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Background: In the emergency department (ED), During airway management, tracheal intubation (TI) is a routine procedure in neonatal and pediatric critical care units, as well as the delivery room. The location of the endotracheal tube (ETT) should be confirmed as soon as possible since tube malposition is linked to severe complications such as aspiration, air leak syndromes, and oesophageal intubation. In perioperative, emergency, and critical care settings, ultrasound (US) gives point-of-care dynamic images of the airway. Objective: The goal of this study is to evaluate the results of utilizing Trans-tracheal POCUS to confirm ETT implantation with other confirmatory procedures including colorimetric capnography and direct viewing. Methods: The study was done at Al-Azhar & Tanta University Emergency Hospital and was a prospective observational study. To locate the tube, we employed tracheal sonography and an ETCO2 analyzer for capnography. We evaluated the amount of time required and the accuracy of the findings. Results: There were a total of 40 children that required emergency endotracheal intubation. Endotracheal ETT was found in 37 (92.5%) of the patients, while esophageal ETT was seen in three (7.5%) patients. The capnography was the standard for detecting the ETT placement correctly. In 97 percent of patients, ultrasound was able to identify all esophageal intubation and confirm the insertion of an endotracheal tube (ETT) with a sensitivity of 100 percent and a specificity of 97.5 percent. The clinical assessment had misunderstood 16.2 percent of tracheal intubations and 2 out of 3 esophageal intubations. Conclusion: POCUS is considered an accurate method in endotracheal tube insertion confirmation, resulting in safe, fast, and reliable airway management approaches.

Ahmed Esmat,1 Mahmoud I Elshamy,2 Doaa Mohamed Zakaria,3 Zakarya Shady,4 Eman Roshdy Mohamed,3 Nashwa El-Khouly,3 Marwa M Hassan,3 Fatma M El-Senosy3 1Department of Neurology, Al-Azhar University, Faculty of Medicine, Cairo, Egypt; 2Department of Radiology, Al-Azhar University, Faculty of Medicine, Cairo, Egypt; 3Department of Internal Medicine, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt; 4Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, EgyptCorrespondence: Zakarya Shady Tel +201001281304Email zakaryashady96@yahoo.comPurpose: Diabetes is a documented risk factor for peripheral neuropathy. It was reported that associated hypertension could increase this risk. The present study aimed to assess the effect of hypertension and diabetes on median nerve using high-resolution ultrasound.Methods: The study includes 50 hypertensive patients (HTN group), 50 diabetic patients (DM group), 50 patients with coexisting diabetes and hypertension (HTN + DM group) and 50 healthy controls. Median nerve affection in the studied groups was studied by vibration perception thresholds (VPT). The median nerve cross-sectional area was determined at the nerve cross-sectional area of the median nerve at the carpal tunnel by high-resolution ultrasound. Clinical symptoms were assessed using Toronto Clinical Severity Score (TCSS).Results: There was significantly higher median nerve CSA in all patient groups in comparison to controls. HTN + DM group had significantly higher median nerve CSA when compared with DM group. Patients with peripheral neuropathy in HTN + DM and DM groups had significantly higher median nerve CSA than patients without. Using ROC curve analysis, it was shown that median CSA could successfully distinguish patients with peripheral neuropathy from patients without in HTN + DM group [AUC (95% CI): 0.71 (0.54– 0.89)] and in DM group [AUC (95% CI): 0.86 (0.72– 0.99)].Conclusion: Hypertensive patients with and without diabetes have significantly higher median nerve CSA when compared with controls.Keywords: hypertension, peripheral neuropathy, high-resolution ultrasound, diabetes mellitus, median nerve

The world's interest now is focusing on the applying of the principles of sustainable development in managing natural resources, especially in managing freshwater, which is one of the greatest challenges the whole world face. In this paper, the illite ore was tested to remove the excess of iron and manganese from groundwater which is used for drinking and household purposes in Assiut. To accomplish this goal, the study was based on two directions. The first direction focused on achieving a physicochemical analytical survey for all the groundwater produced by wells in Assiut governorate, and its averages are plotted on GIS maps, to illustrate the difference in the concentrations of iron and manganese. However, the second direction focused on the preparation and examination of the modified illite ore, and it was characterized by using XRD, SEM, FT-IR, and XRF techniques. The results showed that the sodalite-bearing modified illite (SBMI) was able to remove the excess of iron and manganese from raw groundwater with the efficiency of 99% and 97%, respectively.

Background Metabolic syndrome is defined as a group of interrelated biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease, obesity, and type 2 diabetes mellitus. MicroRNA-33a (miR-33a) and MicroRNA-122 (miR-122) play a crucial role in various biological processes by regulating the gene expression level through post-transcriptional mechanisms, and alterations of their levels are associated with lipid and glucose metabolic disorders. In the present study, we aimed to investigate the correlation of miR-33a and miR-122 with obesity indices and glycemic parameters in a cohort of Egyptian patients. Quantitative real-time polymerase chain reaction (RT-PCR) using TaqMan assay was carried out to estimate the expression levels of miR-33a and miR-122 in serum samples of 100 patients diagnosed as having metabolic syndrome and 50 healthy controls. All patients (100%) had type 2 diabetes (by both history and laboratory assessment) and 70% were obese (BMI ≥ 30 kg/m2). Results Compared to controls, patients had significantly higher serum expression level of miR-33a (p value p value = 0.0016). miR-33a was less expressed (downregulation expression) with 0.8 fold change in the patient group (obese and diabetic) compared to healthy controls, while miR-122 was highly expressed (upregulation expression) in the patient group of patients with 1.9 fold change. Clinical parameters as body mass index (BMI), wrist circumference (Wc), weight (Wt), and height (Ht) (all p < 0.001); total cholesterol (TC) (p = 0.0115); and triglyceride (TG) (p = 0.0286), all were significantly higher in patients compared to the healthy group. Both miRNAs show statistically significant correlations with clinical and biochemical parameters (p < 0.001). Conclusions Circulating miR-33a and miR-122 might be convincing as possible biomarkers for the diagnosis of metabolic syndrome.

T he study aimed to Develop Chemistry curriculum in light of the standards of life applications and the effectiveness of teaching a unit of the developing curriculum based on format model (4MAT) for the Development of Mental Motivation and chemistry awareness for secondary stage students.To achieve this, the researcher prepared a list of standards and indicators of life applications for the content of the chemistry curriculum in the secondary stage ,A list of life applications in light of the list of standards, then the developed framework for the chemistry curriculum were prepared in light of the standards of life applications for secondary school students (the three grades), including curriculum maps, and a unit was prepared. "Industrial Chemistry" from the developed framework for the content of the chemistry curriculum formulated in the light of McCarthy's 4MAT model form for second year secondary school students. The researcher prepared the experimental study tools, the mental motivation scale prepared by Giancarlo & Factions, 1998, and the chemical awareness scale with its three axes and the study group was selected. They were (27) female students from second year secondary school for girls in Bani Mazar. (73%). The results showed the ineffectiveness of teaching the industrial chemistry unit using the (4MAT) model on mental motivation among the students , and the effect of teaching the unit on the chemical awareness of the students was found.

This article is devoted to the study and publication of the funerary stela of the female singer TAwty- nDm, which was discovered in 2008 in Heliopolis near the tomb of Panehsi.It is currently preserved in Arab El-Hisn magazine at El-Matariya under the registration No. 4008. There are no traces of colours on the stela, despite it being in good state of preservation; As some details in the figures have not been executed, it is considered to be unfinished. The decoration of the stela is composed of two registers separated by a horizontal line; it shows the owner of the stela Tjauty- nedjem and other individuals worshipping the gods Osiris and Mr-Wr who were worshipped in Heliopolis mostly. It dates to the Ramesside period.

Calcium Hardness (Ca. H) and total Hardness ions in drinkable groundwater cause great problems for the entire world especially, the population communities which are located far from surface water sources. The present study investigates the use of Sodalite Bearing Modified Illite (SBMI) as a sustainable and new technique to eliminate these ions from drinkable groundwater to compatible with the instruction of the World Health Organization. The methodology was achieved by using a new method to remove these ions’ excess calcium Hardness and total Hardness depending on two main processes; the adsorption as a first step and the coagulation-flocculation-sedimentation process as a second step. The results of this study were achieved through conducting three tasks; (1) Chemical analysis surveys for all the groundwater wells, to determine the areas which are more affected by these salts, and plot them on the location maps. (2) Conducting the alkaline modification of the Illite ore to obtain the (SBMI) which has a high surface area and high adsorption ability, and it had been characterized by using XRD, XRF, SEM, and FTIR techniques. (3) The experimental studies were conducted to evaluate the effect of the modified Illite on raw groundwater containing a high concentration of hardness ions, through the batch studies to determine the factors which affected its ability for removing these ions from groundwater. The present study illustrated that the removing efficiency for both total hardness (Ca. H + Mg. H) and calcium hardness (Ca. H) reached about 98%. Finally, the present study recommended using this technique, when there is a requirement for large quantities of treated water at a low cost.

Herbs and spices are natural ingredients that have been widely used not just as food flavouring but also for their health attributes. The antioxidant, antimicrobial and anticancer components present in them enhance the health and medical status of human beings. The present study aims to produce Labneh fortified with cardamom and bay leaf powder to enhance the quality and shelf life.Cardamom or bay leaf powder were added separately at the ratios of 0.25, 0.50, 0.75 and 1% (w/w) to Labneh and the treatments were compared with a control without cardamom or bay leaf powder during storage (at 5plusmn;1deg;C for 40 days).The total solids, fat, ash, carbohydrate and fiber contents were insignificantly higher in Labneh containing cardamom or bay leaf powder than control. The titratable acidity of Labneh gradually increased, whereas the pH values decreased by increasing the concentration of cardamom or bay leaf powder during the storage period. No significant differences were found in any textural parameters between Labneh containing condiments and control, except for that containing 1% cardamom or bay leaf powder, which exhibited higher hardness during the storage period. Minerals, antioxidants activity (RSA%), total phenolic (TPC) and total flavonoids content (TFC) increased with the increase of the added percentage of cardamom or bay leaf powder compared to control. Due to the stimulatory effect of cardamom and bay leaves on Lactic acid bacteria (LAB), the viability of the total bacterial count (TBC) gradually increased as the level of those condiments increased. The control became moldy after 10 days of cold storage while Labneh containing condiments remained unspoiled with yeasts and moulds for up to 30 days of cold storage. Sensory evaluation indicated that 1% addition of cardamom and 0.75% of bay leaf powder to Labneh improved quality and extends the shelf life of Labneh up to 30 days at 5plusmn;1deg;C.Labneh supplemented with cardamom or bay leaf powder can be considered as a novel product with acceptable quality and extended shelf life.

Background: Non-alcoholic fatty liver disease (NAFLD) is an insidious disease, which leads to the deposition of lipid within the hepatic parenchyma. It affects different age groups in Egypt—including children. Its degree of severity range from steatosis to non-alcoholic steatohepatitis (NASH), which later could progress into life-threatening diseases such as cirrhosis and hepatic malignancy. Progression towards inflammation of the steatotic liver was initially proposed to be related to endotoxemia as a result of increased gut permeability. Subsequently, there is some evidence that intestinal microbiota plays an important part in the pathogenesis of NAFLD.Aim of the work: To detect possible relation of lactobacillus acidophilus to non-alcoholic fatty liver disease in a sample of Egyptian population.Patients and methods: The current study included 60 subjects. They were divided in to Group 1: included 20 obese subjects with NAFLD; Group 2 :included 20 lean subjects with NAFLD; Group 3: included 20 healthy subjects as a control group. Identification of stool lactobacillus acidophilus by quantitative real time PCR technique and abdominal ultrasound for diagnosis of NAFLD.Results: There was non significant difference between studied groups as regard lactobacillus acidophilus concentration in stool P= 0.986. There was non significant elevation of ALT and AST in NAFLD obese subjects in positive PCR group compared to other groupsConclusions: Still there is controversy about the role of lactobacillus acidophilus in the pathogenesis of NAFLD

Background: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, and is the leading cause of blindness and visual impairment in the working-age population. Retinal neovascularization is the most important clinical features of proliferative DR (PDR). Apelin is an endogenous ligand of the G proteincoupled receptor, which has been shown to be involved in retinal angiogenesis. Objective: To study vitreous and serum levels of apelin in type 2 diabetic patients with diabetic retinopathy. Patients and methods: Case control study was conducted on total 60 subjects, 40 type 2 diabetic patients and 20 non diabetic subjects as control group. Diabetic patients were divided into 2 groups. Results: Serum and vitreous levels of apelin were significantly higher in patients with PDR compared to NPDR and control group (P 4.45 ng/ml (P 3.55 ng/ml for detection of NPDR compared to control group. Conclusion: Elevation of serum apelin in patients with PDR compared to NPDR and control group suggesting the role of apelin in development of retinal neovascularization and diabetic retinopathy. So antagonizing effect of apelin can be used as targeted therapy for treatment of diabetic retinopathy. We can rely on serum apelin for early detection of diabetic retinopathy than vitreous apelin.

Background: Diabetes Mellitus (DM) is a major 21st century health and development challenge, this chronic and incurable non-communicable disease is large preventable but remains responsible for millions of deaths annually and many more life-threatening complications. Uncontrolled diabetes and poor diabetic patients' knowledge about disease can lead to a high morbidity and mortality. Aim of the Study: To evaluate the effect of nursing Instructions on adherence of diabetic patients to treatment. Research Design: A quasi-experimental design was utilized in this study. Setting: The study was conducted in outpatient clinic for diabetic follow up at Minia University Hospital and Minia General Hospital. Sample: A purposive sample of 144 adult with type two diabetes mellitus (T2DM) were divided in to two equal groups (study and control) from both sex with duration of diabetic disease more than one year and patients without comorbid disease, and without cerebrovascular accident. Tools of Data Collection: Structured Interview assessment questionnaire sheet (patient socio-demographic characteristics and medical data), Assessment Scale for Treatment Adherence to assess Compliance of T2DM to Diabetic management, andinstructions about diabetes "Booklet". Results: Current study findings revealed that there was a highly a significant improvement in Compliance of T2DM patients to Diabetic management in study group than control group and in post 1st and 2nd follow up for study group than pre application of instructions. Conclusion: The diabetic instructions and the use of booklet would improve patient's Adherence to Treatment. Recommendations: Nurses should emphasis to provide instructions tailored to each diabetic patient andincrease their awareness about the importance of diabetic instruction to improve glycemic control.

This paper numerically investigated the influence of adsorbent materials’ thermal and adsorption characteristics on the overall performance of solar adsorption cooling cum desalination systems. A case study using an array of solar collectors was conducted to compare the emerging Aluminum Fumarate metal-organic framework (Al-Fum) with conventional silica gel (SG) under typical meteorological data at a selected site. Although the adsorption characteristics of Al-Fum outperforms SG at the material level, the former’s low thermal characteristics increased the cumulative heat stored and limited the integrated-system performance. The low thermal diffusivity of Al-Fum slowed down the integrated system’s response, providing that the average solar COPs of the SG-based system over different months were higher by 83%, 43%, and 22% at inlet chilled water temperatures of 15 °C, 20 °C, and 25 °C, respectively, and 1 mm fin spacing. However, the best specific cooling power of the AF-based system were higher than those of the SG-based system by −16.6%, 16.8%, and 30.5% at these temperatures. Furthermore, the SG-based system was more negatively affected by reducing the heat storage initial temperature from 70 °C to 50 °C, but it attained COP and solar COP higher than those of the AF-based system by 14.9%–63%, respectively.

Background: Preceptor ship is a clinical teaching model through which undergraduate nursing students are facilitated to acquire beginning competencies that enable them to function effectively in the complex workplace environment upon graduation. The aims of the current study were to evaluate the effect of tailored educational program about selected clinical measurements regard learning process on nursing preceptors (knowledge) and evaluate the preceptor abilities by their perceptee before the educational program. Quasi-experimental (pre-posttest) research design was used. The study was conducted at Faculty of Nursing and Institute of Nursing which affiliated to Minia University and Institute of Nursing which affiliated to Beni Suef University. Purposive study sample included Sixty one (61) preceptors recruited from previous mentioned settings as following: Group I (n=31) & Group II (n=30) respectively, Two tools was utilized, the first one was a structured self-administered questionnaire: to collect personal data of the preceptor and their knowledge regarding selected clinical measurements, the second one: were used to evaluate the preceptor‘s abilities which collected from the preceptees before the educational program. Results: revealed that Mean ±SD age regarding study participant (group1) equal 28.1+-4.7, about three quarter of participant (74.2%) have baccalaureate of nursing , the Mean ±SD related to the years of experiences was 6.7+-4.9. The majority of them (96.8%) hadn't receiving any staff developmental training program. Lastly the study cleared that total participant (100%) haven’t ongoing any educational program. There are a highly statically significant differences in knowledge between pre and posttest regarding selected clinical measurements that improving nursing preceptor's role among both studied groups p-value= .001**. Conclusion there are improvement in knowledge about selected clinical measurements that improving nursing preceptor's role among both studied groups and the precepts evaluation regarding highest abilities for their preceptor were according to they mentioned as their preceptor available when need help, provide feedback about program, actively sought educational opportunities….ect. Recommendation: the recent study recommended that it is important to design a Preceptorship programs or academy that develop a courses as the best starting point to increase the effectiveness preceptor role and which will reflect on the development of specific skills in their perceptee students