity for relevant focal gastric lesions despite clear patient preferences for this method. MGCE requires improvement of complete gastric visualization including preparation and capsule guidance.

Background Between February and July 2014, a cross-sectional study to estimate the seroprevalence of brucellosis in sheep in the Kafrelsheikh district of Egypt was carried out, together with a survey of knowledge, attitudes and practices (KAPs) among local shepherds. A total of 273 serum samples were collected from 28 sheep flocks in 10 villages within the study area. These samples were analysed by the Rose Bengal Plate test (RBPT) test, with all positive samples being confirmed by complement fixation test (CFT). Results True seroprevalence was 20 % (95 % CI 15.3–24.7 %) with the prevalence of villages with at least one seropositive sheep estimated at 95.5 % (95 % CI 92.2–100 %); village flock seroprevalence ranged from 0 to 46.8 %. Results of the KAPs survey demonstrated that despite good knowledge regarding brucellosis being potentially present within their flocks, shepherds lacked knowledge regarding routes of livestock to humans disease transmission and the symptoms of brucellosis in humans. This lack of knowledge regarding disease transmission resulted in high-risk practices being widespread—practices such as assisting parturition without protective measures, throwing aborted material into water canals and a reluctance to remove animals that had aborted from the flock. Conclusions This study proposes potential measures to reduce seroprevalence of brucellosis in sheep and reduce public health risks from brucellosis such as culling aborted livestock and educational campaigns among shepherds regarding disease risks and modes of transmission. Electronic supplementary material The online version of this article (doi:10.1186/s13028-015-0183-2) contains supplementary material, which is available to authorized users.