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Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

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Asian Journal of Urology 2024年第1期11卷 86-92页

作者： Samer mahmoud Morsy Dalia Farouk Sara Hassan ahmed Yehia Abdelaziz Hussein Aly Hussein Urology Department Kasr Al Ainy HospitalCairo UniversityCairoEgypt Obstetrics and Gynecology Department Kasr Al Ainy HospitalCairo UniversityCairoEgypt

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-ter

关键词： Stressurinary incontinence Estrogen Midurethral sling Overactive bladder symptom

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Pyronaridine combined with diminazene aceturate inhibits Babesia in vitro and in vivo

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Asian Pacific Journal of Tropical Biomedicine 2024年第3期14卷 93-99页

作者： Shimaa Abd El-Salam El-Sayed Mohamed Z.Sayed-ahmed Shaimaa ahmed Awad Ali Nourah Alsadaan Nawazish Alam mahmoud S.Alkhoudary Ikuo Igarashi Mohamed Abdo Rizk National Research Center for Protozoan Diseases Obihiro University of Agriculture and Veterinary MedicineInada-ChoObihiroHokkaido 080-8555Japan Department of Biochemistry and Chemistry of Nutrition Faculty of Veterinary MedicineMansoura UniversityMansoura 35516Egypt Department of Clinical Pharmacy College of PharmacyJazan UniversityJazan 45142Saudi Arabia Medical-Surgical Department College of NursingJouf UniversitySakaka 72388Saudi Arabia Critical Care and Emergency Nursing Faculty of NursingMansoura UniversityEgypt College of Nursing Jouf UniversitySakaka 72388Saudi Arabia Faculty of Pharmacy Mansoura UniversityMansoura 35516DakahliaEgypt Department of Internal Medicine and Infectious Diseases Faculty of Veterinary MedicineMansoura UniversityMansoura 35516Egypt

Objective:To evaluate the combination therapy of pyronaridine tetraphosphate and diminazene aceturate against Babesia in vitro and in vivo.Methods:Bioinformatic analysis was performed using atom pair fingerprints.An in vitro combination test was performed against Babesia bovis and Theileria equi.Moreover,the in vivo chemotherapeutic efficacy of pyronaridine tetraphosphate in combination with diminazene aceturate was investigated against the growth of Babesia microti in mice using a fluorescence inhibitory assay.Results:Pyronaridine tetraphosphate and diminazene aceturate exhibited nearly similar molecular weights.The in vitro combination of pyronaridine tetraphosphate and diminazene aceturate was synergistic on Babesia bovis and additive on Theileria equi.In addition,5 mg/kg pyronaridine tetraphosphate combined with 10 mg/kg diminazene aceturate inhibited Babesia microti growth significantly compared with those observed after treatment with 25 mg/kg diminazene aceturate alone from day 6 post treatment to day 12 post treatment.The combination therapy also normalized the hematological parameters of infected mice.Conclusions:An oral dose of pyronaridine tetraphosphate combined with a subcutaneous dose of diminazene aceturate inhibits Babesia in vitro and in mice,suggesting it might be a new paradigm for the treatment of babesiosis.

关键词： Babesia Pyronaridine tetraphosphate Diminazene aceturate Babesiosis Theileria

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Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

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World Journal of Methodology 2024年第2期14卷 1-16页

作者： Rabea ahmed Gadelkareem Amr Mostafa Abdelgawad Nasreldin Mohammed Mohammed Ali Zarzour mahmoud Khalil ahmed Reda Hisham Mokhtar Hammouda Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal diseases.However,this health service is not available to all patients,especially in developing countries.The deceased donor KT programs are mostly absent,and the living donor KT centers are scarce.Single-center studies presenting experiences from developing countries usually report a variety of challenges.This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries.The financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical personnel.The sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up work.Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT practice.Low medical literacy about KT advantages is prevalent among clinicians,patients,and the public.The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT practices.These challenges resulted in noticeable differences between KT services in developed and developing countries.The coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT programs.The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices.The second mechanism is recruiting external resources,including financial,exp

关键词： Challenges Coping strategies Developing countries Kidney transplantation Low resources Single-center

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Assessment of Radiological Hazards of Sedimentary, Igneous and Sediments Natural Rocks

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World Journal of Nuclear Science and Technology 2024年第2期14卷 131-145页

作者： Wafaa Arafa Hala mahmoud Eman Yousf Ashry Ashry Ibrahim Elaassy ahmed Elsersy Faculty of Women Ain Shams University Cairo Egypt Nuclear Material Authority Cairo Egypt Faculty of Education Ain Shams University Cairo Egypt National Institute of Standard Giza Egypt

Gamma-ray spectroscopy based on a 100% efficiency hyper-pure germanium detector was used to evaluate the activity concentrations of 226Ra, 232Th, and 40K natural radionuclides in sedimentary, conglomerate, igneous and sedi-ments rock samples collected from four different locations in Eastern desert in Egypt. The obtained activity concentrations are used to evaluate the radi-ological hazards indices, absorbed dose rate, annual effective dose equivalent in air, radium equivalent, external and internal hazard index, radiation level index, annual gonadal dose equivalent, excess lifetime cancer risk and expo-sure rate. The results show that 1) the absorbed dose rate depends on the rock type, 2) the annual effective dose equivalent in air in 71% of sample below 20 mSvy-1 (permissible limit for workers), 3) the conglomerate rocks show low radioactivity level, 4) sedimentary rocks are rich in radium while igneous rocks are rich in thorium and the sediments rocks are rich in both radium and thorium.

关键词： Gamma Spectrometry Radiological Hazard Indices NORM Sedimentary Conglomerate Igneous Sediments

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Treatment of Prostatorectal Fistula by Transanorectal Route: About an Observation

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Open Journal of Urology 2024年第4期14卷 262-266页

作者： Mohamed mahmoud Beya ahmed Salem Terouzi Y. Tfeil Diagana Mouhamadou Urology Department Cheikh Zayed Hospital Nouakchott Mauritania

This is a 54-year-old patient admitted for the management of urinary leakage through the anus that had been occurring for a month, in whom the diagnosis of a prostatorectal fistula was made. The fistula was successful... 详细信息

关键词： Fistula Prostate Rectum York Masson

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Optimizing Grey Wolf Optimization: A Novel Agents’ Positions Updating Technique for Enhanced Efficiency and Performance

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Open Journal of Optimization 2024年第1期13卷 21-30页

作者： mahmoud Khatab Mohamed El-Gamel ahmed I. Saleh Asmaa H. Rabie Atallah El-Shenawy Department of Mathematics and Engineering Physics Faculty of Engineering Mansoura University Mansoura Egypt Department of Computers and Control Faculty of Engineering Mansoura University Mansoura Egypt Department of Mathematics Faculty of Science New Mansoura University Mansoura Egypt

Grey Wolf Optimization (GWO) is a nature-inspired metaheuristic algorithm that has gained popularity for solving optimization problems. In GWO, the success of the algorithm heavily relies on the efficient updating of the agents’ positions relative to the leader wolves. In this paper, we provide a brief overview of the Grey Wolf Optimization technique and its significance in solving complex optimization problems. Building upon the foundation of GWO, we introduce a novel technique for updating agents’ positions, which aims to enhance the algorithm’s effectiveness and efficiency. To evaluate the performance of our proposed approach, we conduct comprehensive experiments and compare the results with the original Grey Wolf Optimization technique. Our comparative analysis demonstrates that the proposed technique achieves superior optimization outcomes. These findings underscore the potential of our approach in addressing optimization challenges effectively and efficiently, making it a valuable contribution to the field of optimization algorithms.

关键词： Grey Wolf Optimization (GWO) Metaheuristic Algorithm Optimization Problems Agents’ Positions Leader Wolves Optimal Fitness Values Optimization Challenges

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Surgical Management of Mitral Valve Infective Endocarditis with Accidental Finding of Open Pulmonary Tuberculosis

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World Journal of Cardiovascular Surgery 2024年第5期14卷 61-67页

作者： Ahmad Al Khaddour Mohammed Alharthi Alawab M. Mesallam Mohamed Agawi mahmoud Ghalwash ahmed Gotbi Mohamed Abdel Hafez Fouly Marko Samanovic Nelson David Vega Murad El Gharbi Fawaz Altaf King Abdullah Medical Complex Jeddah KSA

Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.

关键词： Tuberculosis (TB) Mycobacterium tuberculosis (MTB) Heater-Cooler and Bypass Machine New York Heart Association (NYHA)

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Association between direct-acting antiviral agents in hepatitis C virus treatment and hepatocellular carcinoma occurrence and recurrence:The endless debate

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World Journal of Clinical Cases 2022年第6期10卷 1764-1774页

作者： ahmed Kamal ahmed Elsheaita mahmoud Abdelnabi Internal Medicine Department Faculty of Medicine Alexandria UniversityAlexandria 21131Egypt Clinical and Experimental Internal Medicine Department Medical Research Institute Alexandria UniversityAlexandria 21561Egypt Internal Medicine Department Texas Tech University Health Science CenterLubbockTX 79430United States

Since direct-acting antiviral agents(DAAs)have been introduced into hepatitis C virus treatment,the sustained viral response(SVR)rate has significantly increased to more than 95%.Scientific evidence supports the idea that SVR after interferon therapy has beneficial effects related to cirrhosis progression,resulting in a reduction in the incidence of hepatocellular carcinoma(HCC).However,a significant debate exists related to DAA impact on HCC development.We reviewed the current literature highlighting the controversial data related to DAA association with de novo HCC occurrence or recurrence and possible pathophysiology of HCC related to DAAs.After a review of the published literature,we believe that the current evidence does not confirm or repudiate a higher rate of de novo HCC occurrence or recurrence related to DAA therapy.More trials are needed to determine if there is an association between HCC occurrence or recurrence and DAA or if it is related to preexisting liver cirrhosis.

关键词： Hepatitis C virus Sustained virologic response Direct-acting antiviral drugs Hepatocellular carcinoma Liver cirrhosis

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Early detection of hepatocellular carcinoma co-occurring with hepatitis C virus infection: A mathematical model

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World Journal of Gastroenterology 2016年第16期22卷 4168-4182页

作者： Abdel-Rahman Nabawy Zekri Amira Salah El-Din Youssef Yasser Mabrouk Bakr Reham Mohamed Gabr Ola Sayed ahmed Mostafa Hamed Elberry ahmed mahmoud mayla Mohamed Abouelhoda Abeer A Bahnassy Molecular Virology and Immunology Unit Cancer Biology Department National Cancer Institute Cairo University Systems and Biomedical Engineering Department Faculty of Engineering Cairo University Center for Informatics Sciences Nile University Sheikh Zayed City Pathology Department National Cancer Institute Cairo University

AIM: To develop a mathematical model for the early detection of hepatocellular carcinoma(HCC) with a panel of serum proteins in combination with α-fetoprotein(AFP).METHODS: Serum levels of interleukin(IL)-8, soluble intercellular adhesion molecule-1(s ICAM-1), soluble tumor necrosis factor receptor Ⅱ(s TNF-RⅡ), proteasome, and β-catenin were measured in 479 subjects categorized into four groups:(1) HCC concurrent with hepatitis C virus(HCV) infection(n = 192);(2) HCV related liver cirrhosis(LC)(n = 96);(3) Chronic hepatitis C(CHC)(n = 96); and(4) Healthy controls(n = 95). The R package and different modules for binary and multi-class classifiers based on generalized linear models were used to model the data. Predictive power was used to evaluate the performance of the model. Receiver operating characteristic curve analysis over pairs of groups was used to identify the best cutoffs differentiating the different groups. RESULTS: We revealed mathematical models, based on a binary classifier, made up of a unique panel of serum proteins that improved the individual performance of AFP in discriminating HCC patients from patients with chronic liver disease either with or without cirrhosis. We discriminated the HCC group from the cirrhotic liver group using a mathematical model(-11.3 + 7.38 × Prot + 0.00108 × s ICAM + 0.2574 ×β-catenin + 0.01597 × AFP) with a cutoff of 0.6552, which achieved 98.8% specificity and 89.1% sensitivity. For the discrimination of the HCC group from the CHC group, we used a mathematical model [-10.40 + 1.416 × proteasome + 0.002024 × IL + 0.004096 × s ICAM-1 +(4.251 × 10-4) × s TNF + 0.02567 ×β-catenin + 0.02442 × AFP] with a cutoff 0.744 and achieved 96.8% specificity and 89.7% sensitivity. Additionally, we derived an algorithm, based on a binary classifier, for resolving the multi-class classification problem by using three successive mathematical model predictions of liver disease status. CONCLUSION: Our proposed mathematical model may be a useful method for the early detection of different

关键词： Mathematical model Hepatocellular carcinoma α-fetoprotein Soluble intercellular adhesion molecule-1

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A Comparative Analysis on Surgical Outcomes and Complications of Endoscopic and Open Vein Harvesting Techniques

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Open Journal of Thoracic Surgery 2024年第2期14卷 29-39页

作者： Mohammed Fawzy Eltaweel Ismail N. El-Sokkary ahmed Alherazi Mohamed Wael Badawi Mohammed G. Abdellatif Bahaa A. Elkhonezy Ibrahim K. Gamil Haytham Mohamed Abd El Moaty Sarra Sadmi mahmoud Khalil Department of Cardiothoracic Surgery Faculty of Medicine Menoufia University Shibin El Kom Egypt Department of Cardiovascular & Thoracic Surgery Faculty of Medicine Al-Azhar University Cairo Egypt Department of Cardiothoracic Surgery Faculty of Medicine Alexandria University Alexandria Egypt Faculty of Medicine University of Algiers Algiers Algeria Department of Cardiac Surgery Sabah Al-Ahmed Cardiac Center Al-Amiri Hospital Kuwait City Kuwait

Objective: The great saphenous vein (GSV) is commonly used as a conduit for grafting during CABG surgery, and open GSV harvesting (OVH), commonly used with long incision to expose the vein. However, endoscopic vein harvesting (EVH) is an alternative approach, utilizing specialized instruments and small incisions to harvest the vein. Methods: A retrospective analysis was conducted on a cohort of patients who underwent Coronary artery bypass graft (CABG) requiring great saphenous vein (GSV) harvesting which was done by EVH or OVH procedures. Demographic variables, including age and gender, were assessed for both groups. Intraoperative variables such as the number of grafts, cardiopulmonary bypass time, X clamp time, and type of procedure were analyzed. Postoperative variables, including infection and bleeding rates, were also evaluated. Results: The study included 30 patients each undergoing Coronary artery bypass graft (CABG) with need of great saphenous vein harvesting which was done by EVH and OVH. Demographic variables were well-matched between the two groups in terms of age, while a significant difference in gender distribution was observed. Obesity and smoking were more prevalent in the OVH group, and EVH was associated with a higher mean number of grafts compared to OVH. Conversion to an open technique occurred in a portion of the EVH cases, and infection rates did not significantly differ between the EVH and OVH groups. However, the incidence of postoperative bleeding was significantly higher in the EVH group. Conclusion: This study provides valuable insights into the demographic, intraoperative, and postoperative variables associated with EVH and OVH techniques. EVH demonstrated advantages in terms of reduced infection rates compared to OVH. However, the higher incidence of postoperative bleeding associated with EVH raises concerns about potential risks.

关键词： Endoscopic Vein Harvesting (EVH) Open Vein Harvesting (OVH) Coronary Artery Bypass Grafting (CABG) Great Saphenous Vein (GSV) Surgical Outcomes

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