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Abstract Background Congenital anomalies (CAs) are structural, functional, or metabolic anomalies that originate during intrauterine life and can interfere with the body functions. In Egypt, the prevalence of CAs is increasing. The study aimed to estimate the frequency, describe the types, and identify the possible risk factors of CAs among infants attending the Pediatric University Hospital, Alexandria, Egypt. Methods A retrospective case series and a case-control study were conducted. Patients’ records for the years 2010–2015 were reviewed, and a sample of 200 infants (100 cases and 100 controls) was taken from infants presented to Pediatrics, Pediatric Surgery, and Genetics Clinics of the hospital. Data were collected using a record review checklist and a predesigned interviewing questionnaire. Results The study revealed that congenital anomalies of the digestive system (38.0%), musculoskeletal system (32.9%), and circulatory system (11.0%) were the most common types of CAs. Males were more affected with CAs than females (63% versus 37%). The major risk factors for CAs were old-aged parents, complications during pregnancy, unprescribed medications and excessive vitamin A intake during pregnancy, exposure to chemicals and pesticides during pregnancy, and living near mobile strengthening stations. Conclusion Congenital malformations of the digestive, musculoskeletal, and circulatory systems were the most common types of CAs in the Pediatric Hospital. To prevent CAs, there is a need to restrict the prescription of medications that may have a teratogenic effect.

Summary: Background: Unsafe injection practices are a major public health problem and can lead to the transmission of bloodborne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Methods: The present study was conducted to determine the nature and magnitude of unsafe injection practices in healthcare facilities in Hodeidah governorate, Yemen. The study was conducted in two hospitals and a representative sample of the governorate's health centers. A total of 1600 injections were observed in these facilities. Results: This study revealed several unsafe practices, particularly the recapping of needles after use, which occurred in 61.1% and 36.8% of the observations in the hospitals and the health centers, respectively. Conclusion: This study showed that most healthcare workers (HCWs) followed the proper injection protocols but performed some procedures that exposed themselves and the community to the risk of needlestick injuries (NSIs) and bloodborne infections. Keywords: Unsafe injection practices, Needlestick injury, Patient safety, Injection practices, Hodeidah, Yemen

Background: Coronary artery disease (CAD) risk factors seem to cluster in some occupational groups. Objective: The present study was designed to investigate CAD risk factors among naval forces as an example of a high risk sector and to construct a risk prediction model for the disease. Methods: A case control study was carried out at the general naval hospital (GNH) in Alexandria. The study included 250 male consecutive naval CAD cases with a control group of 250 males matches for age, occupational level, sociodemographic characteristics and, free from CAD. All participants were subjected to a questionnaire about personal data, occupational history and exposures, occupational and leisure physical activity, dietary habits, smoking, and medical history. Anthropometric measurements, sitting blood pressure, and lipid profile were determined by the standard methods. Results: revealed that occupational sedentary activity and perceived occupational noise were the significantly reported special occupational characteristics together with other conventional risk factors among CAD naval cases verses controls (p

Alterations in length-dependent activation (LDA) may constitute a mechanism by which cardiomyopathy mutations lead to deleterious phenotypes and compromised heart function, because LDA underlies the molecular basis by which the heart tunes myocardial force production on a beat-to-beat basis (Frank-Starling mechanism). In this study, we investigated the effect of DCM-linked mutation (R173W) in human cardiac troponin T (TnT) on myofilament LDA. R173W mutation is associated with left ventricular dilatation and systolic dysfunction and is found in multiple families. R173W mutation is in the central region (residues 80–180) of TnT, which is known to be important for myofilament cooperativity and cross-bridge (XB) recruitment. Steady-state and dynamic contractile parameters were measured in detergent-skinned guinea pig left ventricular muscle fibers reconstituted with recombinant guinea pig wild-type TnT (TnTWT) or mutant TnT (TnTR174W; guinea pig analog of human R173W mutation) at two different sarcomere lengths (SL): short (1.9 µm) and long (2.3 µm). TnTR174W decreased pCa50 (−log [Ca2+]free required for half-maximal activation) to a greater extent at long than at short SL; for example, pCa50 decreased by 0.12 pCa units at long SL and by 0.06 pCa units at short SL. Differential changes in pCa50 at short and long SL attenuated the SL-dependent increase in myofilament Ca2+ sensitivity (ΔpCa50) in TnTR174W fibers; ΔpCa50 was 0.10 units in TnTWT fibers but only 0.04 units in TnTR174W fibers. Furthermore, TnTR174W blunted the SL-dependent increase in the magnitude of XB recruitment. Our observations suggest that the R173W mutation in human cardiac TnT may impair Frank-Starling mechanism. NEW & NOTEWORTHY This work characterizes the effect of dilated cardiomyopathy mutation in cardiac troponin T (TnTR174W) on myofilament length-dependent activation. TnTR174W attenuates the length-dependent increase in cross-bridge recruitment and myofilament Ca2+ sensitivity. [ABSTRACT FROM AUTHOR]

Background: respiratory distress is the primary diagnosis in nearly 50% of children admitted to the pediatric emergency room and is a common cause of cardiopulmonary arrest in children. There is substantial variability in the etiology and severity of illness. The presenting clinical findings usually help to determine the type of problem. The causes include pneumonia, bronchial asthma, pneumothorax, acute bronchiolitis and pleural effusion. Objective: the present study was designed to compare chest ultrasound, as a diagnostic tool in the diagnosis of children with acute conditions of RD with the diagnosis of other radiological tools (Chest X-ray and CT chest. Methodology: this study included 200 infants and children, attending the Paediatric Department in Sayed Galal and Al- Hussein, AL-Azhar University Hospitals and they were suffering from respiratory distress. Their ages ranged from 12 month to 60months with mean age 32.52 months ± 13.91 months. Males were 134/200 (67%) while, females were 66/200 (33%) with male to female ratio 2.03:1. Results: as regard distribution of patients according to clinical or radiological diagnosis, the study showed that uncomplicated pneumonia n84 (42.0%), pneumonia with effusion n32 (16.0%), non pneumonic effusion n8 (4.0%), lung abscess n4 (2.0%), pneumothorax n14 (7.0%), lung collapse n16 (8.0%), mediastinal mass n4 (2.0%) and acute bronchiolitis n38 (19.0%). Conclusion: from our study, we can conclude the following: in view of our study it can be concluded that, chest US offers an important contribution to the diagnostic procedures of pleuro-pulmonary disorders in children, as pneumonia, pneumothorax, pleural effusion, lung abscess, lung collapse, mediastinal mass and acute bronchiolitis. [ABSTRACT FROM AUTHOR]

Alterations in length-dependent activation (LDA) may constitute a mechanism by which cardiomyopathy mutations lead to deleterious phenotypes and compromised heart function, because LDA underlies the molecular basis by which the heart tunes myocardial force production on a beat-to-beat basis (Frank-Starling mechanism). In this study, we investigated the effect of DCM-linked mutation (R173W) in human cardiac troponin T (TnT) on myofilament LDA. R173W mutation is associated with left ventricular dilatation and systolic dysfunction and is found in multiple families. R173W mutation is in the central region (residues 80-180) of TnT, which is known to be important for myofilament cooperativity and cross-bridge (XB) recruitment. Steady-state and dynamic contractile parameters were measured in detergent-skinned guinea pig left ventricular muscle fibers reconstituted with recombinant guinea pig wild-type TnT (TnT WT ) or mutant TnT (TnT R174W ; guinea pig analog of human R173W mutation) at two different sarcomere lengths (SL): short (1.9 µm) and long (2.3 µm). TnT R174W decreased pCa 50 (-log [Ca 2+ ] free required for half-maximal activation) to a greater extent at long than at short SL; for example, pCa 50 decreased by 0.12 pCa units at long SL and by 0.06 pCa units at short SL. Differential changes in pCa 50 at short and long SL attenuated the SL-dependent increase in myofilament Ca 2+ sensitivity (ΔpCa 50 ) in TnT R174W fibers; ΔpCa 50 was 0.10 units in TnT WT fibers but only 0.04 units in TnT R174W fibers. Furthermore, TnT R174W blunted the SL-dependent increase in the magnitude of XB recruitment. Our observations suggest that the R173W mutation in human cardiac TnT may impair Frank-Starling mechanism. NEW & NOTEWORTHY This work characterizes the effect of dilated cardiomyopathy mutation in cardiac troponin T (TnT R174W ) on myofilament length-dependent activation. TnT R174W attenuates the length-dependent increase in cross-bridge recruitment and myofilament Ca 2+ sensitivity.

Recent clinical studies have revealed a new hypertrophic cardiomyopathy-associated mutation (F87L) in the central region of human cardiac troponin T (TnT). However, despite its implication in several incidences of sudden cardiac death in young and old adults, whether F87L is associated with cardiac contractile dysfunction is unknown. Because the central region of TnT is important for modulating the muscle length-mediated recruitment of new force-bearing cross-bridges (XBs), we hypothesize that the F87L mutation causes molecular changes that are linked to the length-dependent activation of cardiac myofilaments. Length-dependent activation is important because it contributes significantly to the Frank-Starling mechanism, which enables the heart to vary stroke volume as a function of changes in venous return. We measured steady-state and dynamic contractile parameters in detergent-skinned guinea pig cardiac muscle fibers reconstituted with recombinant guinea pig wild-type TnT (TnT WT ) or the guinea pig analogue (TnT F88L ) of the human mutation at two different sarcomere lengths (SLs): short (1.9 µm) and long (2.3 µm). TnT F88L increases pCa 50 (-log [Ca 2+ ] free required for half-maximal activation) to a greater extent at short SL than at long SL; for example, pCa 50 increases by 0.25 pCa units at short SL and 0.17 pCa units at long SL. The greater increase in pCa 50 at short SL leads to the abolishment of the SL-dependent increase in myofilament Ca 2+ sensitivity (ΔpCa 50 ) in TnT F88L fibers, ΔpCa 50 being 0.10 units in TnT WT fibers but only 0.02 units in TnT F88L fibers. Furthermore, at short SL, TnT F88L attenuates the negative impact of strained XBs on force-bearing XBs and augments the magnitude of muscle length-mediated recruitment of new force-bearing XBs. Our findings suggest that the TnT F88L -mediated effects on cardiac thin filaments may lead to a negative impact on the Frank-Starling mechanism., (© 2018 Reda and Chandra.)

Omecamtiv mecarbil (OM) is a pharmacological agent that augments cardiac contractile function by enhancing myofilament Ca 2+ sensitivity. Given that interventions that increase myofilament Ca 2+ sensitivity have the potential to alter length-dependent activation (LDA) of cardiac myofilaments, we tested the influence of OM on this fundamental property of the heart. This is significant not only because LDA is prominent in cardiac muscle but also because it contributes to the Frank-Starling law, a mechanism by which the heart increases stroke volume in response to an increase in venous return. We measured steady-state and dynamic contractile indices in detergent-skinned guinea pig (Cavia porcellus) cardiac muscle fibers in the absence and presence of 0.3 and 3.0 μM OM at two different sarcomere lengths (SLs), short SL (1.9 μm) and long SL (2.3 μm). Myofilament Ca 2+ sensitivity, as measured by pCa 50 (-log of [Ca 2+ ] free concentration required for half-maximal activation), increased significantly at both short and long SLs in OM-treated fibers when compared to untreated fibers; however, the magnitude of increase in pCa 50 was twofold greater at short SL than at long SL. A consequence of this greater increase in pCa 50 at short SL was that pCa 50 did not increase any further at long SL, suggesting that OM abolished the SL dependency of pCa 50 . Furthermore, the SL dependency of rate constants of cross-bridge distortion dynamics (c) and force redevelopment (k tr ) was abolished in 0.3-μM-OM-treated fibers. The negative impact of OM on the SL dependency of pCa 50 , c, and k tr was also observed in 3.0-μM-OM-treated fibers, indicating that cooperative mechanisms linked to LDA were altered by the OM-mediated effects on cardiac myofilaments., (Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.)