This review describes the latest progress of dryland ecosystem dynamic change in the Mediterranean region. Recent findings indicate that extent of dryland in the Mediterranean region has been expanding in the past decades and will continue to expand in the coming decades due to the stronger warming effect than other regions. The warming trend with intensified human activities has generated a series of negative impacts on productivity, biodiversity, and stability of the dryland ecosystem in Mediterranean region. Increased population, overgrazing and, grazing abandonment intensified the land degradation and desertification. The coverage, richness, and abundance of biological soil crust have been reduced due to the decline of soil water availability and increased animals. Future studies are required to further our understanding of the process and mechanism of the dryland dynamics, including the identification of essential variables, discriminating human and climate-induced changes, and modeling future trajectories of dryland changes.

Cardiovascular diseases (CVD) are considered major cause of morbidity and mortality among children with chronic kidney disease (CKD). This study aims to determine the incidence of CVD in children with CKD, to analyze risk factors and early predictors for late onset atherosclerosis. Thirty-five CKD children [25 on regular hemodialysis (HD) and 10 on conservative management] were evaluated clinically. Left ventricular (LV) functions and carotid artery intima-media thickness (c-IMT) were assessed using conventional echocardiography, pulsed wave Doppler (PWD) and tissue Doppler imaging (TDI). There was decreased E/A ratio and increased E/E' ratio in 66% and 77% of patients, respectively signifying diastolic cardiac dysfunction. There was a significant correlation between increased A' value (peak late diastolic annular velocity) and both increased serum cholesterol and anemia (P = 0.009, 0.004 respectively). Serum high density lipoprotein (HDL) significantly correlated negatively with inter-ventricular septal thickness and LV end-diastolic dimensions (P = 0.05, 0.02, respectively) and positively with E' value (peak early diastolic annular velocity) (P = 0.04). Abnormal c-IMT correlated significantly with HD duration (correlation coefficient = 0.428, P = 0.01) and with both increased serum cholesterol and decreased serum HDL (P = 0.021, 0.031, respectively). Diastolic dysfunction and abnormal LV dimensions are present in patients with CKD even those on conservative management. TDI appears to be more impressive than PWD in assessing early myocardial dysfunction. Increased c-IMT and dyslipidemia are prevalent in patients with CKD and more prevalent in patients on HD.

INTRODUCTION: Caring for stroke survivors creates high levels of care burden among family caregivers. Previous initiatives at alleviating the care burden have been unsuccessful. The proposed study aims to evaluate the effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors. Based on the perceived needs of family caregivers, this intervention takes into account scientific recommendations to combine three different approaches: skill-building, psychoeducation and peer support.

METHODS AND ANALYSIS: Using a prospective, randomised, open-label, parallel-group design, 110 family caregivers will be enrolled from Dakahlia Governorate, Egypt between December 2019 and May 2020, and randomly assigned to either the intervention group or the control group. The tailored multidimensional intervention will be administered for 6 months, including three home visits, six home-based telephone calls and one peer support session. The primary outcome is the care burden as measured using the Zarit Burden Interview. Secondary outcomes include changes in the family caregivers' perceived needs (Family Needs Questionnaire-Revised), coping strategies (Brief-Coping Orientation to Problems Experienced) and quality of life (WHO Quality of Life-BREF). Outcomes evaluation will be conducted at baseline (T0), month 3 (T1) and month 6 (T2). Independent t-test will be performed to compare the mean values of study variables between the two groups at both T1 and T2. After adjusting for confounding variables, analysis of covariance will be used to assess the effect of the intervention. In addition, repeated measures analysis of variance will be conducted to assess changes in effect over time.

ETHICS AND DISSEMINATION: This study was approved by the Research Ethics Committee of the Faculty of Nursing, Mansoura University, Mansoura, Egypt (P.0195). The results will be published in a scientific peer-reviewed journal, and findings will be disseminated at the local and international levels.

TRIAL REGISTRATION NUMBER: NCT04211662.

Objectives. It is well documented that acupressure has a beneficial effect on reducing pain severity of primary dysmenorrhea; however, none of the previous studies had investigated the effect of acupressure on prostaglandin levels in females with primary dysmenorrhea. This study aimed to investigate the effect of acupressure on prostaglandin F2α (PGF2α) in primary dysmenorrhea.
Methods. A total of 50 adult females with primary dysmenorrhea participated in this study. Their ages ranged from 19 to 27 years and their body mass index (BMI) ranged from 20 to 25 kg/m2. They were randomized into 2 equal groups. Group (A) received nutritional modification for 3 consecutive menstrual cycles, while group (B) received the same nutritional modification in addition to acupressure at the liver point (LIV3) for 3 consecutive menstrual cycles. The primary outcome was plasma levels of PGF2α while the secondary outcome was short form of McGill pain questionnaire. The outcome measures were evaluated pre- and post- treatment.
Results. Comparing both groups post-treatment revealed that there were significant reductions in PGF2α levels and short form of McGill pain questionnaire scores (p < 0.0001) in favour of group (B).
Conclusions. Acupressure is effective in treating females with primary dysmenorrhea through reducing levels of PGF2α and scores of short form of McGill pain questionnaire.

Key words:

acupressure, prostaglandin F2α, short form of McGill pain questionnaire, primary dysmenorrhea

AIM: The aim of the current study was to evaluate the therapeutic and regenerative effects of MSCs derived exosomes in the treatment of type 1 DM and to compare its effects with MSCs themselves. The experiment was done on forty albino rats grouped as follows, group (1): Ten healthy rats, group (2): Ten induced type 1 DM rats, group (3): Ten induced type 1 DM rats received exosomes intraperitoneally, and group (4): Ten induced type 1 DM rats received MSCs intraperitoneally. Serum glucose and plasma insulin levels were assessed weekly. QRT-PCR was done to assess regeneration of pancreatic beta cells by measuring insulin, Pdx1, Smad2, Smad3 and TGFβ genes. Additionally, histopathological and immune-histochemical examinations were done to confirm pancreatic tissue regeneration.

RESULTS: Regarding the assessed genes (insulin, Pdx1, Smad2, Smad3 and Tgfβ) gene expression in MSCs treated group showed significant increase compared to diabetic group (p value < 0.001) and gene expression in exosomes treated group was increased significantly compared to diabetic and MSCs treated groups (p value < 0.001). Histopathological and immune-histochemical examination revealed regeneration of pancreatic islets in both treated groups.

CONCLUSION: MSCs Derived exosomes showed superior therapeutic and regenerative results than MSCs themselves.

n/a