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Background: Hand osteoarthritis (OA) can be a distressing disorder that impairs a patients' quality of life. There is a relation between OA and vascular damage, especially atherosclerosis, and OA are both common chronic conditions associated with aging and obesity. Aim of the study: The objective of this research was to examine nailfold microcirculation in individuals with hand OA Patients and Methods: a cross-sectional, observational study, about 56 patients with hand OA were enrolled. All subjects underwent a standard radiology X-Ray examination of the hands and a Nailfold vascular examination was performed. Results: of the 56 patients studied were females, and 12 were males. Regarding the Kellgren and Lawrence scoring, it was mild (grade II) in one patient (50%) and severe (grade IV) in one patient (50%) in the male patients without pain, while in those with hand pain, it was moderate (grade III) in eight patients (80%) and severe (grade IV) in two patients (20%).it was mild (grade II) in eight patients (22.2%), moderate (grade III) in 21 patients (58.3%) and severe (grade IV) in seven patients (19.4%). Nailfold examination for studied subjects showed that there were about 41 patients (73.2%) with low capillary density and 32 patients (57.1%) with morphological changes. Conclusion: Our findings provided a general description of the NFC findings most likely to be seen in OA patients; Vascular anomalies may play a role in the illness progression and may assist in elucidating because the condition is frequently found in the distal digit joints.

Oral formulations of insulin are typically designed to improve its intestinal absorption and increase its blood bioavailability. Here we show that polymerized ursodeoxycholic acid, selected from a panel of bile-acid polymers and formulated into nanoparticles for the oral delivery of insulin, restored blood-glucose levels in mice and pigs with established type 1 diabetes. The nanoparticles functioned as a protective insulin carrier and as a high-avidity bile-acid-receptor agonist, increased the intestinal absorption of insulin, polarized intestinal macrophages towards the M2 phenotype, and preferentially accumulated in the pancreas of the mice, binding to the islet-cell bile-acid membrane receptor TGR5 with high avidity and activating the secretion of glucagon-like peptide and of endogenous insulin. In the mice, the nanoparticles also reversed inflammation, restored metabolic functions and extended animal survival. When encapsulating rapamycin, they delayed the onset of diabetes in mice with chemically induced pancreatic inflammation. The metabolic and immunomodulatory functions of ingestible bile-acid-polymer nanocarriers may offer translational opportunities for the prevention and treatment of type 1 diabetes.

Background: Polycystic Ovarian Syndrome (PCOS) is one of the most common female endocrine disorders, which affect about 5%-10% of women worldwide during their reproductive age. Aim: To evaluate the effect of educational program on lifestyle for paramedical students with polycystic ovarian syndrome. Setting: The study conducted at two government colleges in Jordan. Study Design: A Quasi- experimental (pre-test & post-test) design was utilized in this study. Sample type: A purposive sample. Sample size: 68 students. Tools of Data Collection: Identification of students with PCOS tool, Assessment of lifestyle habits tool, POCS structured interviewing questionnaire tool, Follow up sheet, and Psychological assessment tool. Results: The present study findings revealed that a highly significant difference regarding the student's knowledge about the PCOS as compared pre, post, and follow-up program results. Also, there was a significant improvement in the student's lifestyle habits after applying to the educational program compared to before applying them. Conclusion: The results of the study supported the study hypothesis that students who attend the educational program regarding polycystic ovarian syndrome, will improve their knowledge scores and their lifestyles. Recommendations: Applying a screening program for PCOS in young students is a very important to reduce the long-term health complications associated with PCOS.

Automatic segmentation of brain tumor from Magnetic Resonance Images (MRI) is one of the challenging tasks in computer vision. Many proposals investigate the use of Deep Neural Networks (DNN) in image segmentation as they have a high performance in automatic segmentation of brain tumors images. Due to the gradient diffusion problem and complexity, it generally takes a lot of time and extra computational power for training deeper neural networks. In this paper, we present an automatic technique for brain tumor segmentation depending on Deep Residual Learning Network (ResNet) to get over the gradient problem of DNN. ResNets accomplish more accuracy and can make the training process faster compared to their equivalent DNN. To achieve this enhancement, ResNets add a shortcut skip connection parallel to convolutional neural networks layers. Simulation examples have been carried out on dataset BRATS 2015 to verify the superiority of the proposed technique. Results verify that the proposed technique has an improved accuracy of 83%, 90%, and 85% for the complete, core, and enhancing regions, respectively. Moreover, it has an average computation time (3 times) faster than other DNN techniques.

Summary This study aimed to determine the effectiveness of mefl oquine alone or combined with albendazole in reduced doses against T. spiralis infection. One hundred and twenty albino mice were orally infected with 200 T. spiralis larvae/mouse. Drugs were administered during the enteral phase on days 1 to 3 and on the chronic phase on days 35 to 37 post-infection, and mice were sacrificed, respectively, at days 7 or 48 post-infection to count mature intestinal worms or encysted muscle larvae. The effect of the treatment on the histology of the target organs of each phase, intestine and diaphragm, was also evaluated. A signifi cant decrease in intestinal worms was found in all treated groups relative to the untreated control group at a peak of 93.7% in the combination albendazole-mefl oquine group. Results in all treated groups demonstrated a signifi cant decrease in muscle larvae relative to untreated control groups, achieving 86.2 % in the combined albendazole-mefl oquine group. There was a marked improvement in the intestinal and muscular architecture in all treated groups compared to the non-treated control group. Notably, the albendazole-mefl oquine group showed an almost complete recovery. The combined albendazole-mefl oquine low dose regimen had the highest effect on reducing parasite burden and restoring normal histological architecture.

Background: Morbidly adherent placenta is considered one of the most life-threatening obstetric complications and may cause severe intra operative bleeding requiring massive blood transfusion. The challenge is how to preserve the uterus with less complications? Aim of Study: This study aimed to present an alternative applicable surgical technique to save the uterus in cases with MAP by application of stepwise devascularization and resection of the placenta with adherent uterine wall. Material and Methods: It is a retrospective study in which 75 patients with morbidly adherent placenta, who delivered by cesarean section, were selected. Bilateral uterine artery ligation was done after downward dissection of the bladder, followed by upper uterine segment incision, downward step-wise clamping and resection of the whole lower uterine segment with adherent placenta till the cervix by vertical and transverse clamps. Finally reconstruction of the uterus was done. The amount of blood loss, operative time, post-operative hospital stay and operative complications were analyzed. Results: In all cases the placenta was adherent to the lower uterine segment and involving the posterior wall of the bladder in four cases. In all cases the mean estimated blood loss was 1156.3±403.2mL, the mean operative time was 76.3 ±24.5min, and the mean post-operative hospital stay was 3.8± 1.6 days. The four cases, in which the placenta was invading the bladder wall, underwent bladder repair due to bladder injury during dissection. In all cases, the uterus had been preserved. No other intra operative complications were reported. Conclusion: Stepwise devascularization and resection of the placenta with adherent uterine wall is an effective and applicable technique to preserve the uterus in patients with morbidly adherent placenta with excellent operative results, less blood loss, blood transfusion was needed in limited cases.

Voriconazole (VRC) is a broad spectrum, second generation triazole antifungal. The main use of VRC is via the oral and intravenous route. The study aimed to formulate VRC into ternary micellar systems (TMSs) for the topical treatment of ocular mycosis. TMSs were successfully prepared by water addition/solvent evaporation method, applying a 3-factor D-optimal design. The numerical optimization process suggested an optimal formula (OTMS) composed of total Pluronics to drug weight ratio of 22.89: 1, 1:1 weight ratio of Pluronic® P123 and F68, and 2% w/v of Labrasol. OTMS had high solubilization efficiency of 98.0%, small micellar size of 21.8 nm and suitable zeta potential and polydispersity index values of -9.0 mV and 0.261, respectively. OTMS exhibited acceptable stability for 3 months. Transmission electron microscopy demonstrated the spherical morphology of micelles. OTMS was expected to cause no ocular irritation or blurring in vision as reflected by pH and refractive index measurements. The histopathological study revealed the safety of OTMS for ocular use. The fungal susceptibility testing using Candida albicans demonstrated the superiority of OTMS to VRC suspension, with greater and more durable growth inhibition. Therefore, ocular application of optimized VRC-loaded TMSs can be a promising treatment for ocular mycosis.

Background: Recently, numerous studies have associated polymorphisms in 11beta-hydroxysteroid dehydrogenase type 1 (HSD11β1) gene and T2DM risk. However, there is still a lack in the published literature evaluating the association between HSD11β1gene polymorphism and the risk of T2DM. Objective: The Aim of the study was to assess the association of HSD11β1gene polymorphism (rs846910) with Type 2 diabetes mellitus (T2DM) in a sample of the Egyptian population. Patients and methods: Our study was conducted on 100 subjects; their mean age was 50.26 ± 9.1 years old. They were selected from Diabetes Outpatient Clinics of our institution for 6 months in the period from June 2019 to December 2019. They were divided into two groups: 60 type 2 diabetic obese patients with BMI > 25 kg/m2 (Group I) and 40 age- and sex-matched controls (Group II). Results: There was no statistically significant difference between cases and controls in terms of HSD11β1 polymorphism (rs846910). The regression analysis showed that the HSD11β1 polymorphism did not significantly increase the risk of diabetes mellitus (DM). Detection of HSD11β1 gene polymorphism in the study showed that homozygous GG genotype was more prevalent than GA genotype. However, there was no significant difference between GG and GA in terms of fasting and postprandial sugar and in terms of lipid profile. Conclusion: The present study showed no significant association between HSD11β1 polymorphism (rs846910) and T2DM. Moreover, the HSD11β1polymorphism (rs846910) is not correlated with glycemic status or lipid profile.

Antibiotic resistance is a serious problem facing the world; it is increasing every year due to over or misuse of antibiotics that led to developing new mechanisms of drug resistance by bacteria. In the present study Magneto-Liposomes (MLs) loaded with Erythromycin drug were designed; They were subjected to 5 and 15 mT Alternating Magnetic Field (AMF) at 100 KHz for 30 min of exposure to test the effect of exposure to the AMF on inducing the drug release rate beyond the resistance mechanism of bacteria. During exposure, the temperature of the sample was continuously recorded using IR thermometer. After exposure, the percentage of drug released was tested using UPLC-MS/MS method for every hour until 8 h then at 24 h post-exposure. Results showed an elevated temperature of 4 and 24°C in case of exposure the Erythromycin-encapsulated MLs to 5 and 15 mT respectively. Moreover, an increase in the percentage of Erythromycin release with a percentage of (0.83 ± 0.1) μg/mL and with (1.33 ± 4) × 10–7 μg/mL for exposure to 5 and 15 mT respectively, with respect to (0.24 ± 0.06) μg/mL in the control group. Exposing Erythromycin-encapsulated ML to AMF accelerated the release rate due to mechanical actuation of the nanoparticles. These findings suggest that it is possible to trigger and control the drug release by merging the targeted drug delivery system with the nanotechnology and magnetic field. Upon increasing the intensity of the AMF, the release rate increased significantly.

Background: Constipation is a common digestive problem in elderly people. Study Aim: The aim of this study was to assess the effect of nursing intervention on the severity of constipation among elderly people at Sohag geriatric club. Design: A quasi-experimental research design was utilized. Setting: The study was conducted at Sohag geriatric club. Subjects: The study sample consisted of elderly participants were 244 (male & female) was selected by convenient sample; the nursing intervention was applied on all elders who had constipation (84) after assessment phase. Tools of data collection: two proper tools were used, tool (I): consisted of two parts A) socio-demographic characteristics of older adults e.g. age, sex, education level, part (2): medical and nutritional history. Tool (II): Constipation assessment scale to measure constipation severity. Results: about one third (34.4%) of elderly were having constipation, also the study revealed that, there was highly statistical significant improvement in severity of constipation before and after application the nursing intervention. Conclusion: The study concluded that nursing intervention effective to decrease severity of constipation among elderly with constipation. Recommendation Application of nursing intervention to manage and decrease the severity of constipation among elderly people and importance of implementing periodic health education program for gerontological nurses, other health care providers and caregivers about management and prevention of constipation among elderly people.

Purpose of work To study the best planning techniques for post operative breast radiotherapy either F-IMRT or I-IMRT and VMAT . Another strategy is to check the dosimetric difference between using 6 or 10 MV energies for both I-IMRT and VMAT . Materials and Method: In the present study, four different inverse plans and one forward plan of randomly selected twenty left breast cancer patients were compared dosimetrically.Plans were done on Monaco (5.1) treatment planning system and data analyses were accomplished using one-way Anova test using IBM SPSS (20) data editor software. Results: Inverse planning achieve superior target coverage over forward planning (p value =0.001 ,0.07) and conformity index (p value < 0.05) maintaining adequate homogeneity index (p value = 0.461, 0.138) . Left lung and heart high dose levels decreased using I-IMRT, VMAT ( p value

BACKGROUND: Noncontrast cardiac T1 times are increased in dialysis patients which might indicate fibrotic alterations in uremic cardiomyopathy. PURPOSE: To explore the application of the texture analysis (TA) of T1 images in the assessment of myocardial alterations in dialysis patients. STUDY TYPE: Case-control study. POPULATION: A total of 117 subjects, including 22 on hemodialysis, 44 on peritoneal dialysis, and 51 healthy controls. FIELD STRENGTH: A 3 T, steady-state free precession (SSFP) sequence, modified Look-Locker imaging (MOLLI). ASSESSMENT: Two independent, blinded researchers manually delineated endocardial and epicardial borders of the left ventricle (LV) on midventricular T1 maps for TA. STATISTICAL TESTS: Texture feature selection was performed, incorporating reproducibility verification, machine learning, and collinearity analysis. Multivariate linear regressions were performed to examine the independent associations between the selected texture features and left ventricular function in dialysis patients. Texture features' performance in discrimination was evaluated by sensitivity and specificity. Reproducibility was estimated by the intraclass correlation coefficient (ICC). RESULTS: Dialysis patients had greater T1 values than normal (P < 0.05). Five texture features were filtered out through feature selection, and four showed a statistically significant difference between dialysis patients and healthy controls. Among the four features, vertical run-length nonuniformity (VRLN) had the most remarkable difference among the control and dialysis groups (144 ± 40 vs. 257 ± 74, P < 0.05), which overlap was much smaller than Global T1 times (1268 ± 38 vs. 1308 ± 46 msec, P < 0.05). The VRLN values were notably elevated (cutoff = 170) in dialysis patients, with a specificity of 97% and a sensitivity of 88%, compared with T1 times (specificity = 76%, sensitivity = 60%). In dialysis patients, VRLN was significantly and independently associated with left ventricular ejection fraction (P < 0.05), global longitudinal strain (P < 0.05), radial strain (P < 0.05), and circumferential strain (P < 0.05); however, T1 was not. DATA CONCLUSION: The texture features obtained by TA of T1 images and VRLN may be a better parameter for assessing myocardial alterations than T1 times. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 3.

The purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs).Forty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment-group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment.Multivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P.05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point.This study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.

Diabetic foot ulcers (DFU) and concurrent infections are the most frequent complications in patients with diabetes mellitus. Both low-level laser therapy (LLLT), photobiomodulation (PBM), and hyper...

Background: Emergency contraception (EC) is a method to be used in the case of unprotected sexual intercourse, failure of a regular contraceptive method and after rape to try to prevent an unintended pregnancy. They include copper intrauterine devices (IUD) and different types of pills like estrogen-progestin combination pill, levonorgestrel containing pills (LNG). Objective: This study was conducted to compare the efficacy; satisfaction, pregnancy rate and side effect of emergency contraception in women who selected either oral levonorgestrel (LNG) or copper intrauterine device (IUD). Patient and methods: This observational prospective cohort study was conducted on 200 women enrolled and separated into two groups, IUD group: 100 women used cupper T380A IUD. LNG group: 100 women using levonorgestrel 1.5 mg divided into two doses each 0.75 mg 12 hours a part. Satisfaction was assessed using a 5-point Likert scale. Results: There was significantly higher rate of contraption efficacy in IUD group compared with LNG group (p < 0.05). Significantly higher rates of nausea, vomiting and headache in LNG group (p < 0.05) when compared with IUD group. IUD patients had significantly higher rate of bleeding (p < 0.05) and higher rate of satisfaction among LNG users (p < 0.05). Significant association between women satisfaction and efficacy in LNG group (p < 0.05) and significant association between women satisfaction and efficacy in IUD group (p < 0.05). Conclusion: Emergency IUD has higher efficacy than emergency contraceptive pills (LNG) and has fewer side effects. However, there is more satisfaction regarding emergency contraceptive pills (ECP) as compared to IUD.

Introduction: Antibiotics are prescribed for treating bacterial infections. However, Excessive use of antibiotics leads to the development and spread of multidrug resistant bacteria, currently regarded as a global public health crisis threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability and death. Aim of the work: To analyze the use and prescribing patterns of antimicrobials by physicians at Ain-Shams University Specialized Hospital (ASUSH) for inpatients among different infections and to determine the prevalence of different types of bacterial resistance among hospital infections. Subjects and methods: A cross- sectional study was conducted at (ASUSH). A total of 339 microorganisms isolated from several samples types were identified and studied using VITEK® 2 system. Physicians’ attitudes and knowledge were assessed using a questionnaire about antibiotic resistance problem. Results: Among (339) bacterial isolates Klebsiella pneumoniae was the most common isolate n=92 (27.1%), followed by E-coli n=60 (17.7%), Staph coag –ve (SCONs) n= 43 (12.7%) and Methecillin resistant staphylococcus aureas (MRSA), Pseudomonas aeruginosa and Acinetobacter baumanni n=33 (9.7%) for each. In this study, the majority of physicians had good knowledge about the antibiotic resistance meaning and the magnitude of that problem, with a positive attitude towards prescribing antibiotics. Conclusion: Strategies for control of resistant bacteria should consider variations among sample types, wards, and antibiotic resistance variability. There is a need to specifically address staff training and communication procedures for infection prevention and control with respect to drug resistant bacteria.

Background: Cesarean section (CS) is one of the most common surgical procedures in women. A recent study documented that Egypt ranked 3rd among world countries with an estimated rate of CS of 51.8%. Objective: We aimed to evaluate uterine scar after cesarean section (CS) by transvaginal ultrasound (TVS) versus hysterosalpingogram (HSG). Patient and methods: This cross-sectional studywas conducted on 38 patients after obtaining their approval to evaluate CS scar 3 months after delivery using TVS compared to HSG. The study was conducted in Obstetrics and Gynecology Department, Menoufia University in the period between January 2019 and January 2020. Results: Uterine scar defect was identified in 21 cases by HSG (55.3%), while TVS was able to identify it in only 13 cases (34.2%). Compared to HSG, transvaginal ultrasound had sensitivity and specificity of 61.9 and 100% respectively in detecting scar defects, with an accuracy of 78.94%, Conclusion: Along with increased radiological expertise expected with time, TVS will be more comparable to HSG and appears to be a promising tool in evaluation cesarean scar defect as it has significant agreement with HSG.

Background: There is a need for rapid and accurate diagnostic biomarker for diagnosis of Salmonella fever. Aims: The aim of the present study was to assess the importance of procalcitonin (PCT), Soluble Triggering Receptors expressed on Myeloid Cells 1 (sTREM1) and C- reactive protein (CRP) in the diagnosis of enteric fever with positive blood culture for S.typhi. Methods: Blood samples were withdrawn from 200 patients with suspected enteric fever and subjected for the determination of CRP, PCT and sTREM-1. Results: The sensitivity and specificity for PCT cut off were 97.7% & 82.5%, for CRP the sensitivity and specificity were 95.3% and 77% and for s-TREM-1 the sensitivity and specificity were 95.3% & 77%. Conclusion: S-TREM-1 may be considered as a novel biomarker for the diagnosis of enteric fever with good sensitivity and specificity.

Background: Transvaginal ultrasound evaluation of cervical length considered a good predictor of PTL and recently lower uterine segment myometrial thickness had been used for this purpose. Objectives: Evaluating the efficacy and validity of transvaginal ultrasound measurement of lower uterine segment myometrial thickness (LUS-MT) in prediction of preterm delivery (PTL) in twins pregnancies. Patients and Methods: This is an observational prospective cohort study where ninety sex (96) twins pregnant women were enrolled. LUS-MT and CL were measured by transvaginal ultrasound between 16-24 gestational weeks. All patients were scheduled for routine antenatal care till delivery and divided in two groups: preterm group and full-term group. Results: 58 patients delivered at full term and 38 patients had preterm delivery. Among patients who had preterm delivery, 25 patients (56.8%) had LUS-MT

Background: Miscarriage is a common event in the first half of pregnancy. Improvements in Ultrasound and Doppler technology, have led to a better understanding of early pregnancy development. Such a facility may be used in turn to predict pregnancy outcome in threatened miscarriage. Objective: To assess the ability of the Uterine artery RI and Spiral artery RI to predict outcome in cases of Threatened miscarriage Patients and methods: Prospective observational study was conducted in the Department of Obstetrics and Gynecology at Menoufia University Hospital. The study included 90 women with gestational age between 5 – 13 w. divided into three groups; Group (A): involved (30) women diagnosed with threatened miscarriage and was followed up and got aborted before pregnancy completed 24weeks. Group (B): (30) women diagnosed with threatened miscarriage and were followed up and the pregnancy continued till 24weeks. Group (C): 30 women having singleton normal ongoing pregnancy till 24 weeks of gestation as a control group. Results: In this study, the Doppler study of uterine arteries the subchorionic blood flow revealed that (RI) was significantly higher in the miscarried group than both continued and control groups. Conclusion: Uterine artery RI and Subchorionic blood flow RI can predict the fate of pregnancy in cases with threatened miscarriage with high accuracy.

Background: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy due to compression of the median nerve as it travels through the wrist at the carpal tunnel. Aim of Study: The aim of the study was to investigate the efficacy of sensory re-education paradigm on functional outcomes of patients with carpal tunnel syndrome. Subjects and Methods: Thirty participants was be randomly assigned to either the sensory re-education paradigm group or the traditional physical therapy group. First group (control group), the patients received standard physical therapy program including progressive active and resisted therapeutic exercises, median nerve gliding exercises and tendon gliding exercises. Second group (experimental study group), the patients received sensory re-education paradigm as the followings; Step 1: Splinting as a constant maintained touch for fifteen minutes, Step 2: Topical anesthesia for pain reduction by using 8% Lidocaine spray for 15 minutes, Step 3: Massage using different textures; graduating from the softest to rougher one with same speed and pressure, Step 4: Proprioceptive Neuromuscular Facilitation (PNF) technique using extension, adduction and internal rotation with extended elbow pattern. Sensory function was assessed by Semmes-Weinstein monofilament, pain intensity level was assessed by a Visual Analogue Scale (VAS), hand grip was assessed by using hand held dynamom-eter and functional outcomes were assessed by using Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Results: There was a statistically significant improvement in the measured parameters in both groups when comparing their pre and post-treatment mean values. However, significant difference was recorded between the two groups after treatment in favor of the study group. Conclusion: The obtained results suggest that the appli-cation of sensory re-education paradigm become a beneficial therapeutic technique in improving the functional outcomes as a whole in patients with CTS when adjunct to a physical therapy program.

BACKGROUND Acute myocardial infarction (AMI) is a disease with high morbidity and mortality worldwide and the evaluation of myocardial injury and perfusion status following myocardial ischemia and reperfusion is of clinical value. PURPOSE To assess the diagnostic utility of simplified perfusion fraction (SPF) in differentiating salvage and infarcted myocardium and its predictive value for left ventricular remodeling in patients with reperfusion ST-segment elevation myocardial infarction (STEMI). STUDY TYPE Prospective. POPULATION Forty-one reperfused STEMI patients and 20 healthy volunteers. FIELD STRENGTH/SEQUENCE 3.0T MRI. The MR examination included cine, T2 -short tau inversion recovery (T2 -STIR), first pass perfusiong (FPP)，phase sensitive inversion recovery (PSIR), and diffusion-weighted imaging (DWI). ASSESSMENT SPF values among different myocardium regions (infarcted, salvaged, remote, and MVO) and stages of reperfused STEMI patients as well as normal controls were measured. The diagnostic utility of SPF values in differentiating salvaged and infarcted myocardium was assessed. STATISTICAL ANALYSIS Independent t-test and the Mann-Whitney U-test. Logistic regression. RESULTS SPF values in healthy controls were not significantly different than SPF values in the remote myocardium of patients (40.09 ± 1.47% vs. 40.28 ± 1.93%, P = 0.698). In reperfusion STEMI patients, SPF values were lower in infarcted myocardium compared to remote and salvaged myocardium (32.15 ± 2.36% vs. 40.28 ± 1.93%, P

The present work studied the antibacterial effect of different formulations of Chitosan (Chs); free Thymoquinone (Tq), and Thymoquinone-loaded chitosan nanoparticles (Tq-Chs NPs) on Bombyx mori L. infected by pathogenic bacteria, by evaluating some biochemical aspects of larval haemolymph. Bombyx mori larvae classified into three groups; each group was fed on mulberry leaves treated with one of the formulations (free Tq, free Chs and Tq-encapsulated Chs) with drug concentrations (0.05% and 0.1%). Before being used, the prepared formulations were characterized by size, morphology, encapsulation efficiency; in addition, in vitro drug release experiment was performed. The biochemical results revealed an improvement in the antibacterial and antioxidant activity of the studied formulations, especially with increasing the concentrations compared to control; (Tq-encapsulated Chs) followed by free Chs and free Tq revealed highly significant decreases in mixed function oxidase (MFO) activity, especially larvae treated with the high concentration (0.1%). The activity of acid phosphatase, total lipid content and carbohydrates pointed to a highly significant increase. Similarly, the qualitative analysis of silkworm proteins showed an obvious variation in the number and position of the detected protein bands from one treatment to another. It can be concluded that Tq and Chs showed an inhibitory impact against pathogenic bacteria infecting Bombyx mori larvae, proved their effects as antioxidant and anti-inflammatory agents which could be improved by loading Tq on Chs nanoparticles (Tq-Chs NPs).

Four 2-(2-(5-(4-Methoxyphenyl)-1-phenyl-1H-pyrazole-3-carbonyl) hydrazono)-N’-arylpropanehydrazonoyl chlorides were designed outset from 4-methoxyaceteophenone, as raw matter, by interacting of carbohydrazide with four hydrazonoyl chloride derivatives in refluxing ethanol. The synthesized heterocycles stone was depicted and utilized through simple concern finishing as azo dyes for coloring and functionalization of cotton fabric. The outcomes obtained disclosed that the finishing treatments improved the nitrogen percent as well as wrinkle recovery angles along with a modicum decreasing in the tensile strength of treated fabric samples compared with the untreated fabric. The results assured also the perfect color fastness properties of the dyed samples, irrespective of the dye chemical structure. Besides, such dyes improved the treated fabric antibacterial properties as well as protection against the deleterious sun radiation. After 15 washing cycles, the dyed/finished samples exhibited satisfactory color strength and acceptable functional properties confirming stability and the tight binding of such dyes to the fabric chemical structure. Otherwise, both the untreated and treated textiles were recognized by means of scan electron microscope that signalizes hunting of such dyes by the cotton fabric structure.

The sensitivity and speed with which the immune system reacts to host disruption is unrivaled by any detection method for pathogenic biomarkers or infectious signatures. Engagement of cellular immunity in response to infections or cancer is contingent upon activation and subsequent cytotoxic activity by T cells. Thus, monitoring T cell activation can reliably serve as a metric for disease diagnosis as well as therapeutic prognosis. Rapid and direct quantification of T cell activation states, however, has been hindered by challenges associated with antigen target identification, labeling requirements, and assay duration. Here we present an electronic, label-free method for simultaneous separation and evaluation of T cell activation states. Our device utilizes a microfluidic design integrated with nanolayered electrode structures for dielectrophoresis (DEP)-driven discrimination of activated vs naive T cells at single-cell resolution and demonstrates rapid (

Aims The aim of the present study was to evaluate the toxicity of magnetic iron oxide nanoparticles (MIONs) which were synthesized using carob leaf extract on various brain areas of Wistar rats. Main methods Carob leaf synthesized-MIONs were characterized using different techniques: Dynamic Light Scattering (DLS), Transmission Electron Microscope (TEM), UV–vis spectrophotometer, Fourier Transform infrared (FTIR), X-Ray Diffraction (XRD) and Atomic Force Microscope (AFM). The toxicity of MIONs in vivo was evaluated by: monitoring rat’s body weight, measuring iron content in different brain areas, evaluating some oxidative stress parameters, estimating acetylcholinesterase (AChE) in addition to histopathological investigations. Key findings The present study demonstrated no body weight changes of MIONs- treated rats. According to the conditions of the present study, the hippocampus and striatum were the most affected areas and demonstrated neuronal degeneration due to MIONs exposure. MIONs treatment of Wistar rats, also affected the iron homeostasis in both striatum and midbrain by decreasing iron content in these areas. The least affected areas were thalamus and cerebellum. The histopathological examination of brain areas demonstrated moderate neuronal degeneration in hippocampus and striatum, mild neuronal degeneration in cortex and slight degeneration in hypothalamus and pons-medulla areas were detected. Significance The results suggested that MIONs have a toxic impact on different brain areas and the effect varies according to the brain area.

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.

Background Type 2 diabetes mellitus is a heterogeneous group of metabolic disorders caused by the interaction between genetic predisposition and environmental factors. The incidence of type 2 diabetes mellitus has increased over the last decades with more than 170 million individuals suffering from type 2 diabetes mellitus all over the world which imposes a greater economic impact on individuals, families and health systems. Though the genetic susceptibility to type 2 diabetes mellitus is polygenic, single nucleotide polymorphisms (SNP) at Hydroxy steroid dehydrogenase (HSD11B1) gene have been strongly associated with type 2 diabetes risk in various populations and ethnic groups. Objectives The aim of this study is to assess the association of Hydroxy-Steroid-Dehydrogenase-11B1 gene (rs846910) with type 2 diabetes mellitus in a sample of Egyptian population. Patients and Methods In the present study, we included 60 diabetic obese patients and 40 age and sex-matched controls. The mean age of the included patients was 50.26 ±9.1 year; while the majority of them were females (70%). All the participating patients were subjected to detailed history and the following investigations: fasting blood sugar, post prandial sugar,HbA1c, and lipid profile. Detection of gene polymorphism by real time PCR was performed for all subjects in the study. Results The study showed that homozygous GG genotype was more prelevant than GA genotype. No significant difference between GG and GA in terms of fasting and postprandial sugar and in terms of lipid profile: cholesterol (p = 0.642), TG (p = 0.808), LDL (p = 0.238), and HDL (p = 0.945).It showed no statistically significant difference between cases and controls in terms of HSD11B1 polymorphism (rs846910). The regression analysis showed that the HSD11B1 polymorphism did not significantly increase the risk of diabetes mellitus (OR 1.724, 95% CI [0.601 – 4.94]). Conclusion In conclusion, multiple further studies involving other single nucleotide polymorphism of 11 beta hydroxysteroid dehydrogenase gene as well as other genes involved in type 2 diabetes mellitus and obesity need to be done.

BACKGROUND AND OBJECTIVE: Evaluation of the stage and severity of the chronic diabetic foot ulcer (CDFU) is vital to increase the healing rate and to select the suitable treatment. We aim to assess the influence of low-intensity laser irradiation (LILI) and hyperbaric oxygenation therapy (HBOT) to accelerate the CDFU healing thru the transcutaneous oxygen tension (TcPO2) measurements. MATERIALS AND METHODS: Seventy-five diabetic patients (type 2) of both genders, their ages ranged from 40–65 years with CDFUs (duration of ulcer

The ideal combination of adjuncts with induction agents for Laryngeal mask airway (LMA) insertion is a matter of debate, particularly in children. To comparatively evaluate LMA insertion using keta...

Background: Oxytocic are the drugs that give power to excite uterine muscles to contract. Betweena large numbers of drugs belonging to oxytocic, oxytocin is the important one and is extensivelyused in clinical practice. Aim of the study: To assess nurses' knowledge and practice regardingoxytocin infusion care for women during labor. Research design: A descriptive study wasconducted. Setting: The study was conducted in labor unit at obstetrics and gynecologicaldepartment affiliated at Benha University hospital from the end of May to the end of November2017. Sample: Convenient sample of a total nurses 50. Tool: Two tools were utilized to collectdata; Tool (I): structure interviewing questionnaire divided in two parts including generalcharacteristics of nurse and assessment knowledge sheet for assessing nurses’ knowledge regardingoxytocin. Tool (II): an observational checklist to assess nurses' practices during oxytocin infusion.Result: Near half (44%) of the studied nurses had poor knowledge and two thirds (60%) of themhad unsatisfactory practice regarding oxytocin infusion care. Conclusion: Half of studied nurseshad poor knowledge and unsatisfactory practice and there was a positive correlation between totalknowledge and practice score of studied nurses. Recommendation: Improve nurses' knowledgeand practice regarding oxytocin and its safe administration.

Objective The role of noninvasive ventilation (NIV) in patients with acute respiratory failure is uncertain, so we conducted an observational trial of NIV comparing it with standard oxygen therapy in 109 patients with acute hypoxemic respiratory failure to detect the outcomes of NIV and the factors associated with NIV failure. Patients and methods All patients requiring NIV from March 2017 to September 2018 in respiratory ICU were entered into the study. The authors reported the etiology of acute hypoxemic respiratory failure (AHRF) and data were collected for heart rate, respiratory rate, and arterial blood gases (pH, PaO2, PaCO2). The patients were divided into group I standard oxygen therapy, group II NIV, and again group II was divided into group IIa, patients who avoid intubation and group II b, patients who need intubation. Results Simplified acute physiologic score (SAPS II) and acute physiologic and chroic health evaluation (APACHE) scores and mortality were higher in the VIN group but intubation rate, ICU, and hospital stay were higher in the oxygen group. Factors that were associated with failure of NIV were underlying immunosuppression, acute respiratory distress syndrome (ARDS) as a cause of AHRF, underlying malignancy, high SAPS II greater than 33 and APACHE II score of more than 25 and baseline PO2/FiO2 less than 211. Conclusion NIV was effective than oxygen therapy in the management of AHRF regarding intubation rate, complication, ICU, and hospital stay but mortality was higher in the NIV group may be because of severe cases. Factors associated with failure of NIV were immunosuppression, malignancy, ARDS, high SAPS II more than 33 and APACHE II more than 25 score and baseline PO2/FiO2 less than 211.

“Eco” synthesis has become a reliable, sustainable, and ecological protocol in the field of material science, which has given great attention to synthesizing a wide range of material/nanomaterials, such as nanomaterials, hybrid materials, and bio-inspired metal-metal oxides. Green synthesis is therefore considered an important tool for reducing the destructive effects of traditional nanoparticle syntheses commonly used in laboratory and industry. The aim of the present study was to investigate the effect of carob leaf–synthesis magnetic iron oxide nanoparticles on the oxidative status of the liver, kidney, spleen, and testis of male Wistar rats. The green synthesized nanoparticles were characterized through transmission electron microscopy, dynamic light scattering, and atomic force microscopy. The green-synthesized magnetite nanoparticles had 16 ± 2.4 nm average diameter and were monodispersed. The prepared nanoparticles did not cause oxidative stress damage in the tested organs, and this is mainly due to the strong antioxidant power of the carob leaf extract used in their synthesis. Carob leaf–synthesized nanoparticles prepared in the present study are highly safe which make them suitable to be used in many biological and medical applications.

OBJECTIVE To compare effectiveness and safety of carbetocin and misoprostol for prevention of postpartum hemorrhage (PPH) among low-risk women. METHODS Randomized controlled trial among 150 pregnant women with low risk of PPH admitted for vaginal delivery at Kasr Al Ainy Hospital, Cairo, Egypt, between July 2018 and May 2019. Participants were assigned to two groups by a web-based randomization system ensuring allocation concealment. After neonatal delivery, the carbetocin group received one ampoule of carbetocin (100 μg/mL) intravenously and the misoprostol group received two rectal tablets of misoprostol (800 μg) for active management of the third stage. Blood pressure, blood loss, and hemoglobin levels were monitored. The primary outcome measure was need for additional uterotonic drugs. RESULTS The carbetocin group had significantly less blood loss (P

During homeostasis, interactions between tolerogenic dendritic cells (DCs), self-reactive T cells, and T regulatory cells (Tregs) contribute to maintaining mammalian immune tolerance. In response to infection, immunogenic DCs promote the generation of proinflammatory effector T cell subsets. When complex homeostatic mechanisms maintaining the balance between regulatory and effector functions become impaired, autoimmune diseases can develop. We discuss some of the newest advances on the mechanisms of physiopathologic homeostasis that can be employed to develop strategies to restore a dysregulated immune equilibrium. Some of these designs are based on selectively activating regulators of immunity and inflammation instead of broadly suppressing these processes. Promising approaches include the use of nanoparticles (NPs) to restore Treg control over self-reactive cells, aiming to achieve long-term disease remission, and potentially to prevent autoimmunity in susceptible individuals.

Background and aim Diabetic retinopathy is a serious and common complication of diabetes that causes irreversible blindness. The aim of the present study was to assess the knowledge, attitudes, and practice regarding diabetic retinopathy among patients attending a diabetic clinic and identify the effect of an educational program about diabetic retinopathy. Patients and methods Two hundred diabetic patients were recruited from the outpatient's diabetic clinic, Assiut University hospitals, Egypt. Quasi-experimental (pretest-posttest) research design was applied using a structured interview questionnaire; including socio-demographic data, assessment of the patients' knowledge, attitude, and practices toward diabetic retinopathy. Results The mean score of knowledge and attitude showed significant improvement (5.3 and 15.1, respectively in pretest vs 16.7 and 16.8, respectively in posttest) among the diabetic patients (p

Background The link between Vitamin-D deficiency and type 2 diabetes (T2D) is well-established. Since prediabetic obese populations have the greatest risk to develop to T2D, it was important in our study to examine serum 25(OH) D3 concentration among prediabetic obese patients and to evaluate the correlation between serum level of vitamin D and BMI, FBS, HOMA IR and HbA1c among prediabetes patients. Methods A multicenter case control study was carried out among 101 prediabetic persons & 50 controls, after obtaining consent from subjects and clearance from institutional ethics committee. Serum vitamin D level, Plasma levels of glycosylated hemoglobin (HbA1c) and fasting insulin levels were measured by ELISA in both groups enrolled in the study. Results The prevalence of vitamin-D deficiency/insufficiency was (73.3%) (n = 74) among 101 prediabetic obese individuals. Also, A significant inverse correlation was observed between vitamin D levels & body mass index(r = - 0.28, P = 0.004); fasting blood sugar (r = - 0.22, P = 0.002); HOMA insulin resistance (r = - 0.25 P = 0.01); HbA1C (r = - 0.2, P = 0.004). Conclusions High prevalence of vitamin D deficiency exists among obese prediabetic individuals and there is significant inverse correlation between BMI, FBS, HOMA IR, HbA1c and vitamin D level.

Background and aim Recently, studies have identified patain-like phospholipase domain containing 3 (PNPLA3), which is localized in the endoplasmic reticulum and at the surface of lipid droplets. The association of PNPLA3 polymorphisms with fatty liver and histological severity of NAFLD was shown in many studies. We aimed to investigate the association of PNPLA3 with the development and severity of NAFLD in an overweight and obese Egyptian population. Patients and methods Eighty overweight and obese patients with NAFLD were enrolled in the study. Patients were divided into 2 subgroups according to results of liver biopsy: group 1 included 30 patients with simple steatosis, and group 2 included 50 patients with non-alcoholic steatohepatitis (NASH). In addition to 10 age-matched healthy subjects served as a control group. All NAFLD patients underwent a confirmatory biopsy. Laboratory investigations included fasting glucose, liver enzymes and lipid profile were done. Abdominal ultrasound was performed and PNPLA3 was detected in each patient by Quantitative ELISA. Results Levels of PNPLA3 were higher in NAFLD patients compared with controls (85.70±76.42 vs 3.10±2.11 respectively) and levels were also higher in NASH than simple steatosis (125.09±71.78 vs 20.06±8.47 vs 3.10±2.11 respectively, P

Parkinson’s disease is a neurodegenerative disorder with motor symptoms linked to the loss of dopaminergic neurons in the substantia nigra compacta. Although the mechanisms that trigger the loss of dopaminergic neurons are unclear, mitochondrial dysfunction and inflammation are thought to have key roles1,2. An early-onset form of Parkinson’s disease is associated with mutations in the PINK1 kinase and PRKN ubiquitin ligase genes3. PINK1 and Parkin (encoded by PRKN) are involved in the clearance of damaged mitochondria in cultured cells4, but recent evidence obtained using knockout and knockin mouse models have led to contradictory results regarding the contributions of PINK1 and Parkin to mitophagy in vivo5–8. It has previously been shown that PINK1 and Parkin have a key role in adaptive immunity by repressing presentation of mitochondrial antigens9, which suggests that autoimmune mechanisms participate in the aetiology of Parkinson’s disease. Here we show that intestinal infection with Gram-negative bacteria in Pink1−/− mice engages mitochondrial antigen presentation and autoimmune mechanisms that elicit the establishment of cytotoxic mitochondria-specific CD8+ T cells in the periphery and in the brain. Notably, these mice show a sharp decrease in the density of dopaminergic axonal varicosities in the striatum and are affected by motor impairment that is reversed after treatment with l-DOPA. These data support the idea that PINK1 is a repressor of the immune system, and provide a pathophysiological model in which intestinal infection acts as a triggering event in Parkinson’s disease, which highlights the relevance of the gut–brain axis in the disease10. In mice lacking PINK1, bacterial infection in the intestine results in mitochondrial antigen presentation and generation of CD8+ T cells, and infected mice develop motor impairments, suggesting that PINK1 suppresses autoimmunity.

Background: Rheumatoid arthritis is a systemic rheumatic disease characterized by symmetrical, often erosive and deforming poly-arthritis with extra-articular manifestations in 10–20% of patients, especially those with high titers of rheumatoid factor. Extra articular pathology includes bursitis, tendonitis and neuritis, which results from entrapment, nerve ischemia due to vasculitis or drugs used to treat this condition.Carpal tunnel syndrome is the most common compression neuropathy associated with rheumatoid arthritis. Aim of the Work: To evaluate the efficacy of Neural Prolotherapy and Platelet Rich Plasma in treatment of carpal tunnel syndrome secondary to rheumatoid arthritis. Patients and Methods: Ninety patients with Rheumatoid Arthritis (RA) that were all fulfilling the 2016 ACR/EULAR classification criteria for RA. All were over the age of sixteen years at time of diagnosis, complaining of burning pain or paresthesia in the median nerve distribution of the hand. They were recruited from Rheumatology and Rehabilitation Department at Al-Hussein and Sayed Galal University Hospitals during the period from December 2018 to July 2019. Results: Neural Prolotherapy and Platelet Rich Plasma (PRP) have improved all measured parameters like visual analogue scale (VAS), nerve conduction studies and neuromuscular ultrasonography parameters in carpal tunnel syndrome secondary to rheumatoid arthritis. Conclusion: Neural Prolotherapy and Platelet Rich Plasma proved to be effective treatments of carpal tunnel syndrome secondary to rheumatoid arthritis.

Genus Erythrina (Fabaceae) comprises several species, which are widely distributed in tropical and subtropical regions of the world. The plants of this genus exhibited significant role in traditional medicine targeting different diseases. Alkaloids and flavonoids were reported as the chief bioactive constituents of this genus with a wide range of biological activities. About 143 alkaloids were isolated from Erythrina sp. Anticonvulsant, anxiolytic, curare-like activity, insecticidal and cytotoxic activities were reported for Erythrina sp. alkaloids. The present work is an overview of the isolated alkaloids from Erythrina sp. with their reported biological activities.[Figure: see text]Abbreviations: CHCl3: Chloroform; CNS: Central nervous system; DCM: Methylene chloride; DPPH: 2,2-Diphenyl-1-picrylhydrazyl; E.: Erythrina; ERα/β: Estrogen receptors α/β; EtOAc: Ethyl acetate; EtOH: Ethanol; Hep-G2: Human liver carcinoma cell lines; HIV: Human immunodeficiency virus; HL-60: Human promyelocytic leukemia cells; K-562: Human immortalized myelogenous leukemia cell line; LPS: Lipopolysaccharide; MeOH: Methanol; MOLT-4: Acute lymphoblastic leukemia cell line; nAChRs: nicotinic acetylcholine receptors; NO: Nitric oxide; NREM: non-rapid eye movement; Pet. ether: Petroleum ether; RBA: Receptor binder affinity; TRAIL: Tumor necrosis factor (TNF)-related apoptosis-inducing ligand.

To assess the value of endometrial thickness, volume, and sub-endometrial perfusion in women undergoing IVF. In 82 women candidate for ICSI, endometrial thickness and sub-endometrial perfusion were...

Parasitic isopods have received considerable attention as they cause series impacts on their hosts either alone or with other environmental stresses such as water pollution. The present study investigated the infestation status with isopods among the fry collected from the natural sources .Also to demonstrate the effects of different salinity and temperature combination on the survival rates of the identified isopods under the laboratory conditions. In March 2017,a total of 16 thousand mugiliid fry were sampled from The Fry Collection center at Al Behera Governorate ,Egypt and examined for the presence of isopods .Samples were found infested with a rate of 10.6% , the result which practically documented that isopods were introduced into lake Qarun through dumping millions of infected fry from this source without biosecurity procedures. The isolated juvenile isopods were morphologically and molecularly identified as Livoneca redmanii species by using 16S rRNA gene and recorded in the GenBank with accession number: MK584629. The effects of variables of salinity/ temperature combination on the survival% of the identified juveniles showed that the best survival rate(100%) was recorded in salinity 15 -20% at temperature 25⁰C while the lethal combination was in salinity 10, 20,50 and 60% at temperature 35⁰C . Statistical analysis using A-two way ANOVA indicated a significant interaction between the effect of different degree of temperature and variance of salinity% on the survival of L. redmanii juveniles. Analysis of one way ANOVA indicated that the most effective temperature of overall mean temperature affected on survival of juvenile stage was 35 C⁰ while the most effective salinity percentage on survival of Juvenile from overall mean of salinity % was 10%. Results of this study provided applicable procedures which can be recommended as a precaution measures and for eliminating the isopod juvenile stages among the mugiliid fry.

Objective To develop a nanoparticle (NP) platform that can expand both CD4+ and CD8+ Treg cells in vivo for the suppression of autoimmune responses in systemic lupus erythematosus (SLE). Methods Poly(lactic-co-glycolic acid) (PLGA) NPs encapsulating interleukin-2 (IL-2) and transforming growth factor β (TGFβ) were coated with anti-CD2/CD4 antibodies and administered to mice with lupus-like disease induced by the transfer of DBA/2 T cells into (C57BL/6 × DBA/2)F1 (BDF1) mice. The peripheral frequency of Treg cells was monitored ex vivo by flow cytometry. Disease progression was assessed by measuring serum anti-double-stranded DNA antibody levels by enzyme-linked immunosorbent assay. Kidney disease was defined as the presence of proteinuria or renal histopathologic features. Results Anti-CD2/CD4 antibody-coated, but not noncoated, NPs encapsulating IL-2 and TGFβ induced CD4+ and CD8+ FoxP3+ Treg cells in vitro. The optimal dosing regimen of NPs for expansion of CD4+ and CD8+ Treg cells was determined in in vivo studies in mice without lupus and then tested in BDF1 mice with lupus. The administration of anti-CD2/CD4 antibody-coated NPs encapsulating IL-2 and TGFβ resulted in the expansion of CD4+ and CD8+ Treg cells, a marked suppression of anti-DNA antibody production, and reduced renal disease. Conclusion This study shows for the first time that T cell-targeted PLGA NPs encapsulating IL-2 and TGFβ can expand both CD4+ and CD8+ Treg cells in vivo and suppress murine lupus. This approach, which enables the expansion of Treg cells in vivo and inhibits pathogenic immune responses in SLE, could represent a potential new therapeutic modality in autoimmune conditions characterized by impaired Treg cell function associated with IL-2 deficiency.