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Objective This position paper written by the Hepatitis Expert Team of the Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition aimed to systematically evaluate clinical practice guidelines (CPGs), medical consensus, and position papers on the use of direct-acting antivirals (DAA) to treat chronic hepatitis C virus (HCV) infection in adolescents and children in order to compare recommendations and provide the basis for developing a unified position statement. Methods MEDLINE, Cochrane-Library, National Guideline Clearinghouse and select websites of relevant societies/organizations were used to identify CPGs, medical consensus and position papers between 2011-2019. Results A total of 5 documents were analysed: 3 CPGs, 1 medical consensus, and 1 position paper. All publications were consistent in recommending DAA treatment for adolescents (12-17 years old) with chronic HCV infection. Similarly, all of these publications consistently recommended deferring therapy for children between 3 and 11 years of age until DAA became available as standard of care. Finally, none of the included publications recommended treating children younger than 3 years old. By contrast, there was significant discrepancy across the retrieved documents regarding specific DAA regimens and treatment strategies. Conclusions There is strong consensus on treating all adolescents with chronic HCV infection with DAA and on delaying therapy in younger children until these agents are approved for them. Interferon-based therapies should be avoided. Specific recommendations regarding which DAA regimen to use and treatment duration varied significantly. Key stakeholders need to convene to standardize therapeutic strategies at a global level if we are to eradicate HCV in children.

Background The propeller perforator flap is a variant of perforator flaps in which complete skeletonization of the perforator with venae commitantes is done to transfer the islanded flap on its pedicle with up to 180 degrees of twisting that predispose to its gradual occlusion by time. These flaps have been recently advocated for lower extremity reconstruction. However, reconstruction of the lower extremity especially in the distal third of the leg quite often involves multistage procedures that might necessitate flap re-elevation and little knowledge is available about postoperative patency of these flaps. Aim of the work The aim of this study is to assess the postoperative patency and flow pattern in twisted vascular pedicle of propeller perforator flaps used in lower extremity reconstruction. Materials and methods A Prospective study was conducted on 15 patients 18 years or older of both genders undergoing lower extremity soft tissue reconstruction by propeller perforator flaps rotated from 90 to 180 degrees at Ain Shams University Hospitals and Nasser Institute between 1st February and 31th December 2019. With exclusion of smoking, peripheral vascular diseases and diabetes mellitus, each patient was evaluated preoperatively in regards to age, gender, comorbidities, bacterial contamination or infection, cause of tissue loss. The flap size, source vessel, arc of rotation, donor site closure was analyzed. The flow pattern was evaluated by handheld Doppler device and used as a control for the study. Postoperatively, the same handheld Doppler device was used to localize the vascular pedicle, evaluate its patency and assess the flow pattern at a minimum follow up period of 3 months postoperatively in all patients. Results The mean age of the fifteen patients included was 35.3 years old. Six patients lost tissue was caused by unstable scar, while post-traumatic in the remaining. Preoperatively, four patients had osteomyelitis and four had wound infection. The rest of patients did not report any infection. Eight out of fifteen patients used perforators from peroneal vessel source, while seven patients used posterior tibial artery source. Forty percent of included participants had a 180 degrees arc of rotation, while 26.7% of participants had an arc rotation angle of 120 degrees, and 33.3% had 90 degrees. Five patients had early post-operative congestion that improved by conservative methods without de-rotation of the flap, one patient had skin graft loss over the donor site of the flap, and another patient suffered in addition to skin graft loss distal congestion leading to superficial skin necrosis. Eight patients had no complications. All patients had patent vessels with biphasic flow pattern postoperatively at a minimum of 3 months postoperatively. Conclusion The perforator propeller flaps are safe, reliable procedures and are considered as an ideal option in reconstructing small-medium defects of the middle and distal third of the leg providing similar skin texture with low rate of vascular obstruction. The present study documented patent vascular pedicle of propeller perforator flaps at three months postoperatively.

Background Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. Objectives The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. Patients and Methods The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. Results The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block. Conclusion TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.

BACKGROUND The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported. PURPOSE The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures. METHODS This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3-5 years. RESULTS The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study. CONCLUSION Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.

Worldwide and national efforts are directed against eradication of HCV. The introduction of direct-acting antivirals (DAAs) has changed dramatically the outcome of HCV treatment. In spite of the Food and Drug Administration approval of the oral drugs sofosbuvir (SOF) and ledipasvir (LED) for the treatment of HCV in adolescents more than or equal to 12 years old, sufficient real-world experience is still lacking. The aim of this study was to assess the safety and efficacy of the generic SOF/LED fixed-dose combination 400/90 (400 mg SOF + 90 mg LED) for the treatment of adolescents and children (9–12 years) with chronic hepatitis C (CHC). In this prospective observational study, 100 cases of genotype 4 CHC were recruited consecutively from those fulfilling the inclusion and exclusion criteria. All cases received the generic fixed-dose combination SOF/LED (400/90), one tablet daily for 12 weeks. All clinical, laboratory, and virologic characteristics were evaluated at base line, and week (W) 2, 4, 8, and 12 of therapy and W12 post-treatment (SVR12). Recruited children (9–12) and adolescents weighed 28–83 and 31–90 kg, respectively. Eighty cases were naive and 20 cases were pegylated interferon/ribavirin treatment-experienced. Very rapid virologic response (vRVR) at W2 was 96%, while at W4 response rate was 100% and maintained till the end of treatment and at W12 post-treatment (SVR12). All reported side effects were mild and did not lead to treatment termination and disappeared at W12 post-treatment. The generic SOF/LED fixed-dose combination is safe and effective in children, 9–12 years, and adolescents with vRVR rate of 96%, 100% EOT response and SVR12.

Objectives: the aim of this study is to evaluate the healing and anti-inflammatory effects of propolis in critical wound defects in rats ‘ buccal mucosa.Subjects& methods: 20 adult male albino rats of average weight 150-250 grams were used. Rats were divided into 2 groupsGroup I: consists of 10 rats, which were subdivided into 2 sub groupsSub Group I A: consists of 5 rats, the wounds were left un treated for 3 daysSub Group I B: consists of 5 rats, the wounds were left un treated for 7 daysGroup II: Consists of 10 rats which were subdivided into 2 sub groupsSub Group II A: consists of 5 rats, the wounds were treated with propolis for 3 daysSub Group II B: consists of 5 rats, the wounds were treated with propolis for 7 daysThe wounds were examined histologically, histochemically and immunohistochemically Results: Histologiacally, histochemical and immunohistochemical results showed that the healing process was faster in propolis treated rats due to anti inflammatory and anti oxidant effects of Propolis. Immunohistochemical labeling of vimentin in propolis treated groups was higher than un treated groupsConclusion: Propolis could improve wound healing by stimulating the proliferation of epithelial cells; and fibroblast proliferation, thus improving wound closure and decreasing inflammation (as prolonged inflammation and the release of inflammatory cytokines could cause tissue damage)

BackgroundCOVID-19 is a pandemic disease caused by SARS-CoV-2, which is an RNA virus similar to HCV in the replication process. Sofosbuvir/ledipasvir is an approved drug by the FDA to treat HCV infection. This study investigates the efficacy of Sofosbuvir/ledipasvir as a treatment for patients with moderate COVID-19 infection..MethodsThis is a single-blinded parallel-randomized controlled trial. The participants were randomized equally into the intervention group received Sofosbuvir/ledipasvir (S.L. group), and the control group received Oseltamivir, Hydroxychloroquine, and Azithromycin (OCH group). The primary outcomes were the cure rate over time and the incidence of serious adverse events. The secondary outcomes included the laboratory findings.ResultsTwo hundred and fifty patients were divided equally into each group. Both groups were similar regarding gender, but age was higher in the S.L. group (p=0.001). In the S.L. group, 89 (71.2%) patients were cured, while only 51 (40.8%) patients were cured in the OCH group. The cure rate was significantly higher in the S.L. group (RR=1.75, pConclusionSofosbuvir/ledipasvir is suggestive of being effective in treating patients with moderate COVID-19 infection. Further studies are needed to compare Sofosbuvir/ledipasvir with the new treatment protocols.

The term non-alcoholic fatty liver disease (NAFLD), and its definition, have limitations for both adults and children. The definition is most problematic for children, for whom alcohol consumption is usually not a concern. This problematic definition has prompted a consensus to rename and redefine adult NAFLD associated with metabolic dysregulation to metabolic (dysfunction)-associated fatty liver disease (MAFLD). Similarities, distinctions, and differences exist in the causes, natural history, and prognosis of fatty liver diseases in children compared with adults. In this Viewpoint we, an international panel, propose an overarching framework for paediatric fatty liver diseases and an age-appropriate MAFLD definition based on sex and age percentiles. The framework recognises the possibility of other coexisting systemic fatty liver diseases in children. The new MAFLD diagnostic criteria provide paediatricians with a conceptual scaffold for disease diagnosis, risk stratification, and improved clinical and multidisciplinary care, and they align with a definition that is valid across the lifespan.

Aim of the study Neonatal cholestasis (NC) constitutes a large proportion of pediatric liver disorders. Nevertheless, awareness of the variant etiologies and how to manage them appropriately are lacking. So, out of a few specialized centers, many cases pass without appropriate management. This study aimed to present our tertiary level center's experience in NC that could increase the pediatrician's awareness of handling this problematic and common medical morbidity efficiently. Material and methods It is a retrospective study in which we analyzed the NC cases admitted to the inpatient department within three years. For all recruited patients, the available data were retrieved and recorded. Results A total of 412 patients were reviewed with 20 different etiologies diagnosed. The most common cause was biliary atresia (n = 151, 37%), followed by progressive familial intrahepatic cholestasis (n = 51, 12%), neonatal sepsis (n = 39, 9%), and cytomegalovirus (n = 33, 8%). Of the 412 patients, 394 (81%) had follow-up ranging from 1 to 36 months. A total of 173 patients improved with supportive and/or specific therapy, while 108 patients died at a median age of 6 months. The commonest cause of death was liver failure (40.7%), followed by pneumonia (28.7%), sudden death (13%), septicemia (6.5%), and hepatorenal syndrome (5.5%). Conclusions NC constitutes more than one-third of the inpatient admissions of all pediatric liver disorders and has a high rate of mortality. Awareness of the variety of etiologies and a rapid stepwise approach to diagnosis could have an impact on the outcome of this devastating disease.

Background: Pneumonia is a life-threatening disease in children. Diagnosis of pneumonia is mainly clinical. However, some clinical features may be subtle or not specific. Lung ultrasound (LUS) might be used as a diagnostic tool in pneumonia as it is an easily accessible and safe imaging technique. Aim of the work: This study aimed to investigate the role of lung ultrasound in diagnosing pneumonia compared to chest x-ray in children. Subjects and methods: This cross-sectional study was carried out at the general pediatric wards and pediatric intensive care units [PICUs], Department of Pediatrics, Al-Azhar University Hospital [Damietta]. It included 120 patients who were clinically diagnosed to have pneumonia. Each legal guardian signed informed consent. Then, everyone was subjected to chest x-ray and lung ultrasound, and results were compared. Results: Sonographic findings in children with pneumonia as consolidation was detected in 114/120 (95.6%), air bronchogram in 104/120 (86.7%), fluid bronchogram 37(31.1%), multiple B-lines in 68/120 (56.7%), pleural effusion in 29/120 (24.4%). The lung ultrasound [LUS] showed higher diagnostic accuracy (94.45%), sensitivity (95.6%), and specificity (93.3%). There was a statistically significant good agreement between LUS and chest X-ray [CXR]. Conclusion: LUS is safe, accurate, and more sensitive for the diagnosis of suspected pneumonia in the pediatric age group and had the advantage of reducing radiation hazard when compared to chest X-ray

Background Inflammation is an important contributor to the pathogenesis of rheumatic heart disease (RHD). High serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) are commonly seen in patients with chronic (RHD) and indicate the presence of a chronic inflammatory state. The aim of this study was to assess the effect of colchicine as anti-inflammatory drug on the serum levels of the inflammatory markers (CRP) and (IL-6) in patients with chronic (RHD). Results This is a prospective controlled study that enrolled thirty-five patients with chronic (RHD) visiting Ain Shams University Hospital’s outpatient clinic for receiving regular long acting penicillin as rheumatic fever prophylaxis. Ten matched healthy individuals were taken as control group. Blood samples for serum levels of CRP and IL-6 were collected before and 1 month after receiving colchicine 0.5 mg BID. Mean (CRP) level was 6.09 ± 4.39 IU/ml versus 0 IU/ml in the control group respectively (P = 0.0001). Mean (IL-6) level was 113.57 ± 37.41 ng/l versus 10.50 ± 5.99 ng/l, in the control group (p = 0.0001). Mean (CRP) was 6.09 ± 4.39 IU/ml before and became 3.34 ± 3.07I U/ml 1 month after colchicine therapy. Mean (IL-6) level was 113.57 ± 37.4 ng/l before and became 45.57 ± 20.39 ng/l 1 month after colchicine therapy (P = 0.001). Conclusion In this pilot study, using colchicine as anti-inflammatory drug in patients with chronic (RHD) significantly reduced the serum inflammatory markers (CRP) and (IL-6), thus helping in ameliorating their chronic inflammatory state.

This research presents a proposed method to overcome difficulties which we face when we use traditional regression analysis method and provide solutions in an automated manner that does not require experience or a large field study. Some of these difficulties are mathematical difficulties, some of which are the need for considerable experience to choose the appropriate data model, especially when the traditional regression analysis method is not available. The new approach raises forecast accuracy with powerful Neural Network MATLAB code. This approach automatically trains neural networks and applies them for regression analysis, thus getting accurate, business or stock market predictions doesn’t require much effort or time. This means faster and more precise results than ever before.

Metronomic chemotherapy (MC) has shown efficacy in patients with metastatic breast cancer (MBC). We therefore tested the efficacy and toxicity of MC in pretreated MBC.This prospective phase II study included 50 patients with heavily pretreated MBC who received MC in the form of continuous oral cyclophosphamide 50 mg/day and oral methotrexate 2.5 mg twice per day on days 1 and 2 every week. The primary end point was progression-free survival (PFS), whereas the secondary end points were response rate, overall survival (OS), and safety.Forty-eight patients were assessed. One patient achieved complete response and 10 patients had partial response, whereas 19 patients had stable disease. The median PFS was 5 months, whereas the median OS was 7 months. Patients with negative progesterone receptors, Eastern Cooperative Oncology Group performance status (PS) 1, achieving response, and those who developed leucopenia, neutropenia, and anemia had significant prolonged PFS, whereas patients with early stage at presentation, receiving 5 previous treatment lines, achieving response, and experiencing anemia with MC had significant superior OS. In multivariate analysis, achieving response, PS 1, a longer time interval from initial diagnosis until starting MC, and anemia were independent prognostic factors for longer PFS. Initial stage at presentation, number of previous treatment lines, and response were independent prognostic factors for OS.MC is an attractive treatment approach that is effective and less toxic. There are certain groups of patients who seem to benefit more, especially those who experienced toxicity with treatment. Larger trials are warranted to assess this approach early in the course of the disease and with other more active agents.

The increase in Rheumatoid arthritis (RA) associated mortality is predominantly due to accelerated coronary artery and cerebrovascular atherosclerosis with increased risk of ischemic heart disease about 50% in RA patients compared to controls.To study the pathogenesis of ischemic heart disease in RA, role of inflammatory cytokine interplay, disease activity and rheumatoid factor positivity.Eighty RA patients and 44 healthy controls were included. All subjects were younger than 45years for females and 55years for males with exclusion of all traditional risk factors for atherosclerosis. Interleukin (IL) 1, 6 and 18 were assessed in all subjects. RA patients fulfilled ACR/EULAR 2010 criteria and were subjected to Dobutaminestress-echocardiography, diseases activity assessed by DAS-28, X-ray hands for Larsen score and function assessment by HAQ.RA patients had significantly higher serum IL 1, 6 and 18 than controls (p=0.00 in all). Thirty four (42.5%) patients had hypertensive reaction on Dobutamine-stress-echocardiography, four of them had ischemic change, and 46 (57.5%) had normal reaction. All patients with hypertensive reaction had positive RF (p=0.00), 10 had DAS-285.1, 20 had DAS-28 from 3.2 to5.1 and 4 were in remission (p=0.001). CRP was higher in patients with hypertensive reaction (p=0.003) while serum levels of IL1, 6 and 18 showed no significant difference. In all patients, serum levels of IL1, 6 and 18 showed significant positive correlation with VAS, HAQ and DAS-28 (p0.001 in all). Only IL18 showed significant positive correlation with X-ray score in all patients.Disease activity and RF positivity play an important risk factor for ischemic heart disease in RA. Serum levels of IL1, 6 and 18 did not help much in detecting patients at risk of ischemic heart disease. Better control of RA disease activity with early remission helps in preventing cardiac complications. More studies on larger number of patients are needed for better understanding of mechanism of ischemic heart disease in RA.

Background: Jaundice is one of the most common conditions confronting neonatologists daily. Phototherapy is generally regarded as a safe method for treating hyperbilirubinemia, but it may also lead to undesired effects, one of these effects that it can affect the function of the immune system of the newborn. Aim of the work: The aim of the work was to study the effect of phototherapy on the serum level of tumor necrosis factor- alpha [TNF-α] in neonates. Patients and methods: A total of 35 cases of term neonates with Neonatal Jaundice and indirect hyperbilirubinemia high to the level that need phototherapy for 72hrs or more according to the guidelines of the American Academy of Pediatrics were included in this study, and 15 healthy matched newborns were selected as controls. TNF-α was measured before exposure and after 72 hours phototherapy and from control group at the time of examination. Serum levels of TNF alpha were measured using enzyme linked immunosorbent assay kits. Results: The results showed that there was no statistically significant in patient group before phototherapy in comparison to control group as regards TNF-α, patient demographics or laboratory data. On the other side, serum TNF-α levels significantly increased after exposure to phototherapy for 72 hours when compared to values before phototherapy (151.49±61.97 vs 61.36±31.96 respectively), indicating the influence of phototherapy on serum level of TNF-α. Conclusion: The results demonstrated increased serum TNF-α level after 72 hours may affect the immune system in neonates.

Objective To evaluate the safety and efficacy of shortened 8-week regimen of ledipasvir/sofosbuvir (LED/SOF) combination therapy in treatment-naive children without cirrhosis aged 4-10 years of age with chronic hepatitis C virus (HCV) infection. Study design This observational single arm prospective study included 30 treatment-naive children (20 males) with proved chronic HCV fulfilling inclusion criteria. Their body weights ranged from 17 to 26 kg. Four patients were excluded from the study. All the included children received a single oral dose of LED/SOF 45/200 mg for 8 weeks. Body weight, HCV-RNA, complete blood count, and liver function tests were monitored at 0, 2, 4, and 8 weeks and sustained virologic response was evaluated after 12 weeks after treatment (SVR12). The emergence of any side effects was also monitored. Results The most common risk factor (53.3%) was an parent or sibling with HCV infection. Twenty-nine patients (96.7%) were negative for HCV-RNA by week 2 of treatment and 1 patient became negative by week 4. The end of treatment response and SVR12 were 100%. Transaminases levels declined and returned to normal levels by week 2. Major side effects were fatigue in 90% (27/30) and headache in 76.7% (23/30). Side effects were minimal, tolerable, and did not interfere with daily activity or necessitate treatment discontinuation. Conclusions A shortened 8-week regimen of LED/SOF (45/200 mg) is safe and effective with 100% SVR12 in treatment-naive children with cirrhosis aged 4-10 years with chronic HCV infection genotype 4.

Congenital anomalies of urinary system are of wide spectrum ranging from mild, asymptomatic malformations to severe fatal conditions. To investigate occurrence of congenital anomalies in urinary system. It was a cross-sectional study. Study populations were Sudanese patients with ESRD on regular hemodialysis attending Gezira Hospital for Renal Diseases & Surgery, Gezira State, Sudan. Independent variables were horseshoe kidney, polycystic kidney disease, double ureter or ureteral duplication, ureteropelvic junction obstruction, posterior urethral valves, hypogenesis, agenesis, and kidney position. Dependent variable was hemodialysis. Investigation was done using abdominal ultrasound. Personal data was obtained using a questionnaire. Data was analyzed using SPSS version 21. P-value ≤ 0.05 was considered statistically significant. Results: Thirty one (62%) of respondents was male. Minimum age was 19 years while maximum age was 70 years. Maximum affected age group was age group (36-45) years; followed by age groups (46-55) and (56-65) years. Minimum age at which disease was diagnosed was 13 years. Overall prevalence was 12%. Four types of congenital anomalies were encountered and these are: polycystic kidney disease, uretero-pelvic junction obstruction, hypogenesis, and agenesis. Minimum disease duration was 1 year while maximum duration was 16 years. Mean duration was 6.42 years. Gender distribution of these types was as follows: Male (Two cases of polycystic kidney disease, one case of ureteropelvic junction obstruction, and one case of agenesis); female (one case of polycystic kidney disease, and one case of hypogenesis). Duration of disease is higher among male. Conclusion and recommendation: The current study highlighted a significant statistical relationship of the congenital anomalies in the urinary system among respondents and duration of ESRF. Screening for presence of congenital anomalies of renal system among general population of Central State may be of great help.Read Complete Article at ijSciences: V82019082147 AND DOI: http://dx.doi.org/10.18483/ijSci.2147

Background: Carotid artery stenting (CAS)has become widely available and considered as an alternative to carotid endartectomy . Objective: To compare CAS under protection device with medical treatment. M aterial and method: fifty patients were enrolled in these study (30 patients treated with carotid stenting and 20 patients managed medically) with stenosis > 60%.with follow up at six months later clinically and radiologically using carotid duplex . Result: After 6 months 4(13.4%) patients in CAS group develop TIA while in medically treated group 6(30%) patients, 1(3.3%) patient in CAS group develop stroke which was after procedure while 6(30%) patients in medically treated group develop stroke during follow up within 6 months, 1(3.3%) patient die in CAS group due to myocardial infarction, while in medically treated group 2(10%) patients died one of them due to large stroke and the other due to myocardial infarction. There was high significant difference between CAS and medical treated group after 6 months (p

Objectives To assess the upper limit of normal values of antistreptolysin O titer (ASOT) in healthy school-age children in Menoufia governorate. Background Acute rheumatic fever (ARF) and rheumatic heart disease are the most serious complication of group A streptococcal infection. Acute post-streptococcal glomerulonephritis occurs 2–3 weeks after skin or throat infection with group A streptococcus. Overdiagnosis of ARF based on a raised ASOT is common in endemic areas, although an isolated high ASOT is not sufficient to diagnose ARF. Patients and methods This cross-sectional study was carried out in Menoufia governorate, and the collected sample was tested in Clinical Pathology Laboratory at Menoufia University Hospitals. Our study was conducted on 4000 children during the period of September 2018 to April 2019. All children are subjected to full medical history, thorough clinical examination (general and systemic), and laboratory investigation, including ASOT and erythrocyte sedimentation rate assessment and throat culture. Results There was no significant difference between age and sex in the studied group. Our study showed also nonsignificant correlations between age and ASOT among the studied groups and among rural or urban participants. We found that the younger children aged up to 10 years had more basal levels of ASOT than older children. Conclusion We concluded that upper limit of normal values of ASOT in normal Egyptian children in Menoufia governorate is quite high and may reach up to 475 IU/ml.

ObjectiveTo define nomograms for blood pressure in Egyptian children and adolescents.Methods and study designA total of 60 025 Egyptian children from birth to 19 years were enrolled in this cross-sectional randomised study from December 2015 to March 2017. They were selected from diverse geographical districts in Egypt. Healthy children who fulfilled the inclusion criteria, which included good nutritional history, absence of fever or documented underlying disease at the time of examination, no evidence of haemodynamically significant illness, and no antihypertensive drugs or other chronic drug administration, were included in the study. Body weight, recumbent length (for less than 24 months) and height (from 2 years to 19 years), and blood pressure were measured using standard mercury sphygmomanometers.ResultsBlood pressure increases with age in both boys and girls. The 90th percentile of systolic and diastolic blood pressure among Egyptian children was different from other ethnic populations (American and Turkish children) in both sexes. Systolic and diastolic blood pressure showed a positive correlation with weight and height in both sexes (pConclusionWe assumed that normal blood pressure curves should be used cautiously during childhood, and it is recommended that every population have its own normal standard curve to define measured blood pressure levels in children. These centiles increased our knowledge and awareness of normal blood pressure among Egyptian children and adolescents. The percentiles will distinguish children and young adolescents with increased blood pressure and will be of value to both medical practice and scientific research.

Aim Early diagnosis of biliary atresia (BA) is of utmost importance for good outcome; however, it is sometimes difficult due to the overlapping diagnostic test results with other causes of neonatal cholestasis. Moreover, many diagnostic tests are costly, invasive and not available in all centers, especially in developing countries. So, we aimed to investigate the diagnostic performance of urinary urobilinogen; an easy, cheap test that was not tested before in BA. Methods Seventy-five infants divided into three age- and sex-matched groups (BA, non-BA cholestasis and healthy control group) were recruited for the study. Each group comprised 25 infants. Urinary urobilinogen was measured for all infants using the modified Ehrlich's method. Results Urinary urobilinogen was significantly lower in the BA group (0.31 ± 0.25 mg/dL) than both of the non-BA cholestasis (2.08 ± 3.48 mg/dL) and healthy control (0.53 ± 0.64 mg/dL) groups at P

indicates a that there is a positive relationship between regular exercise and aging, which is evident by helping to maintain, on the ability to live independently from the risk of bone fractures, and the risk of death from (heart disease, control in the level of blood pressure, prevention of colon cancer, diabetes) and help keep bones and joints, and muscles healthy, pain control, sense of activity, vitality, keep the balance, and agility this resulting in reducing the probability of falling, as physical activities help to abandoned elderly from unhealthy habits, such as smoking, use of alcohol and improve their awareness as a result of the evolution of the physical abilities, mental, and earn individual nicer look toward life.(22:7).

Field Background In Aug. 2015, Umm Lulu drilling team drilled and completed well014 as a first linerless design by setting the 9 5/8" casing in Thamama-I formation and drilling an 8 ½" section till TD, relying on swell packer for zonal isolation. Post evaluation of UL-14 design found cross flow between Thamama-I formation and Thamama-II target reservoir. The drilling division developed another design by extending drilling the 12 ¼" hole till Thamama-I A base to isolate Thamama-I with cement after running the 9 5/8" casing and drilling 8 ½" hole till section TD. This scenario was not possible to execute due to the unavailability of completion equipment (4 ½" × 8 ½" swell packer). The drilling division thought out of the box to drill 6" hole directly from 9 5/8 casing to address the equipment availability constraint. This option was pursued after thorough evaluation of all potential challenges. In April 2017, well018, which was a first revised design, was drilled and completed successfully 10 days ahead of plan, saving $2.00M. In June 2017, well020 was delivered with the best jack up 10k duration in ADMA-OPCO (31.5 days) and the best single oil producer with lower completion duration of 56 days, saving more than 15 days and $3.2M.

Nowadays, investigating new techniques to accelerate nonlinear systems’ simulations is a need because of their regular usage in industry. Systems’ simulators need to solve an enormous number of nonlinear equations. Software-based solutions cannot solve complex nonlinear equations in a reasonable time while maintaining scalability with the increase in the number of equations. The speedup of the process can be achieved by hardware accelerators. This research enhances a neural network architecture with a new hybrid-updating rule realized in hardware to solve nonlinear equations. A scalable hardware architecture is introduced to solve any number of nonlinear equations and achieve a high performance gain. Results show the increase in the performance gain between our proposed solution and software solvers. For example, our proposed architecture is able to solve 1000 sparse equations on Xilinx Virtex-7 with 400x speedup compared to other software methods.

Background Acute lymphoblastic leukemia (ALL) is the most well-known sort of leukemia in children. In spite of favorable survival rates, some patients relapse and achieve a poor outcome. Methods We analyzed miR-125b and Bcl-2 expressions in pediatric patients with ALL and evaluated their clinical utility as molecular markers for the prediction of disease outcomes. Results Downregulation of miR-125b and increased Bcl-2 expression levels in pediatric patients with ALL were associated with poor prognosis at diagnosis. At day 28 of induction, miR-125b was significantly increased, whereas Bcl-2 was downregulated. Loss of miR-125b during diagnosis and its elevation after therapy are strongly correlated with short leukemia-free survival and worse survival. Moreover, the combination of miR-125b with Bcl-2 markers can clearly enhance the prediction of the disease outcome. Finally, a univariate analysis highlighted the independent prognostic value of miR-125 in a pediatric patient with ALL. Conclusions miR-125b and Bcl-2 together are potent predictors for the prognosis and, therefore, can be used as therapeutic targets in childhood ALL.

Background and Aim Diagnosis of biliary atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis (NC), is challenging. Ultrasonography is a helpful investigation when evaluating NC. The aim was to determine the value of color Doppler ultrasound, particularly hepatic subcapsular flow, as a possible tool in early discrimination of BA from other causes of NC. Methods Ultrasonographic and color Doppler findings of 27 BA patients were compared with that in 27 non-BA cholestasis patients and a control group of 22 non-hepatic neonates. Results Hepatic artery diameter was significantly higher in BA (2.48 ± 0.55 mm) than that in non-BA group (1.91 ± 0.63 mm) (P = 0.001) and the control group (1.6 ± 0.47 mm) (P

This paper demonstrates enhancement of smart completion capabilities by integrating with digital oil field platform for effective performance management of dual lateral wells. Single smart completion with ICVs for controlled comingled production among two reservoirs was successfully deployed and commissioned for 03 oil producers in one of Abu Dhabi green fields. The multi-position ICVs with customized flow trim design enabled regulating flow from reservoirs downhole and performance monitoring in real time. Additionally with launch of digital oil filed (DOF) in ADMA-OPCO, it is recognized as beneficial using the real time data monitoring to remotely control and operate smart wells for better reservoir management; helping to enhance the smart well system operating reliability. Production performance for one of the EPS smart well is also presented in this paper as a successful case history where the water production for the well was managed below 5% to keep the well flowing and resulted in saving the operating expense (OPEX) by US$ 478 K. Three approaches were evaluated for flow allocation modeling among the two reservoirs and are presented in this paper i.e. a steady-state nodal analysis network model built in-house, virtual flow estimator (VFE) to provide real time results based on general choke equation and NETFlow (an alternate to VFE) based on a steady state simulator NETool capable of modeling complex lower completions; with later two approaches provided by the vendor and being optimized jointly with ADMA-OPCO. The steady state models are calibrated against the available PLT and real time downhole and surface flow- test measurements. In the end, some unique issues observed with smart well completions, especially the functionality of the ICVs, are highlighted including the observed anomaly description and associated solutions implemented to restore functionality of some of the smart completion components. Deployment of smart completions in this green field has resulted in simplifying the completion design and optimizes the number of wells required for field development. Integration of DOF with smart completion system has enabled the team to effectively manage the performance of the reservoirs (especially water production); in the absence of gas lift and continuous down-hole chemical injection during EPS tenure.

The diagnosis of biliary atresia (BA) can be challenging as its histopathologic features overlap with those of other pediatric cholestatic liver diseases. We aimed to study the diagnostic value of hepatic CD56 immunostaining in the differentiation of BA from other causes of neonatal cholestasis.Hepatic CD56 immunostaining was investigated in 30 infants with BA and compared with that in 30 infants with non-BA cholestatic disorders. The expression of positive cells was interpreted semiquantitatively on the basis of the extent (percentage or number) of positive cells on a scale of 0-3.The occurrence of CD56-positive biliary epithelial cells was significantly higher in the BA (83.3%) than in the non-BA group (6.7%), whereas the occurrence of CD56 natural killer cells in hepatic parenchyma was significantly higher in the non-BA group (76.7%) than in the BA group (6.7%; P0.0001 for both). In contrast, there was no significant difference between both groups in CD56 natural killer cells in portal tracts (P0.05). Using this differential expression as a discriminative tool between the BA and the non-BA group, positive biliary epithelial cell staining had high specificity, whereas negative parenchymal staining had high sensitivity (93.3% for both) with an accuracy of 88.3 and 84.65%, respectively. The combination of both parameters improved the accuracy up to 91.65%, with 100% specificity in the diagnosis of BA.CD56 immunostaining of the liver had a diagnostic value; it can be used to differentiate BA from other neonatal cholestatic disorders and might be useful as an additional stain when investigating infants with neonatal cholestasis.

A retrospective study was carried out on 125 homicide victims autopsied from 2006 to 2010 at the Forensic Medicine Center in Dammam Saudi Arabia. Dammam is the largest city in the Eastern Province in the Kingdom of Saudi Arabia (KSA). It is a thriving modern economic hub and hosts the largest oil company in the world. The Forensic Medicine Center in Dammam covers most of the cities in this province, which has a population of around two million. The aim of this study is to provide a database representing injury mortality in Dammam and to establish a system that will record information about homicidal deaths, identify new trends and give priority to violence prevention. Of these cases, 104 (83.2%) were males and 21 (16.8%) were females, and in 97 cases (77.6%) the victims were between the ages of 21 and 50 years. Local Saudi nationals comprised the maximum proportion of victims (46.4%), followed by Indian (22.6%) and Bangladeshi (19.8%). Most of the homicides occurred during daytime (80.1%), and summer was the most common season among the homicides. Among this sample, the most common type of injury was caused by blunt force (35.2%), followed by sharp force (34.4%), and firearms (25.6%). Injuries were inflicted to the chest in 29.6% of cases and to the head in 26.4% of cases. Most of the cases (98.3%) were caused by a single offender, whereas multiple offenders were accused in the remainder. Only in 31% of cases was the victim hospitalized. Postmortem blood alcohol was found in 8%, amphetamine in 3%, and opiates in 2.1% of the victims.

End stage renal disease constitutes a public health problem globally. One of methods of solution of this problem is hemodialysis. To determine factors related to duration of hemodialysis among Sudanese Patients. It was a cross-sectional survey. Fifty Sudanese Patients on regular hemodialysis at Gezira Hospital for Renal Diseases & Surgery, Gezira State, Sudan; were selected. Independent variables were age, gender, marital status, level of education, occupation, presence and types of congenital anomalies of urinary system. Dependent variable was hemodialysis. Investigation was done using structured questionnaire. Data was analyzed using SPSS version 21. P-value ≤ 0.05 was considered statistically significant. Age range was 19 - 70 years. Male gender was predominant (62%) among study population. Generally duration of hemodialysis is higher among male. Sixty six percent of respondents were married. There was no statistical association between marital status and duration of hemodialysis. Thirty eight percent were graduated from secondary school, university, and postgraduate studies. Majority of the rest were either illiterateor graduated from Holly Quran School (Khalwa), or primary school. About 78% of study population either non-employed or from low economical class. There was strong statistical association between occupation and duration of hemodialysis. Rate of congenital anomalies was 12%. There was statistical relationship between both presence and types of congenital anomalies of renal system and duration of hemodialysis among study population. Economically active age group was more affected than others. Duration of hemodialysis was higher among male. Un-married respondents were more vulnerable than married groups. Duration of hemodialysis was longer among respondents with low socioeconomic status and among respondents having congenital anomalies of renal system. Screening for presence of congenital anomalies of renal system among general population may be of great help.

End stage renal disease is an irreversible renal damage leading to impairment of renal function and failure of filtration of metabolic wastes from the blood. To determine the socio-demographic characteristics of Sudanese Patients on Hemodialysis at Gezira Hospital for Renal Diseases and Surgery, Gezira State, Sudan; 2018. It was an observational study. Independent variables were socio-demographic characteristics. Dependent variable was hemodialysis. A questionnaire was used to obtain the required data. SPSS version 21 was used for data entry and analysis. Chi square test was used and P-value ≤ 0.05 was considered statistically significant. Sixty two percent of respondents were male. Minimum age was 19 years while maximum age was 70 years. Maximum affected age group was age group (36-45) years; followed by age groups (46-55) and (56-65) years. Minimum age at which disease was diagnosed was 13 years while maximum was 67 years. Regarding residency was as follow: Two percent from East State, 2% from West State, and 96% from Central State. For education: Twenty percent were illiterate, 6.0% Quranic School (Khalwa), 36% primary school, 14% secondary school, 14% university graduate, and 10% had postgraduate certificate. Their occupation was as follows: Twenty percent were labors, 8% were farmers, 6% were employee, 2% were merchants, 4% were students, 24% were households, 2% was from the medical field, 4% were non-employee and 30% did not identify their occupations. Sixty six percent were married. Male is more prone to heamodialysis than female. Risk for heamodialysis increases with increased age. The married rate is an important factor related to the outcome of ESRD. Low levels of education together with low income level of employment are important factors related to ESRD.

Glycogen storage disease (GSD) is a rare inborn error of metabolism with an incidence of 1/20,000-40,000 live births. Some of the presenting clinical features can mimic diseases commonly seen in the tropics and subtropics. We report a 14-month-old Nigerian child who presented at our institution with GSD Type 111a to alert physicians on the need to consider and recognise this rare disorder. The child presented with progressive abdominal swelling due to marked hepatomegaly. From the clinical history, the only clue to hypoglycaemia was that she eats very frequently. Her random blood sugar was normal; however, fasting blood sugar was low. The diagnosis was further entertained with laboratory results showing hypercholesterolaemia and uricaemia and confirmed by histology of biopsied liver tissue. GSD should be suspected in a child with unexplained hepatomegaly and investigated accordingly.

Electromagnetic (EM) computations are the cornerstone in the design process of several real-world applications, such as radar systems, satellites, and cell-phones. Unfortunately, these computations are mainly based on numerical techniques that require solving millions of linear equations simultaneously. Software-based solvers do not scale well as the number of equations-to-solve increases. FPGA solver implementations were used to speed up the process. However, using emulation technology is more appealing as emulators overcome the FPGA memory and area constraints. In this paper, we present a scalable design to accelerate the finite element solver of an EM simulator on a hardware emulation platform. Experimental results show that our optimized solver achieves 101.05x speed-up over the same pure software implementation on MATLAB and 35.29x over the best iterative software solver from ALGLIB C++ package in case of solving 2,002,000 equations.

To investigate the safety and efficacy of a Hansenula-derived PEGylated (polyethylene glycol) interferon (IFN)-alpha-2a (Reiferon Retard) plus ribavirin customized regimen in treatment-naïve and previously treated (non-responders and relapsers) Egyptian children with chronic hepatitis C infection.Forty-six children with chronic hepatitis C virus (HCV) infection were selected from three tertiary pediatric hepatology centers. Clinical and laboratory evaluations were undertaken. Quantitative polymerase chain reaction (PCR) for HCV-RNA was performed before starting treatment, and again at 4, 12, 24, 48, 72 wk during treatment and 6 mo after treatment cessation. All patients were assigned to receive a weekly subcutaneous injection of PEG-IFN-alpha-2a plus daily oral ribavirin for 12 wk. Thirty-four patients were treatment-naïve and 12 had a previous treatment trial. Patients were then divided according to PCR results into two groups. Group I included patients who continued treatment on a weekly basis (7-d schedule), while group II included patients who continued treatment on a 5-d schedule. Patients from either group who were PCR-negative at week 48, but had at least one PCR-positive test during therapy, were assigned to have an extended treatment course up to 72 wk. The occurrence of adverse effects was assessed during treatment and follow up. The study was registered at www.ClinicalTrials.gov (NCT02027493).Only 11 out of 46 (23.9%) patients showed a sustained virological response (SVR), two patients were responders at the end of treatment; however, they were lost to follow up at 6 mo post treatment. Breakthrough was seen in 18 (39.1%) patients, one patient (2.17%) showed relapse and 14 (30.4%) were non-responders. Male gender, short duration of infection, low viral load, mild activity, and mild fibrosis were the factors related to a better response. On the other hand, patients with high viral load and absence of fibrosis failed to respond to treatment. Before treatment, liver transaminases were elevated. After commencing treatment, they were normalized in all patients at week 4 and were maintained normal in responders till the end of treatment, while they increased again significantly in non-responders (P = 0.007 and 0.003 at week 24 and 72 respectively). The 5-d schedule did not affect the response rate (1/17 had SVR). Treatment duration (whether 48 wk or extended course to 72 wk) gave similar response rates (9/36 vs 2/8 respectively; P = 0.49). Type of previous treatment (short acting IFN vs PEG-IFN) did not affect the response to retreatment. On the other hand, SVR was significantly higher in previous relapsers than in previous non-responders (P = 0.039). Only mild reversible adverse effects were observed and children tolerated the treatment well.Reiferon Retard plus ribavirin combined therapy was safe. Our customized regimen did not influence SVR rates. Further trials on larger numbers of patients are warranted.

Background & Aims The dilemma of early diagnosis of biliary Atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis is challenging. The aim was to design and validate a scoring system for early discrimination of BA from other causes of neonatal cholestasis. Methods A twelve-point scoring system was proposed according to clinical, laboratory, ultrasonographic, and histopathological parameters. A total of 135 patients with neonatal cholestasis in two sets were recruited to design (n=60) and validate (n=75) a scoring system. Parameters with significant statistical difference between BA (n=30) and non-BA (n=30) patients in the design set were analyzed by logistic regression to predict the presence or absence of BA then a scoring system was designed and validated. Results The total score ranged from 0 to 37.18 and a cut-off value of >23.927 could discriminate BA from other causes of neonatal cholestasis with sensitivity and specificity of 100% each. By applying this score in the validation set, the accuracy was 98.83% in predicting BA. The diagnosis of BA was proposed correctly in 100% and the diagnosis of non-BA was proposed correctly in 97.67% of patients. By applying this model, unnecessary intraoperative cholangiography would be avoided in non-BA patients. Conclusions This scoring system accurately separates infants with BA and those with non-BA, rendering intraoperative cholangiography for confirming or excluding BA unnecessary in a substantial proportion of patients.

The development of deep tight gas deposits in the UAE is a priority as gas demand increases. The deep carbonate gas reservoir described in this paper is over 1000 ft thick and about 13,000 ft deep and consists of many different layers with different petrophysical properties all capable of gas production with about 2-3% H2S concentration. These complex offshore reservoirs are completed with 7in. CRA (Corrosion Resistant Alloy) casing with monobore designs and are selectively perforated and acid stimulated, a process requiring significant rig time to execute. Any improvement in efficiency and productivity is highly sought after. Working closely with its contractors during the completion of more than 10 of these wells ADMA-OPCO developed a completion process that provides improved gun performance and running efficiency. Efficiency gains have been significant with the adoption of special fit-for-purpose hardware allowing increased gun lengths and higher payload weights per run. Detailed prejob planning with increased efficiency and improved gun performance have positively impacted total job cost and productivity. This paper reviews the development of the best practices for these complex operations, the technologies and procedures employed to improve efficiency, the perforating systems used to improve productivity and the plan going forward for additional improvements in efficiency and well performance. The lessons learned from these operations resulted in significant cost saving and improved productivity to ADMA OPCO and will be of benefit to other countries in the region that are developing similar complex gas reserves.

The generation of friction noise for fatigue-dominated interfaces is studied. A special experimental set up for studying the effects of various parameters on the generation of noise by dry friction under different running conditions of load and speed is constructed. The noise and vibration response signatures are simultaneously measured and statistically analyzed. A simplified model for the friction interface and the supporting structure is also developed, and is used to simulate the vibration and acoustic responses. It is shown that the simulation predictions are in good agreement with the experimental data. The results show that the friction noise signatures have a well defined structure with randomly occuring sharp pulses. For fatigue-dominated interfaces, the departure of the noise signature from a Gaussian process increases as acoustic radiation due to roughness interaction effects becomes more significant. The noise power spectra contain a broad frequency band with a continuous peak level extending over the high frequency range of 2–20 kHz due to the effects of impacts between surface asperities.

This paper presents a new methodology for modeling a priority-based preemptive real time operating system (RTOS) kernel in SystemC. We use the current modeling constructs of SystemC 2.0 and throughout our development of the kernel’s system calls; new constructs dedicated to RTOS modeling have been proposed. The article focuses on kernel architecture and shows its interaction with hardware module representing a bus functional model (BFM) of a generic microcontroller. The usage of the proposed kernel’s APIs is demonstrated by an embedded software example.

1045 Background: Metronomic chemotherapy (MC) has shown efficacy in patients with metastatic breast cancer. We therefore tested the efficacy and toxicity of (MC) in pretreated metastatic breast can...

To study autoimmunity among thyroid diseases, 397 thyroid patients (age 30 (13) years; M/F 75/322) from two referral centres in Bangladesh and 94 healthy controls (age 30 (13) years; M/F 24/70) were studied for antimicrosomal and antithyroglobulin antibodies. Thyroid patients were clinically grouped as suspected autoimmune thyroid disease (AITD), non-autoimmune, or indeterminate groups (where no decision could be reached). Antimicrosomal antibody was strongly positive in 19.4% and weakly positive in 7.3% of patients but only 4.3% and 2.1% respectively in the controls (χ2 = 17.852; p = 0.000) whereas strong and weak positivity were 27.2% and 6.8% in patients compared with 8.5% and 4.3% respectively in the controls (χ2 = 16.916; p = 0.000) for antithyroglobulin antibody. Antibodies were positive in 63.0% with Hashimoto's thyroiditis, 36.4% with Graves' disease, and 44.7% with atrophic thyroiditis among the autoimmune group. In the non-autoimmune group antibodies were positive in 100% with multinodular hypothyroidism, 46.7% with subacute thyroiditis, 40.0% with suspected iodine deficiency goitre, 31.3% with toxic multinodular goitre, 30.8% with non-toxic solitary nodules, and 19.4% with simple diffuse goitre. None was positive for antimicrosomal antibody without being positive for antithyroglobulin antibody. The two antibodies strongly correlated in both patients (r = 0.977, p = 0.000) and controls (r = 0.986, p = 0.000). About 9% (36/397) of patients were mismatched with the final diagnosis on antibody measurement; most of them had Hashimoto's thyroiditis (33/36). Prevalence of AITD among thyroid patients was 48.36%. Specificity of antimicrosomal and antithyroglobulin antibodies were 93% and 87%. It was concluded that AITD is not uncommon in Bangladesh; antimicrosomal antibody is a useful marker for AITD and unless antibodies are checked, an appreciable number of patients with AITDs will remain undetected.

Urban soils polluted with heavy metals are of increasing concern because it is greatly affecting human health and the ecological systems. Hence, it is mandatory to understand the reasons behind this pollution and remediate the contaminated solid. The removal of heavy metals from contaminated soil samples collected from the vicinity of the sewage lake in Jeddah, Saudi Arabia, was explored. The leaching process was studied kinetically and thermodynamically for better understanding of the remediation process. The results showed that the soil samples were slightly basic in nature, and tend to be more neutral away from the main contaminated sewage lake area. The total metal content in the soil samples was measured using the aqua regia extractions by ICP-OES and the results showed that many of the heavy metals present have significant concentrations above the tolerable limits. In general, the metal concentrations at different sites indicated that the heavy metal pollution is mainly due to the sewage discharge to the lake. The results showed excellent correlation between the concentrations of Co, As, and Hg with the distance from the main contaminated area. The leaching of Co, As, and Hg using 1.0 M hydrochloric acid from the soil was studied kinetically at different temperatures and the experimental results were fitted using different kinetics models. The experimental data were best described with two-constant rate and Elovich equation kinetic models. Also, the thermodynamic study showed that the leaching process was spontaneous, endothermic and accompanied with increase in the entropy. In general, the polluted soil could be remediated successfully from the heavy metals using the acid leaching procedure in a short period of time.