Background: Enlargement of inferior nasal turbinates is a common cause of nasal obstruction. There are many surgical methods used to treat hypertrophied inferior turbinates such as electrocautery, partial turbinectomy, microdebrider reduction and radiofrequency thermal ablation (RFTA). The mucosal condition after surgery is an important factor that should be considered in evaluation of different techniques. Objective: This study aimed to examine the microstructural appearance of the ciliated epithelial tissues of inferior turbinates by light microscope. It was done by cytological examination of inferior turbinate mucosa in patients treated by radiofrequency thermal ablation (RFTA) and bipolar electro cautery (BEC) for hypertrophied inferior turbinates. Methods: A prospective study performed on 36 patients with hypertrophied inferior turbinates causing nasal obstruction. Patients were divided into two groups: group (A) were managed with radiofrequency thermal ablation (RFTA) and group (B) were managed with bipolar electro cautery (BEC). Cytological examination of nasal mucosa was done 3 months postoperatively. Results: by cytological microscopic examination, 88% of cases of group (A) showed no abnormalities in ciliated epithelial cells. only 12% of cases showed abnormalities in the form of damage in the ciliated cells with an architectural rearrangement. In group (B) 78% of patients showed abnormalities in cilia and epithelial cell damage and only 22% of them showed no abnormalities. Conclusion: Radiofrequency thermal ablation (RFTA) seems to be a good modality dealing with the problem of inferior turbinate hypertrophy. It showed minimal injury to turbinate mucosal tissues with good ciliary structure, along with an intact and functioning epithelium

Background

Safe anaesthesia and surgery are a public health imperative. There are few data describing outcomes for children undergoing anesthesia and surgery in Africa. We aimed to get robust epidemiological data to describe patient care and outcomes for children undergoing anesthesia and surgery in hospitals in Africa.

Methods

This study was a 14-day, international, prospective, observational cohort study of children (aged <18 years) undergoing surgery in Africa. We recruited as many hospitals as possible across all levels of care (first, second, and third) providing surgical treatment. Each hospital recruited all eligible children for a 14-day period commencing on the date chosen by each participating hospital within the study recruitment period from Jan 15 to Dec 23, 2022. Data were collected prospectively for consecutive patients on paper case record forms. The primary outcome was in-hospital postoperative complications within 30 days of surgery and the secondary outcome was in-hospital mortality within 30 days after surgery. We also collected hospital-level data describing equipment, facilities, and protocols available. This study is registered with ClinicalTrials.gov, NCT05061407.

Findings

We recruited 8625 children from 249 hospitals in 31 African countries. The mean age was 6·1 (SD 4·9) years, with 5675 (66·0%) of 8600 children being male. Most children (6110 [71·2%] of 8579 patients) were from category 1 of the American Society of Anesthesiologists Physical Status score undergoing elective surgery (5325 [61·9%] of 8604 patients). Postoperative complications occurred in 1532 (18·0%) of 8515 children, predominated by infections (971 [11·4%] of 8538 children). Deaths occurred in 199 (2·3%) of 8596 patients, 169 (84·9%) of 199 patients following emergency surgeries. Deaths following postoperative complications occurred in 166 (10·8%) of 1530 complications. Operating rooms were reported as safe for anaesthesia and surgery for neonates (121 [54·3%] of 223 hospitals), infants (147 [65·9%] of 223 hospitals), and children younger than 6 years (188 [84·3%] of 223 hospitals).

Background and aims. Open reading frames (ORFs) are sections of a reading frame that do not include any stop codons. A reading frame is a sequence of nucleotide triplets read as codons indicating amino acids; a single strand of DNA has three potential reading frames. Long ORFs in a DNA sequence may represent possible protein-coding areas. In addition to extended ORFs, which assist in gene locus prediction, there is yet another type of ORFS known as small open reading frames (smORFs), which have 100 codons or fewer. Methods. We develop an offline, cross-platform, and dependable detection tool for regular ORFs and smORFs prevalent in biomedical studies. Results. In this work, the most ORFs were found in the Bos taurus (Cattle) Insulin gene, which had 17 consecutive ORFs, while the fewest ORFs were reported in the Cani's lupus (Dog) Insulin gene, which had only 4 ORFs. Conclusion. The software meets the expected demarcation restrictions. We strongly advise more research into the detection of nested ORFs.

Environmental factors are known to influence carcinogenesis. Procarcinogens, such as heterocyclic amines (HAs) and polycyclic aromatic hydrocarbons (PAHs), are examples of these environmental factors. Procarcinogens are chemically inert and require bioactivation, via enzymes such as Cytochrome P450 (CYP). CYP1A1 isoform, regulated by Aryl hydrocarbon receptor (AhR), plays a significant role in the bioactivation of PAHs and HAs. AhR has multiple co-activators and co-repressors, of which SMRT (silencing mediator for retinoid and thyroid hormone receptors) has been identified as a major co-repressor for AhR. In the present study we examined the effect of SMRT over expression on the Cyp1a1 mRNA levels in murine hepatoma Hepa 1c1c7 cell line. Hepa 1c1c7 cells were maintained in Dulbecco&#39;s modified Eagle&#39;s medium (DMEM), and competent cells were successfully produced using calcium chloride method. Cells were transformed using plasmid DNA and Lipofectamine. TCDD was employed as an inducing agent for CYP1A1. Total cellular RNA was isolated and real-time PCR of Cyp1a1 was conducted. Statistical analysis was conducted using one-way analysis of variance (ANOVA) followed by Student–Newman–Keul’s test. Our results showed that, cells transfected with the co-repressor SMRT has lower TCDD-mediated induction of Cyp1a1 mRNA without affecting constitutive Cyp1a1 mRNA levels, i.e., SMRT was able to significantly decrease inducible Cyp1a1 mRNA levels in Hepa 1c1c7 cells. Moreover, our work demonstrated that calcium chloride is a convenient method for routine transformation. Our work will open new avenues for treatment of carcinogenesis involving CYP1A1 inducing carcinogens.

Background and aims. Open reading frames (ORFs) are sections of a reading frame that do not include any stop codons. A reading frame is a sequence of nucleotide triplets read as codons indicating amino acids; a single strand of DNA has three potential reading frames. Long ORFs in a DNA sequence may represent possible protein-coding areas. In addition to extended ORFs, which assist in gene locus prediction, there is yet another type of ORFS known as small open reading frames (smORFs), which have 100 codons or fewer. Methods. We develop an offline, cross-platform, and dependable detection tool for regular ORFs and smORFs prevalent in biomedical studies. Results. In this work, the most ORFs were found in the Bos taurus (Cattle) Insulin gene, which had 17 consecutive ORFs, while the fewest ORFs were reported in the Cani's lupus (Dog) Insulin gene, which had only 4 ORFs. Conclusion. The software meets the expected demarcation restrictions. We strongly advise more research into the detection of nested ORFs.

Purpose: This study was conducted to determine the impact of supervisory behaviour on organisational commitment in Libyan Government Institutions through the mediation role of organisational justice. The population of the study is managers and employees in the capital of Tripoli and the western part of Libya. The sample size was 302, selected randomly. This study used oriented supervisory behaviour, supportive supervisory behaviour, participatory supervisory behaviour, and supervision behaviour directed at achievement as independent variables. The mediating variable is organisational justice, and the dependent variable is organisational commitment.

Results: The result confirmed a significant impact of the independent variables on organisational commitment. For the mediation effect, organisational justice mediates the relationship between supervisory behaviour, participatory supervisory behaviour, supervisory behaviour, and organisational commitment. In contrast, no significant mediation was found between supervision behaviour directed at achievement and organisational commitment.

Background

Spinal anesthesia (SA) remains the most popular anesthetic technique for caesarean sections (CS), as it abolishes the possible risks of pregnant airway management. The ability to anticipate the episodes of hypotension following spinal anesthesia will enable anesthesiologists to interfere early and provide better patient management.

Objective

The aim of the current study was toevaluate the perfusion index and the blood pressure positional changes in the prediction of hypotension after SA in CSs.

Patients and methods

A prospective cohort study was conducted at the Obstetrics and Gynecology Department of Zagazig University Hospitals. A total of 80 pregnant women who were prepared for elective CS delivery, aged from 18 to 40 years with ASA-II (American Society of Anesthesiologists Status), were recruited in the current study.

Results

The mean perfusion index (PI) pre-spinal was 5.81 and immediately after spinal was 4.65 with a statistically significant decrease (P<0.001). There was also a statistical difference between the mean of mean arterial pressure (MAP) of the studied cases pre-spinal at the lateral position (91.76 mmHg) and mean MAP in the supine position (83.29 mmHg) with P-value <0.001, with a mean difference of 8.48 mmHg. PI cut-off >4 had a sensitivity of 85.9%, specificity of 75%, and accuracy of 83.8% in the prediction of hypotension. The positional change in blood pressure at cut-/off >5 mmHg had a sensitivity of 82.8%, specificity of 75%, and accuracy of 81.3% in the prediction of hypotension among cases.

Conclusion

The preoperative PI and positional blood pressure change can predict spinal anesthesia 

Abstract

Diabetes mellitus with hyperglycaemia is a major risk factor for malignant cardiac dysrhythmias. However, the underlying mechanisms remain unclear, especially during the embryonic developmental phase of the heart. This study investigated the effect of hyperglycaemia on the pulsatile activity of stem cell-derived cardiomyocytes. Mouse embryonic stem cells (mESCs) were differentiated into cardiac-like cells through embryoid body (EB) formation, in either baseline glucose or high glucose conditions. Action potentials (APs) were recorded using a voltage-sensitive fluorescent dye and gap junction activity was evaluated using scrape-loading lucifer yellow dye transfer assay. Molecular components were detected using immunocytochemistry and immunoblot analyses. High glucose decreased the spontaneous beating rate of EBs and shortened the duration of onset of quinidine-induced asystole. Furthermore, it altered AP amplitude, but not AP duration, and had no impact on neither the expression of the hyperpolarisation-activated cyclic nucleotide-gated isoform 4 (HCN4) channel nor on the EB beating rate response to ivabradine nor isoprenaline. High glucose also decreased both the intercellular spread of lucifer yellow within an EB and the expression of the cardiac gap junction protein connexin 43 as well as upregulated the expression of transforming growth factor beta 1 (TGF-β1) and phosphorylated Smad3. High glucose suppressed the autorhythmicity and gap junction conduction of mESC-derived cardiomyocytes, via mechanisms probably involving TGF-β1/ Smad3 signalling. The results allude to glucotoxicity related proarrhythmic effects, with potential clinical implications in foetal diabetic cardiac disease.

Background: Medical students have been shown through multiple studies to be more susceptible to stress and depression than the rest of the population. Libyan students specifically have to undergo the challenges of becoming a doctor while living in the terrifying and stressful outcomes of the Libyan civil war. And the spread of COVID-19 has added to these stressors.

Objective: This study aimed to determine prevalence of depression and anxiety among Libyan medical students and analyze the causing factors.

Methods: A cross sectional study was conducted using an online survey. The survey used the K-10 Kessler psychological distress scale which is a self administered questionnaire used to measure the level of distress. 

Results: A total of 1348 students from 16 Libyan medical schools across the 5 years of study completed the survey. 992 (73.6%) were female students and 356 (26.4%) were male. The mean age (SD) was 22.09 (2.56).

Out of the 1348 participants, 638 (47.3%) scored for severe mental disorder. 213 (15.8%) scored for moderate mental disorder and 200 (14.8%) presented with mild mental disorder. 297 (22%) of the students are likely to be well according to the K-10 psychological distress scale. Out of the students who have had their houses displaced due to the war, 66.3% have presented with moderate to severe mental disorder.

 235 students (17.4%) have reported having suicidal thoughts throughout their time in medical school.

Conclusion: In comparison to similar studies done in other countries, Libyan students scored a higher prevalence of depression. The stress of the current political state of the country and the COVID-19 pandemic were shown to be contributing factors.

Background: Acute pediatric encephalitis is a debilitating neurological disorder that develops as a rapidly progressive encephalopathy (usually in less than 6 weeks) due to brain inflammation, autoimmune encephalitis (AE) is a heterogeneous group of recently identified disorders. Despite severe and even prolonged neurologic deficits, dramatic improvements may occur with proper immunotherapy in some patients with AE. Anti-neuronal antibodies have been discovered in cerebrospinal fluid (CSF) of patients, Aim and Objectives: The aim of the current study was to test the relation of early diagnosis with treatment of N-methyl D- Aspartate Receptor autoimmune encephalitis. Patients and Methods: This is Prospective observational cohort study that was carried out at pediatric department, Faculty of Medicine, Zagazig University, the study was conducted on 36 cases, Results: There was no statistical significant difference between the studied groups with and without autoimmune encephalitis regarding results of CSF analysis (larger percentage without autoimmune encephalitis had abnormal CSF analysis). There is a statistical significant difference between the studied groups with and without autoimmune encephalitis regarding prognosis. Conclusion: CSF NMDAR antibodies are highly sensitive biomarker in prediction of mortality and poor prognosis of encephalitis in children.