The need for a risk-assessment tool among patients with chronic liver diseases interested in intermittent fasting: Ramadan model.

Liver diseases, especially the chronic type, are a global concern. There is a growing interest in the intermittent fasting model due to its presumed health benefits. Ramadan fasting, although religious fasting, is one of the best examples of intermittent fasting, with some differences, and is observed by more than 1 billion Muslims around the world. This month follows the Arabic Hijri calendar, which is 12 days shorter than the Gregorian calendar; hence, this entire month of fasting may occur in any season of the year. There is evidence that many patients with chronic liver disease are prone to adverse events upon observing this month of continuous intermittent fasting, particularly during the hot summer with prolonged hours of fasting, if they are not adequately addressed and prevented from fasting. There is a need to sound the alarm to develop a risk-assessment tool to omit vulnerable patients with chronic liver disease-who are exempted on religious grounds from observing this pattern of fasting.

Nanolayered Structures and Nanohybrids Based on a Ternary System Co/Ti/Zn for Production of Photo-Active Nanocomposites and Purification of Water Using Light.

Water pollution has emerged as a major challenge for the scientific community because of the rapid expansion of the population and the industrial sector in the world. The current study focuses on introducing a new track for designing new optical nanocomposites for purifying water in addition to providing a new additive for building new nanohybrids. These targets were achieved through building a ternary system of Co/Ti/Zn nanocomposites and nanolayered structures. The Co/Ti/Zn nanolayered structures were prepared and intercalated by different kinds of organic acids: monocarboxylic and dicarboxylic acids. Long chains of organic acids were used to construct series of organic-inorganic nanohybrids. X-ray diffraction, thermal analyses, Fourier Transform Infrared spectroscopy, and scanning electron microscopy confirmed the formation of nanolayered structures and nanohybrids. The optical properties of the nanolayered structure showed that the Co/Ti/Zn LDH became photo-active compared with the usual Al/Zn LDH because of the reduction in the band gap energy from 5.3 eV to 3.3 eV. After thermal treatment, a highly photo-active nanocomposite was produced through observing more reduction for the band gap energy to become 2.8 eV. In addition, the dye of Acid Green 1 completely decomposed and converted to water and carbon dioxide during 17 min of UV radiation by the dual Co/Ti-doped zinc oxide nanocomposite. In addition, the kinetic study confirmed that the high optical activity of the dual Co/Ti-doped zinc oxide nanocomposite accelerated the degradation of the green dyes. Finally, from these results it could be concluded that designing effective nanocomposite for purification of water was accomplished through converting 2D nanolayered structures to a 3D porous structure of Ni/Ti/Zn nanocomposites. In addition, a new additive was achieved for heterostructured hybrids through building new Co/Ti/Zn/organic nanohybrids.

Distal hypospadias repair: Comparative study between snodgrass and transverse preputial onlay flap.

INTRODUCTION: Distal hypospadias repair has several operative strategies such as tubularized incised plate (TIP); Transverse preputial onlay flap (TPOF) and Modified Mathieu Procedure. The aim of our work is to compare between TIP and TPOF techniques in the outcome. MATERIAL AND METHOD: We conducted this comparative study on 66 patients with different types of distal hypospadias divided in two groups A and B for TIP and TPOF respectively. We reported outcome and complications for both TIP and TPOF repair. Our results revealed mean operative time was significantly higher in group B (123.1 ± 6.8 min) than in group A (93.73 ± 3.9 min, P value < 0.001). Postoperative urinary fistula was reported in group A (15.2%) while no fistula in group B (p value = 0.05). The vertical slit appearance of meatus was better in group A (54.5%) than in group B (24.2%, P value 0.023). As regard to hypospadias objective scoring evaluation (HOSE) (Summary Figure) the meatal shape score was higher in group A (1.55 ± 0.51) than in group B (1.24 ± 0.44, p value = 0.0 l), the urinary stream score was significantly higher in group A (1.82 ± 0.39) than in group B (1.97 ± 0.17, p value = 0.04) and the urinary fistula score was significantly higher in group A (3.79 ± 0.60) than in group B (4 ± 0, p value = 0.04). DISCUSSION: Complications are more common after TIP than in TPOF. As regard the meatus shape, the naturally looking vertical slit like meatus was achieved more in the TIP than in TPOF. We advocate further studies with a large number of patients with a long follow up period. CONCLUSION: TPOF is a great option to consider in cases of distal hypospadias because it is an effective technique for primary distal hypospadias repair with a good cosmetic outcome and a low associated complication.

Designing inorganic-magnetic-organic nanohybrids for producing effective photocatalysts for the purification of water.

The present study describes a new strategy for modifying the structure of zinc oxide for removing colored pollutants from water after a few minutes of light irradiation. In this context, the magnetic nanocomposite was combined with the nanolayers of Al/Zn to build inorganic-magnetic nanohybrids. The long chains of hydrocarbons of stearic acid have been used as pillars to widen interlayered spacing among the nanolayers to build organic-magnetic-inorganic nanohybrids. These nanohybrids were used as sources for designing zinc oxide nanohybrids to purify water from the green dyes using UV-light. The optical measurements showed that the nanohybrid structure of zinc oxide led to a clear reduction in the band gap energy from 3.30 eV to 2.75 eV to be more effective. In addition, a complete removal of naphthol green B was achieved after 15 min in the presence of zinc oxide nanohybrid using UV-light. The kinetic study showed that the reaction rate for the photocatalytic degradation of the pollutants was faster than that of the conventional photocatalysts. Finally, this strategy for designing photoactive nanohybrids led to positive results for overcoming environment- and water-related problems using the fast technique for purifying water.

Designing Novel Strategy to Produce Active Nanohybrids in Sunlight for Purification of Water Based on Inorganic Nanolayers, Magnetic Nanocomposites and Organic Species.

Energy and water related problems have attracted strong attention from scientists across the world because of deficient energy and water pollution. Following this line, new strategy depended on preparing nanolayers of Al/Zn and magnetic nanoparticles of cobalt iron oxides nanocomposite in addition to long chains of hydrocarbons of stearic acid to be used as roofs, fillers and pillars; respectively, to design optical-active nanohybrids in sunlight for removing the colored pollutants from water in few minutes. By using long chains of hydrocarbons of stearic acid, X-ray diffraction (XRD) results and TEM images showed expansion of the interlayered spacing from 0.76 nm to 2.02 nm and insertion of magnetic nanoparticles among the nanolayers of Al/Zn. The optical properties and activities showed that the nanohybrid structure based on zinc oxide led to clear reduction of the band gap energy from 3.3 eV to 2.75 eV to be effective in sunlight. Photocatalytic degradation of the dye of acid green 1 confirmed the high activity of the prepared zinc oxide nanohybrids because of a complete removal of the dye after ten minutes in sunlight. Finally, this strategy was effective for producing photo-active nanohybrids for using renewable and non-polluting energy for purifying water.

One-Dimensional Nanoscale Si/Co Based on Layered Double Hydroxides towards Electrochemical Supercapacitor Electrodes.

It is well known that layered double hydroxides (LDHs) are two-dimensional (2D) layered compounds. However, we modified these 2D layered compounds to become one-dimensional (1D) nanostructures destined for high-performance supercapacitors applications. In this direction, silicon was inserted inside the nanolayers of Co-LDHs producing nanofibers of Si/Co LDHs through the intercalation of cyanate anions as pillars for building nanolayered structures. Additionally, nanoparticles were observed by controlling the preparation conditions and the silicon percentage. Scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy and thermal analyses have been used to characterize the nanolayered structures of Si/Co LDHs. The electrochemical characterization was performed by cyclic voltammetry and galvanic charge-discharge technique in 2M KOH electrolyte solution using three-electrode cell system. The calculated specific capacitance results indicated that the change of morphology from nanoparticles or plates to nanofibers had a positive effect for improving the performance of specific capacitance of Si/Co LDHs. The specific capacitance enhanced to be 621.5 F g-1 in the case of the nanofiber of Si/Co LDHs. Similarly, the excellent cyclic stability (84.5%) was observed for the nanofiber. These results were explained through the attribute of the nanofibrous morphology and synergistic effects between the electric double layer capacitive character of the silicon and the pseudo capacitance nature of the cobalt. The high capacitance of ternary Si/Co/cyanate LDHs nanocomposites was suggested to be used as active electrode materials for high-performance supercapacitors applications.

An Effective Photocatalytic Degradation of Industrial Pollutants through Converting Titanium Oxide to Magnetic Nanotubes and Hollow Nanorods by Kirkendall Effect.

Controlling of morphology from nanoparticles to magnetic nanotubes and hollow nanorods are interesting for developing the photo-active materials and their applications in the field of photocatalysis and decontamination of aquatic effluents. In the current study, titanium dioxide nanoparticles and nanocomposites were prepared by different techniques to produce various morphologies. The nanoparticles of pure titanium dioxide were prepared by sol-gel technique. Magnetic nanotubes and hollow nanorods were prepared by combining titanium with di- and tri-valent iron through two stages: urea hydrolysis and solvent thermal technique. According to the Kirkendall effect, magnetic nanotubes were fabricated by unequal diffusion of Fe2+, Fe3+ and Ti4+ inside the nanocomposite to produce maghemite-titanian phase. In the same trend, hollow nanorods were synthesized by limited diffusion of both trivalent iron and tetravalent titanium producing amorphous structure of titanium iron oxides. The magnetic and optical properties showed that these nanotubes and hollow nanorods are magnetically active and optically more effective compared with titanium dioxide nanoparticles. Therefore, the Naphthol green B dye completely disappeared after 45 min of UV light irradiation in presence of the hollow nanorods. The kinetic study confirmed the high performance of the hollow nanorods for the photocatalytic degradation of Naphthol green B compared with titanium dioxide nanoparticles.

Ewing sarcoma outcomes in a country with limited resources: Egypt as an example.

As the scarcity of published research that comprehensively and meticulously analyzed the patient, disease, and treatment factors of prognostic significance in Ewing sarcoma (EWS) in Egypt; This study aimed at assessing survival outcomes of EWS in Upper Egypt, delineating factors of prognostic significance in comparison to other leading oncology centers in Egypt and internationally. By retrospectively reviewing medical records of 85 patients with a verified diagnosis of EWS in the period from 2001 to 2015 at Pediatric and Medical Oncology Departments at South Egypt Cancer Institute; We gathered data relevant to the patient, disease, and treatment variables of the study. Survival was estimated using the Kaplan Meier method and differences between various groups were determined by log rank test. Univariable and multivariable analyses were performed using Cox regression. With a median follow-up period of 62.7 months (95% CI 52.2-73.2, SE=5.4) for the study patients, the estimates of event-free survival (EFS) and overall survival (OS) at 3 and 5 years were 42.1% and 50.6%, and 40.8% and 48.5%, respectively. Metastatic disease at initial presentation (HR=8.91, 95% CI, 4.00-19.9; P<0.0001) stood as the most powerful predictor of OS in the multivariable analysis, followed by surgery used as a local modality (HR=0.16, 95% CI, 0.06-0.44; P=0.0004). Response to neoadjuvant chemotherapy (HR=2.61, 95% CI, 1.11-6.13; P=0.028), primary tumor size (HR=2.49, 95% CI, 1.03-6.03; P=0.044) were also shown to be significantly associated with OS. Radiotherapy as a local modality, whose effect, apparently shown to increase the hazard of events occurrence in the univariable analysis, an effect that was reversed to reveal EFS advantage (HR=0.41, 95% CI, 0.18-0.95; P=0.036) after control of other variables. With 5-year OS of 48.5%, our survival results were comparable to those previously published from Egypt; however, differences still exist between centers due to varied representative study samples. However, outcomes in Egypt in general are still inferior to internationally published studies.

New Pulmonary Infiltrates Observed on Computed Tomography-Based Image Guidance for Radiotherapy Warrant Diagnostic Workup for Coronavirus Disease 2019.

INTRODUCTION: Screening for coronavirus disease 2019 (COVID-19) exposure, coupled with engaged decision making to prioritize cancer treatment in parallel with reducing risk of exposure and infection, is crucial in the management of COVID-19 during cancer treatment. After two reported case studies of imaging findings during daily computed tomography (CT)-based image-guided radiotherapy (RT) scans, a call for submission of anonymized case reports was published with the objective of rapidly determining if there was a correlation between the onset of new pulmonary infiltrates found during RT and COVID-19. We hereby report the results of the aggregate analysis. METHODS: Data of deidentified case reports for patients who developed biochemically confirmed COVID-19 during RT were submitted through an online portal. Information requested included a patient's sex, age, cancer diagnosis and treatment, and COVID-19 diagnosis and outcome. Coplanar CT-based imaging was requested to reveal the presence or absence of ground-glass opacities or infiltrates. RESULTS: A total of seven reports were submitted from Turkey, Spain, Belgium, Egypt, and the United States. Results and imaging from the patients reported by Suppli et al. and McGinnis et al. were included for a total of nine patients for analysis. All patients were confirmed COVID-19 positive using polymerase chain reaction-based methods or nasopharyngeal swabs. Of the nine patients analyzed, abnormalities consistent with ground-glass opacities or infiltrates were observed in eight patients. CONCLUSIONS: This is the largest case series revealing the potential use of CT-based image guidance during RT as a tool for identifying patients who need further workup for COVID-19. Considerations for reviewing image guidance for new pulmonary infiltrates and immediate COVID-19 testing in patients who develop new infiltrates even without COVID-19 symptoms are strongly encouraged.

Role of post-therapy 99mTc-MIBI single-photon emission computed tomography/computed tomography scan in predicting survival in patients with high-grade glioma.

OBJECTIVE: High-grade gliomas (HGGs) carry dismal prognosis with survival typically reported as less than a year. We explored the predictive value of qualitative and quantitative evaluations of post-treatment 99m-technetium-labelled methoxyisobutylisonitrile (99mmTc-MIBI) brain single-photon emission computed tomography-computed tomography (SPECT/CT) tumor uptake in relation to overall survival (OS) in patients with HGG. METHODS: Thirty patients with pathologically or radiologically documented high-grade glioma (HGG) were prospectively recruited for this study (24 male, 6 female; mean age 43 ± 14 years). All patients had a clinical or radiological suspicion of residual/recurrent tumor after initial therapy. 99mTc-MIBI brain SPECT/CT scanning was performed, and the scans were evaluated qualitatively on a five-point probability score (1-5, scores ≥3 considered positive for residual/recurrent tumor); and quantitively via drawing volumes of interest (VOI) on the suspected lesions and normal contralateral brain tissue. All patients were followed up for 1 year or till death. RESULTS: Positive visual MIBI results were associated with poor survival. Among 10 patients with negative MIBI scores, only two patients died (OS = 75%), while 11/20 patients reported positive on MIBI died, with a median survival of 9 months (OS = 14.5%; P = 0.03). All patients with active isocontour volume ≤1.96 cm3 were alive at the end of the study, compared to a median survival of 9 months and OS of 12% for patients with an isocontour volume of >1.97% (P = 0.003). CONCLUSION: In patients with HGG, post-therapy brain SPECT/CT with 99mTc-MIBI can provide useful prognostic information.

Preoperative CT staging of borderline pancreatic cancer patients after neoadjuvant treatment: accuracy in the prediction of vascular invasion and resectability.

OBJECTIVES: To assess the utility of MDCT tumor-vascular interface criteria for predicting vascular invasion and resectability in borderline pancreatic cancer (BRPC) patients after neoadjuvant therapy (NAT). METHODS: This prospective study included 90 patients with BRPC who finished NAT, showed no progression in preoperative CTs and underwent surgery. Two radiologists independently assessed preoperative vessel-tumor interface criteria. The area under the ROC curve (AUC) was used to evaluate the diagnostic performance for predicting vascular invasions and resectability using surgical and pathological results as the gold standard. Inter-reader agreement was assessed using the κ coefficient. RESULTS: Pathologic vascular invasion was confirmed in 47 (54.7%) veins and 14 (16.3%) arteries. R0 resection was achieved in (82.6%71/86) pancreatic resection. Using criteria of circumferential interface ≥ 180 degrees with contour deformity ≥ grade 3 and/or length of tumor contact > 2 cm to predict vascular invasion, the AUCs for the two readers were 0.85-0.88 for arterial invasion and 0.92-0.87 for venous invasion. Using criteria of circumferential interface ≤ 180° with contour deformity ≤ grade 2 and/or length of tumor contact < 2 cm to predict R0 resection, the AUCs was 0.85-0.86 for the two readers. The overall inter-reader agreement was good (κ = 0.75-0.80). The κ values for venous invasion, arterial invasion and R0 resection were 0.76, 0.78, and 0.80. CONCLUSION: Tumor-vessel criteria demonstrated good diagnostic performance and reproducibility in the prediction of vascular invasion after NAT in BRPC. These criteria could be helpful in the prediction of R0 resection in cases with only venous involvement.

Conversion of Non-Optical Material to Photo-Active Nanocomposites through Non-Conventional Techniques for Water Purification by Solar Energy.

Development of optical materials has attracted strong attention from scientists across the world to obtain low band gap energy and become active in field of solar energy. This challenge, which cannot be accomplished by the usual techniques, has overcome through the current study using non-conventional techniques. This study has used explosive reactions to convert non-optical alumina to series of new optical nanocomposites with very low band gap energy for the first time. In this trend, alumina nanoparticles were prepared and modified by explosive reactions using ammonium nitrate as a solid fuel. By using methanol or ethanol as a source of carbon species, three nanocomposites were produced indicating a gradual reduction of the band gap energy of alumina from 4.34 eV to 1.60 eV. These nanocomposites were obtained by modifying alumina via two different carbon species; core-shell structure and carbon nanotubes. This modification led to sharp reduction for the band gap energy to become very sensitive in sunlight. Therefore, these nanocomposites caused fast decolorization and mineralization of green dyes after illuminating in sunlight for ten minutes. Finally, it can be concluded that reduction of the band gap energy introduces new optical materials for developing optical nano-devices and solar cells.

Accelerating the Photocatalytic Degradation of Green Dye Pollutants by Using a New Coating Technique for Carbon Nanotubes with Nanolayered Structures and Nanocomposites.

The present study has two aims, first to accelerate the degradation of pollutants by coating carbon nanotubes (CNTs) with nanoplatelets or nanocomposites of aluminum zinc oxides and second to fabricate an advanced photocatalyst. Accordingly, Zn-Al layered double hydroxides (LDHs) were grown in the presence of functionalized CNTs during urea hydrolysis. The presence of CNTs led to the formation of LDH nanoplatelets, and TEM images showed that the CNTs were coated with nanoplatelets. The nanoplatelets were thermally treated to form nanocomposite-coated CNTs. Raman spectra demonstrated the successful coating of CNTs with LDHs and nanocomposite. The coated CNTs were very effective in the photocatalytic degradation of industrial pollutants. A kinetics study demonstrated that the rate of photocatalytic degradation of green dye in the presence of CNTs coated with aluminum zinc oxide nanocomposite was five times faster than with the aluminum zinc oxide nanocomposite.

Perioperative use of cyproterone acetate with transurethral resection of large prostate: preliminary results.

PURPOSE: To assess the impact of short-term treatment with cyproterone acetate (CPA) on intraoperative and early postoperative complications of transurethral resection of relatively large prostate. PATIENTS AND METHODS: We recruited patients with prostate size of 60-90 g and randomized them into two equal groups. The first one had 50 mg of CPA orally twice a day (bds) for 2 weeks before the operation and maintained it for an extra week postoperatively. The other group received placebo. All patients underwent monopolar transurethral prostatectomy (M-TURP) and the prostatic chips were stained for CD34 specific for nascent blood vessels. RESULTS: Ninety-five patients were included. Mean patient age was 60.88±2.5 years and mean prostate size was 72.76±7.21 g. CPA was well tolerated with no serious adverse effects. The mean resection time and the mean weight of the resected tissue were comparable between the two groups. Intraoperative blood loss, fluid absorption, and blood loss per gram of resected tissue (259.47±78.27 mL, 787.38±300.56 mL, and 14.87±4.02 mL/g and 327.25±98.97 mL, 937.4±350.2 mL, and 17.08±5.55 mL/g, respectively) were significantly lower in the treatment group (p<0.05). In addition, excessive postoperative bleeding was encountered in one case in the treatment group and in seven in the control (p<0.05). Finally, the histopathological study revealed that the mean microvessel density in each of the suburethral portion and the hyperplastic nodules of the prostate was significantly lower in the CPA group (p<0.001). CONCLUSION: The perioperative use of CPA with M-TURP of a relatively large prostate may help in decreasing the perioperative bleeding and fluid absorption that usually take place during this procedure.