Therapeutic effects of thymoquinone or capsaicin on acrylamide-induced reproductive toxicity in rats mediated by their effect on oxidative stress, inflammation, and tight junction integrity.

In the field of environmental toxicology, endocrine-disrupting effects have become a major concern. The present research set out to investigate the possible reproductive toxicity of acrylamide. The research was also expanded to explore the protective effects of two nutraceuticals, thymoquinone (TQ) and capsaicin, against acrylamide-induced reproductive toxicity. Six groups of sixty male albino rats were created. Group 1 was used as a control. Rats were administered a daily dose of acrylamide and acted as the model in Group 2. TQ was provided to rats once a day in Group 3. Capsaicin was administered to rats once a day in Group 4. TQ was given once daily to rats exposed to acrylamide in Group 5. Rats were given capsaicin once a day for eight weeks after being exposed to acrylamide in Group 6. Acrylamide induced oxidative stress, testicular NF-κB/p65 expression, and down-regulated the expression of occludin, all of which can contribute to its testicular toxicity, while TQ or capsaicin removes all of these toxicity signs. TQ and capsaicin have shown efficacy in alleviating all of the acrylamide's toxic insults in the current reproductive toxicity model. Both nutraceuticals upregulated the expression of occludin in testicular tissue and restored tight junction integrity, in addition to their well-known antioxidant and anti-inflammatory effects, which were confirmed in this study.

Possible protective effect of TNF-α inhibition and triad NO/cGMP/VEGF activation on gastric ulcer in rats.

Peptic ulcers are one of the world's major gastrointestinal disorders, embracing both gastric and duodenal ulcers, and affecting 10% of the world population. The current study aimed to investigate the possible protective effect of tadalafil and pentoxifylline (PTX) on indomethacin-induced peptic ulcers. Male albino rats were divided into five groups: control group; ulcerated group; Indomethacin + Tadalafil, in which animals were pretreated with tadalafil orally before indomethacin; Indomethacin+ PTX, in which animals were pretreated with PTX orally before indomethacin; and Indomethacin + Tadafil + PTX. Indomethacin treatment revealed histopathological changes and ulcer scoring and ulcer index were markedly increased. Serum levels of prostaglandin and heme oxygenase-1 were significantly decreased. The ulcerogenic also induced marked oxidative stress as evident from the increased malondialdehyde, decreased in gastric glutathione content and superoxide dismutase activity, while the gastric myeloperoxidase was increased. Gastric nitric oxide content was decreased and the expression of vascular endothelial growth factor was downregulated while the tumor necrosis factor α (TNF-α) level was dramatically increased. Pretreatment of the ulcerative group by either tadalafil or PTX or their combination improved all these pathological changes. Tadalafil or PTX may have a role in protecting gastric mucosa damage caused by indomethacin which may be useful in the future for the treatment of gastric ulceration.

Antimalarial alkaloid from Hypoestes forskaolii.

Following on from previous studies, we brought further our quest for anti-malarial agents isolated from plants grown in the Saudi Arabian Peninsula. Methanolic extracts were prepared from eighteen Saudi plants and then tested in vitro to assess their anti-malarial effects on Plasmodium falciparum K1, (a chloroquine-resistant strain) as well as their cytotoxicity on MRC5 (human diploid embryonic lung cell line) cells. Moderate anti-malarial activity was observed in extracts prepared from Hypoestes forskaolii (Vahl) R. Br. (IC50 value of 5.5 µg/ml) and Rhus retinorrhaea (IC50: 7.71 µg/ml). The remaining sixteen plant extracts appeared to be inactive (IC50 > 12.5 µg/ml). A novel phenanthro-quinolizidine alkaloid, 15ß-hydroxycryptopleurine-N-oxide, was isolated from H. forskaolii using bio-guided fractionation procedures. Chloroquine-resistant (K1) and chloroquine-sensitive (FCR3) strains of P. falciparum appeared very sensitive to the anti-malarial activity of 15ß-hydroxycryptopleurine-N-oxide, giving IC50 of 6.11 and 5.13 nM respectively. It showed cytotoxicity against MRC5 "IC50 of 24.45 nM" with selectivity indices of 4.0 and 4.76 against K1 and FCR3 strains, respectively. It is our understanding that this is the first account on phenanthro-quinolizidine alkaloids anti-malarial activity on a chloroquine-resistant P. falciparum strain.

Naturally Occurring Isocoumarins Derivatives from Endophytic Fungi: Sources, Isolation, Structural Characterization, Biosynthesis, and Biological Activities.

Recently, the metabolites separated from endophytes have attracted significant attention, as many of them have a unique structure and appealing pharmacological and biological potentials. Isocoumarins represent one of the most interesting classes of metabolites, which are coumarins isomers with a reversed lactone moiety. They are produced by plants, microbes, marine organisms, bacteria, insects, liverworts, and fungi and possessed a wide array of bioactivities. This review gives an overview of isocoumarins derivatives from endophytic fungi and their source, isolation, structural characterization, biosynthesis, and bioactivities, concentrating on the period from 2000 to 2019. Overall, 307 metabolites and more than 120 references are conferred. This is the first review on these multi-facetted metabolites from endophytic fungi.

Effect of Viscum schimperi on advanced glycation endproducts formation.

Diabetes is a disease characterized by elevated uncontrolled glucose level. Hyperglycemia results in diabetic complication due to a reaction between sugar and amino acid of proteins to form advanced glycation endproducts (AGEs) in different tissues. Medicinal plants are considered as a great source of bioactive compounds that affect many ailments. In this regard; AGEs formation could be inhibited by many bioactive compounds isolated from medicinal plants. Viscum schimperi Engl. is a plant belongs to Loranthaceae and known for its antidiabetic activity. In this study; total methanol extract of V. schimperi (VT) was prepared, suspended in water and subjected to fractionation with chloroform followed by n-butanol to give (VC) and (VB) fractions respectively. The aqueous mother liquor was evaporated to form (VA) fraction. The inhibitory effect of all prepared fraction on the formation of advanced glycation endproducts (AGEs) was studied. The results revealed that V. schimperi extract and its different fractions inhibited protein glycation and oxidation of BSA induced by ribose together with decrease of protein aggregation. In conclusion; V. schimperi will be useful in management of diabetic complications based on its inhibition of advanced glycation endproduct formation.

Prognostic Value of Polypoid Changes of the Middle Turbinate in Relapsed Nasal Polypi after FESS: A Prospective Cohort Study.

Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups ( p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups ( p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months ( p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.

Diabetic ketoacidosis in pregnancy.

The clinical presentation of diabetic ketoacidosis (DKA) includes nausea, vomiting, thirst, polyuria, polydipsia, abdominal pain, tachypnoea, and change in mental status in cases of severe DKA. DKA is similar in pregnant and non-pregnant women, but in pregnant women it can be seen at lower serum glucose levels and symptoms may develop more rapidly. Most, but not all, cases occur in the second or third trimester.DKA results in reduction in uteroplacental blood flow due to osmotic diuresis, and also in metabolic abnormalities (maternal acidosis, hyperglycaemia, electrolyte imbalance), resulting in fetal hypoxaemia and acidosis. In fetuses with mature cardiac activity, the fetal heart rate may show minimal or absent variability, repetitive deceleration and absence of acceleration. These abnormalities in heart rate usually resolve with resolution of the DKA, which may last for several hours before normalisation.For the patient reported on here, immediate delivery based on pathological fetal heart rate would have resulted in preterm delivery and jeopardised the maternal clinical condition. However, a holistic clinical approach by the multidisciplinary team to management of the patient led to normal term delivery 5 weeks after presentation with DKA; fetal and maternal outcome were good.

Covid-19-Related Acute Invasive Fungal Sinusitis: Clinical Features and Outcomes.

Introduction There is a noticeable increase in the incidence of acute invasive fungal sinusitis which coincides with the ongoing coronavirus pandemic. It is a potentially-lethal fungal infection, with the most common form being the rhino-orbito-cerebral presentation. Objectives The aim of the present study is to discuss the different epidemiological factors, risk factors, clinical presentations and outcomes of acute invasive fungal sinusitis which is noticeably related to the coronavirus disease 2019 (Covid-19) pandemic. Methods The present cross-sectional cohort study included 22 adult patients who presented with Covid-19-related acute invasive fungal sinusitis. The diagnosis of acute invasive fungal sinusitis was confirmed by histopathological biopsy. All data, including demographics, risk factors, clinical findings, different lines of treatment and their outcomes, were recorded and analyzed. Results All patients had diabetes mellitus (100%), and 17 (77.3%) had been submitted to systemic steroids. All patients (100%) had unilateral sinonasal disease. Proptosis was found in 15 patients (68.2%), ophthalmoplegia was observed in 12 patients (54.5%), and intracranial affection occurred in 10 patients (45.5%). A total of 20 patients (90.9%) received liposomal amphotericin B. Surgical debridement was performed in 18 patients (45.5%). Non-septated mycelia was present in 19 biopsies (86.4%), while 3 (13.6%)showed septated mycelia. Total improvement was achieved in 10 patients (45.5%), while the mortality rate was of 27.3% (6 out of 22 participants). Conclusion Diabetes mellitus is the most common preexisting medical condition associated with Covid-19-related acute invasive fungal sinusitis. Systemic corticosteroid therapy is considered a predisposing factor. It is necessary to raise the level of awareness to diagnose this condition, especially in patients with Covid-19 infection or those who have recently recovered from it.

Should intravenous acetaminophen be considered for post craniotomy pain management? A meta-analysis of randomized controlled trials.

INTRODUCTION: Post-craniotomy pain management with opioids is challenging due to their side effects, which might mask neurological deterioration symptoms. Recently, intravenous (IV) acetaminophen has been tested in this population. This meta-analysis aimed to synthesize evidence from published randomized controlled trials (RCTs) about the efficacy of IV acetaminophen in reducing pain scores in postoperative craniotomy patients. EVIDENCE ACQUISITION: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) was conducted. We selected RCTs comparing IV acetaminophen versus placebo for postoperative pain management in craniotomy patients. Data on the Visual Analog Scale (VAS), opioid requirements, hospital stay, and patients' satisfaction were extracted and pooled as standardized mean difference (SMD) with the corresponding 95% confidence intervals (CI) in the meta-analysis model. EVIDENCE SYNTHESIS: Five RCTs, with a total of 493 patients, were pooled in the final analysis. Patients in the IV acetaminophen group had significantly lower VAS pain scores compared to the placebo group (SMD=-0.28, 95% CI: -0.46 to -0.10). However, in terms of opioid requirement, hospital stay, and patients' satisfaction, there were no statistically significant differences between both groups (P>0.05). CONCLUSIONS: This meta-analysis provides class one evidence that IV Acetaminophen can significantly reduce postoperative pain in craniotomy patients with an excellent safety profile; however, there are not benefits in terms of hospital stay, opioid requirement, or patients' satisfaction.

Fabrication and Optimisation of Ti-6Al-4V Lattice-Structured Total Shoulder Implants Using Laser Additive Manufacturing.

This work aimed to study one of the most important challenges in orthopaedic implantations, known as stress shielding of total shoulder implants. This problem arises from the elastic modulus mismatch between the implant and the surrounding tissue, and can result in bone resorption and implant loosening. This objective was addressed by designing and optimising a cellular-based lattice-structured implant to control the stiffness of a humeral implant stem used in shoulder implant applications. This study used a topology lattice-optimisation tool to create different cellular designs that filled the original design of a shoulder implant, and were further analysed using finite element analysis (FEA). A laser powder bed fusion technique was used to fabricate the Ti-6Al-4V test samples, and the obtained material properties were fed to the FEA model. The optimised cellular design was further fabricated using powder bed fusion, and a compression test was carried out to validate the FEA model. The yield strength, elastic modulus, and surface area/volume ratio of the optimised lattice structure, with a strut diameter of 1 mm, length of 5 mm, and 100% lattice percentage in the design space of the implant model were found to be 200 MPa, 5 GPa, and 3.71 mm-1, respectively. The obtained properties indicated that the proposed cellular structure can be effectively applied in total shoulder-replacement surgeries. Ultimately, this approach should lead to improvements in patient mobility, as well as to reducing the need for revision surgeries due to implant loosening.

Machine Learning Model for Predicting Postoperative Survival of Patients with Colorectal Cancer.

PURPOSE: Machine learning (ML) is a strong candidate for making accurate predictions, as we can use large amount of data with powerful computational algorithms. We developed a ML based model to predict survival of patients with colorectal cancer (CRC) using data from two independent datasets. MATERIALS AND METHODS: A total of 364,316 and 1,572 CRC patients were included from the Surveillance, Epidemiology, and End Results (SEER) and a Korean dataset, respectively. As SEER combines data from 18 cancer registries, internal validation was done using 18-Fold-Cross-Validation then external validation was performed by testing the trained model on the Korean dataset. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), sensitivity and positive predictive values. RESULTS: Clinicopathological characteristics were significantly different between the two datasets and the SEER showed a significant lower 5-year survival rate compared to the Korean dataset (60.1% vs. 75.3%, p < 0.001). The ML-based model using the Light gradient boosting algorithm achieved a better performance in predicting 5-year-survival compared to American Joint Committee on Cancer stage (AUROC, 0.804 vs. 0.736; p < 0.001). The most important features which influenced model performance were age, number of examined lymph nodes, and tumor size. Sensitivity and positive predictive values of predicting 5-year-survival for classes including dead or alive were reported as 68.14%, 77.51% and 49.88%, 88.1% respectively in the validation set. Survival probability can be checked using the web-based survival predictor (http://colorectalcancer.pythonanywhere.com). CONCLUSION: ML-based model achieved a much better performance compared to staging in individualized estimation of survival of patients with CRC.

Genotypic and Phenotypic Structure of the Population of Phytophthora infestans in Egypt Revealed the Presence of European Genotypes.

Late blight disease of potato and tomato, caused by Phytophthora infestans, results in serious losses to Egyptian and global potato and tomato production. To understand the structure and dynamics of the Egyptian population of P. infestans, 205 isolates were collected from potato and tomato plants during three growing seasons in 2010-2012. The characterization was achieved by mating-type assay, metalaxyl sensitivity assay, and virulence pattern. Additionally, genotyping of 85 Egyptian isolates and 15 reference UK isolates was performed using 12 highly informative microsatellite (SSR) markers David E. L. Cooke and five effector (RxLR) genes. Mating-type testing showed that 58% (118 of 205) of the isolates belonged to mating type A1, 35% (71 isolates) to mating type A2, and the rest 8% (16 isolates) were self-fertile. The phenotype of metalaxyl response was represented as 45% resistant, 43% sensitive, and 12% as intermediate. Structure analysis grouped the 85 identified genotypes into two main clonal lineages. The first clonal lineage comprised 21 isolates belonging to A2 mating type and 8 self-fertile isolates. This clonal lineage was identified as Blue_13 or EU_13_A2. The second main clonal lineage comprised 55 isolates and was identified as EU_23_A1. A single isolate with a novel SSR genotype that formed a distinct genetic grouping was also identified. The effector sequencing showed good correspondence with the virulence data and highlighted differences in the presence and absence of loci as well as nucleotide polymorphism that affect gene function. This study indicated a changing population of P. infestans in Egypt and discusses the findings in the context of late blight management.

Multistage Tool Path Optimisation of Single-Point Incremental Forming Process.

Single-point incremental forming (SPIF) is a flexible technology that can form a wide range of sheet metal products without the need for using punch and die sets. As a relatively cheap and die-less process, this technology is preferable for small and medium customised production. However, the SPIF technology has drawbacks, such as the geometrical inaccuracy and the thickness uniformity of the shaped part. This research aims to optimise the formed part geometric accuracy and reduce the processing time of a two-stage forming strategy of SPIF. Finite element analysis (FEA) was initially used and validated using experimental literature data. Furthermore, the design of experiments (DoE) statistical approach was used to optimise the proposed two-stage SPIF technique. The mass scaling technique was applied during the finite element analysis to minimise the computational time. The results showed that the step size during forming stage two significantly affected the geometrical accuracy of the part, whereas the forming depth during stage one was insignificant to the part quality. It was also revealed that the geometrical improvement had taken place along the base and the wall regions. However, the areas near the clamp system showed minor improvements. The optimised two-stage strategy successfully decreased both the geometrical inaccuracy and processing time. After optimisation, the average values of the geometrical deviation and forming time were reduced by 25% and 55.56%, respectively.

Comparison Between Silicone Oil and Gas in Tamponading Giant Retinal Breaks.

PURPOSE: The purpose of this study is to compare anatomical and visual outcomes after using silicone oil (SO) or C3F8 gas as tamponades after pars plana vitrectomy (PPV) for retinal detachment (RD) associated with giant retinal tears (GRTs). METHODS: A retrospective chart review was conducted for cases that underwent PPV for GRT-associated RD. We excluded eyes that had prior vitreoretinal surgery, a history of ocular trauma or worse than grade B proliferative vitreoretinopathy (PVR). Baseline demographic and ocular characteristics, surgical details and postoperative anatomical and visual outcomes were recorded and statistically analyzed. RESULTS: We included 88 eyes; 48 eyes had C3F8 gas and 40 eyes had SO as a tamponading agent. Mean age was 39 years. All eyes underwent 23G PPV with no adjuvant scleral buckling and phacovitrectomy was performed for all phakic eyes. Final retinal reattachment was achieved in 86 eyes (97.7%). One eye from each group had recurrent RD. Postoperative vision was significantly better in the gas group (p= 0.008). Prolonged increase of IOP developed in 6 eyes in the SO group and 5 eyes in the gas group. Prolonged uveitis developed in 4 eyes in the gas group and 6 eyes in the oil group (P= 0.04). Epiretinal membranes (ERM) developed in 10 eyes in the gas group and 9 eyes in the oil group. We found no significant difference between both groups regarding postoperative glaucoma or ERM formation. CONCLUSION: Both agents achieved similar favorable anatomical outcomes in a series of eyes with fresh GRT-associated RD and low-grade PVR, with better visual outcome and less frequent uveitis associated with the use of gas tamponade.

Rates and profile of victimization in a sample of Egyptian patients with major mental illness.

BACKGROUND: Patients with major mental illness have an increased risk of victimization. Nevertheless, this topic was not thoroughly studied in Egyptian patients with major mental illness. OBJECTIVES: The objectives of this study are to investigate the rates of victimization and understand its profile, psycho-demographic and clinical correlates among a sample of Egyptian patients with major mental illness. PARTICIPANTS AND METHODS: A total of 300 patients (100 patients with schizophrenia, 100 with bipolar and 100 with major depression) were recruited from the inpatient wards and outpatient clinics at Ain Shams University. They were subjected to a demographic questionnaire, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Global Assessment of Functioning (GAF), Clinical Global Impression (CGI) and a Victimization Questionnaire (VQ). RESULTS: In our study population, 130 (43.3%) of patients were victimized, of them 52 (40%) were diagnosed with major depressive disorder, 48 (36.9%) with bipolar disorder and 30 (23.1%) with schizophrenia. Victimization was more in female, married, unemployed individuals and those living in rural areas. Patients exposed to domestic violence or abuse during childhood had higher rates of victimization. All victimized patients were subjected to emotional victimization, 64.6% were physically victimized and 53.8% were subjected to miscellaneous types of victimization. Patients were victimized mainly by acquaintance followed by family members. The majority of patients did not report their victimization and considered it as a personal issue or not important enough to be reported. CONCLUSION: Patients with major mental illness are susceptible to significant victimization. Clinicians should explore possible history of abuse or victimization in their patients, empower and support the victimized ones.

Validation of the Egyptian Arabic Assessment of Auditory Skills development using children with Cochlear Implants.

INTRODUCTION: Audition is the gateway to spoken language, and infants' early accomplishments in acquiring the sound structure of their native language lays a critical ground work for subsequent learning. The development of pre-lingual auditory perceptual skills for cochlear implanted children is crucial for initial development of oral language. OBJECTIVE: The aims of the present study were to validate the Egyptian Arabic Assessment of Auditory Skills, and to track the development of auditory skills in Egyptian children fitted with CI during the first three years post implantation. METHODS: The study included 90 Arabic Egyptian children attending the phoniatric unit, Kasr El Aini hospital. Their chronological age ranged from 36 to 72 months. The study lasted for 18 months from July 2015 to January 2017. The children were divided into six groups according to their cochlear age i.e., amount of implant experience. An Arabic assessment chart of auditory skills was tailored that included six auditory skills' domains; detection, identification, short term auditory memory, supra-segmental discrimination, segmental discrimination and linguistic auditory processing. This chart was then used to develop an assessment tool which was then applied to all the study participants. All children had bilateral Sensorineural Hearing Loss (SNHL) since birth. None of the participants had prior Cochlear Implant (CI), but all had tried conventional hearing aids. All participants were implanted unilateral, with CI devices. All met selection criteria applied in the Egyptian national insurance committee for cochlear implantation. RESULTS: All auditory skills domains improved with cochlear age. There was significant improvement between 1-6 and 7-12 months in the scores of the Detection (DET) domain. There was significant difference between 1-6 and 7-12 months, 7-12 and 13-18 months, 19-24 and 25-30 months in the scores of the Identification (IDENT) domain. Regarding the Short Term Auditory Memory (STAM) domain scores and the Supra-segmental Discrimination (SSD) domain scores there was significant difference between all the groups. Regarding the Segmental Discrimination (SGD) domain scores, there was significant difference between group 1-6 and 7-12 months, 7-12 and 13-18 months, 19-24 and 25-30 months, 25-30 and 31-36 months. Regarding the Linguistic Auditory Processing (LAP) domain, there was significant difference between group 1-6 and 7-12 months, 7-12 and 13-18 months, 25-30 and 31-36 months. CONCLUSIONS: Children fitted with Cochlear Implants (CIs) appeared to show improvement in acquisition of auditory skills over a period of three years that followed a hierarchy of development dependent on the cochlear age.

Prognostic Value of Polypoid Changes of the Middle Turbinate in Relapsed Nasal Polypi after FESS: A Prospective Cohort Study

Abstract Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups (p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups (p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months (p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.

SPECIAL ARTICLE COVID-19: Covid-19-Related Acute Invasive Fungal Sinusitis: Clinical Features and Outcomes

Abstract Introduction There is a noticeable increase in the incidence of acute invasive fungal sinusitis which coincides with the ongoing coronavirus pandemic. It is a potentiallylethal fungal infection, with the most common form being the rhino-orbito-cerebral presentation. Objectives The aim of the present study is to discuss the different epidemiological factors, risk factors, clinical presentations and outcomes of acute invasive fungal sinusitis which is noticeably related to the coronavirus disease 2019 (Covid-19) pandemic. Methods The present cross-sectional cohort study included 22 adult patients who presented with Covid-19-related acute invasive fungal sinusitis. The diagnosis of acute invasive fungal sinusitis was confirmed by histopathological biopsy. All data, including demographics, risk factors, clinical findings, different lines of treatment and their outcomes, were recorded and analyzed. Results All patients had diabetes mellitus (100%), and 17 (77.3%) had been submitted to systemic steroids. All patients (100%) had unilateral sinonasal disease. Proptosis was found in 15 patients (68.2%), ophthalmoplegia was observed in 12 patients (54.5%), and intracranial affection occurred in 10 patients (45.5%). A total of 20 patients (90.9%) received liposomal amphotericin B. Surgical debridement was performed in 18 patients (45.5%). Non-septated mycelia was present in 19 biopsies (86.4%), while 3 (13.6%) showed septated mycelia. Total improvement was achieved in 10 patients (45.5%), while the mortality rate was of 27.3% (6 out of 22 participants). Conclusion Diabetes mellitus is the most common preexisting medical condition associated with Covid-19-related acute invasive fungal sinusitis. Systemic corticosteroid therapy is considered a predisposing factor. It is necessary to raise the level of awareness to diagnose this condition, especially in patients with Covid-19 infection or those who have recently recovered from it.

Ovarian response and conception rate following oestrus synchronization using three protocols in Egyptian buffalo heifers.

OBJECTIVE: The aim of this study was to monitor the ovarian response and conception rate following estrous synchronization using CIDR, Ovsynch and double prostaglandin F2α protocols in Egyptian buffalo heifers. MATERIAL AND METHODS: A total of 80 cyclic buffalo heifers were divided into four equal groups: CIDR (intravaginal progesterone releasing device, EAZI-BREEDTM CIDR®), Ovsynch (GnRH, PGF2α, GnRH injections), PGF (double PGF2α doses) and control. Timed artificial insemination (TAI) was performed in all heifers. All animals were examined using ultrasound and blood samples were collected for measurement of progesterone. RESULTS: A new follicular wave occurred earlier in the Ovsynch and PGF groups than in the CIDR group (p < 0.05). The mean diameter of the ovulatory follicle was smaller in the CIDR group than in the Ovsynch and PGF groups (p < 0.05). The ovulation rate was 100% in the CIDR group, 75% in the Ovsynch group and 70% in the PGF group. In the control group a lower pregnancy rate (20%) was determined in than in the CIDR (35%), Ovsynch (40%) and PGF (35%) groups. Progesterone concentrations were numerically higher in pregnant heifers of the CIDR group but the difference was non-significantly compared to the Ovsynch, PGF and control groups (p > 0.05). CONCLUSION AND CLINICAL RELEVANCE: EAZI-BREEDTM CIDR®, Ovsynch-based TAI and PGF protocols were effective in synchronizing oestrus and resulted in nearly similar pregnancy rates in Egyptian buffalo heifers.

In Vivo Positional Analysis of Implantable Collamer Lens Using Ultrasound Biomicroscopy.

Purpose. To evaluate the anterior segment, the anatomical position of the implantable collamer lenses (ICL), and its relationship to adjacent ocular structures using Ultrasound Biomicroscopy (UBM). Methods. In a prospective study, 142 myopic eyes of 93 patients implanted with Visian ICL were subjected to UBM examination between March 2010 and January 2015. The relative position of ICL to the adjacent structure and the overall iris configuration were evaluated. The machine calibers were used to measure the minimum central distance between the ICL and anterior lens capsule (vault) and the vertical central distance between the corneal endothelium and the ICL (E-ICL). Results. The mean ICL vault was 376 ± 105 µm. The mean E-ICL was 2826 ± 331 µm. Contact between ICL and the posterior epithelium of the iris was present in all eyes. The overall iris configuration was flat in 89 eyes. Central anterior convexity was present in 41 eyes and mild peripheral iris bombe in 12 eyes. The haptics could be imaged in the ciliary sulcus in 112 eyes and at least one haptic resting on the lens periphery and zonules in 30 eyes. Conclusion. UBM can provide valuable anatomical information that allows detailed postoperative in vivo assessment of ICL.