Search

This article presents output voltage sharing among series output connected battery power modules (BPMs) in plug-and-play (PnP) dc microgrids with a wide bus voltage range. The system provides active cell balancing and interfaces cells to the bus voltage through series output connected BPMs. A cell current sensor is utilized to achieve both state-of-charge regulation and output voltage sharing. To improve microgrid modularity, the battery pack behaves as a current source. A current-dependent droop between the individual output voltages and input currents is used to facilitate series output connected voltage sharing with bidirectional power flow, simple control, and smooth transitions between charge and discharge regions. Experimental results are reported for a 3 kWh 1C-rate prototype consisting of two parallel 24 V subsystems, with five series output connected BPMs in each subsystem. Each BPM consists of three battery cells and three 100 W dc–dc converters.

Background Fluoxetine (FLX) has been widely used as first-line treatment in cases of depression and other neuropsychiatric disorders. Although its safety has been approved, the use of FLX was associated with liver injury and chronic liver disease. Vinpocetine (Vinpo), a nootropic drug, possesses antioxidant and anti-inflammatory effects. Objective This study aimed to evaluate the protective effects of Vinpo on FLX-induced liver damage pointing to the role of peroxisome proliferator-activated receptor-gamma (PPAR-γ) and nuclear factor erythroid 2-related factor 2 (Nrf2). Methods Rats were randomized to four groups: control group, Vinpo group (20 mg/kg/day; orally), FLX group (10 mg/kg/day; orally), and Vinpo + FLX group. Results FLX-induced liver damage was evidenced through elevated liver function biomarkers and induced hepatic histopathological changes. Concurrent Vinpo treatment resulted in a significant decrease in hepatotoxicity biomarkers and histopathological alterations. FLX-induced oxidative stress and inflammation were attenuated by Vinpo. In addition, Vinpo attenuated the hepatic NRF2 and HO-1 levels and up-regulated PPAR-γ expression. Moreover, FLX elevated Bcl-2-associated X protein (Bax) mRNA expression and decreased B-cell lymphoma 2 (Bcl2) mRNA expression were markedly reversed by Vinpo. Conclusion Vinpo possesses ameliorative effects against FLX-induced liver injury in rats. This effect may be due to attenuation of oxidative stress and inflammation, in addition to upregulation of PPAR-γ expression.

Background: Peripheral arterial occlusive disease (PAOD) is a major disease that limits active aging in elderly people. Complications of PAOD are the leading cause of hospitalization and amputation for people with lower limb ischemia, and account for billion-dollar expenditures annually around the world. Objective: To assess the balloon dilation angioplasty in limb salvage rate and patency in infra-popliteal arterial occlusive disease. Patients and methods: This study was carried out as a prospective study, in Al-Azhar University Hospitals and 6 October HIO hospital on 20 diabetic patients with critical limb ischemia as defined by Rutherford classification, between Jan, 2019 and July, 2019. Written consents were obtained from all patients. Every patient received an explanation to the purpose of the study. Results: The present study was conducted on 20 diabetic patients, 11 males (55%) and 9 females (45%).Their ages ranged between 50 years and 87 years with a mean age of 66.7. Limb salvage was defined as freedom from major amputation, toe, ray, or trans-metatarsal amputations were considered as minor amputations. The limb salvage after 6 months was 70%, clinical successes were defined as relief of rest pain or improve healing of the ulcer and limb salvage, based on Rutherford categories. Of 3 patients (15 %) suffering from rest pain, Percutaneous Transluminal Angioplasty (PTA) succeeded in 2 patients (66.7%) and became non-disabling cludicants at more than 400m. PTA failed in one patient (33.3%), who underwent redo angioplasty, but failed again. He received conservative treatment in the form of anticoagulants, antiplatelets and vasodilators without improvement and ended by major amputation. Of 17 patients (85 %) suffering from minor tissue loss, PTA succeeded in 11 patients (64.7%) improve healing was achieved, PTA failed in 6 patients (35.3%) four patients underwent femoro-distal bypass surgery, but failed and diabetic foot infection with osteomyelitis reached up to ankle joint and ended by major amputation. Two patients underwent above knee amputation before six months. Two patients underwent below knee amputation at six months. The other 2 patients underwent above knee amputation before six months due their deterioration of their general condition. Conclusion: Tibial angioplasty demonstrated its feasibility, safety and effectiveness in the treatment of diabetic patients with CLI.

Background: Non-valvular atrial fibrillation (AF) is the most common cardiac arrhythmia with a prevalence as high as 1.5±2.0% in the general population. This arrhythmia remains one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity in the world. The aim of study was to evaluation of the patients in delta region who have non-valvular AF and on oral anticoagulation with Vitamin K antagonist as regard the time they spend within therapeutic range. Patients and Methods: A total of 100 patients were included in this study for evaluation of the patients in delta region who have non-valvular AF and on oral anticoagulation with Vitamin K antagonist as regard the time they spend within therapeutic range. Results: Our study showed that only 35% achieved the recommended TTR (percent time in therapeutic range) above 60% from studied risk factors, none showed statistical significance. Conclusions: The quality of anticoagulant control was lower that reported in European countries with a significant proportion of patients had TTR below 60%.

Photography, as we know it today, was not invented on a specific date, but it went through gradual stages over the yearsOver the course of nearly a century and over these years, it is difficult to speak of a single "inventor" because there are so many photographs in my view.The types of processes that can be considered a “photograph” and the many different starting points for each type of technology. WherePhysics, chemistry, light science, agriculture, animal studies, and many intermediate industrial activities all had developments until they beganconverge upon photographic technology. This network of sciences and industries formed, and still is, a mixture of photographic technology and art.

Background The anatomical variation of the frontal sinus and its intimate relation to the skull base and orbit makes its surgery demanding. The extended endoscopic frontal sinus surgery allows wide better drainage and preventing the recurrence of the disease. Fourteen patients underwent EEFSS from May 2017 to May 2019. These patients are nine patients presented by chronic recurrent frontal sinusitis, three patients presented by chronic recurrent fronto ethmoidal mucocele and two patients with chronic recurrent external frontal fistula. Draff III done for ten patients of them and Draff IIB done for four patients of them. This study is designed for evaluating the efficacy of the extended endoscopic frontal sinus surgery (E E F S S) in management of chronic and recurrent frontal sinus diseases. Results The neo opening of the restored frontal sinus was remained opened with Draff III with high success rate; two patients from four patients with Draff IIb were with closed nasofrontal duct. The main follow-up was 12 months; the patients were followed up post-operatively for many office visits without any other manifestations. Conclusion The chronic recurrent frontal sinus diseases can be treated successfully with extended endoscopic frontal sinus surgery (E E F S S). The extended endoscopic frontal sinus surgery (Draff III) provides good results with low morbidity and less post-operative care.

Aim: this study preformed to evaluate clinically and radiographically, the efficacy of Metformin Gel in the surgical treatment of intrabony periodontal defects. Subjects and methods: Twenty chronic periodontitis patients with intrabony defect were divided randomly into two groups. Group I: ten patients with infrabony defects treated by open flap surgery only. Group II: ten patients with infrabony defects treated by open flap surgery combined with metformin gel 1%. Clinical and radiographic parameters were gathered at baseline, 6 and 9 months. Results: There were statistically significant differences between Group I & Group II at 6 months regarding probing depth, clinical attachment level and marginal bone level. And vice versa, no statistically significant differences at 9 months. Conclusions: usage of metformin gel 1% seems to be superior in gaining bone than surgical treatment by open flap surgery only but this improvement was limited in time, that was probably due to gel formulation or lower concentration of metformin.

Introduction: Temporomandibular joint (TMJ) osteoarthritis is usually treated by intra-articular injection of medications. Intra-articular hyaluronic acid (HA) injection reduces friction and stress on the joint cartilage through lubrication, chondro-protection and proteoglycans synthesis. Platelet Rich Plasma (PRP) with its high concentration of growth factors plays a great role in joint repair through enhancing osteo-inductivity, and chondrogenic differentiation. This study aims at comparing intra-articular injection of combination of hyaluronic acid and platelet rich plasma to intra-articular injection of each of them alone. Materials& Methods: 24 young adult male 250-300 grams albino rats were used in the current study divided randomly into 4 groups: Group 1 (control) in which animals were left without treatment. Group 2 which was subdivided into 3 study groups, in Group 2A: the animals received 2 doses of HA, in Group 2B: the animals received 2 doses of PRP, and in Group 2C: the animals received 2 doses of combined PRP and HA. After 28 days, the animals were sacrificed and histological analysis was performed. Synovial fluid Samples were extracted before each intra-articular injection, the concentration of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) were detected and statistically analyzed. Results: Group 2C showed superior findings to the other 2 study groups regarding fibrocartilage and bone regeneration, while Group 2B was superior to group 2A regarding the study parameters. Conclusion: Intra-articular injection of combination of PRP and HA is superior to intra-articular injection of HA or PRP alone for the treatment of TMJ osteoarthritis in rats.

In Ad Hoc networks, route failure may occur due to less received power, mobility, congestion and node failures. Many approaches have been proposed in literature to solve this problem, where a node predicts pre-emptively the route failure that occurs with the less received power. However, these approaches encounter some difficulties, especially in scenario without mobility where route failures may arise. In this paper, we propose an improvement of AOMDV protocol called LO-PPAOMDV (Link Quality and MAC-Overhead aware Predictive Preemptive AOMDV). This protocol is based on new metric combine two routing metrics (Link Quality, MAC Overhead) between each node and one hop neighbor. Also we propose a cross-layer networking mechanism to distinguish between both situations, failures due to congestion or mobility, and consequently avoiding unnecessary route repair process. The LO-PPAOMDV was implemented using NS-2. The simulation results demonstrate the merits of our proposed LO-PPAOMDV with approximately 10-15% increase in the packet delivery ratio while average end-to-end delay is reduced by 20%, and normalized routing load is reduced about 45%, also with 7% increase in the throughput, when compared with PPAOMDV.

International audience; Coronavirus disease 2019 (COVID-19) has become a challenging public health catastrophe worldwide. The newly emergeddisease spread in almost all countries and infected 100 million persons worldwide. The infection is not limited to the respiratorysystem but involves various body systems and may lead to multiple organ failure. Tissue degenerative changes result from directviral invasion, indirect consequences, or through an uncontrolled immune response. Severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) spreads to the brain via hematogenous and neural routes accompanied with dysfunction of theblood–brain barrier. The involvement of the central nervous system is now suspected to be among the main causes of death. Thepresent review discusses the historical background of coronaviruses, their role in previous and ongoing pandemics, the way theyescape the immune system, why they are able to spread despite all undertaken measures, in addition to the neurologicalmanifestations, long-term consequences of the disease, and various routes of viral introduction to the CNS.

Background Myringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. The aim of this study is the assessment of the topical use of autologous platelet-rich fibrin (PRF) in the improvement of myringoplasty success rate. Results Patients were divided to two groups, group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF. At 6 months postoperatively, the success rate (graft taking) in case group A (95%) was significantly higher than in the control group (70%) (P value = 0.037). Success in terms of hearing gain of the air-bone gap was more than 10 dB achieved in 19 patients (95%) in case group A, and 14 patients (70%) in control group B were with a statistically non-significant difference (P value = 0.079). There was no effect of PRF use on hearing gain in graft-taken cases because hearing gain is related to the closure of TM. Conclusion Topical PRF application over tragal perichondreal graft during myringoplasty is successful, safe, and highly efficient with no complications. PRF improves healing of chronic TM perforations and prevents postoperative infection.

Background: adjunctive local periodontal therapy is one of the best options to improve the health of the pocket tissue. The comparison of local effects of simvastatin and metformin as aid in enhance the healing of periodontal tissue is the point of importance. Methods: a total of 45 systemically healthy patients with mild to moderate chronic periodontitis; which having a generalized pocket depth varied from 3mm to 5mm. All patients handled by scaling and root planning and divided haphazardly into: group I, as a control group (n= 15), in which the patients treated by application of placebo gel; group II, (n= 15) treated with application 1.2% simvastatin gel; group III, (n= 15), treated with application of 1% metformin gel. Clinical and biochemical criteria were collected at threshold 3, 6 and 9 months. Results: an advancement in both plaque and gingival indexes was noticed in total 3 groups at 6 and 9 months. Plaque index and gingival index showed decrement in group II and III than group I. The cutback in probing depth and clinical attachment loss was higher in the group III than other groups. Significant minimization in both IL-6 and TNF-α levels occurred from baseline to the end of measurement duration in all groups. Clear interaction was established amid IL-6 and TNF-α heights. Conclusion: metformin was comparatively better than simvastatin in respect of clinical and biochemical markers.

To characterize the safety and practice patterns of artificial urinary sphincter (AUS) placement on a population level. Increasingly AUS implantation has shifted to be an outpatient surgery; however, there is a lack of large-scale research evaluating factors associated with early (≤ 24 hours) versus late (24 hours) discharges and complications in men following AUS placement. We utilized the National Surgical Quality Improvement Program (NSQIP) database to identify and compare factors and outcomes associated with each approach.NSQIP database was queried for men undergoing AUS placement between 2007 and 2016. Patients were classified as either early discharge (ED ≤ 24 hours) and late discharge (LD24 hours). Baseline demographics, operating time, and complications were compared between the 2 groups. Multivariate logistic regression evaluated factors associated with discharge timing and 30-day complications.A total of 1176 patients were identified and were classified as ED in 232 and LD in 944 patients. Operative time was shorter in ED (83 minutes) compared to LD (95 minutes, P.001). Hypertension was more prevalent among LD patients (60.3% vs 69.1% for ED and LD respectively, P.001). The 30-day complication rate was similar in both groups (ED: 4.3% vs LD: 3.4%, P = .498). Multivariable analysis revealed that surgery after 2012 was associated with ED (OR = 3.66, P.001).At the national level, there are no differences in postoperative morbidity between early and late discharges. There is a trend toward more ED, specifically after 2012. A prospective study on the feasibility and safety of outpatient AUS is needed.

Introduction: Osteoarthritis (OA) is the most common chronic musculoskeletal disorder. Nowadays, the role of synovial fluid mesenchymal stem cells (SF MSCs) is increasingly attributed to the treatment of Temporomandibular joint osteoarthritis. This study aimed to compare single versus multiple intra-articular injection of SFMSCs in terms of macroscopic, biochemical, and histological analysis. Material & methods: 18 young adult male 200–300 grams albino rats were used in the current study divided randomly into 3 equal groups. Group (A) comprised control in which OA was induced with no treatment, group (B) comprised MSCs single intra-articular injection group, and group (C) comprised MSCs multiple intra-articular injection group. Biochemical and histologic analysis were performed. Results: histological findings showed that both groups B, C showed regeneration of meniscus and retrodiscal tissues, but group C was superior in regeneration compared to group B. Biochemical analysis showed that TNF-α and IL-1B had the highest value in the control group, followed by the single injection group, while the lowest value was found in multiple injections group respectively. Conclusion: Multiple Intra-articular SF MSCs is a potential disease-modifying therapy for patients suffering from TMJ-OA.

Background: Gynecological Pelvic masses are common problem that are commonly discovered during routine gynecologic or physical examinations. Radiologists routinely evaluate a wide range of pelvic masses during daily practice. Proper management depends on proper preoperative assessment with the help of clinical examination, laboratory tests and different imaging modalities. Radiological evaluation includes ultrasonography (US), computed tomography (CT) and recently magnetic resonance imaging (MRI). Diffusion weighted imaging (DWI) is widely used in protocols for magnetic resonance imaging (MRI) of the female pelvis. It provides functional and structural information about biological tissues, without the use of ionizing radiation or intravenous administration of contrast medium. Objective: This study aimed to evaluate the role of diffusion weighted imaging in the characterization of gynecological pelvic masses and differentiation between benign and malignant tumors. Patients and Methods: This study was performed on 63 patients. All patients had US findings of uterine and adnexal lesions then they underwent conventional MRI with contrast & DWI. Results: DWI is significant promising tool factors for characterization of gynecological tumors and differentiation between benign & malignant lesions with high sensitivity 95% (81%:99% with 95% CI). The sensitivity, specificity and accuracy of detection of the nature of the lesions have been increased after adding of DWI to the conventional imaging. Conclusions: Adding of DWI to the conventional MRI improves the sensitivity and specificity of diagnosis and allows confident diagnosis and differentiation between benign and malignant lesions.

Background: Abdominal trauma one of the main series proplem faced in emergency room it is management is directly related to the incidence of morbidity and mortality Laparoscopy approach has gained wide acceptance among all surgeon.Aim of the work: To study role of laparoscopy in management of violating abdominal stab wounds in hemodynamically stable patients regarding current applications, advantages, disadvantages and future developments. Patients and methods: This prospective nonrandomized clinical study included 80 patients who presented to Ain Shams emergency unit with anterior abdominal stab wound(s) during the period from January 2018 till January 2019. Informed consent regarding conservative management or the need for diagnostic laparoscopy / laparotomy was obtained from all patients.Results: In our study results of 80 patients showed 15 patients (18.8%) were negative without intraabdominal lesion.65 patients (81.3%) had positive finding 46 patients (57.5%) were managed by laparoscopy and 19 patients (23.8%) were converted to open surgery.46 patients were managed by laparoscopy 12 (15%) patients underwent repair of serosal and small tears with simple intracoporcal suturing.10 patients (12.5%) with omental injury, cauterization was done to the 8 patients and clipping of omental bleeder in 2 patients was done.8 patients (10%) with gastric tear were repaired by intracoporial suturing.11 patients (13.8%) with liver injury, haemostasis was done by cauterization and gel foam.5 patients with left colonic and sigmoid injuries underwent lap. colostomy.Conclusion: Exploratory laparoscopy applied to carefully selected hemodynamically stable penetrating trauma patients proved to be safe and technically feasible. It also reduced the negative and non-therapeutic laparotomies and offered profound therapeutic potential and cost effectiveness. So 61 patients (76.3%) ovoid unnecessary laparotomy [15 negative (8.8%) + 46 (57.5%) underwent laparoscopic management] so it's proved to both diagnostic and therapeutic role

Objectives: the work was to determine the maxillary tissue changes under acrylic and flexible lower tooth supported overdentures. Methods: The study was accomplished on 20 patients; the selected cases were upper completely edentulous and lower tooth supported one. lower overdenture supported with canines bilaterally. The cases randomly split into two groups: Group I; ten patients wear acrylic complete upper denture and acrylic mandibular tooth supported overdenture Group II; ten patients wear flexible complete upper denture and flexible lower tooth supported overdenture. Clinical tests were performed by measuring the soft tissue thickness of superimpose the anterior upper ridge at 2 dots 1 cm and 2 cm on each hand to the midline at time of prosthesis delivery and at 12 months. Also, radiographic evaluations of upper edentulous area estimated at time of prosthesis delivery and at 12 months. Results: there was non-significant increase in upper mucosa thickness in both groups at both points of measurements. Also, both groups showed radiographic bony changes in maxillary ridge. There was significant increase in maxillary bony changes in Group I in compare to Group II. Conclusion: it was concluded that there was slight increase in the thickness of soft tissue above the anterior upper ridge in each sequence. More bone resorption allover region of maxilla was observed in Group I, but there was slight decrease in Group II more than Group I.

Background: Neonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the hospitals in the newborn period. We should assess all babies for jaundice at every opportunity. Methods include visual assessment, transcutaneous bilirubinometer (TcB) or total serum bilirubin (TSB). Objective: This is a descriptive study aimed to evaluating the protocol of management of unconjugated hyperbilirubinemia in neonatal intensive care unit at Qena University Hospital. Patients and method(s): This descriptive study included neonates admitted to neonatology unit at Qena university hospital from (April to October 2019), Total number of admitted neonates in our NICU through this period were 1274, from which 517 neonates had jaundice as a primary cause of admission or developed during the course of NICU stay. Result(s): In this period the total number of NICU admission was 1274 cases, out of 517 jaundiced neonates, 100 (19.3%) were diagnosed to have unconjugated jaundice on admission without any associated other diseases and 417 (80.7%) of them were admitted due to other causes and developed jaundice during the course of the disease. The other 417 neonates were admitted to our NICU due to RD in 409 (79.1%) cases, 4 (0.8%) cases due to sepsis, two (0.4%) cases due to CHD and two (0.4%) cases due to surgical causes. The unconjugated neonatal jaundice represented (7.8%) (100 cases out of 1274 neonates admitted during the period of the study). Physiological jaundice represented 89.4% while pathological jaundice represented 10.6% of causes of neonatal jaundice. Regarding treatment of studied neonates 12% of cases need only follow up with no need for Phototherapy, 62.8% of cases needed single or double Phototherapy, 12.4% needed extensive Phototherapy (triple phototherapy), 12.8% of cases needed capsule Phototherapy and no cases needed neither exchange transfusion nor drug therapy. Only 0.4% of jaundiced neonates developed prolonged hyperbilirubinemia, while no complications were detected in 99.6% of cases. We started treatment based on measuring bilirubin by TSB in 62.3% of jaundiced neonates and 37.7% by TCB. The mean values of TSB in jaundiced neonates (11.46 ± 4.92) were significantly higher than the TCB (10.31 ± 4.61), P =0.0005. There was significant positive correlation between mean TSB and mean TCB (R= 0.946, P < 0.001). There was no significant difference regarding mean TSB between different gestational age groups p= 0.242). Conclusions: Hyperbilirubinemia is one of the most common causes of hospital admission in our nursery. Among the causes of hyperbilirubinemia, physiologic jaundice was the most common. Intensive phototherapy is effective in lowering TSB in unconjugated jaundice at / or near levels of exchange transfusion, and this may be helpful in decreasing needs for and risks of exchange transfusions. TcB measurements may underestimate the TSB values, so it should be considered only as a screen and samples should be sent to the laboratory for confirmation especially at high risk groups and high levels of TCB.

Background: Hepatocellular carcinoma (HCC) is the most typical primary viscus malignancy and also the second leading reason behind cancer-related death worldwide. Objectives: To study the association between the tomography and pathological options of HCC for getting an honest designation on the lesions of HCC for getting the best treatment and prognosis of these lesions. Patients and Methods: Study of the imaging criteria of HCC which includes the arterial enhancement and venous washout in both CT and MRI within a background of cirrhosis, and it’s a possible association with the vascular density and microvascular invasion seen in the biopsy. We enrolled consecutive cirrhotic patients with HCC liver resection in 2 years (from January 2018 till December 2019). Results: Our results on the number of lesions cleared that, the number of lesions ranged from 1 in number that observed in 68 (66.02 %) and 2 that observed in 11 (10.68 %), followed by 3, 4, and 5 lesions that observed in 1 (0.97 %) of the examined patients. The higher incidences of the lesions observed in middle hepatic vein 55 (53.40 %) right lobe of the liver 16 (15.54 %) , seg 2/3 10 (9.71 %), right liver 5 (4.86 %), left liver 5 (4.86 %) and in left lateral liver 4 (3.88 %). Conclusion: The association between the Imaging and pathological features of HCC including microvascular invasion and density which is very important for getting an honest designation on the lesions of HCC and for getting the best treatment and prognosis of these lesions.

We sought to discuss the updates in the 8th edition (8E) of The American Joint Committee on Cancer (AJCC) staging for penile cancer and to provide relevant evidence associated with the major changes that occurred. A comprehensive search of PubMed® and Web of Science® was performed for relevant English language articles from 2004 through 2019. Literature resulting from this search were reviewed and articles pertinent to penile cancer staging changes were included. Modifications were observed in the tumor and nodal staging. In the 8E AJCC, Ta disease indicates noninvasive localized squamous cell carcinoma, which allows for inclusion of other historical variants. T1 is subcategorized into T1a and T1b according to existence of lymphovascular invasion, perineural invasion and high-grade tumor. This subcategorization demonstrates different risks for lymph node (LN) metastases and will affect decision strategy when opting for inguinal lymphadenectomy. Urethral invasion is no longer a differentiator between T2 and T3 disease, as T2 includes invasion of the corpus spongiosum and T3 involves invasion of the corpus cavernosum. For nodal staging, pN1 has been increased from a single LN metastases to two unilateral inguinal LN metastases, while pN2 has been modified to three or more inguinal LN metastases. This change was evidenced by demonstrating no significant difference in disease specific mortality between the previous edition’s pN1 and pN2. The 8E penile cancer staging provides several modifications that have relevant clinical implications in the management of penile cancer. Nevertheless, it requires refinements that allow for better staging of penile tumors.

Introduction:Excision and primary anastomosis has emerged as a standard of care for urethral strictures in men with satisfactory results for urethral patency. Several improvements, particul...

Aims: To compare the 30-day postoperative complications of robotic radical cystectomy (RRC) vs open radical cystectomy (ORC) in obese patients (body mass index ≥30) with bladder cancer (BC). Method...

Background Noninvasive measurement of blood hemoglobin could save time and decrease the risk of anemia and infection. The accuracy of CO-oximetry-derived noninvasive hemoglobin (Sp-Hb) had been evaluated in pediatric population; however, its accuracy in children with congenital heart disease has not been studied till date. We evaluated the accuracy of Sp-Hb in relation to laboratory-measured hemoglobin (Lab-Hb) in children with congenital heart disease. Methods This prospective observational study included children with congenital heart disease undergoing procedural intervention. Sp-Hb measurements were obtained using Radical-7 Masimo pulse CO-oximeter and were compared against simultaneous Lab-Hb measurements obtained from the arterial line. Children were divided in cyanotic and acyanotic, and separate analysis was performed for each group. The values of both measurements were analyzed using Spearman's correlation coefficient and Bland-Altman analysis. Correlation was performed between Sp-Hb and Lab-Hb bias and each of arterial oxygen saturation and perfusion index. Results One-hundred and eleven pairs of readings were obtained from 65 children. The median (quartiles) age and weight of the children were 1 (1.2-4) years and 11 (8-17) kg, respectively. There was moderate correlation between Lab-Hb and Sp-Hb with a correlation coefficient (95% confidence interval [CI]) of 0.75 (0.63-0.83) in acyanotic children and 0.62 (0.37-0.79) in cyanotic children. The mean bias (95% limits of agreements) was -0.4 g/dL (-2.4 to 1.6 g/dL) and 1 g/dL (-2.7 to 4.6 g/dL) in acyanotic and cyanotic children, respectively. The mean bias between Sp-Hb and Lab-Hb showed a weak negative correlation with oxygen saturation (r [95% CI]): (-0.36 [-0.51--0.18]), and a weak positive correlation with the perfusion index (r [95% CI]): (0.19 [0.01-0.37]). Conclusion The large bias and the wide limits of agreement between Sp-Hb and Lab-Hb denote that Masimo-derived Sp-Hb is not accurate in children with congenital heart disease especially in the cyanotic group; the error in Sp-Hb increases when oxygen saturation decreases.

Purpose: To report the outcomes in eyes with noninfectious uveitis receiving dexamethasone implant at the time of pars plana vitrectomy (PPV).Methods: Retrospective analysis of visual acuity (VA), ...

Background : Variceal hemorrhage is a serious life-threatening complication of portal hypertension. The patient with esophageal variceal bleeding may present with hematemesis, melena, or general deterioration in mental or physical status and symptoms of shock. Nursing care is very important during initial period to achieve best possible outcome and have good prognosis for the patient. Aim: This study aimed toassess nurse's performance regarding care of patients with esophageal variceal bleeding. Design A descriptive exploratory design was utilized for the conduction of this study. Setting the study was carried out in intensive care unit of hematemsis at Elmery hospital affiliated to Alexandria University. Study sample: A purposive subject of (40) registered nurses caring for patients with EVB. Data Tools: three tools were used for data collection; 1st tool was nurses ' self-administered questionnaire and the 2 nd tool was nurses’practice observational checklist and 3 rd tool was nurses' attitude questionnaire. Result: the results of this study showed that, nearly three quarters of the studied nurses were having unsatisfactory total level of knowledge regarding pain management of patients with EVB, while more than half of them had got satisfactory level of practice and more than half of them had positive attitude. Conclusion: There were unsatisfactory level of knowledge, satisfactory level of practice among nurses under study. Recommendations: In-service training program must be developed based on need assessment for nurses in relation to care and management associated with EVB and evaluating the effect of its implementation on their performance and patients' outcome.

Purpose Image guided musculoskeletal MSK biopsy could afford initial and ultimate judgment and lead choices to the best treatment Nonsurgical intervention grants less complication rate than surgical intervention It is rapid harmless and decisive procedure yields accuracy in diagnosis up to Ultrasound and computed axial tomography represent the key procedures in performing MSK intervention Numerous needles and procedures are existing for helping the physician accomplishing this procedure without harm This study was accepted in order to evaluate ultrasound and computed tomography CT guided core needle biopsies CNB of musculoskeletal lesions accurateness and medical worth in the management plan nbsp Materials and methods Fifty patients with MSK lesions underwent image guided Ultrasound or CT guided CNB for deeply located musculoskeletal pathology Radiological Pathological and clinical data were recorded and analysed nbsp Results Of fifty CNBs forty nine were adequate to obtain pathological diagnosis while one CNB seemed to be inadequate Of the fifty CNBs forty eight patients were correctly diagnosed while two patients were misdiagnosed and this gives an overall accuracy rate of nbsp Conclusion The image guided CNB of MSK lesions signify the decisive and harmless method for gaining a final histopathological decision

BACKGROUND Recently, mesenchymal stem cells (MSCs) have proven to have a high potentiality in tissue regeneration. However, genetic diseases or certain environmental risk factors, such as smoking, may compromise the functioning of MSCs, thus leading to a change in the expected clinical outcomes. OBJECTIVES The aim of this study was to investigate the proliferation capacity and osteogenic potential of dental pulp stem cells (DPSCs) in smokers in comparison with non-smokers. MATERIAL AND METHODS Mesenchymal stem cells were isolated from the cultured dental pulp tissue from the third molars of 5 smokers and 5 non-smokers. The proliferation capacity of DPSCs derived from both groups was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) proliferation assay. Alizarin red staining and the gene expression analysis of the alkaline phosphatase (ALP) and osteocalcin (OC) genes were performed in order to assess osteogenic differentiation. RESULTS The MTT proliferation assay revealed that the mean absorbance rate of the DPSCs of the nonsmokers was significantly higher than that of the group of smokers (p < 0.0001). When stained with alizarin red after 21 days of osteogenic induction, fewer calcium deposits were observed among the smokers. Moreover, the ALP and OC gene expression was significantly higher in the differentiated DPSCs of the nonsmokers (p < 0.05). CONCLUSIONS The group of smokers showed a reduced cell viability. The expression of the ALP and OC genes was lower in the DPSCs of the smokers. Therefore, smoking has a negative impact on the proliferation and regenerative potential of human MSCs.

Aims Robot-assisted laparoscopic intracorporeal urinary diversion (ICUD) has several potential benefits of a smaller incision and reduced pain over extracorporeal urinary diversion (ECUD). We compared the perioperative outcomes of patients who have undergone these procedures with or without cystectomy. Subjects and methods This study is a retrospective chart review of patients who underwent ICUD and ECUD in a single tertiary referral hospital. Patient demographics, perioperative outcomes, and the 90-day postoperative complications were collected. Statistical analysis used The statistical analyses were performed using the Chi-square test for categorical variables which are specified as frequency (percentage). Results Thirty-five patients who underwent urinary diversion procedure were identified for inclusion in the study. Of these patients, 14 underwent ICUD and 21 underwent ECUD. The mean operative time was longer in the ICUD group compared to that of the ECUD (457.14 ± 103.91 and 388.29 ± 110.17, respectively, P = 0.07). The median blood loss was statistically significantly lower in the ICUD group (250 ml) than in the ECUD group (450 ml, P = 0.05). The mean hospital stay was marginally longer for the ECUD group (8.1 days) as compared to the ICUD group (6.3 days, P = 0.17). There was no difference in the readmission or reoperation rates after 30 days. The 90-day complication rate was not statistically significantly different between the two groups, but a trend favoring ICUD (64%) over ECUD (71%, P = 0.656) was noted. Conclusions Robot-assisted ICUD is associated with decreased blood loss, and there is a trend toward fewer postoperative complications and shorter hospital stays.

Aims: To compare early postoperative morbidity and mortality rates in obese patients (body mass index ≥30 kg/m2) who underwent minimally invasive partial nephrectomy (MIPN) vs open partial...

Background Phenylephrine is the most commonly used vasopressor for prophylaxis against maternal hypotension during cesarean delivery; however, the best regimen for its administration is not well established. Although variable infusion protocols had been suggested for phenylephrine infusion, evidence-based evaluation of variable infusion regimens are lacking. The aim of this work is to compare variable infusion, fixed on-and-off infusion, and intermittent boluses of phenylephrine for prophylaxis against maternal hypotension during cesarean delivery. Methods A randomized controlled study was conducted, including full-term pregnant women scheduled for elective cesarean delivery. Participants were divided into three groups which received phenylephrine by either intermittent boluses (1.5 mcg/Kg phenylephrine), fixed on-and-off infusion (with a dose of 0.75 mcg/Kg/min), or variable infusion (with a starting dose of 0.75 mcg/Kg/min). The three groups were compared with regard to frequency of: maternal hypotension (primary outcome), second episode hypotension, reactive hypertension, and bradycardia. Other outcomes included heart rate, systolic blood pressure, physician interventions, and neonatal outcomes. Results Two-hundred and seventeen mothers were available for final analysis. The 2 infusion groups showed less incidence of maternal hypotension {26/70 (37%), 22/71 (31%), and (51/76 (67%)} and higher incidence of reactive hypertension compared to the intermittent boluses group without significant differences between the two former groups. The number of physician interventions was highest in the variable infusion group compared to the other two groups. The intermittent boluses group showed lower systolic blood pressure and higher heart rate compared to the two infusion groups; whilst the two later groups were comparable. Conclusion Both phenylephrine infusion regimens equally prevented maternal hypotension during cesarean delivery compared to intermittent boluses regimen. Due to higher number of physician interventions in the variable infusion regimen, the current recommendations which favor this regimen over fixed infusion regimen might need re-evaluation.

Background: Mycobacterium tuberculosis (MTB) is one of the top ten causes of death and the leading cause of a single infectious agent (above HIV/AIDS) Worldwide. Each year millions of people continue to fall sick with TB. Aim: To evaluate the MTB/RIF assay for rapid diagnosis and detection of rifampin resistance of tuberculosis in both positive and negative smears-as well as pulmonary and non-pulmonary clinical specimens. Patients and Methods: A prospective study was conducted on 50 patients (37 pulmonary, 13 extrapulmonary) patients attending the Outpatient Clinic and inpatients of Chest Department, Benha University Hospital, Egypt. Pulmonary samples were analyzed by (Sputum smear exam. by Ziehl Neelsen (ZN) stain, culture on Lowenstein-Jensen(LJ)media, and assessment of rifampin sensitivity). Extrapulmonary samples were analyzed by reference methods (pathological diagnosis) and by GeneXpert. Results: pulmonary patients’ smears were 32 (86.5%) positive and 5 (13.5%) negative. Culture on LJrevealed rifampin sensitivity in 33/37 (89.1%) and rifampin-resistant in 4/37 (10.9%), GeneXpert was positive in 32(86.5%) and negative in 5 (13.5%), rifampin assay was sensitive in 33 (89.1%) and resistant in 4(10.9%). All extrapulmonary patients, (n=13) were positive on GeneXpert and sensitive for rifampin. Conclusion: GeneXpert could be considered as a leading way to early diagnosis, treatment, and prevention of transmission of tuberculosis which could reduce TB- associated morbidity and mortality.

Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.

Background Plantar fasciitis due to calcaneal spur is a common cause of heel pain and functional disability, and its management presents a huge challenge for clinicians which results sometimes in unpleasant clinical outcomes. The efficacy of extracorporeal shock wave therapy (ESWT) as an alternative therapeutic option to surgical management after failure of conservative treatment has been addressed. Our aim was to evaluate the efficacy of ESWT in the treatment of plantar fasciitis in calcaneal spur patients using ultrasonography. Results The mean plantar fascia (PF) thickness was statistically significantly higher in the calcaneal spur patient group (5.66 ± 1.14 mm) than in the healthy control group (2.40 ± 0.35 mm), (P = 0.001). Significant PF thickness reduction, visual analog scale (VAS), and Roles and Maudsley score (RMS) improvement were observed (P < 0.001) after 4 sessions of ESWT. Conclusion PF thickness increases significantly in calcaneal spur patients and responds to treatment. ESWT decreases the thickness of the PF and improves pain and function significantly.

Aim: The severity of COVID-19 has raised a great public health concern evoking an urgency for developing multitargeted therapeutics. Phlomis species was ethno-pharmacologically practiced for respiratory ailments. Materials & methods: An array of 15 phytoligands previously isolated from Phlomis aurea were subjected to molecular docking to explore their potential SARS-CoV-Spike-angiotensin-converting enzyme 2 complex inhibition, that is essential for virus entry to host cell. Results: Acteoside (11) showed the most potent in silico inhibition with an additional merit, over hesperidin (16), of not binding to angiotensin-converting enzyme 2 with well proven in vivo pulmonary protective role in acute lung injury, followed by chrysoeriol-7-O-β-glucopyranoside (12) and luteolin-7-O-β-glucopyranoside (14). Conclusion: Phytoligands (11, 12 and 14) were posed as promising candidates with potential prophylactic action against COVID-19. These phytoligands were prioritized for further biological experimentation because of their acceptable predicted ADME and drug-likeness parameters. Moreover, they could aid in developing multitargeted strategy for better management of COVID-19 using phytomedicines., Graphical abstract

Background Intrathecal opioids administration is an attractive analgesic technique since the opioids is injected directly into the cerebrospinal fluid providing safe and effective postoperative analgesia for up to 24 hours. The most common adverse effects after intrathecal morphine are postoperative nausea, vomiting and pruritus. We evaluated the effect of intrathecal atropine on prevention of postoperative nausea and vomiting in patients receiving intrathecal hyperbaric bupivacaine and morphine in lower limb surgeries and on its effect on duration of postoperative analgesia. Methods 80 patients undergoing lower limb surgeries under spinal anesthesia were randomized into two groups. BM group Received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + Normal saline (0.1ml). BMA group received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + 100 mcg preservative-free atropine sulphate (0.1ml). Follow-up of both nausea and vomiting episodes was done during the first 24 hours postoperatively. Results Nausea and vomiting were noticed in 17 patients (42.5%) in group BM and 7 patients (17.5%) in group BMA, with significant differences (p = 0.015). As regards postoperative analgesia, there was no significant differences between BM and BMA group. Conclusions Intrathecal atropine has antiemetic effect after spinal anesthesia using bupivacaine and morphine for lower limb surgeries without affecting postoperative analgesia.

Intimal sarcomas are rare malignant mesenchymal tumors that arise in the large arteries and rarely in the heart. Herein, we report the case of a 55-year-old man who was referred for further assessment of a right ventricular outflow tract mass. Assessment with cardiac magnetic resonance imaging revealed an enhancing mobile mass arising within the right ventricular outflow tract and extending into the main pulmonary artery. The initial diagnostic possibilities included thrombus and myxoma. The patient underwent surgical recession of the mass and the histopathology examination confirmed the diagnosis of cardiac intimal sarcoma.

Background: The potential role of antioxidants in treatment of periodontitis, there is a recent interest about the relationship between antioxidants and periodontitis, so the present study was designed to prove this correlation. The aim of the present study was to investigate the effects of use of antioxidants as adjuncts in treatment of periodontitis. Materials and Methods: 75 subjects were divided into five groups: clinically healthy, gingivitis treated non surgically, gingivitis treated non surgically with antitoxins supplementation, periodontitis treated non surgically, periodontitis treated non surgically with antitoxins supplementation, groups were dividedaccording to Community Periodontal Index of Treatment Needs. At the baseline, periodontal attachment loss was recorded and scaling and root planning was performed in gingivitis and periodontitis groups. Antioxidants supplementations were administrated in the form of single daily dosage taken orally for two weeks. Saliva samples were collected at baseline, 15th day, 30th day, and 45th day for evaluation of uric acid levels. Results: Uric acid levels were significantly low in patients with more destructive periodontitis as compared to clinically healthy and gingivitis groups. As the treatment was initiated, significant increase in uric acid levels was observed as the time elapsed.Conclusion: the increase in salivary antioxidants levels was observed after administration of antioxidants therapy, therefore antioxidant therapy can be used as an adjunct to nonsurgical periodontal therapy.

Severe burns lead to decreased pulmonary function and impaired aerobic capacity for long periods postinjury. Low-level laser therapy is a modality used to improve aerobic capacity, enhance exercise performance, and increase the time until fatigue when used before aerobic exercises. This work aims to determine the impacts of pre-exercise low-level laser therapy on aerobic capacity in burn cases. Sixty adults burned cases of both sex, aged from 25 to 40 years, with second-degree healed thermal burns, and the total burned body surface area ranged from 20 to 40% participated in this study after complete wound healing. They were randomly categorized into two groups of equal numbers. The study group received low-level laser therapy before aerobic exercises, three sessions per week for 12 weeks, while the control group performed aerobic exercises three times weekly for 12 weeks. All cases received the routine physical treatment program. Aerobic capacity was assessed for both groups by measuring maximum oxygen consumption and time to exhaustion at baseline and 12 weeks following interventions. There was a statistically significant rise in the mean values of maximum oxygen usage and time to fatigue after 12 weeks of treatment in both groups. However, after comparison, the improvements in the study group were statistically significant than those in the control group with P < .01 and P < .05, respectively. Low-level laser therapy has a beneficial therapeutic impact on promoting aerobic capacity, improving maximum oxygen consumption, and increasing treadmill time in burned cases when preceding aerobic exercises.

ObjectiveTo report the trends for the use of eye protection methods during retinal laser in clinic and operating room.Methods and analysisRetrospective analysis of a 14-item survey questionnaire submitted to the European Vitreoretinal Society members.ResultsResponses from 630 members were analysed. Most of the respondents practised in Europe (52.7%), followed by North America (21.0%). The majority of respondents had laser filters in the microscope for the operating surgeon (92.1%), or used protective goggles (6.8%). Only 38.9% of respondents indicated that auxiliary staff in the operative room used protective goggles during laser treatment. Three-dimensional retina viewing system was used by only 22.5% of respondents, of those, 34.5% reported use of laser protection goggles by the operating surgeon. Rates of laser protection by auxiliary staff were 62.9% for indirect laser and 60.8% for slit lamp laser. We found a higher rate for use of laser protection by auxiliary staff in North America-based practices for endolaser (pConclusionThe use of laser protection methods is routinely adopted by the physicians in the operating room and clinic, but less so by their assisting or auxiliary staff.

In the last decade, the number of surveillance cameras has increased significantly, with much research conducted to automate the process of surveillance, as humans cannot manage to monitor all these cameras individually, which may cause errors in public safety or abnormal situations. Also, humans may overlook key details in such abnormal behaviours in surveillance cameras. The proposed approach predicts abnormal behaviour using generative adversarial networks (GANs). GANs are trained using different datasets that contain various behaviours to predict future frames. These future frames are transmitted to a deep learning neural network to classify them as normal or abnormal activities, and future anomalies can be detected before they happen. Our initial results show that depending on the future frames extracted by the GAN model is possible, as these extracted frames either improve the accuracy of the detection model or do not affect it, but they can also be further enhanced to detect more frames at a longer duration and predict anomalies before they happen. Anomalies in surveillance will not only be detected but also predicted before they happen, which will result in the prevention of crimes, reductions in surveillance costs and a safer environment overall.

Background and Aims Pregnancy related acute kidney injury (PRAKI) is still a common serious problem in developing countries. Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor metalloproteinases-2 (TIMP-2) can identify critically ill patients at risk for the development of severe AKI. Aims: To identify main causes and timing of PRAKI and to study the G1 cell cycle arrest biomarkers in cases diagnosed with (PRAKI) as a diagnostic tool. Method 80 pregnant women diagnosed with PRAKI were recruited from a single hospital as well as 30 age-matched pregnant women with normal pregnancy participated in this study. A urine specimen was collected from all study participants with established AKI within 24 hours of ICU admission to measure [TIMP-2]*[IGFBP7]. Results The incidence of PRAKI was 1.1%. The most common cause of PRAKI is preeclampsia/eclampsia spectrum (61%). Most of the cases occur in the third trimester (60%) and postpartum period (23%). At a cutoff 0.33 ng/mL, the estimated sensitivity and specificity of urinary [TIMP-2]*[IGFBP7] in predicting PRAKI is 100% (95% CI) with NPV and PPV are 100%. Conclusion Urinary [TIMP-2]*[IGFBP7] serves as a sensitive and specific biomarker in the diagnosis of PRAKI.

Background: Myocardial infarction (MI) is one of the causes of cardiovascular diseases that lead to death despite of the great advancements in the medical interventions.Aim of the work: To assess the possible effect of mangosteen and mesenchymal stem cells (MSCs) in Isoproterenol (ISO)-induced MI in adult male albino rats, monitored by histological and immunohistochemical methods.Materials and Methods: Fifty-five adult male albino rats were divided into: control group (GI), group II (ISO), group III (Mangosteen+ISO), group IV (ISO+MSCs), group V (Mangosteen+Isoproterenol+MSCs). ISO was given subcutaneously, twice (250mg/kg/d), mangosteen was given orally (18mg/200gm) and MSCs (5x106 cells in 1mL of PBS) were injected intracardiac. Myocardial sections were stained with H&E, Masson’s trichrome and immunohistochemical stain for caspase-3 and vascular endothelial growth factor (VEGF). The mean area % of collagen fibers and immunoreactivity of caspase-3 and VEGF were measured by the image analyzer. The statistical analysis was applied by using ANOVA.Results: Myocardial sections of G II revealed discontinuity and degeneration of cardiac muscle fibers, pyknotic nuclei, inflammatory cellular infiltration and congested blood vessels. There were increased collagen deposition and significant increase in caspase-3 immunoreactivity. Mangosteen administration (G III) showed partial improvement in cardiac muscle fibers and reduced inflammatory cellular infiltration.MSCs treatment (G IV) resulted in obvious decline in myocardial damage, apoptosis with significant reduction of collagen deposition and significant increase in VEGF immunoreactivity. Better results are obtained when MSCs and mangosteen were combined (G V).Conclusion: Mangosteen exerts a synergistic effect with MSCs against ISO-induced MI.

The study aims to identifying the development of quantities and values of exports and imports of some dairy products manufactured in Egypt during the period 2002-2016

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)

Objective Salvage surgery (SS) for penile cancer (PC) is indicated in the management of local failure following radiation therapy (RT). Reports describing survival outcome are rare. This study aims to assess survival outcome of SS following RT failure in PC. Materials and methods We used The Surveillance, Epidemiology, and End Results database to identify patients received SS on the penis following RT. Social, demographic and pathological criteria of the patients were gathered. The 1-, 3-, 5-, 10-year survival rates were assessed. Results Between 1976 and 2013, 17 patients received penile SS following RT. Median age was 65 years (range 47-91 years). The mean follow-up was 51 months (range 3-213 months). Sixteen (94.12%) patients received external beam radiation and 1 (5.88%) received combined external beam radiation with brachytherapy. Tumor histology was squamous cell carcinoma in 16 (94.12%) patients and mucinous adenocar-cinoma in 1 (5.88%). The 1-, 3-, 5- and 10-year overall survival rates were 68.8, 35.7, 35.7 and 10.7%, respectively. The 1-, 3-, 5- and 10-year cancer specific survival rate was 72.7, 48.4, 48.4, and 36.3% respectively. Conclusion Our results demonstrate, the overall survival of PC patients underwent SS was poor with nearly one third of patients dying within the first year and only one third surviving up to 3 years from the SS.

This review will address the current literature available regarding complications after intravesical Bacillus Calmette-Guerin (BCG) therapy for bladder cancer. Topics include intravesical BCG therapy–related complications, role of BCG therapy in immunosuppression, and future directions in the context of BCG-related complications. There are several new reviews and case reports discussing unique complications following intravesical BCG therapy that should raise awareness of possible short-term and long-term effects after using this common treatment modality in bladder cancer patients. Since intravesical BCG is a common treatment option for non-muscle invasive bladder cancer and can cause a variety of complications, it is important to recognize this aspect of the patient’s history when evaluating patients who present with symptoms similar to the ones discussed in this review. This will allow for prompt delivery of treatment as well as preventing unnecessary morbidity and mortality.