Search results for: Salah Mostafa

Authors: Nesreddine Djafar Henni, Akram Khelaifia, Salah Guettala, Rachid Chebili

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Reinforced concrete shear walls and vertical plate-like elements play a pivotal role in efficiently managing a building's response to seismic forces. This study investigates how the performance of reinforced concrete buildings equipped with shear walls featuring different shear wall-to-frame stiffness ratios aligns with the requirements stipulated in the Algerian seismic code RPA99v2003, particularly in high-seismicity regions. Seven distinct 3D finite element models are developed and evaluated through nonlinear static analysis. Engineering Demand Parameters (EDPs) such as lateral displacement, inter-story drift ratio, shear force, and bending moment along the building height are analyzed. The findings reveal two predominant categories of induced responses: force-based and displacement-based EDPs. Furthermore, as the shear wall-to-frame ratio increases, there is a concurrent increase in force-based EDPs and a decrease in displacement-based ones. Examining the distribution of shear walls from both force and displacement perspectives, model G with the highest stiffness ratio, concentrating stiffness at the building's center, intensifies induced forces. This configuration necessitates additional reinforcements, leading to a conservative design approach. Conversely, model C, with the lowest stiffness ratio, distributes stiffness towards the periphery, resulting in minimized induced shear forces and bending moments, representing an optimal scenario with maximal performance and minimal strength requirements.

Keywords: dual RC buildings, RC shear walls, modeling, static nonlinear pushover analysis, optimization, seismic performance

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Authors: Mostafa Mabrouk, Basma E. Abdel-Ghany, Mona Moaness, Bothaina M. Abdel-Hady, Hanan H. Beherei

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Tissue engineering became a promising field for bone repair and regenerative medicine in which cultured cells, scaffolds and osteogenic inductive signals are used to regenerate tissues. The annual cost of treating bone defects in Egypt has been estimated to be many billions, while enormous costs are spent on imported bone grafts for bone injuries, tumors, and other pathologies associated with defective fracture healing. The current study is aimed at developing a more strategic approach in order to speed-up recovery after bone damage. This will reduce the risk of fatal surgical complications and improve the quality of life of people affected with such fractures. 3D scaffolds loaded with cheap nano-particles that possess an osteogenic effect were prepared by nano-electrospinning. The Microstructure and morphology characterizations of the 3D scaffolds were monitored using scanning electron microscopy (SEM). The physicochemical characterization was investigated using X-ray diffractometry (XRD) and infrared spectroscopy (IR). The Physicomechanical properties of the 3D scaffold were determined by a universal testing machine. The in vitro bioactivity of the 3D scaffold was assessed in simulated body fluid (SBF). The bone-bonding ability of novel 3D scaffolds was also evaluated. The obtained nanofibrous scaffolds demonstrated promising microstructure, physicochemical and physicomechanical features appropriate for enhanced bone regeneration. Therefore, the utilized nanomaterials loaded with the drug are greatly recommended as cheap alternatives to growth factors.

Keywords: bone regeneration, cheap scaffolds, nanomaterials, active molecules

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Authors: Salah Al-Ali

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The role of technology transfer in technical and vocational education is significant since lecturers, trainers, and students can obtain the updated knowledge, skills, and attitudes that are currently being practiced by local and international businesses and industries. Technology transfer can indeed close the gap between what is being learned and practiced in technical and vocational institutions and the world of work. However, the success of technology transfer in technical and vocational education perspectives would depend entirely on the quality of management. It is their responsibility when signing an agreement with internal or external providers of technology, to include calluses that enable academic staff in related specialty to interact positively and freely with the supplier of technology. In other terms, ensuring no clear or hidden restriction is imposed by the supplier of technology to acquire the know-how and know-why that are embedded in the agreement. In this paper, I present some of the empirical results and observations which describe the interactions between the supplier of technology (Electrical Engineering System) and the recipient of the technology (PAAE&T) in the field of technology transfer. In another word, whether the PAAE&T have taken the opportunity while building its new headquarter, the transfer of technology from the supplier of an electrical engineering system to its academic staff in its various Electrical Engineering Academic Departments at the PAAE&T colleges and institutions. The paper argues that, for effective and efficient transfer of technology, the recipient (PAAE&T) must ensure that the agreement with the supplier of the Electrical Engineering System must include calluses that would allow the PAAE&T academic staff in its various Electrical Engineering Academic Departments in its various colleges and institutions to acquire the technology embedded in the agreement. The paper concludes that the transfer of technology and the building of a local scientific and technical infrastructure must be viewed by Kuwaiti decision-makers as complementary to one another. Thus, reducing, to great extent, the level of dependence on expatriates, particularly in the essential sectors of the economy.

Keywords: vocational and technical education, technology transfer, enhancing indigenous capabilities, Kuwait

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Authors: Abdellah Hanafi, G. M. Mostafa, Mohamed Mortada, Ahmed Hamed

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The steam ejectors are the heart of most of the desalination systems that employ vacuum. The systems that employ low grade thermal energy sources like solar energy and geothermal energy use the ejector to drive the system instead of high grade electric energy. The jet-ejector is used to create vacuum employing the flow of steam or air and using the severe pressure drop at the outlet of the main nozzle. The present work involves developing a one dimensional mathematical model for designing jet-ejectors and transform it into computer code using Engineering Equation solver (EES) software. The model receives the required operating conditions at the inlets and outlet of the ejector as inputs and produces the corresponding dimensions required to reach these conditions. The one-dimensional model has been validated using an existed model working on Abu-Qir power station. A prototype has been designed according to the one-dimensional model and attached to a special test bench to be tested before using it in the solar desalination pilot plant. The tested ejector will be responsible for the startup evacuation of the system and adjusting the vacuum of the evaporating effects. The tested prototype has shown a good agreement with the results of the code. In addition a numerical analysis has been applied on one of the designed geometry to give an image of the pressure and velocity distribution inside the ejector from a side, and from other side, to show the difference in results between the two-dimensional ideal gas model and real prototype. The commercial edition of ANSYS Fluent v.14 software is used to solve the two-dimensional axisymmetric case.

Keywords: solar energy, jet ejector, vacuum, evaporating effects

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Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: colorectal cancer, Hail Region, changing pattern, distal shift

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Authors: Asghar Zamani, Mostafa Falahmorad

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Virtualization is established to combine and use the unique capabilities of employees to increase productivity and agility to provide services regardless of location. Adapting to fast and continuous change and getting maximum access to human resources are reasons why virtualization is happening. The distance problem is solved by information. Flexibility is the most important feature of virtualization, and information will be the main focus of virtualized companies. In this research, we used the Covid-19 opportunity window to assess the productivity of the companies that had been going through more virtualized management before the Covid-19 in comparison with those that just started planning on developing infrastructures on virtual management after the crises of pandemic occurred. The research process includes financial (profitability and customer satisfaction) and behavioral (organizational culture and reluctance to change) metrics assessment. In addition to financial and CRM KPIs, a questionnaire is devised to assess how manager and employees’ attitude has been changing towards the migration to virtualization. The sample companies and questions are selected by asking from experts in the IT industry of Iran. In this article, the conclusion is that companies open to virtualization based on accurate strategic planning or willing to pay to train their employees for virtualization before the pandemic are more agile in adapting to change and moving forward in recession. The prospective companies in this research, not only could compensate for the short period loss from the first shock of the Covid-19, but they could also foresee new needs of their customer sooner than other competitors, resulting in the need to employ new staff for executing the emerging demands. Findings were aligned with the literature review. Results can be a wake-up call for business owners especially in developing countries to be more resilient toward modern management styles instead of continuing with traditional ones.

Keywords: virtual management, virtual organization, competitive advantage, KPI, profit

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Authors: Amanat Ali, Muhammad S. Al-Siyabi, Mostafa I. Waly, Hashem Al-Kilani

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In a cross-sectional research design, we assessed the nutrient intake, nutritional status, nutritional knowledge and dietary habits of Sultan Qaboos University (SQU) student athletes. A total of 71 (49 male and 22 female) student athletes with a mean age of 21.0 ± 1.81 and 19.32 ± 0.72 years and body mass index (BMI) of 22.51 ± 1.98 and 20.34 ± 2.97 kg/m2 for male and female respectively, participated in this study. A study questionnaire consisting of 2 sections was distributed to the participants. Section I included 18 questions regarding the demographic information, whereas the Section II consisted of 20 questions regarding the nutrition knowledge. The dietary intake of participants was collected by using a 7-days food diary identifying the frequency as well as the variety of food consumption. Significant differences (P < 0.05) were observed in the main sources of nutrition information used by the male and female athletes. Male athletes mainly had most of the nutrition information from friends (17%) whereas female athletes relied mainly on the family (20%). More female athletes (20%) were using TV as a source of nutrition information as compared to male athletes (15%). Both male and female athletes had the minimum nutrition information from dietitians and physicians. Significant (P < 0.05) differences were also observed in the nutritional knowledge and dietary habits scores of male and female athletes, which were 57 % and 49 %, respectively. Male athletes were classified to have fair nutritional knowledge and dietary habits, whereas the female athletes had poor nutritional knowledge and dietary habits. The average daily energy intake of male athletes was 2595 ± 358 kcal/day. Carbohydrate, fat, and protein contributed 64%, 22%, and 14%, of the total energy intake for the male athletes, respectively. The energy and macronutrients intake of male athletes was within the recommended dietary intake. The results indicated some gaps in the nutritional knowledge of SQU student athletes and suggest that there is a need for developing strategies in counseling and teaching the athletes to improve their nutritional knowledge and dietary habits.

Keywords: nutrient assessment, nutritional knowledge, dietary habits, Omani University athletes

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Authors: Mostafa Fanaei, Shahram R. Sistani, Athare Nazri-Panjaki

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Introduction: Critical thinking skills are increasingly recognized as vital for academic success, particularly in higher education. This study examines the influence of critical thinking on learning achievement among undergraduate and master's students enrolled in foreign language programs. By investigating this correlation, educators can gain valuable insights into optimizing teaching methodologies and enhancing academic outcomes. Methods: This cross-sectional study involved 150 students from the Shahid Bahonar University of Kerman, recruited via random sampling. Participants completed the Critical Thinking Questionnaire (CThQ), assessing dimensions such as analysis, evaluation, creation, remembering, understanding, and application. Academic performance was measured using the students' GPA (0-20). Results: The participants' mean age was 21.46 ± 5.2 years, with 62.15% being female. The mean scores for critical thinking subscales were as follows: Analyzing (13.2 ± 3.5), Evaluating (12.8 ± 3.4), Creating (18.6 ± 4.8), Remembering (9.4 ± 2.1), Understanding (12.9 ± 3.3), and Applying (12.5 ± 3.2). The overall critical thinking score was 79.4 ± 18.1, and the average GPA was 15.7 ± 2.4. Significant positive correlations were found between GPA and several critical thinking subscales: Analyzing (r = 0.45, p = 0.013), Creating (r = 0.52, p < 0.001), Remembering (r = 0.29, p = 0.021), Understanding (r = 0.41, p = 0.002), and the overall CThQ score (r = 0.54, p = 0.043). Conclusion: The study demonstrates a significant positive relationship between critical thinking skills and learning achievement in foreign language programs. Enhancing critical thinking skills through educational interventions could potentially improve academic performance. Further research is recommended to explore the underlying mechanisms and long-term impacts of critical thinking on academic success.

Keywords: critical thinking, learning achievement, higher education, foreign language programs, student success

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Authors: Dina F. Mansour, Dalia O. Saleh, Rasha E. Mostafa

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Cyclophosphamide (CP), the most commonly used chemotherapeutic agent, was reported to cause many side effects including urotoxicity, cardiotoxicity, gonadotoxicity, and hepatotoxicity; this limits its clinical practice. In the present study, the protective effect of genistein (GEN), the major phytoestrogen in soy products that possesses various pharmacological activities, has been investigated against CP-induced acute liver damage in rats. Forty adult Sprague-Dawley rats were allocated into five groups. The first group received the vehicles and act as normal control. In the other groups, rats were injected with a single dose of CP (200 mg/kg, i.p). The last three groups were pretreated with subcutaneous GEN at doses of 0.5, 1 and 2 mg/kg/day, respectively, for 15 consecutive days prior CP injection. Forty-eight hours following CP injection, rats of all groups were investigated for the serum levels of alanine transaminase and aspartate transaminase, as well as the liver contents of reduced glutathione, malondialdehyde, nitrite, interleukin-1β, and myeloperoxidase. Histopathological examination of liver tissues was also conducted. CP resulted in acute liver damage in rats as evidenced by alteration of liver function biomarkers, oxidative stress, and inflammatory markers; that was confirmed by the histopathological outcomes. Pretreatment of rats with GEN significantly protected against CP-induced deterioration of liver function and showed marked anti-oxidant and anti-inflammatory properties that were demonstrated by the biochemical and histopathological findings. In conclusion, the present findings demonstrated the protective effects of GEN against CP-induced liver damage and suggested role of its antioxidant and anti-inflammatory activities.

Keywords: cyclophosphamide, genistein, inflammation, interleukin-1β, liver, myeloperoxidase, oxidative stress

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Authors: Nawaf A. Alqahtani, Ali M. Alqahtani, Khalid A. Alqahtani, Huda S. Abdullfattah, Ebtehal A. Alessa, Khalid S. Al Gelban, Ossama A. Mostafa

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Background: The internet is an exciting medium that is becoming an essential part of everyday life. Although the internet is fully observed in Saudi Arabia, young people may be vulnerable to problematic internet use, possibly leading to addiction. Aim of study: To explore the magnitude of internet addiction (IA) among medical students associated risk factors and its impact on students' academic achievement. Subjects and Methods: A cross sectional study was conducted in 2014 on 571 medical students (293 males and 278 females) at the College of Medicine, King Khalid University, Abha, Saudi Arabia. Data Collection was done through using the Arabic version of the Compulsive Internet Use Scale and a checklist of demographic characteristics. Results: Age of participants ranged from 19 to 26 years (Mean+SD: 21.9+1.5 years). Internet access was available to 97.4% of students at home and to 80.2% of students at their mobile phones. The most frequently accessed websites by medical students were the social media (90.7%), scientific website (50.4%) and the news websites (31.3%). IA was mild in 47.8% of medical students while 5.8% had moderate IA. None of the students had severe IA. Prevalence of IA was significantly higher among female medical students (p=0.002), availability of internet at home (p=0.022), and availability of internet at the students' mobile phone (p=0.041). The mean General Point Average (GPA) was highest among students with mild IA (4.0+0.6), compared with 3.6+0.6 among those with moderate addiction, and 3.9+0.6 among those who did not show IA. Differences in mean GPA according to grade of IA were statistically significant ((P=0.001). Conclusions: Prevalence of IA is high among medical students in Saudi Arabia. Risk factors for IA include female gender, availability of internet at home or at the mobile phone. IA has a significant impact on students' GPA. Periodic screening of medical students for IA and raising their awareness toward the possible risk of IA are recommended.

Keywords: internet addiction, medical students, risk factors, Saudi Arabia

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Authors: Yosra Ben Salah, Wang Li Jun, Salem Bellil

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The village Hammem Zriba is a lost little paradise in the middle of a beautiful landscape that captures the eyes of every visitor. The village alone is a rich expression of different elements such as urban, architecture, technical and vernacular elements, as well as sociological, spiritual and religious behaviors. This heritage is in degrading conditions and is threatened by disappearing soon; thus, actions have to be taken as soon as possible to preserve this heritage, record, analyze and learn from its traditional ways of construction. The strategy of this study is to examine the architecture within the Berber society over a period of time and influenced by a certain location and its relationship to the social and cultural aspects; this research will focus on historical, environmental, social and cultural aspects influencing architecture. The contents of this paper should mainly be constructed by three successive layouts of historical view, a cultural view and an architectural view that will include the urban and domestic scale. This research relies on the integration of both theoretical and empirical investigations. On the theoretical level: A documentary analysis of secondary data is used. Documentary analysis means content analysis of the relevant documents that include books, journals, magazines, archival data, and field survey and observations. On the empirical level: analysis of these traditional ways of planning and house building will be carried out. Through the Analysis, three techniques will be employed to collect primary data. These techniques are; systematic analysis of the architectural drawings, quantitative analysis to the houses statistics, and a direct observation. Through this research, the technical, architectural and urban achievements of the Berber people who represent a part of the general history and architectural history will be emphasized. And on a second point the potential for the sustainability present in this traditional urban planning and housing to be used to formulate guidelines for modern urban and housing development.

Keywords: culture, history, traditional architecture, values

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Authors: Majid Azizi, Payam Ghorbannezhad, Mostafa Amiri, Mohammad Ghofrani

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Environmental issues in the furniture industry are of great importance due to the use of natural materials such as wood and chemical substances like adhesives and paints. These issues encompass environmental conservation and managing pollution and waste generated. Improper use of wood resources, along with the use of chemicals and their release, leads to the depletion of natural resources, damage to forests, and the emission of greenhouse gases. Therefore, identifying influential indicators in the life cycle assessment of classic furniture and proposing solutions to reduce environmental impacts becomes crucial. In this study, the life cycle of classic furniture was evaluated using a hierarchical analytical process from cradle to grave. The life cycle assessment was employed to assess the environmental impacts of the furniture industry, ranging from raw material extraction to waste disposal and recycling. The most significant indicators in the furniture industry's production chain were also identified. The results indicated that the wood quality indicator is the most essential factor in the life cycle of classic furniture. Furthermore, the relative contribution of each type of traditional furniture was proposed concerning impact categories in the life cycle assessment. The results showed that among the three proposed types, the design and production of furniture with prefabricated parts had the most negligible impact in categories such as global warming potential and ozone layer depletion compared to furniture design with solid wood and furniture design with recycled components. Among the three suggested types of furniture to reduce environmental impacts, producing furniture with solid wood or other woods was chosen as the most crucial solution.

Keywords: life cycle assessment, analytic hierarchy process, environmental issues, furniture

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Authors: Adham M. Salah, Tariq A. Nagem, Raed A. Abd-Alhameed, James M. Noras

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Recently, the demand for wireless communications systems to cover more than one frequency band (multi-band) with high data rate has been increased for both fixed and mobile services. Multiple Input Multiple Output (MIMO) technology is one of the significant solutions for attaining these requirements and to achieve the maximum channel capacity of the wireless communications systems. The main issue associated with MIMO antennas especially in portable devices is the compact space between the radiating elements which leads to limit the physical separation between them. This issue exacerbates the performance of the MIMO antennas by increasing the mutual coupling between the radiating elements. In other words, the mutual coupling will be stronger if the radiating elements of the MIMO antenna are closer. This paper presents a low–profile dual-band (2×1) MIMO antenna that works at 2.4GHz, 5.3GHz and 5.8GHz for wireless local area networks (WLAN) applications. A neutralization line (NL) technique for enhancing the isolation has been used by introducing a strip line with a length of λg/4 at the isolation frequency (2.4GHz) between the radiating elements. The overall dimensions of the antenna are 33.5 x 36 x 1.6 mm³. The fabricated prototype shows a good agreement between the simulated and measured results. The antenna impedance bandwidths are 2.38–2.75 GHz and 4.4–6 GHz for the lower and upper band respectively; the reflection coefficient and mutual coupling are better than -25 dB in both lower and higher bands. The MIMO antenna performance characteristics are reported in terms of the scattering parameters, envelope correlation coefficient (ECC), total active reflection coefficient, capacity loss, antenna gain, and radiation patterns. Analysis of these characteristics indicates that the design is appropriate for the WLAN terminal applications.

Keywords: ECC, neutralization line, MIMO antenna, multi-band, mutual coupling, WLAN

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Authors: Hicham Amar, Mustapha El Ghorfi, Yassine Taha, Abdellatif Elghali, Rachid Hakkou, Mostafa Benzaazoua

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Phosphate mine waste rock (PMWR) generated during ore extraction is continuously increasing, resulting in a significant environmental footprint. The main objectives of this study consist of i) elaboration of the sampling strategy of PMWR piles, ii) a mineralogical and chemical characterization of PMWR piles, and iii) 3D block model creation to evaluate the potential valorization of the existing PMWR. Destructive drilling using reverse circulation from 13 drills was used to collect samples for chemical (X-ray fluorescence analysis) and mineralogical assays. The 3D block model was created based on the data set, including chemical data of the realized drills using Datamine RM software. The optical microscopy observations showed that the sandy phosphate from drills in the PMWR piles is characterized by the abundance of carbonate fluorapatite with the presence of calcite, dolomite, and quartz. The mean grade of composite samples was around 19.5±2.7% for P₂O₅. The mean grade of P₂O₅ exhibited an increasing tendency by depth profile from bottom to top of PMWR piles. 3D block model generated with chemical data confirmed the tendency of the mean grades’ variation and may allow a potential selective extraction according to %P₂O₅. The 3D block model of P₂O₅ grade is an efficient sampling approach that confirmed the variation of P₂O₅ grade. This integrated approach for PMWR management will be a helpful tool for decision-making to recover the residual phosphate, adopting the circular economy and sustainability in the phosphate mining industry.

Keywords: 3D modelling, reverse circulation drilling, circular economy, phosphate mine waste rock, sampling

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Authors: Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh

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Reflexology treatment is a method for enhancing body relaxation. It is a widely recognized as an alternative therapy, effective for many health conditions. This study aimed to evaluate the effect of reflexology treatment on arterial blood gases among mechanically ventilated patients. A quasi-experimental (pre and post-test) research design was used. Research hypothesis was mechanically ventilated patients who will receive the reflexology treatment will have improvement in their arterial blood gases than those who will not. The current study was carried out in different Intensive Care Units at the Cairo University Hospitals. A purposeful sample of 100 adults’ mechanically ventilated patients was recruited over a period of three months of data collection. The participants were divided into two equally matched groups; (1) The study group who has received the routine care, in addition, two reflexology sessions on the feet, (2) The control group who has received only the routine care. One tool was utilized to collect data pertinent to the study; mechanically ventilated patients' data sheet that consists of demographic and medical data. Result: Majority (58% of the study group and 82% of the control group) were males, with mean age of 50.9 years in both groups. Patients who received the reflexology treatment significantly increase in the oxygen saturation pre second session (t=5.15, p=.000), immediate post sessions (t=4.4, p=.000) and post two hours (t= 4.7, p= .000). The study group was more likely to have lower PaO2 (F=5.025, p=.015), PaCo2 (F=4.952, p=.025) and higher HCo3 (F=15.211, p=.000) than the control group. Conclusion: This study results support the positive effect of reflexology treatment in improving some arterial blood gases among mechanically ventilated patients’ with the conventional therapy as in the study group there was increase in the oxygen saturation. In differences between groups there decrease PaO2, PaCo2 and increase HCo3 in the study group. Recommendation: Nurses should be trained how to demonstrate the foot reflexology among mechanically ventilated patients.

Keywords: arterial blood gases, foot, mechanical ventilated patient, reflexology

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Authors: Ghorbeli Eya, Naija Lamia, Khessairi Nayssem, Saadallah Fatma, Slimane Maher, Tarek Ben Dhiab

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INTRODUCTION: Borderline ovarian tumors account for 15 to 20% of ovarian tumors. Prognostic factors of recurrence include the stage of the disease, presence of peritoneal implants, micropapillary pattern, microinvasion and intra-epithelial carcinoma. Fertility sparing constitutes a major therapeutic issue in young patients that leads to conservative surgical treatment in specific cases. METHODS: We conducted a retrospective descriptive study including patients treated at the Salah Azaiez Institute for Borderline Ovarian Tumor who underwent conservative surgical treatment from 2003 to 2018. RESULTS: Nine patients were included in our study. The median age was 33 years. Three patients were nulliparous. Given the age, conservative treatment was indicated in all these patients. Cystectomy without ovariectomy was indicated in 5 of the 9 women, which was within the margin of tumor resection on definitive anatomopathic examination in 3 of the 5 women. In contrast, given the impossibility of ovarian conservation, total annexectomy was carried out in 4 of all these women. All of the patients were followed regularly postoperatively; three had a carcinomatous transformation as an ovarian adenocarcinoma at an average interval of 18 months. Among these three patients, a single one presented intra-peritoneal metastases, requiring radical surgical treatment and adjuvant chemotherapy with 6 cures of Carbo-Taxol, with a good tolerance and a complete response. Moreover, one patient had a recurrence on the contralateral ovary as a Borderline mucinous ovarian tumor. For the remaining four women, after a median follow-up of 35 months, one patient fell spontaneously pregnant during follow-up, and three patients were in complete remission at 16 months. CONCLUSION: Borderline tumors of the ovary usually occur in young patients, which makes conservative treatment advisable if possible, but this always comes with a risk of recurrence and/or carcinomatous transformation, especially if the conservative surgical procedure was a cystectomy instead of a total annexectomy, and even more so if the resection margins were tumoral.

Keywords: ovarian tumor, conservative treatment, surgical management, borderline ovarian tumor, recurrence management

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Authors: Mostafa Firoozabadi, Alireza Foroughi Nematollahi

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Semi autogenous mills are designed for grinding or primary crushed ore, and are the most widely used in concentrators globally. Any defect occurrence in semi autogenous mills can stop the production line. A Gearbox is a significant part of a rotating machine or a mill, so, the gearbox monitoring is a necessary process to prevent the unwanted defects. When a defect happens in a gearbox bearing, this defect can be transferred to the other parts of the equipment like inner ring, outer ring, balls, and the bearing cage. Vibration analysis is one of the most effective and common ways to detect the bearing defects in the mills. Vibration signal in a mill can be made by different parts of the mill including electromotor, pinion girth gear, different rolling bearings, and tire. When a vibration signal, made by the aforementioned parts, is added to the gearbox vibration spectrum, an accurate and on time defect detection in the gearbox will be difficult. In this paper, a new method is proposed to detect the gearbox bearing defects in the semi autogenous mill on time and accurately, using the vibration signal analysis method. In this method, if the vibration values are increased in the vibration curve, the probability of defect occurrence is investigated by comparing the equipment vibration values and the standard ones. Then, all vibration frequencies are extracted from the vibration signal and the equipment defect is detected using the vibration spectrum curve. This method is implemented on the semi autogenous mills in the Golgohar mining and industrial company in Iran. The results show that the proposed method can detect the bearing looseness on time and accurately. After defect detection, the bearing is opened before the equipment failure and the predictive maintenance actions are implemented on it.

Keywords: condition monitoring, gearbox defects, predictive maintenance, vibration analysis

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Authors: Hassan Nour, Nouh Mounadi, Oussama Abchir, Belaidi Salah, Samir Chtita

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Cholinesterase enzymes are biological catalysts essential for the transformation of acetylcholine, which is a neurotransmitter implicated in memory and learning, into acetic acid and choline, altering the neurotransmission process in Alzheimer’s disease patients. Therefore, inhibition of cholinesterase enzymes is a relevant strategy for the symptomatic treatment of Alzheimer’s disease. The current investigation aims to explore potential Cholinesterase (ChE) inhibitors through a comprehensive computational approach. Forty-nine phytoconstituents extracted from Cannabis sativa L were in-silico screened using molecular docking, pharmacokinetic and toxicological analysis to evaluate their possible inhibitory effect towards the cholinesterase enzymes. Two phytoconstituents belonging to cannabinoid derivatives were revealed to be promising candidates for Alzheimer therapy by acting as cholinesterase inhibitors. They have exhibited high binding affinities towards the cholinesterase enzymes and showed their ability to interact with key residues involved in cholinesterase enzymatic activity. In addition, they presented good ADMET profiles allowing them to be promising oral drug candidates. Furthermore, molecular dynamics (MD) simulations were executed to explore their interactions stability under mimetic biological conditions and thus support our findings. To corroborate the docking results, the binding free energy corresponding to the more stable ligand-ChE complexes was re-estimated by applying the MM-PBSA method. MD and MM-PBSA studies affirmed that the ligand-ChE recognition is spontaneous reaction leading to stable complexes. The conducted investigations have led to great findings that would strongly guide the pharmaceutical industries towards the rational development of potent anti-Alzheimer agents.

Keywords: alzheimer’s disease, molecular docking, cannabis sativa l, cholinesterase inhibitors

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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Authors: Sepideh Nikounejad, Mostafa Ghaderi, Nematollah Azizi, Per-Olof Thang, Mohamad Reza Neyestani

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From an educational perspective, an effective and efficient relationship between university and industry can be considered as an important means by which not only both sides are improved but also it brings many advantages and benefits for both parties. It means more specifically, mutual collaboration between universities and industry can not only reduce youth unemployment, but it can improve the quality of teaching and learning in higher education settings while providing more qualified people to industrial enterprises. Indeed the lack of effective interaction between Iranian universities and industry has confronted the country and created many challenges include in increasing number of unskillful and unemployed graduates. However, in order to suggest appropriate practical strategies, it is very important to see how this issue has been tackled by Swedish universities, which have had a good background in this collaboration and how they are connected to the industry in particular and labour market in general. The research aims to study and compare the mechanisms, processes, and policies of the current model in the relationships between university and industry in Iran and Sweden. As a qualitative study, grounded theory was applied. Data were collected via semi-structured interviews. Participants were selected purposefully and by the snowball sampling method. The findings indicate that despite reported needs from both sides for close collaborations between universities and industries in Iran, current policies and practices, including internship, laboratory, and financial support, need to be revised critically. However, in light of our findings on the Swedish policies and practices for linking universities and industries, some practical strategies will be suggested for the Iranian higher education context. In conclusion, cooperation models between universities and industries in Iran and Sweden will be described.

Keywords: cooperation, higher education, industry, comparative

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Authors: Ghada A. Abdelbary, Maha M. Amin, Mostafa Abdelmoteleb

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Zaleplon (ZP) is a non-benzodiazepine poorly soluble hypnotic drug indicated for the short term treatment of insomnia having a bioavailability of about 30%. The aim of the present study is to enhance the solubility and consequently the bioavailability of ZP using hydrotropic agents (HA). Phase solubility diagrams of ZP in presence of different molar concentrations of HA (Sodium benzoate, Urea, Ascorbic acid, Resorcinol, Nicotinamide, and Piperazine) were constructed. ZP/Sodium benzoate and Resorcinol microparticles were prepared adopting melt, solvent evaporation and melt-evaporation techniques followed by XRD. Directly compressed mixed hydrotropic ZP tablets of Sodium benzoate and Resorcinol in different weight ratios were prepared and evaluated compared to the commercially available tablets (Sleep aid® 5 mg). The effect of shelf and accelerated stability storage (40°C ± 2°C/75%RH ± 5%RH) on the optimum tablet formula (F5) for six months were studied. The enhancement of ZP solubility follows the order of: Resorcinol > Sodium benzoate > Ascorbic acid > Piperazine > Urea > Nicotinamide with about 350 and 2000 fold increase using 1M of Sodium benzoate and Resorcinol respectively. ZP/HA microparticles exhibit the order of: Solvent evaporation > melt-solvent evaporation > melt > physical mixture which was further confirmed by the complete conversion of ZP into amorphous form. Mixed hydrotropic tablet formula (F5) composed of ZP/(Resorcinol: Sodium benzoate 4:1w/w) microparticles prepared by solvent evaporation exhibits in-vitro dissolution of 31.7±0.11% after five minutes (Q5min) compared to 10.0±0.10% for Sleep aid® (5 mg) respectively. F5 showed significantly higher GABA concentration of 122.5±5.5mg/mL in plasma compared to 118±1.00 and 27.8±1.5 mg/mL in case of Sleep aid® (5 mg) and control taking only saline respectively suggesting a higher neuropharmacological effect of ZP following hydrotropic solubilization.

Keywords: zaleplon, hydrotropic solubilization, plasma GABA level, mixed hydrotropy

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Kyosuke Kamada, Christoph Kapeller, Michael Jordan, Mostafa Mohammadpour, Christy Li, Christoph Guger

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Cortico-cortical evoked potentials (CCEP) refer to responses generated by cortical electrical stimulation at distant brain sites. These responses provide insights into the functional networks associated with language or motor functions, and in the context of epilepsy, they can reveal pathological networks. Locating the origin and spread of seizures within the cortex is crucial for pre-surgical planning. This process can be enhanced by employing cortical stimulation at the seizure onset zone (SOZ), leading to the generation of CCEPs in remote brain regions that may be targeted for disconnection. In the case of a 24-year-old male patient suffering from intractable epilepsy, corpus callosotomy was performed as part of the treatment. DTI-MRI imaging, conducted using a 3T MRI scanner for fiber tracking, along with CCEP, is used as part of an assessment for surgical planning. Stimulation of the SOZ, with alternating monophasic pulses of 300µs duration and 15mA current intensity, resulted in CCEPs on the contralateral frontal cortex, reaching a peak amplitude of 206µV with a latency of 31ms, specifically in the left pars triangularis. The related fiber tracts were identified with a two-tensor unscented Kalman filter (UKF) technique, showing transversal fibers through the corpus callosum. The CCEPs were monitored through the progress of the surgery. Notably, the SOZ-associated CCEPs exhibited a reduction following the resection of the anterior portion of the corpus callosum, reaching the identified connecting fibers. This intervention demonstrated a potential strategy for mitigating the impact of intractable epilepsy through targeted disconnection of identified cortical regions.

Keywords: CCEP, SOZ, Corpus callosotomy, DTI

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Authors: Hassan Nour, Nouh Mounadi, Oussama Abchir, Belaidi Salah, Samir Chtita

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Cholinesterase enzymes are biological catalysts essential for the transformation of acetylcholine, which is a neurotransmitter implicated in memory and learning, into acetic acid and choline, altering the neurotransmission process in Alzheimer’s disease patients. Therefore, inhibition of cholinesterase enzymes is a relevant strategy for the symptomatic treatment of Alzheimer’s disease. The current investigation aims to explore potential cholinesterase (ChE) inhibitors through a comprehensive computational approach. Forty-nine phytoconstituents extracted from Cannabis sativa L. were in-silico screened using molecular docking and pharmacokinetic and toxicological analysis to evaluate their possible inhibitory effect on the cholinesterase enzymes. Two phytoconstituents belonging to cannabinoid derivatives were revealed to be promising candidates for Alzheimer's therapy by acting as cholinesterase inhibitors. They have exhibited high binding affinities towards the cholinesterase enzymes and showed their ability to interact with key residues involved in cholinesterase enzymatic activity. In addition, they presented good ADMET profiles allowing them to be promising oral drug candidates. Furthermore, molecular dynamics (MD) simulations were executed to explore their interaction stability under mimetic biological conditions and thus support our findings. To corroborate the docking results, the binding free energy corresponding to the more stable ligand-ChE complexes was re-estimated by applying the MM-PBSA method. MD and MM-PBSA studies affirmed that the ligand-ChE recognition is a spontaneous reaction leading to stable complexes. The conducted investigations have led to great findings that would strongly guide the pharmaceutical industries toward the rational development of potent anti-Alzheimer agents.

Keywords: Alzheimer’s disease, molecular docking, Cannabis sativa L., cholinesterase inhibitors, molecular dynamics, ADMET, MM-PBSA

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Authors: M. M. Hefnawy, A. M. A. Homoda, M. A. Abounassif, A. M. Alanazia, A. Al-Majed, Gamal A. E. Mostafa

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PVC membrane sensors using different approach e.g. ion-pair, ionophore, and Schiff-base has been used as testing membrane sensor. Analytical applications of membrane sensors for direct measurement of variety of different ions in complex biological and environmental sample are reported. The most important step of such PVC membrane sensor is the sensing active material. The potentiometric sensors have some outstanding advantages including simple design, operation, wide linear dynamic range, relative fast response time, and rotational selectivity. The analytical applications of these techniques to pharmaceutical compounds in dosage forms are also discussed. The construction and electrochemical response characteristics of Poly (vinyl chloride) membrane sensors for moxifloxacin HCl (MOX) are described. The sensing membranes incorporate ion association complexes of moxifloxacin cation and sodium tetraphenyl borate (NaTPB) (sensor 1), phosphomolybdic acid (PMA) (sensor 2) or phosphotungstic acid (PTA) (sensor 3) as electroactive materials. The sensors display a fast, stable and near-Nernstian response over a relative wide moxifloxacin concentration range (1 ×10-2-4.0×10-6, 1 × 10-2-5.0×10-6, 1 × 10-2-5.0×10-6 M), with detection limits of 3×10-6, 4×10-6 and 4.0×10-6 M for sensor 1, 2 and 3, respectively over a pH range of 6.0-9.0. The sensors show good discrimination of moxifloxacin from several inorganic and organic compounds. The direct determination of 400 µg/ml of moxifloxacin show an average recovery of 98.5, 99.1 and 98.6 % and a mean relative standard deviation of 1.8, 1.6 and 1.8% for sensors 1, 2, and 3 respectively. The proposed sensors have been applied for direct determination of moxifloxacin in some pharmaceutical preparations. The results obtained by determination of moxifloxacin in tablets using the proposed sensors are comparable favorably with those obtained using the US Pharmacopeia method. The sensors have been used as indicator electrodes for potentiometric titration of moxifloxacin.

Keywords: potentiometry, PVC, membrane sensors, ion-pair, ionophore, schiff-base, moxifloxacin HCl, sodium tetraphenyl borate, phosphomolybdic acid, phosphotungstic acid

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Authors: Mostafa Mjahed

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This paper concerns the control of a nonlinear system using two different methods, reference model and genetic algorithm. The quadcopter is a nonlinear unstable system, which is a part of aerial robots. It is constituted by four rotors placed at the end of a cross. The center of this cross is occupied by the control circuit. Its motions are governed by six degrees of freedom: three rotations around 3 axes (roll, pitch and yaw) and the three spatial translations. The control of such system is complex, because of nonlinearity of its dynamic representation and the number of parameters, which it involves. Numerous studies have been developed to model and stabilize such systems. The classical PID and LQ correction methods are widely used. If the latter represent the advantage to be simple because they are linear, they reveal the drawback to require the presence of a linear model to synthesize. It also implies the complexity of the established laws of command because the latter must be widened on all the domain of flight of these quadcopter. Note that, if the classical design methods are widely used to control aeronautical systems, the Artificial Intelligence methods as genetic algorithms technique receives little attention. In this paper, we suggest comparing two PID design methods. Firstly, the parameters of the PID are calculated according to the reference model. In a second phase, these parameters are established using genetic algorithms. By reference model, we mean that the corrected system behaves according to a reference system, imposed by some specifications: settling time, zero overshoot etc. Inspired from the natural evolution of Darwin's theory advocating the survival of the best, John Holland developed this evolutionary algorithm. Genetic algorithm (GA) possesses three basic operators: selection, crossover and mutation. We start iterations with an initial population. Each member of this population is evaluated through a fitness function. Our purpose is to correct the behavior of the quadcopter around three axes (roll, pitch and yaw) with 3 PD controllers. For the altitude, we adopt a PID controller.

Keywords: quadcopter, genetic algorithm, PID, fitness, model, control, nonlinear system

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Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

Procedia PDF Downloads 282

Authors: Norhan H. Mahdally, Bathini Thissera Riham A. ElShiekh, Noha M. Elhosseiny, Mona T. Kashef, Ali M. El Halawany, Mostafa E. Rateb, Ahmed S. Attia

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Multidrug-resistant (MDR) pathogens pose a global threat to healthcare settings. The exhaustion of the current antibiotic arsenal and the scarcity of new antimicrobials in the pipeline aggravate this threat and necessitate a prompt and effective response. This study focused on two major pathogens that can cause serious infections: carbapenem-resistant Acinetobacter baumannii (CRAB) and methicillin-resistant Staphylococcus aureus (MRSA). Multiple soil isolates were collected from several locations throughout Egypt and screened for their conventional and non-conventional antimicrobial activities against MDR pathogens. One isolate exhibited potent antimicrobial activity and was subjected to multiple rounds of fractionation. After fermentation and bio-guided fractionation, we identified pure microbial secondary metabolites with two scaffolds that exhibited promising effects against CRAB and MRSA. Scaling up and chemical synthesis of derivatives of the identified metabolite resulted in obtaining a more potent derivative, which we designated as 2HP. Cytotoxicity studies indicated that 2HP is well-tolerated by human cells. Ongoing work is focusing on formulating the new compound into a nano-formulation to enhance its delivery. Also, to have a better idea about how this compound works, a proteomic approach is currently underway. Our findings suggest that 2HP is a potential new broad-spectrum antimicrobial agent. Further studies are needed to confirm these findings and to develop 2HP into a safe and effective treatment for MDR infections.

Keywords: broad-spectrum antimicrobials, carbapenem-resistant acinetobacter baumannii, drug discovery, methicillin-resistant staphylococcus aureus, multidrug-resistant, natural products

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Authors: Marzia Bilkiss, Muhammad J. A. Shiddiky, Mostafa K. Masud, Prabhakaran Sambasivam, Ido Bar, Jeremy Brownlie, Rebecca Ford

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A greater achievement in the Integrated Disease Management (IDM) to prevent the loss would result from early diagnosis and quantitation of the causal pathogen species for accurate and timely disease control. This could significantly reduce costs to the growers and reduce any flow on impacts to the environment from excessive chemical spraying. Necrotrophic fungal disease botrytis grey mould, caused by Botrytis cinerea and Botrytis fabae, significantly reduce temperate legume yield and grain quality during favourable environmental condition in Australia and worldwide. Several immunogenic and molecular probe-type protocols have been developed for their diagnosis, but these have varying levels of species-specificity, sensitivity, and consequent usefulness within the paddock. To substantially improve speed, accuracy, and sensitivity, advanced nanoparticle-based biosensor approaches have been developed. For this, two sets of primers were designed for both Botrytis cinerea and Botrytis fabae which have shown the species specificity with initial sensitivity of two genomic copies/µl in pure fungal backgrounds using multiplexed quantitative PCR. During further validation, quantitative PCR detected 100 spores on artificially infected legume leaves. Simultaneously an electro-catalytic assay was developed for both target fungal DNA using functionalised magnetic nanoparticles. This was extremely sensitive, able to detect a single spore within a raw total plant nucleic acid extract background. We believe that the translation of this technology to the field will enable quantitative assessment of pathogen load for future accurate decision support of informed botrytis grey mould management.

Keywords: biosensor, botrytis grey mould, sensitive, species specific

Procedia PDF Downloads 172

Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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