Mohamed Zaki

Medication non-compliance is an ignored health problem in developing countries, which have an alarming average of less than 50% of patients complying with medication instructions. Such non-compliance is considered a major challenge to effective management of most chronic diseases such as diabetes mellitus, hypertension, and dyslipidemia. Objective: To evaluate the factors affecting patient compliance and the impact of better compliance on the control of chronic diseases. Another objective is to measure the prevalence of intentional and non-intentional non compliance and their causes. Method: A cross-sectional study was conducted for 240 patients with chronic diseases who are followed up at Al-Qassimi Hospital, Sharjah, United Arab Emirates (ARE) during the period of September 2008 until March 2009. The hospital ethical committee approval was obtained before the commencement of the study. A validated data collection form and questionnaire were used to collect patients' demographics, degree of knowledge about their medications and concurrent diseases. Patients were selected based on inclusion and exclusion criteria which include chronic diseased adult patients who have one or more of the following chronic conditions (Diabetes, hypertension and/or dyslipidemia) confirmed in the patients' medical file (not on their initial diagnosis). Participants should have an active prescription without changes for at least 90 days at the time of study recruitment. Descriptive statistics were reported and statistical analysis using SPSS software version 18 was done to correlate patient demographics and patient compliance and to measure the correlation of patient compliance and the control of chronic diseases using chi square test. Results: The mean age of participants was 56.6 ± 12.4 years. Most of participants were illiterate (62.5%). Most of them had family history with chronic disease (69.2%). Most patients have more than one chronic disease (86.7%). More than three quarters of participants (77.5%) do not control one or more of their diseases. Also high percentage of participants (76.7%) was on polypharmacy regimen (mean number of drug used 7.0 ± 3.0). The most prominent complication related to chronic diseases that participants suffered from is cardiovascular diseases (27.6%). Forgetfulness is the main reason for non-intentional non-compliance (75%), while polypharmacy was considered the main causes for intentional non-compliance (13.3%). The current study revealed that there is significant association between patients' young age, having family member with chronic disease, having complications and good compliance (p-value < 0.05). Also, there is a statistically significant association between good compliance and better achievement of chronic diseases control (p-value < 0.05). It was also found that level of education and number of chronic diseases have no correlation with compliance (P-value > 0.05) Conclusion: Medication compliance is very important to control chronic diseases such as diabetes mellitus, hypertension and/or dyslipidemia and decrease their complications. Results of the study showed that there is a positive association between good compliance and achievement of better control of chronic diseases. The current study also revealed that there is significant association between patients' young age, having family member with chronic disease, having complications and good medication compliance.

PURPOSE: To evaluate the role of preoperative intravitreal bevacizumab as an adjunct to vitrectomy in diabetic eye disease.

METHODS: Twenty eyes of 18 patients were recruited and underwent a single intravitreal injection of bevacizumab 1.25 mg 1 week prior to vitrectomy. Fundus fluorescein angiography (FFA) was done before and 1 week after injections. Best corrected visual acuity (BCVA) and ophthalmic evaluation were done before, 1 week after injections, 1 day, 1 week and monthly for 3 months after vitrectomy.

RESULTS: The mean age was 47.7 ± 10.39 years. The male:female ratio was 2:3. Mean preinjection BCVA (logMAR) was 1.460 ± 0.439. FFA showed a dramatic reduction in dye leakage 1 week after injection. Intraoperative bleedings were minimal in most cases (85%, n = 17). Postoperatively, 16 patients had no bleeding (80%), 4 had minimal bleeding (20%), and 1 had recurrent fibrovascular proliferation (5%). The mean BCVA on day 1, week 1, months 2 and 3 after surgery were 1.645 ± 0.422, 1.300 ± 0.413, 1.065 ± 0.538 and 1.065 ± 0.538 logMAR, respectively (p = 0.078, 0.123, 0.002 and 0.002, respectively).

CONCLUSION: Bevacizumab administered prior to vitrectomy was well tolerated and was particularly useful during surgery.

The structure and magnetic properties of Co1-XCu XFe2O4 were investigated. Cobalt copper ferrites have been synthesized by the double sintering ceramic technique. X-ray diffraction analysis and transmission electron microscopy (TEM) confirmed the formation of single-phase cobalt ferrite nanoparticles. The particle size was estimated by TEM micrography to be 46, 51, 40 and 36 nm for X=0.0, 0.1, 0.3 and 0.6, respectively, which is a good result for this method of preparation. The magnetic susceptibility was studied at different temperatures as a function of magnetic field intensities. The room temperature hysteresis loop was found for the present samples in a field intensity of 7 kOe using a vibrating sample magnetometer. The parameters of x-ray density (dx) and apparent density (da) increase with increasing Cu2+ concentration in the prepared samples. © 2011 The Royal Swedish Academy of Sciences.

The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL) treated at National Cancer Institute (NCI-Cairo), in Egypt from January 2007 to January 2011. The median age at presentation was 29 years. Bleeding was the most common presenting symptom (79%). Most patients had an intermediate risk Sanz score (49%) and 34% had a high risk score. The median follow-up time was 36 months. All evaluable patients were treated for induction with the simultaneous administration of all-trans retinoic acid (ATRA) and an anthracycline. The original AIDA treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with daunorubicin or doxorubicin in most of the cases and the inclusion of cytarabine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. Five patients died before treatment initiation due to bleeding, three died during induction chemotherapy due to infectious complications (n=2) and bleeding (n=1) and one patient died during consolidation therapy due to infection. The main therapeutic complications during the induction phase were febrile neutropenia (42%), bleeding (18%) and differentiation syndrome (11%). All patients achieved molecular CR at end of consolidation therapy at a median time of 100 days. The 3-year OS was 89%. Two patients relapsed at 13 and 24 months, respectively. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin) may be a valid treatment option for APL in developing countries. In spite of the increased incidence of high and intermediate risk disease in our cohort, we reported an acceptable CR rate, toxicity and OS.

The gene (pox1) encoding a phenol oxidase 1 from Pleurotus ostreatus was sequenced and the corresponding pox1-cDNA was also synthesized, cloned and sequenced. The isolated gene is flanked by an upstream region called the promoter (399 bp) prior to the start codon (ATG). The putative metal-responsive elements (MREs) were determined in the promoter region, where MRE 1, 2 and 3 were located in positions -20, -62 and -389, respectively. Functional TATA consensus sequences were recognized in positions -78 and -245, while CAAT consensus sequence was recognized in position -171. The putative GC boxes consensus sequences were recognized in positions -175 and -344, and xenobiotic-responsive elements (XREs) in positions -100 and -270. The pox1-DNA gene consists of 2656 bp, with the coding sequence being interrupted by 19 introns. The nucleotide sequence of cDNA (pox1-cDNA) was found to contain an ORF of 1590 bp capable of coding for a protein of 529 amino acid residues. The signal peptide was predicted to be 23 amino acids in length using SIGNALP 3.0 program. Northern blot analysis revealed that strong transcriptional induction was observed in the copper-supplemented cultures for pox1 gene.

OBJECTIVES: Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented.

METHODS: A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients.

RESULTS: The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and >5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases.

CONCLUSION: In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.

OBJECTIVES: Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented.

METHODS: A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients.

RESULTS: The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and >5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases.

CONCLUSION: In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.

Garnet nanoparticles Dy2.8Sr0.2Fe5O 12 (DySrIG) were prepared by citrate auto-combustion method and characterized by X-ray diffraction (XRD), transmission electron microscope (TEM) and differential thermal analysis (DTA). The suitable formation of this garnet in single phase was at 1100 °C with crystallite of size 95 nm. The Curie temperature of DySrIG is obtained at 610 K. The effective magnetic moment μeff was calculated experimentally and theoretically and they are compatible with each other. The dielectric constant ε′ increases from order 102 at room temperature to 104 at 850 K passing by four transition temperatures. The temperature dependence of the resistivity of DySrIG at different frequencies (f) 100 kHz ≤ f ≤ 5 MHz indicates the presence of 5 transition temperatures which are slightly different from those of ε′ data. The resistivity data are frequency independent at f < 1 MHz. The transition height is decreased by increasing the temperature from ≈5 MΩ cm at 320 K and 200 kHz to ≈20 Ω cm at 700 K. Accordingly, Dy2.8Sr0.2Fe5O12 (DySrIG) is recommended for the use in phase shifter, circulators and microwave applications. © 2010 Elsevier B.V. All rights reserved.

OBJECTIVE: The characteristics of 451 Egyptian children (aged 0-14 years) with primary intracranial neoplasms were investigated for demographic, clinical, topographical and pathological features using the most recent 2007 Classification of Central Nervous System Tumors.

PATIENTS AND METHODS: This was a retrospective study performed in the Departments of Pediatric Neurosurgery of the Cairo University Hospitals from 2005 to 2008.

RESULTS: There was a slight male predominance (51.4%) observed in our study, and the most affected age group was 5-9 years old (43.2%). Most of the tumors were confined to a single compartment (infratentorial in 49.7%, supratentorial in 46.6%), while 3.8% of the tumors involved multiple compartments. The most common intracranial tumors were astrocytomas (35%), medulloblastomas (18.8%), craniopharyngiomas (11.3%) and ependymomas (10%). Pilocytic astrocytomas constituted 55% of all astrocytomas and 19.3% of all brain tumors, only slightly ahead of medulloblastomas. Less common types were primitive neuroectodermal tumors (2.7%), followed by meningiomas, germ cell tumors and choroid plexus tumors (2.4% each). According to the International Classification of Diseases for Oncology Coding (ICD-O-4), benign, borderline and malignant tumors constituted 7.54, 36.14 and 56.32%, respectively.

CONCLUSION: The characteristics of pediatric intracranial tumors in Egypt are generally similar to those reported in the literature, with only minor differences.

The reaction kinetics of epoxy resin cured with stoichiometric amounts of amine-like structure and loaded with different levels of Cloisite 25A (C25A), has been studied by dynamic differential scanning calorimetry (DSC) to investigate the effect of the nano-organoclay particles on the kinetic parameters of the cure reaction. The kinetic analysis of non-isothermal cure showed that the Šesták-Berggren autocatalytic model is suitable to describe the kinetics of these reactions. Analysis of DSC data indicated that the presence of the C25A filler has a very small effect on the kinetics of cure. Thermogravimetric analyses showed higher thermal stability for the epoxy nanocomposites compared to pure epoxy. The activation energy of degradation process was estimated using both Kissinger and Ozawa methods. The epoxy nanocomposites loaded with 10 wt% C25A proved to exhibit high activation energy, indicating that C25A acquired a stabilizing effect upon the decomposition of polymer matrix. © 2011 Elsevier B.V.