Search

Background: Cardiac surgery has become more common and crucial nowadays. The matter which leads to increased redo-surgeries with expected increase of overall complications after the redo. The used approach could affect overall outcome. However, this is not addressed well in literature.Aim of the work: To examine the overall outcome of patients underwent redo-mitral valve replacement [redo-MVR].Patients and methods: This study is a retrospective comparative study that was conducted in Cardiothoracic Surgery Department, Al-Hussein University Hospital in the last three years [from January, 1st, 2017 to the end of December 2019]. Collected data included patient demographics, surgical approach and overall short-term outcome.Results: The current study included 37 patients; the mean age was 45.19±9.16 years. The most common indication for redo was pannus formation [48.6%], followed by thrombosis [45.9%]. There was no significant difference between preoperative and postoperative heart rhythm. Redo sternotomy was the most common, reported in all patients, and femoral bypass done for 3 patients. Trans-atrial approach reported in 24 patients [64.86%] while Trans-septal approach reported in 13 patients [35.14%]. No significant difference between preoperative and postoperative echo data [Ejection Friction, left atrial dimension or left ventricle end diastolic dimension]. However, there was a significant reduction of left ventricle end-systolic dimension [LVESD], pulmonary artery systolic pressure [PASP] and pressure gradient [PG] cross mitral valve after operation. Reoperation for bleeding was not reported in any cases, while need for new pacemaker reported in 2 patients [5.41%], new postoperative neurological dysfunction reported in new heart failure or need to dialysis in two patients [5.41%]. The postoperative arrhythmia was reported in 7 patients [18.9%] and there has been mortality in three patients [10.8%].Conclusion: The results of the current study showed that, both transseptal and transatrial approaches are comparable and no one is superior to the other.

Background: Anhedonia, is defined as reduced capacity to gain pleasure from pleasurable experiences, is a key symptom of major depression. Several studies had investigated anhedonia in schizophrenia and major depressive disorder, using different psychometric and radiological assessment tools with controversy results in either severity of anhedonia or radiological findings. The aim of this study was to differentiate the nature of the issue of anhedonia in schizophrenia versus major depressive disorder; from clinical and brain function part of view, and to study different variables in this regard. Methods: This study was carried on 60 participants who were divided into three groups: Group 1: 20 schizophrenic patients, diagnosed according to DSM-5. The symptoms of schizophrenic patients must include anhedonia as a main symptom, Group 2: 20 patients with major depressive disorder according to DSM-5 criteria, and anhedonia was one of their prominent symptoms, Group 3: 20 control subjects. Results: Our results revealed statically significant differences between participants as regards age of onset, occupational career. Statically significant differences were found between 3 groups. Most of patients in group 1 lacks the interest for social activities and intimate relationships. Statically significant Difference was found between patients in both groups compared to controls. Striatal activity (mainly caudate) was significantly diminished in group 2 (P value

Background Children with autism spectrum disorder (ASD) are almost universally delayed in the acquisition of spoken language as primary means of communication so they tend to have restricted outcomes in terms of independence and integration. Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study (study and modulate excitability and plasticity, applied in single pulses to investigate corticospinal excitability, pairs of pulses to study intracortical inhibition and facilitation) and potential treatment of ASD. The purpose of this study is to evaluate the role of repetitive TMS in language progress in children with ASD. Results There was a statistically significant clinical improvement in patients receiving active TMS (group I) comparing baseline Childhood Autism Rating Scale (CARS) assessment and after treatment (P ≤ 0.05). There was mild improvement with no significant difference between the patients receiving active TMS (group I) and those of sham TMS (group II), and both groups received language therapy as regard post-treatment CARS. There was significant difference in improvement between the two groups according to eye contact (P ≤ 0.05). There was significant improvement in response to examiner (P ≤ 0.05). There was mild improvement with no statistically significant difference in attention between the two groups. There was significant difference in improvement between the two groups according to active expressive language. There was no statistically significant difference in passive vocabulary between the two groups. Conclusion Repetitive transcranial magnetic stimulation (rTMS) over left inferior frontal gyrus may be a safe and effective way of improving language of ASD. The joint application of rTMS and standard language therapy may lead to more rapid improvement in the language progress of children with ASD.

Background: Thelifetime prevalence of obsessive-compulsive disorders (OCD) is estimated to be around 3% in the general population. Selective serotonin reuptake inhibitors (SSRIs) are considered to be the primary treatment strategy of OCD in addition to psychotherapy. Unfortunately, current medications, augmentation strategies, and behavioral therapies fail to provide adequate benefits in many cases. A large percentage of patients (40-60%) do not show satisfactory response to the standard treatments, some of them experiencing a chronically deteriorating course, leading to marked interpersonal and occupational impairments. In recent years, non-invasive neuromodulatory techniques such as repetitive transcranial magnetic stimulation have been increasingly studied as potential adjunct or alternative therapies for a wide range of neurological and psychiatric conditions including pain disorder, depression, and stroke rehabilitation and OCD. Aims: the aim of this work to evaluate rTMS as an augmentation strategy in treatment-resistant OCD, to test the potential value oflow frequency rTMS to SMA,orbitofrontal cortex and right DLPFC in the treatment of resistant OCD and to compare between the therapeutic values of applying the TMS coil to those different areas of the cortex. Patients and Methods: This study was carried out in Psychiatry, Neurology and Neurosurgery Center, Tanta University from September 2017 to November 2019. Eighty patients (52 females and 28 males) aging between 18 and 65 years underwent complete psychiatric evaluation, including full medical history, psychiatric and physical examination and diagnosed as having OCD accordingto DSM-5 with failure of at least two adequate therapeutic trials of SRIs. Results: Before rTMS sessions there was no statistical significant difference between the three active groups and the sham group regarding the scores onYale-Brown obsessive compulsive scale,Hamilton anxiety rating scale, Hamilton depression rating scale and Clinical global impression scale. Results after rTMS sessions revealed the following: Active rTMS on the SMA, the left OFC and right DLPFC was associated with marked improvement in YBOCS, Hamilton anxiety rating scale, Hamilton Depression rating scale and clinical global impression scale. The most significant improvement in Yale Brown Obsessive Compulsive scale was obtained when the brain target was the SMA. The most significant improvement in anxiety rating scale and depression ratingscale was obtained when the brain target was the left OFC. Sham group didnt have significant improvement through the study. Conclusions: We can thus conclude that low frequency rTMS is significantly effective as an adjunctive treatment for resistant OCD and that the SMA is the most effective brain target.

Osteoporosis is a global health and economic burden. It is a major chronic health condition that affects women more than men and it is incurable disease. Postmenopausal women are among those at greatest risk of osteoporosis, but any one of either gender or any race can develop this disease. Effective disease management ultimately lies in the hands of the individual patient, who must take responsibility for key health behaviors related to bone health. One behavior modification strategy that has proven effective to osteoporosis is self-management. The self-management program for osteoporosis, choices for better bone health, helps to educate people about the disease and to promote behavioral strategies for maximizing bone health. Telenursing bridges the access gap to specialized osteoporosis care in remote areas. Improving coordination of investigations, access to allied health members, and future initiatives may improve morbidity and mortality related to osteoporosis in this population. Mobile health (m-Health) interventions hold promise to effect engagement in health behavior change related to calcium and vitamin D intake, balance, core and leg strength, and physical activity.

Background Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Although children with ADHD made much more spelling errors, they had a distinct pattern of letter insertions, replacements, transpositions, and omissions. This mistake type is sometimes referred to as graphemic buffer errors, and it is caused by a lack of attention required for motor planning. The aim of study was to assess the incidence of dysgraphia in Arabic language in children with ADHD for better helping, diagnosis and management of those children. Results Ten percent of ADHD children had normal handwriting with no disability, 40% had excellent handwriting with a minimum of disability and 50% of ADHD children showed mild to moderate disability. There were significant differences between ADHD children and control children regarding results of each item on the subtest of handwriting of dysgraphia disability scale (DDS), respecting lines, spacing between words, letter direction, spelling a sentence, and punctuation. Drawing affected in ADHD children. The finger tapping speed was affected in almost ADHD children. Conclusions Dysgraphia highly presents in our sample of ADHD children with poor fine motor skills in ADHD children than normal children. ADHD children have illegible handwriting, not respecting lines, insufficient space between and within words, multiple spelling errors, and omissions of letters or words. Graphesthesia and stereognosis are affected more in ADHD children than in control children drawing and finger tapping speed affected in ADHD children.

Background For centuries, physicians have observed a temporal relation between the occurrence of female-specific reproductive events and the symptoms of illness that traditionally have been classified as "mental". Objectives: study of phenomenology of postpartum psychosis. Methods: 60 female patients with postpartum psychosis during the first four weeks after delivery (patients group) and 30 female patents within the first four weeks after delivery not suffering any psychiatric disorders (Control group). The two groups were subjected to clinical psychiatric assessment using structured psychiatric interview of DSM -V, BPRS, HDRS and EPDS. Results: Postpartum psychosis was more in younger females than older and in primipara than multipara. The onset of symptoms of postpartum psychosis was more common in first week after delivery (mean 6.11 days), sleep disturbance, irritability and hypomanic symptoms are the most early symptoms of postpartum psychosis followed by anxiety, confusion and somatic complain. Mood congruent psychotic feature significantly more than mood non-congruent psychotic feature. Conclusion: postpartum psychosis is more common in younger and primipara females with onset of symptoms in first in first week after delivery. Sleep disturbance, irritability and hypomanic symptoms are the earliest symptoms of postpartum psychosis

Background:Deep vein thrombosis (DVT) is one of the causes of maternal morbidity and mortality. During pregnancy, and after caesarian section surgery the risk of DVT increases by five-ten times than the other time. It can be prevented through practising of calf muscle pump exercise and following preventive measures as early ambulation.The purpose of the study:was to evaluatethe effect of calf muscle pump exercise and preventive measures on the prevention of deep vein thrombosis (DVT)and its manifestationsamong a postpartum cesarean section. Method: A quasi-experimental design was used to fulfil the purpose of the study. Sample: A purposive sample of(200)post-partum women after cesarean section (study and control groups) wererecruited. Setting:The study was carried out atante-natal and post-natal wards of Menoufia University HospitalatShebin El-Kom city at Menoufia Governorate, Egypt.Instruments: Five instrumentswere used by the researchers; (1) An interviewing questionnaire;(2) Author DVT risk assessment scale;(3) Women’s knowledge assessment questionnaire;(4) Calf muscle pump exercise and preventive measures questionnaire, and (5)DVTand its manifestations questionnaire.Results:The mean age of the control and thestudygroups were (25.16±5.41) and (25.59 ± 5.92) years old respectively.There were highly statistically significant differencesbetween the study and the control groups regarding the level of knowledge, calf muscle pump exercise, preventive measures after the intervention (P

Trauma injury is the leading cause of mortality and hospitalization worldwide and the leading cause of potential years of productive life lost. Hypercatabolism after trauma may lead to acute protein malnutrition that ultimately results in multiple organ failure. Therefore, nutritional support is an essential component of the care of critical trauma patients for optimizing outcomes. Evidence-based practice improves the quality of care through patient-centered care, the utilization of patient resources, provider resources and experiences, current research and scientific information. The main objective; of this study was to assess and evaluate the effect of evidence-based enteral nutrition (EN) protocol on complications prevention among trauma patients. The research hypothesis; evidence-based enteral nutrition protocol will prevent complications among trauma patients. The study subjects consisted of 50 adult patients diagnosed with trauma and divided equally into two groups; control group who received the routine hospital nutrition and study group who received evidence-based enteral nutrition protocol at the Intensive Care Unit (ICU) El-Minia University Hospital. The tools of data collection were; 1) Assessment sheet, it includes two parts, 1st part included socio-demographic data of the patient. 2nd part included five items that cover medical data, 2) Evidence-based enteral nutrition protocol, and 3) Evaluation sheet, it includes two parts, 1st part included the laboratory investigations. 2nd part covers the vital signs. Results: This study revealed that the majority of the control group less than thirty years old compared to study group equal or more than forty years old. There are statistically significant differences regarding mouth condition, severe infection, and nutritional assessment, among study and control groups. The result also revealed that the highest percent regarding the time of start enteral feeding and body positioning were among the study group. Conclusion: Evidence-based enteral nutrition protocol had significantly prevention of complications among trauma patients. Recommendation: Hospital should be following evidence-based enteral nutrition protocol to prevent complications among trauma patients at intensive care unit.

Background: Bronchiolitis is a common lower respiratory tract infection in infants. Lactate Dehydrogenase (LDH) may be a useful biomarker to assist its severityAim of current study was to study the efficacy of LDH in both nasal secretions (NW-LDH) and serum (S-LDH) as a useful biochemical indicator of bronchiolitis severity .Subject and Methods: The present study was conducted on 96 infant with bronchiolitis ( < 24 months old ) presenting to pediatric department of Al-ahrar and Ahmed Maher Teaching Hospital. during the period from November 2018 to March 2019. Patients were subjected to history taking, clinical examination general and systemic, investigations including blood gases &CRP, chest X –ray if necessary, total LDH activity in both nasal secretions and serum. Results: In bronchiolitis, percentage of male was higher than female (65.6%, 34.4 %), with a mean ±SD of age 8.25±2.61 months, percentage of mild , moderate and severe cases were 36 (37.5%) , 44(45.8 %) ,16 (16.7%) respectively. No significant difference in serum LDH(S-LDH) between mild cases " not require admission " moderate "require hospital admission " or severe cases "require PICO admission (F:1.46 P: 0.237) while there was significant difference in nasal wash LDH (NW-LDH) among different grades of severity (F: 70.85 ,P:0.001) The significant predictors for severity of bronchiolitis were NW-LDH , younger age , longer hospital stay ,. Conclusion: NW-LDH is a biochemical Predictor of bronchiolitis severity , hospital ,PICO admission than S-LDH if demographic variable and viral etiology are taken in consideration

Background: Type 1 diabetes (T1D) is more prevailing disease in adolescence. Intervening in self-care is crucial for disease management and to reduce the risk of diabetes-specific complications. The aim of the study was to assess self-care practices of preparatory school students with type 1 Diabetes Mellitus in EL Behira Governorate. Egypt. Subjects: A total number of 300 students constituted the subjects of the study. Research design: A descriptive research design was used. Setting: Data was gained from governmental preparatory schools in El-Behira governorate. Sampling students were chosen by multistage sampling technique. Tools: one tool was used for data collection, a structured interview schedule composed of three parts to collect data about socio-demographic characteristics, students’ knowledge about TID, and assessment of students’ self-care practices. Results: 53.3% of the studied diabetic preparatory school students have fair total self-care practices score while 29.7% of them have poor self-care practices. A significant difference was revealed between the studied diabetic students’ total score of knowledge and self-care practices. 76.7% of the studied diabetic preparatory school students have poor total knowledge score. A significant difference was revealed between the studied diabetic students’ total score of knowledge and self-care practices In addition, diabetic students' age, previous hospitalization due to hypo/hyperglycemic coma, duration of disease discovery and socioeconomic status were significantly varied among them in relation to their total knowledge and self-care practices scores. Moreover, diabetic students' gender, father's education, mothers' education, mother's working condition were significantly varied among them in relation to their total self-care practices score. Conclusion and recommendations: The results of the present study concluded that the highest percentage of the studied diabetic preparatory school students have either fair or poor self-care practices and poor total knowledge score, so it is recommended to develop hotlines, mass media campaigns for dissemination of accurate information about juvenile diabetes and establishing an accurate surveillance and documentation system of diabetic students for easy accessibility and provision of accurate information.

Wafaa MA Farghaly,1 Mohamed A Ahmed,1 Hamdy N El-Tallawy,1 Taha AH Elmestikawy,2 Reda Badry,1 Mohammed Sh Farghaly,3 Montaser S Omar,3 Amr Sayed Ramadan Hussein,4 Mohammed Salamah,5 Adel T Mohammed1 1Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Psychology, Faculty of Arts, Assiut University, Assiut, Egypt; 3Department of Educational Psychology, Faculty of Education, Assiut University, Assiut, Egypt; 4Department of Hearing Disability, Faculty of Sciences of Special Needs, Beni-Suef University, Beni-Suef, Egypt; 5Department of Phoniatrics, Faculty of Medicine, Assiut University, Assiut, Egypt Purpose: The aim of this study was to design an Arabic computerized battery of cognitive skills for training children with specific learning disabilities (SLD).Subjects and methods: Nineteen students from fourth grade primary schools in Assiut, Egypt, who were previously diagnosed with SLD, agreed to participate in the rehabilitation program. The study passed through four stages: first stage, detailed analysis of the cognitive profile of students with SLD (n=19), using a previously constructed diagnostic cognitive skill battery, to identify deficits in their cognitive skills; second stage, construction of an Arabic computerized battery for cognitive training of students with SLD; third stage, implementation of the constructed training program for the students, each tailored according to his/her previously diagnosed cognitive skill deficit/deficits; and fourth stage, post-training re-evaluation of academic achievement and cognitive skills’ performance.Results: Students with SLD have a wide range of cognitive skill deficits, which are more frequent in auditory cognitive skills (68.4%) than in visual cognitive skills (64.1%), particularly in phonological awareness and auditory sequential memory (78.9%). Following implementation of the training program, there was a statistically significant increase (P

Background and aim Non-Hodgkin's lymphoma (NHL) is a type of cancer that manifests itself in a number of histological and biological lymphoid malignancies with uncertain triggers. The most common type is diffuse large B cell lymphoma (DLBCL) representing 30–40% of all cases. Most cases of DLBCL, approximately 80%, are designated as not otherwise specified. Recently, alterations of Zinc finger 384 (ZNF384), dynein axonemal heavy chain17 (DNAH17), and N-deacetylase and Nsulfotransferase 2 (NDST2) genetic expression have been frequently reported in several types of cancers, including acute leukemia and Hodgkin's lymphoma, and may influence patients' prognosis and survival. Using our recent research tools, we have examined the role of these genes ZNF384, DNAH17, and NDST2 in the tumorigenesis of DLBCL and discussed their potential as novel prognostic markers as well as molecular targets for DLBCL treatment. Subjects and methods This study recruited 100 subjects classified into the following groups: Group I included 50 patients newly diagnosed with NHL, DLBCL type, including both germinal center and non-germinal center subtypes. Group II included 50 age- and gender-matched healthy individuals as a control group. All of the participants have been subjected to thorough medical history-taking and clinical examination. As a part of metastatic workup, all patients underwent an abdominal ultrasound, a computed tomography (CT) scan of the chest, abdomen, and pelvis, and bone marrow aspirate. Blood samples were collected to perform complete blood count (CBC) and erythrocyte sedimentation rate (ESR), to estimate serum lactate dehydrogenase (LDH) and β 2 microglobulin (β 2 M) levels, as well as to obtain RNA samples to detect the expression of ZNF384, DNAH17, and NDST2 genes. cDNA samples were extracted from RNA samples through the use of reverse transcription and the SYBR Green real-time polymerase chain reaction technique. Results Approximately, 78% of cases presented with stages II and III according to Ann Arbor staging system, and 50% had extranodal involvement. The most common extranodal site was gastrointestinal tract. Patients with DLBCL had significantly higher levels of LDH, β 2 M, and ESR versus controls. The ZNF384 expression was significantly higher in patients compared with controls and in patients with stages III and IV versus those with stages I and II. The NDST2 expression was significantly lower in patients versus controls and in stages I and II versus stages III and IV of the disease. The genetic expression of DNAH17 showed no statistical significance between the two groups. Kaplan–Meier survival analysis revealed that patients who expressed lower levels of NDST2 had better overall survival. On the contrary, overexpression of DNAH17 had a negative effect on survival. Conclusion The ZNF384 is overexpressed, whereas NDST2 is downexpressed in DLBCL patients, and their expression levels are related to the prognosis of the disease. The increase in DNAH17 overexpression among patients is not statistically significant; however, it has an adverse effect on survival.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease leading to structural abnormalities in the airways. Mortality and disability in COPD cases are high, causing an intense economic burden. This study aims to investigate the relationship between NLRP3 rs10754558 and NOS3rs1799983 polymorphisms and the risk of COPD. This work was carried out on 152 subjects classified into Group I, with 38 COPD patients who are smokers, Group II 38 nonsmoker COPD patients, Group III 38 healthy smokers, and Group IV with 38 healthy nonsmokers. Genotyping of NLRP3rs10754558C/G and NOS3rs1799983G/T polymorphisms was assayed by real-time PCR. For NLRP3rs10754558 polymorphism, significantly higher frequencies of G/G genotype versus C/C were evident in COPD patients more than controls (p ≤ 0.001). Also, G allele can increase the risk of COPD by (OR) 95% CI [2.498 (1.521–4.101)]. Higher frequencies of mutant G/T and T/T genotypes of NOS3 rs1799983 versus G/G in COPD patients (48.7% and 17.1%) were more than the values evident in controls (p = 0.004 and 0.005). T allele can also increase the risk of COPD by (OR) 95% CI [2.457 (1.491–4.049)]. Conceivable LD was evident between both polymorphisms in COPD patients and controls. No significant difference between the severity of COPD was detected by the GOLD staging and the studied polymorphisms variants in the COPD group (p = 0.441 and 0.83). Coding polymorphisms in NLRP3 and NOS3 can be associated with the hazard of COPD and the probability of cigarette smokers suffering the studied polymorphisms to develop COPD.

Ahmed O Tantawy,1 Hamdy N El Tallawy,2 Hussein RS Farghaly,3 Wafaa M Farghaly,3 Amr S Hussein1 1Educational Psychology Department, Faculty of Education, 2Neurology and Psychiatry Department, 3Nuclear Medicine Unit, Faculty of Medicine, Assiut University, Assiut, Arab Republic of Egypt Background and methods: This study investigated the effects of sleep deprivation on total and partial (early and late) declarative memory and activation in the areas of the brain involved in these activities. The study included two experiments. Experiment 1 included 40 male residents of an orphanage aged 16–19 years, who were divided into four groups (n = 10 each) and subjected to total sleep deprivation, normal sleep, early-night sleep deprivation, or late-night sleep deprivation. Experiment 2 included eight students from the same institution who were divided into the same four groups (n = 2) as in experiment 1. Declarative memory was tested using lists of associated word pairs in both experiments, and activation of the relevant brain regions was measured before and after retrieval by single-photon emission computed tomography for subjects in experiment 2 only. Results: Students subjected to normal sleep had significantly higher scores for declarative memory retrieval than those subjected to total sleep deprivation (P = 0.002), early-night sleep deprivation (P = 0.005), or late-night sleep deprivation (P = 0.02). The left temporal lobe showed the highest rate of activity during memory retrieval after normal sleep, whereas the frontal, parietal, and right temporal lobes were more active after sleep deprivation. Conclusion: Both slow wave sleep and rapid eye movement sleep play an active role in consolidation of declarative memory, which in turn allows memory traces to be actively reprocessed and strengthened during sleep, leading to improved performance in memory recall. Keywords: late-night sleep deprivation, early-night sleep deprivation, total sleep deprivation, declarative memory

The implications of oxidative stress and neuro-inflammation in the pathogenesis of schizophrenia have been elucidated. Despite their effectiveness against positive symptoms of schizophrenia, antipsychotics have limited effectiveness against negative and cognitive symptoms and are associated with remarkable adverse effects. The use of celecoxib or omega-3 in schizophrenia may have beneficial effects. This study aimed to evaluate the possible efficacies of celecoxib, omega-3 or the combination of celecoxib+risperidone and omega-3+ risperidone compared to risperidone on the behavior and brain biochemistry in rats. In the present study, an amphetamine-induced model of schizophrenia in adult male rats was used to evaluate the effects of celecoxib, omega-3, celecoxib+risperidone and omega-3+ risperidone on the behavior of animals and on brain lipid peroxidation or tumor necrosis factor-alpha. In the water maze task, celecoxib, omega-3, celecoxib+risperidone, omega-3+ risperidone significantly decreased the latency time compared to amphetamine-treated group. Celecoxib, omega-3, celecoxib+risperidone, omega-3+risperidone also significantly reversed the decreased spontaneous alternation induced by amphetamine in the Y-maze task. In the social interaction task, groups treated with celecoxib, omega-3, celecoxib+risperidone, omega-3+ risperidone spent less time to recognize foreign animals than animals in the amphetamine-treated group. Increased brain MDA and TNF-α levels due to amphetamine were significantly reduced in groups treated with celecoxib+risperidone or omega-3+ risperidone. The present findings showed that celecoxib or omega-3 can attenuate amphetamine- induced behavioral impairment and these effects may be associated with their ability to decrease lipid peroxidation and cytokine release. Celecoxib or omega-3 may be promising candidates as adjuvant therapy for schizophrenia.

Acute leukemia (AL) is a heterogeneous group of hematopoietic neoplasms and it is the most common childhood malignancy. Many patients with AL develop severe anemia that requires multiple blood transfusions. Hepcidin expression may play a role in anemia which is often seen in these patients. The aim of this study is to evaluate the role of hepcidin in acute lymphoblastic leukemia in children in Egypt. 60 patients with acute lymphoblastic leukemia (ALL) and 20 age and gender matched healthy children, taken as control group, were included in the study. Complete blood count (CBC), Serum ALT and serum AST were measured by colorimetric methods. Serum hepcidin and ferritin were measured by ELISA. The study showed a significant difference between newly diagnosed ALL cases and other groups regarding all CBC parameters. There was a significant difference in serum levels of hepcidin and ferritin between studied groups. A significant negative correlation was found between serum level of hepcidin and ferritin and each of hemoglobin level and reticulocytic count %, while significant positive correlation was found between hepcidin and ferritin serum levels. From this study, it could be concluded that serum hepcidin level is elevated in ALL children patients at time of diagnosis and correlates with the disease extent. Hepcidin may be one of the serum markers that accounting for anemia associated with ALL in children. Key words : Hepcidin, ferritin, acute lymphoblastic leukemia, ELISA. From master degree thesis submitted to Faculty of Medicine, Menoufia University, by Shaimaa E. Genena, 2014.

Background: Hepcidin is the master regulator of iron homeostasis but until now, data about its expression in acute lymphoblastic leukemia (ALL) is scarce. Objectives: To evaluate hepcidin level in a group of ALL children in different treatment phases, investigating its relation to serum ferritin and erythroid activity. Materials and Methods: Forty ALL children were included and categorized into; Group I: Included 20 newly diagnosed ALL children who were evaluated at diagnosis and after remission. Group II: Included 20 ALL children in the maintenance phase of therapy. Twenty age and gender matched healthy children were enrolled as a control group. Complete blood count including reticulocytes %, liver functions, renal functions, and C-reactive protein were assayed. Serum hepcidin and ferritin were measured by enzyme-linked immunosorbent assay. Results: Serum hepcidin and ferritin levels were significantly higher among both ALL groups compared to the controls. These values were higher before therapy than after remission in the newly diagnosed group as well as than the maintenance group. Before therapy, both serum hepcidin and ferritin levels had significant negative correlation with hemoglobin and reticulocytes % while directly correlated with each other. Conclusion: Hepcidin level increased in ALL children at diagnosis and in different treatment phases. The highest rise was at diagnosis. These results indicate that hepcidin level among ALL patients is under the opposing effects of the iron stores and erythroid activity with the net level is determined by the strength of each stimulus.

O bjective: To determine whether serum cholesteryl ester transfer protein (CETP), is increased and associated with atherogenic lipoprotein profile in obese subjects. Methods: Blood was drawn in the morning after an overnight fast from 102 subjects (76 obese subjects and 26 apparently healthy subjects as control group) and, at the same time, anthropometric measurements including height, body weight, waist girth were taken. CETP activity were measured in serum using fluorescence assay, whereas total cholesterol (TC), triglyceride, HDL-cholesterol, LDL-cholesterol and Glucose levels were measured using enzymatic colorimetric assay and insulin was measured using ELISA. Results: Serum CETP activity was significantly higher (58.15 ± 12.24 vs. 47.75 ± 7.54 pmol/µl/1hr, means ± SEM, p < 0.0001) in the obese group than in the control group. There was considering direct relation for CETP activity with BMI, TC, and LDL-C (p

Background Suicide is a major public and mental health concern worldwide today. It lies behind exceeding numbers of deaths every year. This necessitates studying the causes and risk factors involved in suicidal behavior. Suicide attempts are found to be more common in women, with higher risk during the low estrogen phases of the menstrual cycle. Serotonin is a neurotransmitter that is proved by many studies to be involved in suicidal behavior. A relation between circulating estrogen levels and serotonergic function is supposed by some studies to explain the link between female suicide attempts and low estrogen phases of the menstrual cycle. Aim The aim of this work was to study serum serotonin level as a potential risk factor in female suicide attempts in the different menstrual cycle phases. Also, this study aimed to investigate the potential correlation between serum serotonin and estrogen levels. Patients and methods This cross-sectional study was carried out on two groups: the suicidal group that included women with suicide attempts who came to Tanta Poison-Control Center during the period from the beginning of July 2015 to the end of December 2015, and the control group that included 25 nonsuicidal apparently healthy female volunteers. The menstrual cycle phase was assessed for those women; the serum serotonin level was estimated by specific ELISA techniques, and the suicidal intent of the suicidal group was assessed by Pierce’s suicidal intent scale. Results and conclusion This study demonstrated that the suicide attempters had significantly lower serum serotonin levels. This significance was observed to be in the menstrual and the whole luteal phases. A significant inverse correlation was found between serum serotonin levels and Pierce’s suicidal intent scale for the women who attempted suicide in the late luteal and menstrual phases. Also, a significant positive correlation was found between serum estrogen and serotonin levels.

Background Osteoarthritis (OA) is the most common rheumatic disease of the knee and causes uncontrolled pain and disability. It affects millions of people across different races at different ages and of both sexes. Daily physical exercise is the first line of management for women with early OA to maintain muscle strength, physical fitness, and overall health. Aim The aim of the study was to evaluate the impact of physical exercise on the activities of daily living in women with early OA. Participants and methods A quasiexperimental design ‘time-series’ was used to achieve the objectives of the study. A total of 46 women were recruited from the outpatient clinic of El-Demerdash University Hospital. Tools of data collection Three tools were developed and used by researchers to collect the data: (a) a structured interview questionnaire; (b) scale of daily living activities; and (c) a physical exercise questionnaire for women with OA. The women performed exercises at the rate of one session per week for a period of 1 month in the presence of researchers, who clarified any queries. Results The women were aged 43–65 years, with a mean age of 41.8±14.67 years. There are significant differences regarding pain intensity, degree of difficulty, and need for assistance after practicing physical exercises. Conclusion A regular exercise program improved the daily living activity levels of women with early OA. There was also a significant improvement in pain, knee flexion, muscle strength, and functional capacity after practicing physical exercise. Recommendation Nurses have an active role in raising awareness about the importance of physical exercise in the treatment of early OA. Hospitals should implement a plan of action to include exercise in early OA treatment for women.