Background With the growing incidence of children with coronavirus disease 2019 (COVID-19), the h... more Background With the growing incidence of children with coronavirus disease 2019 (COVID-19), the hospitalization rate in this age category has been increasing. This study aimed to assess the length of hospital stay (LOS) among children with COVID-19 and examine potential risk factors. Patients and methods We retrospectively collected data on 50 consecutive children and adolescents with mild to moderate COVID-19 who were discharged after treatment from one hospital in Egypt during July 2020. Betas (Bs) and their 95% confidence intervals (CIs) for the association of patients' sociodemographic and clinical characteristics with their LOS were computed using unadjusted and multivariable-adjusted linear regression models. Results The average LOS was 8.3 days (median 9 days). Presenting with fever, cough, and ground-glass opacity in radiograph was associated with longer LOS in the unadjusted model with Bs (95% CIs): 4.30 (1.07, 7.52), 3.50 (0.34, 6.66), and 5.55 (2.72, 8.37), respectively. In the multivariable-adjusted model, only ground-glass opacity in radiograph remained statistically associated with longer LOS (B = 4.75, 95% CI: 0.31, 9.20). Conclusion Children and adolescents with COVID-19 stayed in the hospital for a relatively short period. Selected clinical and radiological findings may be associated with longer LOS.
Objective Evaluation of immediate and 6-month postoperative (PO) outcomes of laparoscopic repair ... more Objective Evaluation of immediate and 6-month postoperative (PO) outcomes of laparoscopic repair of unilateral indirect inguinal hernia (IIH) and comparison of outcomes of purse-string versus stitch closure of the deep inguinal ring (DIR). Patients and methods The study included 84 children who had unilateral IIH, and they were randomly divided into two groups: group I included patients who underwent sac disconnection and stitch closure, and group II included patients who underwent purse-string suture closure of DIR without manipulation or sac dissection. PO pain sensation was evaluated using the observational pain-discomfort scale. Time till first oral intake, length of PO hospital stay, and immediate and 6-month PO outcomes were determined. Results One patient in group I was converted to open procedure and another patient in group II required sac disconnection. Patients of group II had significantly shorter operative time, lower collective observational pain-discomfort scale pain score, and shorter time till first oral intake and duration of PO hospital stay compared with patients of group I. A total of three (3.6%) patients developed port site wound infection. At the end of follow-up, in group I, one patient developed hydrocele and three patients developed recurrent hernia, for a 6-month PO complication rate of 9.8%. In group II, one (2.4%) patient developed recurrent hernia. Conclusion Application of laparoscopic purse-string suture closure of the DIR shortens operative time, time till first oral intake, and home return of children with unilateral IIH with low 6-month recurrence rate than disconnection and stitch closure of the DIR (2.4 vs. 7.3%).
Gaucher disease is a rare genetic disorder characterized by the deposition of glucocerebroside in... more Gaucher disease is a rare genetic disorder characterized by the deposition of glucocerebroside in cells of the macrophage-monocyte system. Gaucher disease is an inborn error of metabolism that affects the recycling of cellular glycolipids. This disease is a consequence of deficiency of the enzyme glucocerebrosidase. It causes bone pain, anemia, enlarged organs, painful belly and bruising and bleeding problems. There are many types of Gaucher disease, all cause similar symptoms in the organs and bones. Some forms of the disease also affect the brain. There is no cure for Gaucher disease, but a variety of treatments can help control symptoms, prevent irreversible damage and improve quality of life. Enzyme replacement therapy is the primary form of treatment for Gaucher disease. Types of Gaucher disease GD has 3 main types, namely, non-neuronopathic (type I), acute neuronopathic (type II), and chronic neuronopathic (type III), primarily based on the central nervous system involvement. There are 2 rarer subtypes, the perinatal-lethal form and the cardiovascular form. The perinatal lethal type can begin before birth or in early infancy. Type I affects spleen, liver, bone, and bone
Titanium dioxide (TiO2) NPs have been broadly used in sunscreens, personal care, paint, pharmaceu... more Titanium dioxide (TiO2) NPs have been broadly used in sunscreens, personal care, paint, pharmaceutical and food products, but it has the ability to generating radical’s oxygen species (ROS) including oxidative stress, lipid peroxidation and DNA damage. So, the study evaluated the ameliorative effects of Turmeric and/or Graviola extract against the titanium dioxide nanoparticles (TiO2) on rats for 1 month. Methods: The study was conducted in 80 Adult male of Swiss Albino rats which divided equally to eight groups: 1st was control: The rats were kept under standard condition, 2nd was Turmeric: The animals received Turmeric 400 mg/kg body weight orally, 3rd was Graviola: The animals received Graviola 400 mg/kg body weight orally, 4th was Turmeric + Graviola: The animals received Turmeric and Graviola, 5th was TiO2: The animals received 600 mg/kg body weight TiO2 orally, 6 th was TiO2 + Turmeric: The animals received TiO2 and Turmeric, 7 th was TiO2 + Graviola: The animals received TiO2...
Titanium dioxide (TiO2) nanoparticles (NPs) are used as a white pigment in the production of pain... more Titanium dioxide (TiO2) nanoparticles (NPs) are used as a white pigment in the production of paints, plastics, foods, paper, cosmetics and toothpaste. Although the wide ranges of uses, there is not enough information on the effect of TiO2NPs on animal and human health. Our study evaluated the ameliorative effects of Turmeric and/or Graviola extract against the titanium dioxide nanoparticles (TiO2NPs) on rats for 1 month. The study was performed in 80 Adult male Albino rats and divided into eight groups. Rats were administered TiO2 NPs by 600 mg/Kg body weight (BW) orally, Turmeric by 400 mg/kg BW orally and Graviola by 400 mg/kg BW orally. Administration of TiO2NPs induced a highly significant increase in serum Creatinine levels, BUN levels and MDA in addition, TiO2NPs rats exhibited anemia, thrombocytopenia, leukocytosis and significantly decrease in catalase. Also TiO2NPs induced histological alterations in the kidney. But groups that were administrated with Turmeric and /or Gravi...
Thyroid hormones have been known to regulate the energy metabolism of most tissues including live... more Thyroid hormones have been known to regulate the energy metabolism of most tissues including liver. Alterations in their normal levels cause some biochemical and clinical abnormalities such as hypothyroidism and hyperthyroidism. The present study evaluated the effect of thyroid hormone, L-thyroxin on liver of albino rats. Additionally the ameliorating role of folic acid supplementation was investigated. Fifty male albino rats were randomly divided into five groups (group I, control; group II, folic acid; group III, L-thyroxin sodium administration (100 μg/kg / body weight); group IV, L-thyroxin and folic acid group and V, recovery group). The results showed that there were a significant increase in ALT, AST, MDA and nitric oxide in L-thyroxin treated rats as compared to control group. On the other hand, a significant decrease in glutathione (GSH) in L-thyroxin treated rats as compared to control group. Histological results showed that liver sections of Lthyroxin group showed histopathological lesions such as leucocytic infiltrations, congestion of central and portal veins and cytoplasmic vacuolation of hepatocytes with the presence of pyknotic nuclei, in addition to fatty infiltration. Immunohistochemical results revealed that strong positive expression of PCNA, P53, and Bcl-2 were detected in the liver section in L-thyroxin treated rats and recovered rats as compared to control and folic acid groups. However; mild to moderate positive expressions of PCNA, P53, and Bcl-2 were observed in rats treated with L-thyroxin and folic acid in liver section. This reflects oxidative stress associated with hyperthyroid state.
International Journal of Medical Science and Clinical invention, 2019
A substantial number of patients admitted to the ICU because of an acute illness, complicated sur... more A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as “intensive care unit acquired weakness” (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy. ICUAW is typically symmetrical and affects predominantly proximal limb muscles and respiratory muscles, whereas facial and ocular muscles are often spared. ICUAW is diagnosed in awake and cooperative patients by bedside manual testing of muscle strength and the severity is scored by the Medical Research Council sum score. In cases of atypical clinical presentation or evolution, additional electrophysiological t...
Background/Purpose: Gastric antral vascular ectasia(GAVE) can cause recurrent bleeding and chroni... more Background/Purpose: Gastric antral vascular ectasia(GAVE) can cause recurrent bleeding and chronic anemia in children with portal hypertension(PHT). We aimed to evaluate the efficacy of EBL in comparison to argon plasma coagulation(APC) in children with PHT, bleeding from GAVE. Methods: This Prospective comparative study included 40 children with PHT who presented with non-variceal GIT bleeding from GAVE. Patients were divided into 2 groups, each including 20 cases: one group were managed with APC and the other with EBL. Endoscopy was repeated every 3-4 weeks until complete ablation of GAVE. Patients were re-evaluated earlier in the event of recurrence of bleeding or in case of severe anemia necessitating blood transfusion. A follow-up endoscopy was done 6 months after the last APC or EBL session. Results: The ages ranged between 2 to 16 years. The EBL group required a significantly lower number of sessions for complete obliteration of the lesions (1.85±0.81) as compared to APC group(4.15±1.22), p<0.05. EBL was superior to APC as regards; shorter procedure time(p=0.001), lower blood transfusion requirement(p<0.05), less hospitalization(p<0.05) and significantly lower recurrence rate of GAVE after 6 months follow up(p=0.01) Conclusions: EBL is more effective and time saving when compared to APC in treatment of bleeding from GAVE in children.
Background: Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in a... more Background: Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in adolescents was based on clinical trials on patients mainly with genotype 1. We aimed to evaluate the effectiveness and short-term safety of this newly approved antiviral in adolescents with HCV genotype 4. Methods: This was a study of 51 HCV-infected adolescents, who received the adult dose of ledipasvir/sofosbuvir, once daily for 12 weeks, and were followed-up for 12 weeks post-treatment. Laboratory tests, quantitation of HCV RNA, HCV genotyping, IL-28rs gene polymorphism and transient elastography were performed at baseline. Follow-up visits were done for blood testing and adverse events recording. Results: The mean age was 14.7 ± 1.5 years (11-17.5), with a male to female ratio of 1.7:1. All patients were genotype 4a, and 76.5% had the CC IL-28 gene polymorphism. About 50% gave a history of HCV-infected mother, and 31% were treatment-experienced. Liver stiffness was F0 in 72.5%, F0-F1 in 13.7% and F1-F2 in 13.7%. Adverse events were mainly abdominal pain in 72.5%, headache in 64.7% and diarrhea in 53% of patients; these were mild. A reversible increase in creatinine level with a concomitant decline in estimated glomerular filtration rate was observed in the first month of treatment. By the end of week 12, a significant decline in liver enzymes was observed. All patients achieved an early, end of treatment, and a sustained virologic response. Conclusions: Adolescent patients with genotype 4 chronic HCV infection achieved a good response rate with good ontreatment tolerability for ledipasvir/sofosbuvir therapy.
Objective The aim of the present study was to evaluate the surgical and functional outcome of the... more Objective The aim of the present study was to evaluate the surgical and functional outcome of the laparoscopic-aided transanal pull-through procedure for the management of Hirschsprung’s disease (HD). Patients and methods The study included 17 patients older than 12 months. Diagnosis of HD relied on the inability of the patients to relax the anal internal sphincter in response to colonic extension on anorectal manometry. The laparoscopic part entailed transition zone identification, seromuscular biopsy for fresh frozen histopathology, and sigmoid and rectal mobilization up to 1 cm down the peritoneal reflection. The transanal part included mobilization of the rectal lower by 2 cm, resection till the ganglionic segment, and anastomosis. Patient outcome included evaluation of fecal consistency, frequency of soiling, and presence of perianal skin excoriation at 1, 3, and 6 months after the procedure. Colonic manometry and functional outcome evaluation according to qualitative clinical Holschneider scoring were carried out at 1 and 6 months after the procedure. Results One (5.9%) patient required open conversion for dissection of thick adhesions. Frequency of patients that passed formed stool and free of soiling increased progressively till the end of 6 months after the procedure. At 1 month after the procedure, six patients developed perianal skin excoriation, but all were free by the sixth postoperative (PO) month. Manometric pressure measures at 3 and 6 months after the procedure were significantly higher compared with the preoperative measures, with significant difference in favor of 6-month measures. At 6 months after the procedure, Holschneider scoring was significantly higher compared with that at 1 month, and 10 patients had a score of 14. No surgery-related complications were detected. Conclusion Laparoscopic-aided transanal pull-through is a feasible procedure for the management of children older than 12 months and who have HD. The procedure is safe with minimal PO complications, which are gradually resolved within 6 months PO.
Objective The aim of this study is to evaluate the safety and efficacy of laparoscopic splenectom... more Objective The aim of this study is to evaluate the safety and efficacy of laparoscopic splenectomy (LS) in the management of benign hematologic and splenic diseases in children. Patients and methods Thirty-eight patients, with the mean age of 10.4±4.3 years, underwent LS between May 2010 and November 2014; out of them, 92.1% suffered from benign hematologic diseases and 7.9% suffered from benign splenic diseases. The indication of splenectomy was different according to the underlying disease. Results The rate of conversion to open surgery was 5.2% and to hand-assisted procedure was 7.8%. The mean operative time was 148.4±26.7?min and the mean duration of hospital stay was 4.5±1.6 days. Five (13.1%) patients had accessory spleen diagnosed and removed successfully and one patient was diagnosed with missed accessory spleen. Postoperative complications were observed in five (13.1%) patients, which are wound infection (one patient), incisional hernia (one patient), upper respiratory tract infection (two patients), and missed accessory spleen (one patient). No mortality was reported in the study. Conclusion LS is well tolerated and effective in the management of benign hematologic and splenic diseases. It has many advantages over open surgery and should be the standard option in the surgical treatment of such cases.
In this work, we study the flow and heat transfer characteristics of a viscous nanofluid over a n... more In this work, we study the flow and heat transfer characteristics of a viscous nanofluid over a nonlinearly stretching sheet in the presence of thermal radiation, included in the energy equation, and variable wall temperature. A similarity transformation was used to transform the governing partial differential equations to a system of nonlinear ordinary differential equations. An efficient numerical shooting technique with a fourth-order Runge-Kutta scheme was used to obtain the solution of the boundary value problem. The variations of dimensionless surface temperature, as well as flow and heat-transfer characteristics with the governing dimensionless parameters of the problem, which include the nanoparticle volume fraction ϕ, the nonlinearly stretching sheet parameter n, the thermal radiation parameter N R , and the viscous dissipation parameter Ec, were graphed and tabulated. Excellent validation of the present numerical results has been achieved with the earlier nonlinearly stret...
International Communications in Heat and Mass Transfer, 2011
This work is focused on the study of the natural convection boundary-layer flow over a downward-p... more This work is focused on the study of the natural convection boundary-layer flow over a downward-pointing vertical cone in a porous medium saturated with a non-Newtonian nanofluid in the presence of heat generation or absorption. The transformed boundary layer governing equations are solved numerically. The influences of pertinent parameters such as the heat generation or absorption, the solid volume fraction of nanoparticles and the type of nanofluid on the flow and heat transfer rate in terms of Nusselt number are discussed. Comparisons with previously published work on special cases of the problem are performed and found to be in excellent agreement. The generalized governing equations derived in this work can be applied to different cases of non-Newtonian fluids with different values of the power-law viscosity index. The results of this parametric study are shown graphically and the physical aspects of the problem are highlighted and discussed
Our zero-copy ATM Memory-Integrated Network Interface targets 1-Gbps bandwidth with 1.2-p4 latenc... more Our zero-copy ATM Memory-Integrated Network Interface targets 1-Gbps bandwidth with 1.2-p4 latency for applications that need to send or receive data at very frequent intervals. Applications can send or receive packets without operating system support, initiate packet
Background With the growing incidence of children with coronavirus disease 2019 (COVID-19), the h... more Background With the growing incidence of children with coronavirus disease 2019 (COVID-19), the hospitalization rate in this age category has been increasing. This study aimed to assess the length of hospital stay (LOS) among children with COVID-19 and examine potential risk factors. Patients and methods We retrospectively collected data on 50 consecutive children and adolescents with mild to moderate COVID-19 who were discharged after treatment from one hospital in Egypt during July 2020. Betas (Bs) and their 95% confidence intervals (CIs) for the association of patients' sociodemographic and clinical characteristics with their LOS were computed using unadjusted and multivariable-adjusted linear regression models. Results The average LOS was 8.3 days (median 9 days). Presenting with fever, cough, and ground-glass opacity in radiograph was associated with longer LOS in the unadjusted model with Bs (95% CIs): 4.30 (1.07, 7.52), 3.50 (0.34, 6.66), and 5.55 (2.72, 8.37), respectively. In the multivariable-adjusted model, only ground-glass opacity in radiograph remained statistically associated with longer LOS (B = 4.75, 95% CI: 0.31, 9.20). Conclusion Children and adolescents with COVID-19 stayed in the hospital for a relatively short period. Selected clinical and radiological findings may be associated with longer LOS.
Objective Evaluation of immediate and 6-month postoperative (PO) outcomes of laparoscopic repair ... more Objective Evaluation of immediate and 6-month postoperative (PO) outcomes of laparoscopic repair of unilateral indirect inguinal hernia (IIH) and comparison of outcomes of purse-string versus stitch closure of the deep inguinal ring (DIR). Patients and methods The study included 84 children who had unilateral IIH, and they were randomly divided into two groups: group I included patients who underwent sac disconnection and stitch closure, and group II included patients who underwent purse-string suture closure of DIR without manipulation or sac dissection. PO pain sensation was evaluated using the observational pain-discomfort scale. Time till first oral intake, length of PO hospital stay, and immediate and 6-month PO outcomes were determined. Results One patient in group I was converted to open procedure and another patient in group II required sac disconnection. Patients of group II had significantly shorter operative time, lower collective observational pain-discomfort scale pain score, and shorter time till first oral intake and duration of PO hospital stay compared with patients of group I. A total of three (3.6%) patients developed port site wound infection. At the end of follow-up, in group I, one patient developed hydrocele and three patients developed recurrent hernia, for a 6-month PO complication rate of 9.8%. In group II, one (2.4%) patient developed recurrent hernia. Conclusion Application of laparoscopic purse-string suture closure of the DIR shortens operative time, time till first oral intake, and home return of children with unilateral IIH with low 6-month recurrence rate than disconnection and stitch closure of the DIR (2.4 vs. 7.3%).
Gaucher disease is a rare genetic disorder characterized by the deposition of glucocerebroside in... more Gaucher disease is a rare genetic disorder characterized by the deposition of glucocerebroside in cells of the macrophage-monocyte system. Gaucher disease is an inborn error of metabolism that affects the recycling of cellular glycolipids. This disease is a consequence of deficiency of the enzyme glucocerebrosidase. It causes bone pain, anemia, enlarged organs, painful belly and bruising and bleeding problems. There are many types of Gaucher disease, all cause similar symptoms in the organs and bones. Some forms of the disease also affect the brain. There is no cure for Gaucher disease, but a variety of treatments can help control symptoms, prevent irreversible damage and improve quality of life. Enzyme replacement therapy is the primary form of treatment for Gaucher disease. Types of Gaucher disease GD has 3 main types, namely, non-neuronopathic (type I), acute neuronopathic (type II), and chronic neuronopathic (type III), primarily based on the central nervous system involvement. There are 2 rarer subtypes, the perinatal-lethal form and the cardiovascular form. The perinatal lethal type can begin before birth or in early infancy. Type I affects spleen, liver, bone, and bone
Titanium dioxide (TiO2) NPs have been broadly used in sunscreens, personal care, paint, pharmaceu... more Titanium dioxide (TiO2) NPs have been broadly used in sunscreens, personal care, paint, pharmaceutical and food products, but it has the ability to generating radical’s oxygen species (ROS) including oxidative stress, lipid peroxidation and DNA damage. So, the study evaluated the ameliorative effects of Turmeric and/or Graviola extract against the titanium dioxide nanoparticles (TiO2) on rats for 1 month. Methods: The study was conducted in 80 Adult male of Swiss Albino rats which divided equally to eight groups: 1st was control: The rats were kept under standard condition, 2nd was Turmeric: The animals received Turmeric 400 mg/kg body weight orally, 3rd was Graviola: The animals received Graviola 400 mg/kg body weight orally, 4th was Turmeric + Graviola: The animals received Turmeric and Graviola, 5th was TiO2: The animals received 600 mg/kg body weight TiO2 orally, 6 th was TiO2 + Turmeric: The animals received TiO2 and Turmeric, 7 th was TiO2 + Graviola: The animals received TiO2...
Titanium dioxide (TiO2) nanoparticles (NPs) are used as a white pigment in the production of pain... more Titanium dioxide (TiO2) nanoparticles (NPs) are used as a white pigment in the production of paints, plastics, foods, paper, cosmetics and toothpaste. Although the wide ranges of uses, there is not enough information on the effect of TiO2NPs on animal and human health. Our study evaluated the ameliorative effects of Turmeric and/or Graviola extract against the titanium dioxide nanoparticles (TiO2NPs) on rats for 1 month. The study was performed in 80 Adult male Albino rats and divided into eight groups. Rats were administered TiO2 NPs by 600 mg/Kg body weight (BW) orally, Turmeric by 400 mg/kg BW orally and Graviola by 400 mg/kg BW orally. Administration of TiO2NPs induced a highly significant increase in serum Creatinine levels, BUN levels and MDA in addition, TiO2NPs rats exhibited anemia, thrombocytopenia, leukocytosis and significantly decrease in catalase. Also TiO2NPs induced histological alterations in the kidney. But groups that were administrated with Turmeric and /or Gravi...
Thyroid hormones have been known to regulate the energy metabolism of most tissues including live... more Thyroid hormones have been known to regulate the energy metabolism of most tissues including liver. Alterations in their normal levels cause some biochemical and clinical abnormalities such as hypothyroidism and hyperthyroidism. The present study evaluated the effect of thyroid hormone, L-thyroxin on liver of albino rats. Additionally the ameliorating role of folic acid supplementation was investigated. Fifty male albino rats were randomly divided into five groups (group I, control; group II, folic acid; group III, L-thyroxin sodium administration (100 μg/kg / body weight); group IV, L-thyroxin and folic acid group and V, recovery group). The results showed that there were a significant increase in ALT, AST, MDA and nitric oxide in L-thyroxin treated rats as compared to control group. On the other hand, a significant decrease in glutathione (GSH) in L-thyroxin treated rats as compared to control group. Histological results showed that liver sections of Lthyroxin group showed histopathological lesions such as leucocytic infiltrations, congestion of central and portal veins and cytoplasmic vacuolation of hepatocytes with the presence of pyknotic nuclei, in addition to fatty infiltration. Immunohistochemical results revealed that strong positive expression of PCNA, P53, and Bcl-2 were detected in the liver section in L-thyroxin treated rats and recovered rats as compared to control and folic acid groups. However; mild to moderate positive expressions of PCNA, P53, and Bcl-2 were observed in rats treated with L-thyroxin and folic acid in liver section. This reflects oxidative stress associated with hyperthyroid state.
International Journal of Medical Science and Clinical invention, 2019
A substantial number of patients admitted to the ICU because of an acute illness, complicated sur... more A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as “intensive care unit acquired weakness” (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy. ICUAW is typically symmetrical and affects predominantly proximal limb muscles and respiratory muscles, whereas facial and ocular muscles are often spared. ICUAW is diagnosed in awake and cooperative patients by bedside manual testing of muscle strength and the severity is scored by the Medical Research Council sum score. In cases of atypical clinical presentation or evolution, additional electrophysiological t...
Background/Purpose: Gastric antral vascular ectasia(GAVE) can cause recurrent bleeding and chroni... more Background/Purpose: Gastric antral vascular ectasia(GAVE) can cause recurrent bleeding and chronic anemia in children with portal hypertension(PHT). We aimed to evaluate the efficacy of EBL in comparison to argon plasma coagulation(APC) in children with PHT, bleeding from GAVE. Methods: This Prospective comparative study included 40 children with PHT who presented with non-variceal GIT bleeding from GAVE. Patients were divided into 2 groups, each including 20 cases: one group were managed with APC and the other with EBL. Endoscopy was repeated every 3-4 weeks until complete ablation of GAVE. Patients were re-evaluated earlier in the event of recurrence of bleeding or in case of severe anemia necessitating blood transfusion. A follow-up endoscopy was done 6 months after the last APC or EBL session. Results: The ages ranged between 2 to 16 years. The EBL group required a significantly lower number of sessions for complete obliteration of the lesions (1.85±0.81) as compared to APC group(4.15±1.22), p<0.05. EBL was superior to APC as regards; shorter procedure time(p=0.001), lower blood transfusion requirement(p<0.05), less hospitalization(p<0.05) and significantly lower recurrence rate of GAVE after 6 months follow up(p=0.01) Conclusions: EBL is more effective and time saving when compared to APC in treatment of bleeding from GAVE in children.
Background: Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in a... more Background: Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in adolescents was based on clinical trials on patients mainly with genotype 1. We aimed to evaluate the effectiveness and short-term safety of this newly approved antiviral in adolescents with HCV genotype 4. Methods: This was a study of 51 HCV-infected adolescents, who received the adult dose of ledipasvir/sofosbuvir, once daily for 12 weeks, and were followed-up for 12 weeks post-treatment. Laboratory tests, quantitation of HCV RNA, HCV genotyping, IL-28rs gene polymorphism and transient elastography were performed at baseline. Follow-up visits were done for blood testing and adverse events recording. Results: The mean age was 14.7 ± 1.5 years (11-17.5), with a male to female ratio of 1.7:1. All patients were genotype 4a, and 76.5% had the CC IL-28 gene polymorphism. About 50% gave a history of HCV-infected mother, and 31% were treatment-experienced. Liver stiffness was F0 in 72.5%, F0-F1 in 13.7% and F1-F2 in 13.7%. Adverse events were mainly abdominal pain in 72.5%, headache in 64.7% and diarrhea in 53% of patients; these were mild. A reversible increase in creatinine level with a concomitant decline in estimated glomerular filtration rate was observed in the first month of treatment. By the end of week 12, a significant decline in liver enzymes was observed. All patients achieved an early, end of treatment, and a sustained virologic response. Conclusions: Adolescent patients with genotype 4 chronic HCV infection achieved a good response rate with good ontreatment tolerability for ledipasvir/sofosbuvir therapy.
Objective The aim of the present study was to evaluate the surgical and functional outcome of the... more Objective The aim of the present study was to evaluate the surgical and functional outcome of the laparoscopic-aided transanal pull-through procedure for the management of Hirschsprung’s disease (HD). Patients and methods The study included 17 patients older than 12 months. Diagnosis of HD relied on the inability of the patients to relax the anal internal sphincter in response to colonic extension on anorectal manometry. The laparoscopic part entailed transition zone identification, seromuscular biopsy for fresh frozen histopathology, and sigmoid and rectal mobilization up to 1 cm down the peritoneal reflection. The transanal part included mobilization of the rectal lower by 2 cm, resection till the ganglionic segment, and anastomosis. Patient outcome included evaluation of fecal consistency, frequency of soiling, and presence of perianal skin excoriation at 1, 3, and 6 months after the procedure. Colonic manometry and functional outcome evaluation according to qualitative clinical Holschneider scoring were carried out at 1 and 6 months after the procedure. Results One (5.9%) patient required open conversion for dissection of thick adhesions. Frequency of patients that passed formed stool and free of soiling increased progressively till the end of 6 months after the procedure. At 1 month after the procedure, six patients developed perianal skin excoriation, but all were free by the sixth postoperative (PO) month. Manometric pressure measures at 3 and 6 months after the procedure were significantly higher compared with the preoperative measures, with significant difference in favor of 6-month measures. At 6 months after the procedure, Holschneider scoring was significantly higher compared with that at 1 month, and 10 patients had a score of 14. No surgery-related complications were detected. Conclusion Laparoscopic-aided transanal pull-through is a feasible procedure for the management of children older than 12 months and who have HD. The procedure is safe with minimal PO complications, which are gradually resolved within 6 months PO.
Objective The aim of this study is to evaluate the safety and efficacy of laparoscopic splenectom... more Objective The aim of this study is to evaluate the safety and efficacy of laparoscopic splenectomy (LS) in the management of benign hematologic and splenic diseases in children. Patients and methods Thirty-eight patients, with the mean age of 10.4±4.3 years, underwent LS between May 2010 and November 2014; out of them, 92.1% suffered from benign hematologic diseases and 7.9% suffered from benign splenic diseases. The indication of splenectomy was different according to the underlying disease. Results The rate of conversion to open surgery was 5.2% and to hand-assisted procedure was 7.8%. The mean operative time was 148.4±26.7?min and the mean duration of hospital stay was 4.5±1.6 days. Five (13.1%) patients had accessory spleen diagnosed and removed successfully and one patient was diagnosed with missed accessory spleen. Postoperative complications were observed in five (13.1%) patients, which are wound infection (one patient), incisional hernia (one patient), upper respiratory tract infection (two patients), and missed accessory spleen (one patient). No mortality was reported in the study. Conclusion LS is well tolerated and effective in the management of benign hematologic and splenic diseases. It has many advantages over open surgery and should be the standard option in the surgical treatment of such cases.
In this work, we study the flow and heat transfer characteristics of a viscous nanofluid over a n... more In this work, we study the flow and heat transfer characteristics of a viscous nanofluid over a nonlinearly stretching sheet in the presence of thermal radiation, included in the energy equation, and variable wall temperature. A similarity transformation was used to transform the governing partial differential equations to a system of nonlinear ordinary differential equations. An efficient numerical shooting technique with a fourth-order Runge-Kutta scheme was used to obtain the solution of the boundary value problem. The variations of dimensionless surface temperature, as well as flow and heat-transfer characteristics with the governing dimensionless parameters of the problem, which include the nanoparticle volume fraction ϕ, the nonlinearly stretching sheet parameter n, the thermal radiation parameter N R , and the viscous dissipation parameter Ec, were graphed and tabulated. Excellent validation of the present numerical results has been achieved with the earlier nonlinearly stret...
International Communications in Heat and Mass Transfer, 2011
This work is focused on the study of the natural convection boundary-layer flow over a downward-p... more This work is focused on the study of the natural convection boundary-layer flow over a downward-pointing vertical cone in a porous medium saturated with a non-Newtonian nanofluid in the presence of heat generation or absorption. The transformed boundary layer governing equations are solved numerically. The influences of pertinent parameters such as the heat generation or absorption, the solid volume fraction of nanoparticles and the type of nanofluid on the flow and heat transfer rate in terms of Nusselt number are discussed. Comparisons with previously published work on special cases of the problem are performed and found to be in excellent agreement. The generalized governing equations derived in this work can be applied to different cases of non-Newtonian fluids with different values of the power-law viscosity index. The results of this parametric study are shown graphically and the physical aspects of the problem are highlighted and discussed
Our zero-copy ATM Memory-Integrated Network Interface targets 1-Gbps bandwidth with 1.2-p4 latenc... more Our zero-copy ATM Memory-Integrated Network Interface targets 1-Gbps bandwidth with 1.2-p4 latency for applications that need to send or receive data at very frequent intervals. Applications can send or receive packets without operating system support, initiate packet
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Papers by Mohamed Rabea