A new promising approach to urodynamic stress urinary incontinence care can help menopausal women.

Introduction: The goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling. Material and methods: This prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire - Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale). Results: The single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups. Conclusions: Single-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.

A paradigm of higher success rate of intracytoplasmic sperm injection - preovulatory human chorionic gonadotropin-day serum oestradiol.

Introduction: The aim of the study is to evaluate the correlation between the level of serum oestradiol (E2) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome. Material and methods: This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E2 level on the day of hCG administration: Group A - serum E2 < 1000 pg/ml; Group B - serum E2 1000 to < 2000 pg/ml; Group C - serum E2 2000 to < 3000 pg/ml;Group D - serum E2 3000 to < 4000 pg/ml; Group E - serum E2 ≥ 4000 pg/ml. Results: The highest fertilization rate (58.1%) was among women with E2 ≥ 4000 pg/ml, while the lowest (37%) was in women with E2 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E2 > 4000 pg/ml, while the lowest (5.3%) was in women with E2 < 1000 pg/ml. In the current study the median serum E2 level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E2 at hCG administration was ≥ 3682.3 pg/ml. Conclusions: this study suggests that the optimal range of E2 level for achieving a successful pregnancy is > 4000 pg/ml.

A novel injection technique for ilioinguinal nerve block for post-operative pain relief in caesarean delivery - a randomized, double-blind, placebo-controlled trial.

AIM: To determine whether the novel method is successful in blocking both ilioinguinal nerves to lessen postoperative pain following caesarean surgery. MATERIALS AND METHODS: Between January 2022 and January 2023, 300 patients were enrolled in this study at the Obstetrics and Gynaecology Departments of the Faculty of Medicine at Al-Azhar University. About 150 of these patients received bupivacaine infiltration on both sides close to the anterior superior iliac spine, and 150 received a normal saline injection at the same locations. RESULTS: The study compared the two groups and discovered significant differences in the timing of analgesic requests, interval before the patient's first ambulation, length of hospital stay, postoperative pain score, and incidence of postoperative nausea and vomiting, with group A performing better. CONCLUSION: After a caesarean section, the local anaesthetic "bupivacaine" injection used to block the ilioinguinal nerves bilaterally is an efficient way to lessen postoperative discomfort and analgesic use.

Prevalence of negative mental health status during COVID-19 pandemic among general population of seven Arab countries: A cross-sectional study of 28843 participants.

Background: Previous studies documented a narrow scope of knowledge about the negative mental health status during the lockdown following the COVID-19 pandemic, especially in Arab countries. Aim: We aimed to assess the association between negative mental health status and the COVID-19 pandemic and determine the different factors affecting mental health among the general population of seven Arab countries. Methods: This study is a multinational cross-sectional questionnaire-based survey conducted online from June 11, 2020 to June 25, 2020. The depression, anxiety, and stress Scale 21 Items (DASS-21) and the Event scale-Revised Arabic version (IES-R-13) scales were used. Multiple linear regressions were performed to study the association between the scales' total scores with COVID-19 and demographic characteristics. Results: A total of 28,843 participants from seven Arab countries were included. During the COVID-19 pandemic, the prevalence of mental health disorders has significantly increased. A total of 19006 participants (66%) were affected by variable degrees of depression, 13,688 (47%) had anxiety, and 14,374 (50%) had stress ranging from mild to severe. Higher levels were associated with other factors, such as lower age, female gender, chronic disease, unemployed, fear of getting infected, and a history of psychiatric disorders. Conclusion: Our study findings show an increased incidence of mental disorders during the pandemic. This is expected to play a crucial role in guiding a psychological support strategy provided by healthcare systems to the general public during pandemics.

Disruption of GMNC-MCIDAS multiciliogenesis program is critical in choroid plexus carcinoma development.

Multiciliated cells (MCCs) in the brain reside in the ependyma and the choroid plexus (CP) epithelia. The CP secretes cerebrospinal fluid that circulates within the ventricular system, driven by ependymal cilia movement. Tumors of the CP are rare primary brain neoplasms mostly found in children. CP tumors exist in three forms: CP papilloma (CPP), atypical CPP, and CP carcinoma (CPC). Though CPP and atypical CPP are generally benign and can be resolved by surgery, CPC is a particularly aggressive and little understood cancer with a poor survival rate and a tendency for recurrence and metastasis. In contrast to MCCs in the CP epithelia, CPCs in humans are characterized by solitary cilia, frequent TP53 mutations, and disturbances to multiciliogenesis program directed by the GMNC-MCIDAS transcriptional network. GMNC and MCIDAS are early transcriptional regulators of MCC fate differentiation in diverse tissues. Consistently, components of the GMNC-MCIDAS transcriptional program are expressed during CP development and required for multiciliation in the CP, while CPC driven by deletion of Trp53 and Rb1 in mice exhibits multiciliation defects consequent to deficiencies in the GMNC-MCIDAS program. Previous studies revealed that abnormal NOTCH pathway activation leads to CPP. Here we show that combined defects in NOTCH and Sonic Hedgehog signaling in mice generates tumors that are similar to CPC in humans. NOTCH-driven CP tumors are monociliated, and disruption of the NOTCH complex restores multiciliation and decreases tumor growth. NOTCH suppresses multiciliation in tumor cells by inhibiting the expression of GMNC and MCIDAS, while Gmnc-Mcidas overexpression rescues multiciliation defects and suppresses tumor cell proliferation. Taken together, these findings indicate that reactivation of the GMNC-MCIDAS multiciliogenesis program is critical for inhibiting tumorigenesis in the CP, and it may have therapeutic implications for the treatment of CPC.

Efficacy and safety of flow diverters in posterior circulation aneurysms and comparison with their efficacy in anterior circulation aneurysms: A systematic review and meta-analysis.

PURPOSE: We aimed to assess the efficacy and safety of flow-diverter stents (FDs) in the management of posterior circulation cerebral aneurysms and compare FD efficacy between anterior and posterior circulation aneurysms. METHODS: We searched the PubMed, Scopus, Cochrane, and Web of Science databases for relevant studies through March 2020. Studies assessing FDs for posterior circulation aneurysms that included ≥20 treated aneurysms were included. Moreover, the studies compared FD efficacy between anterior and posterior circulation aneurysms were included. Data regarding angiographic aneurysmal occlusion, procedural complications, mortality, and morbidity were extracted and pooled in a random-effects meta-analysis model. RESULTS: Fourteen studies with a total of 659 patients and 676 posterior circulation aneurysms were included. The pooled rate of aneurysmal occlusion at long-term angiographic follow-up was 78% [95% confidence interval (CI), 71-85]. The pooled rates of intraparenchymal hemorrhage, ischemia, and procedure-related mortality and neurological morbidity were 2%, 8%, 7%, and 6%, respectively. Complete occlusion occurred in 82.4% of the posterior circulation aneurysm subgroup and 77.5% of the anterior circulation aneurysm subgroup. The difference was not significant (relative risk 1.01; 95% CI, 0.86-1.19; p = 0.91). Regression analysis showed that elderly patients and females had higher morbidity. CONCLUSION: Posterior circulation aneurysms can be effectively treated with FDs with comparable occlusion rates to those in anterior circulation aneurysms. However, periprocedural complications are not negligible.

The effectiveness of the abdominal binder in relieving pain after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Abdominal binder is a non-pharmacological method of relieving pain after surgical procedures. OBJECTIVES: To evaluate the effectiveness of the abdominal binder in relieving pain and distress scores after cesarean delivery (CD). SEARCH STRATEGY: The following terms were searched: cesarean section, cesarean, caesarean, abdominal deliveries, C-section, abdominal delivery, abdominal binding, binder, and abdominal binder. SELECTION CRITERIA: Randomized controlled trials (RCTs) with patients undergoing CD receiving an abdominal binder compared with non-users of the abdominal binder. DATA COLLECTION AND ANALYSIS: Five electronic databases were searched until November 2019. Records were screened for eligibility. Data were extracted independently and analyzed. The main outcomes were pain and distress scores. RESULTS: The final analysis included six RCTs. Overall effect estimate favored the abdominal binder group over the control group in the following outcomes: VAS pain scores after 24 h (mean difference [MD] -1.76; 95% confidence interval [CI] -3.14 to -0.39; P = 0.01), VAS scores after 48 h (MD -1.21; 95% CI -1.51 to -0.90; P < 0.001), distress score after 24 h (MD -1.87; 95% CI -3.01 to -0.73; P = 0.001), and distress score after 48 h (MD -1.87; 95% CI -3.07 to -0.67; P = 0.002). CONCLUSION: The abdominal binder could be an effective, simple, non-pharmacological option of relieving pain and distress after CD.

Effect of Botulinum Toxin on Equinus Foot Deformity in Cerebral Palsy Patients: A Systematic Review and Network Meta-analysis.

BACKGROUND: Cerebral palsy (CP) is a brain disorder that affects the development, movement and posture leading to limitation of Range of Movement (ROM) in the growing children. CP leads to deformities such as equinus foot deformity. We aim to investigate the efficacy of different botulinum toxin (BTX) products with or without serial casting in reducing the muscle spasticity in equinus foot deformity in patients with CP. METHODS: A systematic review of the literature was performed by searching different electronic databases. Pub- Med, Scopus, Web of Science (WOS), and GHL databases were used. We analyzed the extracted data by network meta-analysis method using the R software package (version 3.5.0). RESULTS: Regarding Modified Ashworth score (MAS), BTX-A was superior compared to placebo and BTX-A plus immediate casting (MD = -0.39, 95% CI [-0.60; -0.18]) and (MD = -0.50, 95% CI [-0.98; -0.02]), respectively. Concerning growth motor function movement Classification System (GMFM), Neuronox ranked above at 3 months (MD = -1.60, 95% CI [-2.87; -0.33]) and at six months (MD = -1.90, 95% CI [-3.48; -0.32]) compared to BTX-A. Regarding the Modified Tardieu scale (MTS) with knee flexion, BTX-A was superior to BTX-A plus immediate casting (MD = 8.60, 95% CI [1.76; 15.44]). Concerning passive range of movement (PROM) with Knee flexion or extension at 3 months, BTX-A showed a significant improvement compared to BTX-A plus immediate casting. CONCLUSION: BTX-A ranked best on a physician rating scale (PRS), MAS, MTS with knee flexion and PROM (Knee flexion and extension) compared to Neuronox and Botulax. BTX-A alone was also better than BTX-A plus immediate casting.

Phosphonium-based Ionic Liquid Modified Activated Carbon from Mixed Recyclable Waste for Mercury(II) Uptake.

The contamination of water surfaces by mercury is a dangerous environmental problem due to its toxicity, which leads kidney damage. Activated carbon from mixed recyclable waste modified by phosphonium-based ionic liquid (IL-ACMRW) was therefore prepared and evaluated for Hg(II) remediation. The activated carbon used in this study was prepared from mixed waste, including cardboard, papers and palm wastes as cheap raw materials. The mixed Recyclable Waste Activated Carbon was combined with trihexyl(tetradecyl)phosphonium Bis2,4,4-(trimethylpentyl)phosphinate (Cyphos® IL 104) ionic liquid to form an adsorbent with organic-inorganic content, in order to improve the Hg(II) uptake from aqueous solutions. FTIR confirms the presence of P, C=O and OH after this modification. The adsorption process was investigated and the evaluated results showed that the capacity was 124 mg/g at pH 4, with a contact time of 90 min, an adsorbent dose of 0.4 g/L, and a Hg(II) concentration of 50 mg/L. This Hg(II) adsorption capacity is superior than that reported in the literature for modified multiwall carbon nanotubes. The adsorption of Hg(II) on the modified activated carbon from mixed recyclable waste was found to follow the pseudo second-order kinetics model. Isotherms of adsorption were analyzed via Freundlich and Langmuir models. The results indicated that Freundlich is the best model to describe the process, suggesting multilayer adsorption.

Pretreatment of wheat straw using basic ethanolamine-based deep eutectic solvents for improving enzymatic hydrolysis.

A series of ethanolamine based deep eutectic solvents (DESs), which have strong basicity, were firstly applied in wheat straw pretreatment. Typically, choline chloride: monoethanolamine (C:M) as the best solvent among these DESs can remove 71.4% lignin and reserve 93.7% cellulose (70 °C, L/S mass ratio of 20:1, 9 h), and improve the enzymatic hydrolysis of residue, i.e., 89.8% cellulose and 62.0% xylan conversion. The pretreatment capacity of C:M is comparable to other solvents while C:M has several advantages, e.g., lower cost with cheap materials and simpler preparation process, mild conditions and lower polysaccharide loss. The XRD, SEM and FT-IR results verified that the polysaccharide conversion and sugars yield were enhanced by the removal of lignin in the pretreatment process. The basic ethanolamine based DESs are promising solvents for industrial application of wheat straw pretreatment.

Cholinium amino acids-glycerol mixtures: New class of solvents for pretreating wheat straw to facilitate enzymatic hydrolysis.

New solvents for pretreating wheat straw, mixtures of cholinium amino acids ionic liquids ([Ch][AA] ILs) and glycerol, were developed. As a typical result, 50% cholinium alanine-glycerol is capable of removing 67.6% lignin while reserving 95.1% cellulose (90°C, L/S mass ratio of 20:1, 6h) and the conversions of cellulose and xylan are 89.7% and 70.9%, respectively, which is comparable to the pretreatment capability of other solvents, while [Ch][AA]-glycerol mixtures have desirable advantages, e.g., biocompatibility, lower cost with adding glycerol than pure IL, much lower pretreatment temperature (typically <100°C) than that by glycerol (typically >200°C). Lignin removal and polysaccharide conversion are dependent on [Ch][AA] content and pH of pretreatment solvents. [Ch][AA] not only remove lignin in wheat straw effectively but also swell cellulose while not remarkably dissolve cellulose with high cellulose reservation, favoring the enzymatic hydrolysis. Such mixtures of ILs and co-solvents are potential solvents for pretreating biomass.

Elimination of the azeotropic point of acetone and methanol by 1,3-dimethylimidazolium dimethylphosphate: an ab initio calculation study.

1,3-Dimethylimidazolium dimethylphosphate ([C1mim][DMP]) was observed experimentally to be able to eliminate the atmospheric azeotropic point of acetone and methanol, which is an important azeotrope generally encountered in furfural production and the Fischer-Tropsch process. Here, we employed ab initio calculation to understand the underlying mechanism of [C1mim][DMP] in eliminating the azeotropic point of acetone and methanol. Structure, energy and interaction in binary-, ternary- and quaternary-clusters composed of methanol, acetone, [C1mim]+ or/and [DMP]‾ were calculated. The σ-hole, AIM and NBO analyses were performed to understand intermolecular interaction with electron density, electron occupancy, charge transfer and molecular orbital interaction. Hydrogen bond interaction plays a key role in azeotropic point elimination; due to the much stronger hydrogen bond interaction between methanol and [C1mim][DMP] than that between acetone and [C1mim][DMP], [C1mim][DMP] prefers to interact with methanol rather than acetone, and the original interaction between methanol and acetone is separated by [C1mim][DMP]. The hydrogen bond is from the orbital interaction between O lone-pair-electron orbitals of the hydrogen bond acceptor and σ * (C-H) or σ * (O-H) anti-bonding orbitals of the hydrogen bond donor, where remarkable electron or charge transfer occurs. These theoretical calculation results are in agreement with the experimental observation that [C1mim][DMP] eliminates the azeotropic point of methanol and acetone. This work shows that ab initio calculation may be employed to rationalize the design or synthesis of ionic liquids for separating azeotropes. Graphical Abstract Elimination of azeotropic point of acetone and methanol by [C1mim][DMP].

Computational fluid dynamics study on mixing mode and power consumption in anaerobic mono- and co-digestion.

Computational fluid dynamics (CFD) was applied to investigate mixing mode and power consumption in anaerobic mono- and co-digestion. Cattle manure (CM) and corn stover (CS) were used as feedstock and stirred tank reactor (STR) was used as digester. Power numbers obtained by the CFD simulation were compared with those from the experimental correlation. Results showed that the standard k-ε model was more appropriate than other turbulence models. A new index, net power production instead of gas production, was proposed to optimize feedstock ratio for anaerobic co-digestion. Results showed that flow field and power consumption were significantly changed in co-digestion of CM and CS compared with those in mono-digestion of either CM or CS. For different mixing modes, the optimum feedstock ratio for co-digestion changed with net power production. The best option of CM/CS ratio for continuous mixing, intermittent mixing I, and intermittent mixing II were 1:1, 1:1 and 1:3, respectively.

Soil-parasites particularly Toxocara eggs in Egypt.

Soil-transmitted helminths (STHs) remain a major threat to the human health throughout the world, mostly in developing nations. Soil is usually contaminated by different parasitic stages through promiscuous defecation of man particularly children. This is more liable to occur in fields, public gardens and sides of streets or canals. Also, feces of domestic and wild animals & birds play a role in soil contamination. This study was conducted at Mansoura city and Batra village & El-Minia city and Zohra village representing the urban and rural areas of Dakahlia Governorate, Lower Egypt and Minia Governorate, Upper Egypt respectively. The most common helminthic stage presents in the soil of the two Governorates was Toxocara eggs. No ova was detected in-door yards in the urban areas, but only in the sides of streets, crop fields and fruit gardens, around houses and canal banks of both Governorates, and the highest intensity was 13-19 eggs/10 gm soil at canal banks at Zohra village, El-Minia Governorate, Upper Egypt.

Past and present situation of human fascioliasis in Dakahlia Governorate, Egypt.

Zoonotic fascioliasis is a problem not only in Dakahlia Governorate, but also in other Egyptian Governorates. This work was conducted in ten centers at Dakahlia Governorate, Egypt. Three thousand cases were randomly selected annually from each center representing five rural and five urban areas. Cases were examined for Fasciola infection by stool examination using, direct smear, formol ether sedimentation and Kato-Katz technique. Infection was higher in rural areas than urban areas. Female /male ratio was 1.5:1. Children between five and ten years old represent the highest infected group. The prevalence of infection was more among illiterate compared to educated individuals examined. Remarkable reduction in the prevalence rate was recorded in the last year of study compared to previous years, which is a good index of excellent control measures conducted by the Egyptian governorate to overcome parasitic infections.