Search results for: Nehal Adel Khalil

Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: B. Sadek, N. Khan, Shreesh K. Ojha, Adel Sadeq, D. Lazewska, K. Kiec-Kononowicz

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The involvement of Histamine H3 receptors (H3Rs) in memory and the potential role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., Alzheimer disease (AD) is well established. Therefore, the memory-enhancing effects of the H3R antagonist DL77 on MK801-induced cognitive deficits were evaluated in passive avoidance paradigm (PAP) and novel object recognition (NOR) tasks in adult male rats, applying donepezil (DOZ) as a reference drug. Animals pretreated with acute systemic administration of DL77 (2.5, 5, and 10 mg/kg, i.p.) were significantly ameliorated in regard to MK801-induced memory deficits in PAP. The ameliorative effect of most effective dose of DL77 (5 mg/kg, i.p.) was abrogated when animals were pretreated with a co-injection with the H3R agonist R-(α)-methylhistamine (RAMH, 10 mg/kg, i.p.). Moreover, and in the NOR paradigm, DL77 (5 mg/kg, i.p.) reversed MK801-induced deficits long-term memory (LTM), and the DL77-provided procognitive effect was comparable to that of reference drug DOZ, and was reversed when animals were co-injected with RAMH (10 mg/kg, i.p.). However, DL77(5 mg/kg, i.p.) failed to alter short-term memory (STM) impairment in NOR test. Furthermore, DL77 (5 mg/kg) failed to induce any alterations of anxiety and locomotor behaviors of animals naive to elevated-plus maze (EPM), indicating that the ameliorative effects observed in PAP or NOR tests were not associated to alterations in emotions or in natural locomotion of tested animals. These results reveal the potential contribution of H3Rs in modulating CNS neurotransmission systems associated with neurodegenerative disorders, e.g., AD.

Keywords: histamine H3 receptor, antagonist, learning and memory, Alzheimer's disease, neurodegeneration, passive avoidance paradigm, novel object recognition, behavioral research

Procedia PDF Downloads 155

Authors: Ibrahim M. Labouta, Gina N. Tageldin, Salwa M. Fahmy, Hayam M. Ashour, Mounir A. Khalil, Tamer M. Ibrahim, Nefertiti A. El-Nikhely

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Bruton’s tyrosine kinase (BTK) is a critical effector molecule in B cell antigen receptor (BCR) signaling transduction. It regulates B cell proliferation, development and survival. Since BTK is widely expressed in many B cell leukaemias and lymphomas, targeting BTK by small molecules inhibitors became an attractive idea as new treatment modalities for B cell mediated hematologic malignancies. Ibrutinib is the 1st generation BTK inhibitor, approved by FDA for treatment of relapsed mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL). It binds irreversibly to the unique cysteine (Cys481) within the ATP-binding pocket of BTK. Besides ibrutinib, many irreversible covalent BTK inhibitors comprising pyrimidine nucleus such as spebrutinib (phase IIb) showed high selectivity and potency when compared to it. In this study, the designed compounds were based on 5-cyano-2-methylsulfanyl pyrimidine core and decorated with electrophilic warheads which are essential for the optimal activity for targeted covalent inhibition (TCI). However, modifications at pyrimidine C4 or C6 were made by introduction of substituted amines which are provided to behave differently. The synthesized derivatives were evaluated for their anticancer activity in leukemia cell lines (e.g. THP-1). Results showed that, some derivatives exhibited antiproliferative activity with IC50 ranged from 5-50 μM, The in vitro enzymatic inhibitory assay for these compounds against BTK is still under investigation. Nevertheless, we could conclude from the initial biological screening that, the synthesized 4 or 6-subsitituted aminopyrimidines represent promising and novel antileukemic agents. Meanwhile, further studies are still needed to attribute this activity through targeting BTK enzyme and inhibition of BCR signaling pathway.

Keywords: BTK inhibitors, hematologic malignancies, structure based drug design (SBDD), targeted covalent inhibitors (TCI)

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Authors: Adel A. Ghoneim

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Air conditioning devices are substantially utilized in the summer months, as a result maximum loads in Kuwait take place in these intervals. Peak energy consumption are usually more expensive to satisfy compared to other standard power sources. The primary objective of the current work is to enhance the performance of high concentrated photovoltaic (HCPV) systems in an attempt to minimize peak power usage in Kuwait using HCPV modules. High concentrated PV multi-junction solar cells provide a promising method towards accomplishing lowest pricing per kilowatt-hour. Nevertheless, these cells have various features that should be resolved to be feasible for extensive power production. A single diode equivalent circuit model is formulated to analyze multi-junction solar cells efficiency in Kuwait weather circumstances taking into account the effects of both the temperature and the concentration ratio. The diode shunt resistance that is commonly ignored in the established models is considered in the present numerical model. The current model results are successfully validated versus measurements from published data to within 1.8% accuracy. Present calculations reveal that the single diode model considering the shunt resistance provides accurate and dependable results. The electrical efficiency (η) is observed to increase with concentration to a specific concentration level after which it reduces. Implementing grid systems is noticed to increase with concentration to a certain concentration degree after which it decreases. Employing grid connected HCPV systems results in significant peak load reduction.

Keywords: grid connected, high concentrated photovoltaic systems, peak load, solar cells

Procedia PDF Downloads 156

Authors: Nasibeh Mohammadpour, Ali Rajabzadeh, Adel Azar, Hamid Zargham Borujeni,

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Generally, various industries development depends on their stakeholders and beneficiaries supports. One of the most important stakeholders in tourism industry ( which has become one of the most important lucrative and employment-generating activities at the international level these days) are host communities in tourist destination which are affected and effect on this industry development. Recognizing host community and its segmentations can be important to get their support for future decisions and policy making. In order to identify these segments, in this study, clustering of the residents has been done by using some tools that are designed to encounter human complexities and have ability to model and generalize complex systems without any needs for the initial clusters’ seeds like classic methods. Neural networks can help to meet these expectations. The research have been planned to design neural networks-based mathematical model for clustering the host community effectively according to multi criteria, and identifies differences among segments. In order to achieve this goal, the residents’ segmentation has been done by demographic characteristics, their attitude towards the tourism development, the level of satisfaction and the type of their support in this field. The applied method is self-organized neural networks and the results have compared with K-means. As the results show, the use of Self- Organized Map (SOM) method provides much better results by considering the Cophenetic correlation and between clusters variance coefficients. Based on these criteria, the host community is divided into five sections with unique and distinctive features, which are in the best condition (in comparison other modes) according to Cophenetic correlation coefficient of 0.8769 and between clusters variance of 0.1412.

Keywords: Artificial Nural Network, Clustering , Resident, SOM, Tourism

Procedia PDF Downloads 185

Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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Authors: Adel Al Hashlan

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Parent and family engagement plays a crucial role in supporting the success of students with special needs in educational settings. This paper explores the significance of parental involvement in special education, examining its impact on academic achievement, social-emotional development, and overall well-being. Meaningful collaboration between educators, parents, and families can promote positive outcomes for students with diverse learning needs. The study employs a mixed-methods approach, incorporating both qualitative and quantitative techniques. Data were collected through structured interviews, focus groups, and surveys involving students with special needs, their parents, and educators across diverse educational settings. The analysis identifies patterns, themes, and correlations to understand the impact of parent and family engagement on student outcomes. Major findings reveal that effective parent and family involvement initiatives, characterized by strong communication strategies, collaboration frameworks, and partnership-building approaches, significantly enhance students’ academic performance, social-emotional development, and overall well-being. The study also identifies common barriers to parental involvement, such as cultural differences and accessibility issues, and suggests strategies for overcoming these challenges. In conclusion, the study underscores the importance of systemic support and resource allocation to facilitate meaningful partnerships between schools and families. Ongoing research and professional development are crucial to enhancing the effectiveness of parent and family engagement initiatives in special education, ultimately maximizing student achievement and well-being.

Keywords: parental involvement, special education, student success, collaborative partnerships

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Authors: Ahmed Khalil, Elhamy Tarabees, Svetlana Kovacikova

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The Red Sea Mountains have been famous for their ore deposits since ancient times. Also, petrographic analysis and previous potential field surveys indicated large unexplored accumulations of ore minerals in the area. Therefore, the main goal of the presented study is to contribute to the discovery of hitherto unknown ore mineral deposits in the Red Sea region. To achieve this goal, we used two geophysical techniques: land magnetic survey and magnetotelluric data. A high-resolution land magnetic survey has been acquired using two proton magnetometers, one instrument used as a base station for the diurnal correction and the other used to measure the magnetic field along the study area. Two hundred eighty land magnetic stations were measured over a mesh-like area with a 500m spacing interval. The necessary reductions concerning daily variation, regional gradient and time observation were applied. Then, the total intensity anomaly map was constructed and transformed into the reduced magnetic pole (RTP). The magnetic interpretation was carried out using the analytical signal as well as regional–residual separation is carried out using the power spectrum. Also, the tilt derivative method (TDR) technique is applied to delineate the structure and hidden anomalies. Data analysis has been performed using trend analysis and Euler deconvolution. The results indicate that magnetic contacts are not the dominant geological feature of the study area. The magnetotleruric survey consisted of two profiles with a total of 8 broadband measurement points with a duration of about 24 hours crossing a wadi um Gheig approximately 50 km south of El Quseir. Collected data have been inverted to the electrical resistivity model using the 3D modular 3D inversion technique ModEM. The model revealed a non-conductive body in its central part, probably corresponding to a dolerite dyke, with which possible ore mineralization could be related.

Keywords: magnetic survey, magnetotelluric, mineralization, 3d modeling

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Authors: Kasra Majbouri Yazdi, Adel Majbouri Yazdi, Saeid Khodayi, Jingyu Hou, Wanlei Zhou, Saeed Saedy

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Fake news and false information are big challenges of all types of media, especially social media. There is a lot of false information, fake likes, views and duplicated accounts as big social networks such as Facebook and Twitter admitted. Most information appearing on social media is doubtful and in some cases misleading. They need to be detected as soon as possible to avoid a negative impact on society. The dimensions of the fake news datasets are growing rapidly, so to obtain a better result of detecting false information with less computation time and complexity, the dimensions need to be reduced. One of the best techniques of reducing data size is using feature selection method. The aim of this technique is to choose a feature subset from the original set to improve the classification performance. In this paper, a feature selection method is proposed with the integration of K-means clustering and Support Vector Machine (SVM) approaches which work in four steps. First, the similarities between all features are calculated. Then, features are divided into several clusters. Next, the final feature set is selected from all clusters, and finally, fake news is classified based on the final feature subset using the SVM method. The proposed method was evaluated by comparing its performance with other state-of-the-art methods on several specific benchmark datasets and the outcome showed a better classification of false information for our work. The detection performance was improved in two aspects. On the one hand, the detection runtime process decreased, and on the other hand, the classification accuracy increased because of the elimination of redundant features and the reduction of datasets dimensions.

Keywords: clustering, fake news detection, feature selection, machine learning, social media, support vector machine

Procedia PDF Downloads 177

Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

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Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

Procedia PDF Downloads 440

Authors: Magdi Elmessiry, Adel Elmessiry

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The fashion industry represents a significant portion of the global gross domestic product, however, it is plagued by cheap imitators that infringe on the trademarks which destroys the fashion industry's hard work and investment. While eventually the copycats would be found and stopped, the damage has already been done, sales are missed and direct and indirect jobs are lost. The infringer thrives on two main facts: the time it takes to discover them and the lack of tracking technologies that can help the consumer distinguish them. Blockchain technology is a new emerging technology that provides a distributed encrypted immutable and fault resistant ledger. Blockchain presents a ripe technology to resolve the infringement epidemic facing the fashion industry. The significance of the study is that a new approach leveraging the state of the art blockchain technology coupled with artificial intelligence is used to create a framework addressing the fashion infringement problem. It transforms the current focus on legal enforcement, which is difficult at best, to consumer awareness that is far more effective. The framework, Crypto CopyCat, creates an immutable digital asset representing the actual product to empower the customer with a near real time query system. This combination emphasizes the consumer's awareness and appreciation of the product's authenticity, while provides real time feedback to the producer regarding the fake replicas. The main findings of this study are that implementing this approach can delay the fake product penetration of the original product market, thus allowing the original product the time to take advantage of the market. The shift in the fake adoption results in reduced returns, which impedes the copycat market and moves the emphasis to the original product innovation.

Keywords: fashion, infringement, blockchain, artificial intelligence, textiles supply chain

Procedia PDF Downloads 261

Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

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Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

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Authors: Mohamed Abdalla Khalil Mahmoud, Omnia Haidar Suliman

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Information and Communication technologies have revolutionized the way services are developed and offered to customers and have achieved evident success in a variety of vital sectors and widely contributed to the growth and resilience of the economy worldwide. Consequently, governments, especially of developing countries, have turned their attention to examine possible ways to utilize contemporary technology advances to offer essential governmental services to citizens, especially in areas where government agencies are not present. This paper investigates the challenges that impede governments of developing countries to provide basic services to its constituents nationwide. Sudan, as a case study, has taken major steps to provide essential governmental services via electronic channels. However, these services are still not widely used by the citizens, resulting in waste of financial and human resources and efforts that could have been invested more appropriately. This paper examines the challenges that hinder the Sudan’s government in their pursuit of availing its services via electronic channels. Different categories of e-government challenges, such as organizational, technological, social and, demographic, and financial and economic, have been explored in order to pinpoint the major challenges. A structured questionnaire is used to survey the target population of e-government professionals and executives who have direct involvement in the implementation of this nationwide endeavor in Sudan. The survey has successfully identified the main challenges that have high impact on the government’s effort to offer its services via electronic channels, such as Lack of coordination between public and private sectors and Lack of the benefits recognition of the e-government program. The findings of this paper can be used as a solid foundation for improving the way governmental services are offered to citizens in Sudan, resulting in a successful investment of financial and human resources and benefiting the targeted customers of all types.

Keywords: citizen, digital, e-channels, public sector, Sudan, technology

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Authors: Mohammed Khalil Ur Rahman, Khanita Aammatullh

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Rasayana is one of the eight clinical specialities of classical Ayurveda The disease preventive and health promotive approach of ‘Ayurveda’, which takes into consideration the whole body, mind and spirit while dealing with the maintenance of health, promotion of health and treating ailments is holistic and finds increasing acceptability in many regions of the world. Ancient Ayurvedic physicians had developed certain dietary and therapeutic measures to arrest/delay ageing and rejuvenating whole functional dynamics of the body system. This revitalization and rejuvenation is known as the ‘Rasayan chikitsa’ (rejuvenation therapy). Traditionally, Rasayana drugs are used against a plethora of seemingly diverse disorders with no pathophysiological connections according to modern medicine. Though, this group of plants generally possesses strong antioxidant activity, only a few have been investigated in detail. Over about 100 disorders like rheumatoid arthritis, hemorrhagic shock, CVS disorders, cystic fibrosis, metabolic disorders, neurodegenerative diseases, gastrointestinal ulcerogenesis and AIDS have been reported as reactive oxygen species mediated. In this review, the role of free radicals in these diseases has been briefly reviewed. ‘Rasayana’ plants with potent antioxidant activity have been reviewed for their traditional uses, and mechanism of antioxidant action. Fifteen such plants have been dealt with in detail and some more plants with less work have also been reviewed briefly The Rasayanas are rejuvenators, nutritional supplements and possess strong antioxidant activity. They also have antagonistic actions on the oxidative stressors, which give rise to the formation of different free radicals. Ocimum sanctum, Tinospora cordifolia, Emblica officinalis, Convolvulus pluricaulis, Centella asiatica, Bacopa monniera, Withania somnifera, Triphala rasayana, Chyawanprash, Brahma rasayana are very important rasayanas which are described in ayurveda and proved by new researches.

Keywords: rasayana, antioxidant activity, Bacopa monniera, Withania somnifera Triphala, chyawanprash

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi, Morvarid Lalenoor

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Background: Plantar pressure distribution measurement has been used for a long time to assess foot disorders. Plantar pressure is an important component affecting the foot and ankle function and Changes in plantar pressure distribution could indicate various foot and ankle disorders. Morphologic and mechanical properties of the foot may be important factors affecting the plantar pressure distribution. Accurate and early measurement may help to reduce the prevalence of pes planus. With recent developments in technology, new techniques such as machine learning have been used to assist clinicians in predicting patients with foot disorders. Significance of the study: This study proposes a neural network learning-based flat foot classification methodology using static foot pressure distribution. Methodologies: Data were collected from 895 patients who were referred to a foot clinic due to foot disorders. Patients with pes planus were labeled by an experienced physician based on clinical examination. Then all subjects (with and without pes planus) were evaluated for static plantar pressures distribution. Patients who were diagnosed with the flat foot in both feet were included in the study. In the next step, the leg length was normalized and the network was trained for plantar pressure mapping images. Findings: From a total of 895 image data, 581 were labeled as pes planus. A computational neural network (CNN) ran to evaluate the performance of the proposed model. The prediction accuracy of the basic CNN-based model was performed and the prediction model was derived through the proposed methodology. In the basic CNN model, the training accuracy was 79.14%, and the test accuracy was 72.09%. Conclusion: This model can be easily and simply used by patients with pes planus and doctors to predict the classification of pes planus and prescreen for possible musculoskeletal disorders related to this condition. However, more models need to be considered and compared for higher accuracy.

Keywords: foot disorder, machine learning, neural network, pes planus

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Authors: Rawia M. Khalil, Ahmed A. Abd El Rahman, Mahfouz A. Kassem, Mohamed S. El Ridi, Mona M. Abou Samra, Ghada E. A. Awad, Soheir S. Mansy

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Solid lipid nanoparticles (SLNs) have gained great attention for the topical treatment of skin associated fungal infection as they facilitate the skin penetration of loaded drugs. Our work deals with the preparation of nystatin loaded solid lipid nanoparticles (NystSLNs) using the hot homogenization and ultrasonication method. The prepared NystSLNs were characterized in terms of entrapment efficiency, particle size, zeta potential, transmission electron microscopy, differential scanning calorimetry, rheological behavior and in vitro drug release. A stability study for 6 months was performed. A microbiological study was conducted in male rats infected with Candida albicans, by counting the colonies and examining the histopathological changes induced on the skin of infected rats. The results showed that SLNs dispersions are spherical in shape with particle size ranging from 83.26±11.33 to 955.04±1.09 nm. The entrapment efficiencies are ranging from 19.73±1.21 to 72.46±0.66% with zeta potential ranging from -18.9 to -38.8 mV and shear-thinning rheological Behavior. The stability studies done for 6 months showed that nystatin (Nyst) is a good candidate for topical SLN formulations. A least number of colony forming unit/ ml (cfu/ml) was recorded for the selected NystSLN compared to the drug solution and the commercial Nystatin® cream present in the market. It can be fulfilled from this work that SLNs provide a good skin targeting effect and may represent promising carrier for topical delivery of Nyst offering the sustained release and maintaining the localized effect, resulting in an effective treatment of cutaneous fungal infection.

Keywords: candida infections, hot homogenization, nystatin, solid lipid nanoparticles, stability, topical delivery

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Authors: Ahmed Atwa, Ashraf Hafez, Mohamed Abdelhameed, Adel Nabeeh, Mohamed Dawaba, Tamer Helmy

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Introduction and Objective: Tumour staging and grading do not usually reflect the future behavior of Wilms' tumor (WT) regarding mortality. Therefore, in this study, P53, Ki67 and cyclin A immunohistochemistry were used in a trial to predict WT cancer-specific survival (CSS). Methods: In this nonconcurrent cohort study, patients' archived data, including age at presentation, gender, history, clinical examination and radiological investigations, were retrieved then the patients were reviewed at the outpatient clinic of a tertiary care center by history-taking, clinical examination and radiological investigations to detect the oncological outcome. Cases that received preoperative chemotherapy or died due to causes other than WT were excluded. Formalin-fixed, paraffin-embedded specimens obtained from the previously preserved blocks at the pathology laboratory were taken on positively charged slides for IHC with p53, Ki67 and cyclin A. All specimens were examined by an experienced histopathologist devoted to the urological practice and blinded to the patient's clinical findings. P53 and cyclin A staining were scored as 0 (no nuclear staining),1 (<10% nuclear staining), 2 (10-50% nuclear staining) and 3 (>50% nuclear staining). Ki67 proliferation index (PI) was graded as low, borderline and high. Results: Of the 75 cases, 40 (53.3%) were males and 35 (46.7%) were females, and the median age was 36 months (2-216). With a mean follow-up of 78.6±31 months, cancer-specific mortality (CSM) occurred in 15 (20%) and 11 (14.7%) patients, respectively. Kaplan-Meier curve was used for survival analysis, and groups were compared using the Log-rank test. Multivariate logistic regression and Cox regression were not used because only one variable (cyclin A) had shown statistical significance (P=.02), whereas the other significant factor (residual tumor) had few cases. Conclusions: Cyclin A IHC should be considered as a marker for the prediction of WT CSS. Prospective studies with a larger sample size are needed.

Keywords: wilms’ tumour, nephroblastoma, urology, survival

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Authors: Meera A. Albloushi, Adel B. Gougam

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The development in the field of piezoelectrics has led to a renewed interest in ZnO nanowires (NWs) as a promising material in the nanogenerator devices category. It can be used as a power source for self-powered electronic systems with higher density, higher efficiency, longer lifetime, as well as lower cost of fabrication. Highly aligned ZnO nanowires seem to exhibit a higher performance compared with nonaligned ones. The purpose of this study was to develop ZnO nanowires and to investigate their electrical and chemical properties for various applications. They were grown on silicon (100) and glass substrates. We have used a low temperature and non-hazardous method: aqueous chemical growth (ACG). ZnO (non-doped) and AZO (Aluminum doped) seed layers were deposited using RF magnetron sputteringunder Argon pressure of 3 mTorr and deposition power of 180 W, the times of growth were selected to obtain thicknesses in the range of 30 to 125 nm. Some of the films were subsequently annealed. The substrates were immersed tilted in an equimolar solution composed of zinc nitrate and hexamine (HMTA) of 0.02 M and 0.05 M in the temperature range of 80 to 90 ᵒC for 1.5 to 2 hours. The X-ray diffractometer shows strong peaks at 2Ө = 34.2ᵒ of ZnO films which indicates that the films have a preferred c-axis wurtzite hexagonal (002) orientation. The surface morphology of the films is investigated by atomic force microscope (AFM) which proved the uniformity of the film since the roughness is within 5 nm range. The scanning electron microscopes(SEM) (Quanta FEG 250, Quanta 3D FEG, Nova NanoSEM 650) are used to characterize both ZnO film and NWs. SEM images show forest of ZnO NWs grown vertically and have a range of length up to 2000 nm and diameter of 20-300 nm. The SEM images prove that the role of the seed layer is to enhance the vertical alignment of ZnO NWs at the pH solution of 5-6. Also electrical and optical properties of the NWs are carried out using Electrical Force Microscopy (EFM). After growing the ZnO NWs, developing the nano-generator is the second step of this study in order to determine the energy conversion efficiency and the power output.

Keywords: ZnO nanowires(NWs), aqueous chemical growth (ACG), piezoelectric NWs, harvesting enery

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Authors: Bsma Adel Bany Mohammad

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The University campuses are a small city containing basic city functions such as educational spaces, accommodations, services and transportation. They are spaces of functional and social life with different activities, different occupants. The campus designed and transformed like cities so both experienced and memorized in same way. Campus memory is the ability of individuals to maintain and reveal the spatial components of designed physical spaces, which form the understandings, experiences, sensations of the environment in all. ‘Cognitive mapping’ is used to decode the physical interaction and emotional relationship between individuals and the city; Cognitive maps are created graphically using geometric and verbal elements on paper by remembering the images of the Urban Environment. In this study, to determine the emotional urban identity belonging to Jordan University of science and technology Campus, architecture students Asked to identify the areas they interact with in the campus by drawing a cognitive map. ‘Campus memory items’ are identified by analyzing the cognitive maps of the campus, then the spatial identity result of such data. The analysis based on the five basic elements of Lynch: paths, districts, edges, nodes, and landmarks. As a result of this analysis, it found that Spatial Identity constructed by the shared elements of the maps. The memory of most students listed the gates structure- which is a large desirable structure, located at the main entrances within the campus defined as major landmarks, then the square spaces defined as nodes, in addition to both stairs and corridors defined as paths. Finally, the districts, edges of educational buildings and service spaces are listed correspondingly in cognitive maps. Findings suggest that the spatial identity of the campus design is related mainly to the gates structures, squares and stairs.

Keywords: cognitive maps, university campus, urban memory, identity

Procedia PDF Downloads 149

Authors: U. Ali Rahoma, Nabil Esawy, Fawzia Ibrahim Moursy, A. H. Hassan, Samy A. Khalil, Ashraf S. Khamees

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The design of any solar energy conversion system requires the knowledge of solar radiation data obtained over a long period. Satellite data has been widely used to estimate solar energy where no ground observation of solar radiation is available, yet there are limitations on the temporal coverage of satellite data. Reanalysis is a “retrospective analysis” of the atmosphere parameters generated by assimilating observation data from various sources, including ground observation, satellites, ships, and aircraft observation with the output of NWP (Numerical Weather Prediction) models, to develop an exhaustive record of weather and climate parameters. The evaluation of the performance of reanalysis datasets (ERA-5) for North Africa against high-quality surface measured data was performed using statistical analysis. The estimation of global solar radiation (GSR) distribution over six different selected locations in North Africa during ten years from the period time 2011 to 2020. The root means square error (RMSE), mean bias error (MBE) and mean absolute error (MAE) of reanalysis data of solar radiation range from 0.079 to 0.222, 0.0145 to 0.198, and 0.055 to 0.178, respectively. The seasonal statistical analysis was performed to study seasonal variation of performance of datasets, which reveals the significant variation of errors in different seasons—the performance of the dataset changes by changing the temporal resolution of the data used for comparison. The monthly mean values of data show better performance, but the accuracy of data is compromised. The solar radiation data of ERA-5 is used for preliminary solar resource assessment and power estimation. The correlation coefficient (R2) varies from 0.93 to 99% for the different selected sites in North Africa in the present research. The goal of this research is to give a good representation for global solar radiation to help in solar energy application in all fields, and this can be done by using gridded data from European Centre for Medium-Range Weather Forecasts ECMWF and producing a new model to give a good result.

Keywords: solar energy, solar radiation, ERA-5, potential energy

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Authors: Pulari C. Milu Maria Anto

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Background: Cognitive Rehabilitation/Retraining has been variously used in the research literature to represent non-pharmacological interventions that target the cognitive impairments with the goal of ameliorating cognitive function and functional behaviors to optimize the quality of life. Along with adult’s cognitive impairments, the need to address acquired cognitive impairments (due to any chronic illnesses like CHD - congenital heart diseases or ALL - Acute Lymphoblastic Leukemia) among child populations is inevitable. Also, it has to be emphasized as same we consider the cognitive impairments seen in the children having neurodevelopmental disorders. Methods: All published brain image studies (Hermann, B. et al,2002, Khalil, A. et al., 2004, Follin, C. et al, 2016, etc.) and studies emphasizing cognitive impairments in attention, memory, and/or executive function and behavioral aspects (Henkin, Y. et al,2007, Bellinger, D. C., & Newburger, J. W. (2010), Cheung, Y. T., et al,2016, that could be identified were reviewed. Based on a systematic review of the literature from (2000 -2021) different brain imaging studies, increased risk of neuropsychological and psychosocial impairments are briefly described. Clinical and research gap in the area is discussed. Results:30 papers, both Indian studies and foreign publications (Sage journals, Delhi psychiatry journal, Wiley Online Library, APA PsyNet, Springer, Elsevier, Developmental medicine, and child neurology), were identified. Conclusions: In India, a very limited number of brain imaging studies and neuropsychological studies have done by indicating the cognitive deficits of a child having or undergone chronic illness. None of the studies have emphasized the relevance nor the need of implementingCR among such children, even though its high time to address but still not established yet. The review of the current evidence is to bring out an insight among rehabilitation professionals in establishing a child specific CR and to publish new findings regarding the implementation of CR among such children. Also, this study will be an awareness on considering cognitive aspects of a child having acquired cognitive deficit (due to chronic illness), especially during their critical developmental period.

Keywords: cognitive rehabilitation, neuropsychological impairments, congenital heart diseases, acute lymphoblastic leukemia, epilepsy, and neuroplasticity

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Authors: Adel A. Ghobbar

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The airline industry is continuously challenging how to safely increase the service life of the aircraft with limited maintenance budgets. Operators are looking for the most qualified maintenance providers of aircraft components, offering the finest customer service. Component owner and maintenance provider is offering an Abacus agreement (Aircraft Component Leasing) to increase the efficiency and productivity of the customer service. To increase the customer service, the current focus on No Fault Found (NFF) units must change into the focus on Early Failure (EF) units. Since the effect of EF units has a significant impact on customer satisfaction, this needs to increase the reliability of EF units at minimal cost, which leads to the goal of this paper. By identifying the reliability of early failure (EF) units with regards to No Fault Found (NFF) units, in particular, the root cause analysis with an integrated cost analysis of EF units with the use of a failure mode analysis tool and a cost model, there will be a set of EF maintenance improvements. The data used for the investigation of the EF units will be obtained from the Pentagon system, an Enterprise Resource Planning (ERP) system used by Fokker Services. The Pentagon system monitors components, which needs to be repaired from Fokker aircraft owners, Abacus exchange pool, and commercial customers. The data will be selected on several criteria’s: time span, failure rate, and cost driver. When the selected data has been acquired, the failure mode and root cause analysis of EF units are initiated. The failure analysis approach tool was implemented, resulting in the proposed failure solution of EF. This will lead to specific EF maintenance improvements, which can be set-up to decrease the EF units and, as a result of this, increasing the reliability. The investigated EFs, between the time period over ten years, showed to have a significant reliability impact of 32% on the total of 23339 unscheduled failures. Since the EFs encloses almost one-third of the entire population.

Keywords: supportability, no fault found, FMEA, early failure, availability, operational reliability, predictive model

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Authors: Adel A. Ghoneim

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Desalination using solar energy is an interesting option specifically at regions with abundant solar radiation since such areas normally have scarcity of clean water resources. Desalination is the procedure of eliminating dissolved minerals from seawater or brackish water to generate fresh water. In this work, a simulation program is developed to determine the performance of reverse osmosis (RO) water desalination plant powered by high concentrated photovoltaic (HCPV) panels in Kuwait climate conditions. The objective of such a photovoltaic thermal system is to accomplish a double output, i.e., co-generation of both electricity and fresh water that is applicable for rural regions with high solar irradiation. The suggested plan enables to design an RO plant that does not depend on costly batteries or additional land and significantly reduce the government costs to subsidize the water generation cost. Typical weather conditions for Kuwait is employed as input to the simulation program. The simulation program is utilized to optimize the system efficiency as well as the distillate water production. The areas and slopes of HCPV modules are varied to attain maximum yearly power production. Maximum yearly distillate production and HCPV energy generation are found to correspond to HCPV facing south with tilt of 27° (Kuwait latitude-3°). The power needed to produce 1 l of clean drinking water ranged from 2 to 8 kW h/m³, based on the salinity of the feed water and the system operating conditions. Moreover, adapting HCPV systems achieve an avoided greenhouse gases emission by about 1128 ton CO₂ annually. Present outcomes certainly illustrate environmental advantages of water desalination system powered by high concentrated photovoltaic systems in Kuwait climate conditions.

Keywords: desalination, high concentrated photovoltaic systems, reverse osmosis, solar radiation

Procedia PDF Downloads 142

Authors: Adel Dalilottojari, Bahman Delalat, Frances J. Harding, Michaelia P. Cockshell, Claudine S. Bonder, Nicolas H. Voelcker

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Endothelial Progenitor Cell (EPC) based therapies continue to be of interest to treat ischemic events based on their proven role to promote blood vessel formation and thus tissue re-vascularisation. Current strategies for the production of clinical-grade EPCs requires the in vitro isolation of EPCs from peripheral blood followed by cell expansion to provide sufficient quantities EPCs for cell therapy. This study aims to examine the use of different biomolecules to significantly improve the current strategy of EPC capture and expansion on collagen type I (Col I). In this study, four different biomolecules were immobilised on a surface and then investigated for their capacity to support EPC capture and proliferation. First, a cell microarray platform was fabricated by coating a glass surface with epoxy functional allyl glycidyl ether plasma polymer (AGEpp) to mediate biomolecule binding. The four candidate biomolecules tested were Col I, collagen type II (Col II), collagen type IV (Col IV) and vascular endothelial growth factor A (VEGF-A), which were arrayed on the epoxy-functionalised surface using a non-contact printer. The surrounding area between the printed biomolecules was passivated with polyethylene glycol-bisamine (A-PEG) to prevent non-specific cell attachment. EPCs were seeded onto the microarray platform and cell numbers quantified after 1 h (to determine capture) and 72 h (to determine proliferation). All of the extracellular matrix (ECM) biomolecules printed demonstrated an ability to capture EPCs within 1 h of cell seeding with Col II exhibiting the highest level of attachment when compared to the other biomolecules. Interestingly, Col IV exhibited the highest increase in EPC expansion after 72 h when compared to Col I, Col II and VEGF-A. These results provide information for significant improvement in the capture and expansion of human EPC for further application.

Keywords: biomolecules, cell microarray platform, cell therapy, endothelial progenitor cells, high throughput screening

Procedia PDF Downloads 292

Authors: Khalil Trigui, Rafik Ben Said, Fourat Akrout, Neji Aloui

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In this study, we examined in the first part the eco-biology of Artemia (A.salina) collected from Sahline Salt Lake (governorate of Monastir: Tunisia) during an annual cycle. The correlations between environmental factors and some biological parameters of Artemia were determined. The results obtained showed that the environmental factors affected the biology of Artemia. The highest abundance was recorded in May (550 ± 2,16 ind/l) and all life history stages existed with different seasonal proportions. The Artemia population is bisexual with ovoviviparous reproduction at the beginning and oviparous at the end of the life cycle. We also recorded the dominance of males at the start and the females at the end of the cycle. During all the study period, the size of mature females is bigger than that of males. The fertility obtained resulted in a significant production of cysts compared to the nauplii. A negative correlation with highly significant effect was deduced between environmental factors (temperature and salinity) and the production of nauplii (ovoviviparity) in contrast with dissolved oxygen. In the second part of our work is consecrated to the mastery of breeding Artemia. For this, we tested the effect of five external factors (temperature, salinity, dissolved oxygen, light intensity and food) on the survival of this crustacean. Thereby, the survival rates of Artemia were affected by the different values of studied factors. The recorded results showed that Artemia salina has an optimum temperature ranged from 25 to 27°C with a survival rate ranging from 84 to 88%. The optimal salinity to breed Artemia salina was 37 psu (62 ± 0,23%). Nevertheless, this crustacean was able to survive and withstand the salinity of 0 psu (freshwater). The optimum concentration of dissolved oxygen was 7mg/l with a survival rate of 87,11 ± 0,04%. An optimum light intensity of 10 lux revealed a survival rate equal to 85,33 ± 0,01%. The results also showed that the preferred micro-algae by Artemia is Dunaliella salina with a maximum survival rate of the order of 80 ± 0,15%. There is a significant effect for all experienced parameters on the survival of Artemia reared except the nature of food.

Keywords: Artemia salina, biology, breeding, ecology, Sahline salt lake

Procedia PDF Downloads 361

Authors: Adel Francis

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Most of scheduling methods and software apply the critical path logic. This logic schedule activities, apply constraints between these activities and try to optimize and level the allocated resources. The extensive use of this logic produces a complex an erroneous network hard to present, follow and update. Planning and management building projects should tackle the coordination of works and the management of limited spaces, traffic, and supplies. Activities cannot be performed without the resources available and resources cannot be used beyond the capacity of workplaces. Otherwise, workspace congestion will negatively affect the flow of works. The objective of the space planning is to link the spatial and temporal aspects, promote efficient use of the site, define optimal site occupancy rates, and ensures suitable rotation of the workforce in the different spaces. The Chronographic scheduling modelling belongs to this category and models construction operations as well as their processes, logical constraints, association and organizational models, which help to better illustrate the schedule information using multiple flexible approaches. The model defined three categories of areas (punctual, surface and linear) and four different layers (space creation, systems, closing off space, finishing, and reduction of space). The Chronographical modelling is a more complete communication method, having the ability to alternate from one visual approach to another by manipulation of graphics via a set of parameters and their associated values. Each individual approach can help to schedule a certain project type or specialty. Visual communication can also be improved through layering, sheeting, juxtaposition, alterations, and permutations, allowing for groupings, hierarchies, and classification of project information. In this way, graphic representation becomes a living, transformable image, showing valuable information in a clear and comprehensible manner, simplifying the site management while simultaneously utilizing the visual space as efficiently as possible.

Keywords: building projects, chronographic modelling, CPM, critical path, precedence diagram, scheduling

Procedia PDF Downloads 155

Authors: G. N. Simonian, R. F. Basalah, F. T. Abd El Halim, F. F. Abd El Latif, A. M. Adel, A. M. El Shafey.

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Carboxymethyl cellulose (CMC) is an anionic water soluble polymer that has been introduced in paper coating as a strength agent. One of the main objectives of this research is to investigate the influence of CMC concentration in improving the strength properties of paper fiber. In this work, we coated the paper sheets; Xerox paper sheets by different concentration of carboxymethyl cellulose solution (0.1, 0.5, 1, 1.5, 2, 3%) w/v. The mechanical properties; breaking length and tearing resistance (tear factor) were measured for the treated and untreated paper specimens. The retained polymer in the coated paper samples were also calculated. The more the concentration of the coating material; CMC increases, the more the mechanical properties; breaking length and tear factor increases. It can be concluded that CMC enhance the improvement of the mechanical properties of paper sheets result in increasing paper stability. The aim of the present research was also to study the effects on the vessel element structure and vessel picking tendency of the coated paper sheets. In addition to the improved strength properties of the treated sheet, a significant decrease in the vessel picking tendency was expected whereas refining of the original paper sheets (untreated paper sheets) improved mainly the bonding ability of fibers, CMC effectively enhanced the bonding of vessels as well. Moreover, film structures were formed in the fibrillated areas of the coated paper specimens, and they were concluded to reinforce the bonding within the sheet. Also, fragmentation of vessel elements through CMC modification was found to be important and results in a decreasing picking tendency which reflects in a good printability. Moreover, Scanning – Electron Microscope (SEM) images are represented to specifically explain the improved bonding ability of vessels and fibers after CMC modification. Finally, CMC modification enhance paper mechanical properties and print quality.

Keywords: carboxymethyl cellulose (CMC), breaking length, tear factor, vessel picking, printing, concentration

Procedia PDF Downloads 424

Authors: Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

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Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

Procedia PDF Downloads 155