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Heba Essam Jalloun,이인규,김민기,성나영,Suhail Abdullah Al Turkistani,박선민,Dae Youn Won,홍상현,계봉현,이윤석,전해명 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.4
Purpose: Many studies have shown that the enhanced recovery after surgery (ERAS) protocols improve postoperative surgical outcomes. The purpose of this study was to observe the effects on postoperative inflammatory markers and to explore the effects of a high degree of compliance and the use of epidural anesthesia on inflammation and surgical outcomes. Methods: Four hundred patients underwent colorectal cancer surgery at 2 hospitals during 2 different periods, namely, from January 2006 to December 2009 and from January 2017 to July 2017. Data related to the patient’s clinicopathological features, inflammatory markers, percentage of compliance with elements of the ERAS protocol, and use of epidural anesthesia were collected from a prospectively maintained database. Results: The complication rate and the length of hospital stay (LOS) were less in the ERAS group than in the conventional group (P=0.005 and P≤0.001, respectively). The postoperative white blood cell count and the duration required for leukocytes to normalize were reduced in patients following the ERAS protocol (P≤0.001). Other inflammatory markers, such as lymphocyte count (P=0.008), neutrophil/lymphocyte ratio (P=0.032), and C-reactive protein level (P≤0.001), were lower in the ERAS protocol group. High compliance (≥70%) was strongly associated with the complication rate and the LOS (P= 0.008 and P≤0.001, respectively). Conclusion: ERAS protocols decrease early postoperative inflammation and improves short-term postoperative recovery outcomes such as complication rate and the LOS. High compliance (≥70%) with the ERAS protocol elements accelerates the positive effects of ERAS on surgical outcomes; however, the effect on inflammation was very small.
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Heba A. Elgizawy,Ali A. Ali,Mohammed A. Hussein 한국식품영양과학회 2021 Journal of medicinal food Vol.24 No.1
Resveratrol (RES) (trans-3, 5,-4′-trihydroxystilebene) is a multi-biofunctional compound found in a variety of plants such as grapes and mulberries. Studies of nanoencapsulated resveratrol have indicated that this compound can inhibit the growth of cancer cells and free radicals. The aim of this study was to isolate resveratrol from Vitis vinifera, develop and evaluate resveratrol nanostructured lipid carriers (NLCs) and/or resveratrol encapsulated chitosan-coated nanostructured lipid carriers (CSNLCs) using low-viscous chitosan for anticancer therapy. In addition, our study was carried out to examine the prophylactic potential of RES, NLC, and CSNLC on paraquat-induced injury in rat hepatocytes. In this study we isolated resveratrol and encapsulated NLCs in phosphate-buffered saline solution using a phase inversion method. In addition, CSNLCs were prepared by ionic gelation method of NLCs using chitosan. NLCs and CSNLCs were then characterized for their particle size, zeta potential, morphology, and entrapment efficiency. Furthermore, NLCs and CSNLCs were evaluated for their cytotoxic effect on Hep-G2, human HCT-116 (colorectal cancer cell line), lymphoblastic leukemia (1301), and human MCF-7 (Michigan Cancer Foundation-7) cells as well as their effect on caspase-3 and death receptor (DR-4). In addition, incubation of hepatocytes with paraquat resulted in increased formation of TBARS (thiobarbituric acid reactive substances) with a parallel increase in lactate dehydrogenase (LDH) leakage at 1 h after incubation. Time-dependent depletion of cellular glutathione (GSH) was observed starting 2 h after incubation with paraquat. The mean particle size of NLC and CSNLC were 67.0 and 98.41 nm, zeta potential were (−) 24.8 and (+) 31.6 mV, entrapment efficiency were 74.15% and 85.46%, respectively, with the observed shapes of nanoparticle being spherical. The treatment of Hep-G2, human HCT-116, lymphoblastic leukemia (1301), and human MCF-7 cells with NLC led to high inhibition in the cell proliferation as concluded by the low IC50 values 27.7, 17.43, 35.39, and 47.66 μg/mL, respectively, whereas CSNLC had high cytotoxic effect on Hep-G2, human HCT-116, lymphoblastic leukemia (1301), and human MCF-7 cells with low IC50 values 13.29, 10.56, 16.79 and 22.60 μg/mL, respectively. Both NLC and CSNLC possess apoptotic properties through activation of the caspase-3 and death receptor (DR-4). In addition, incubation of hepatocytes with RES, NLC, and CSNLC markedly protected against paraquat-induced formation of TBARS, increase in LDH leakage, and prevented GSH depletion. The most effective doses for ethyl acetate, ethanolic, and aqueous extracts were 7.5, 10, and 12.5 μg, respectively. The results presented here may suggest that nanoencapsulated resveratrol isolated from the stems of V. vinifera to obtain NLC and CSNLC possess anticancer and apoptotic effects on cell proliferation, and therefore, can be used as new approach of pharmaceutical drugs. In addition, the results clearly suggest that the RES, NLC, and CSNLC exerted protective effect against cytotoxicity induced by paraquat. On the contrary, the effect decreased in order of CSNLC, NLC, and RES.
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Heba Ezzeldin Khorshid,Noha Ossama Issa,Amr Mohamed Ekram 대한치과보철학회 2023 The Journal of Advanced Prosthodontics Vol.15 No.3
PURPOSE. This randomized controlled trial aimed to evaluate the effect of implants’ two different diameters and cantilever lengths on the marginal bone loss and stability of mplants supporting maxillary prostheses. MATERIALS AND METHODS. Ninety-six implants were placed in sixteen completely edentulous maxillary ridges. Patients were randomly divided into two groups: Group A, implants were placed with a cantilever to anterior-posterior AP spread length (CL:AP) at a ratio of 1:3; Group B, implants were placed with a CL:AP at a ratio of 1:2. Patients were further divided into four sub-groups: Groups A1, A2, B1, and B2. Groups A1 and B1 received small diameter implants while Groups A2 and B2 received standard diameter implants. Bone height and stability measurements around each implant were performed at 0, 4, 8 and 24 months after definitive prostheses delivery. RESULTS. Statistical analysis of the mean implant stability and height values revealed an insignificant difference between Group A1 and Group A2 at all the different time intervals while significantly higher values in Group B1 in comparison with Group B2. Results also showed significantly higher values in Group A1 in comparison with Group B1 and an insignificant difference between Group A2 and Group B2 at all the different time intervals. CONCLUSION. It can be concluded that the use of small diameter implants placed with a CL:AP at a ratio of 1:3 provided predictable results and that the 1:2 CL:AP significantly induced more critical bone loss in the small diameter implants group, which can significantly reduce long term success and survival of implants.
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Nondaily dosing schedule of allergen-specific sublingual immunotherapy: efficacy and safety
Heba Wagih Abdelwahab 대한백신학회 2023 Clinical and Experimental Vaccine Research Vol.12 No.2
Purpose: Sublingual immunotherapy is currently promoted by various companies, with administration schedules variable in the different products even though almost all are standardized immunologically. So, this study was planned to examine the efficacy of simple nondaily dosing of sublingual immunotherapy instead of the widely used daily schedule. Materials and Methods: Fifty-two patients with allergic rhinitis and bronchial asthma were enrolled. Sublingual immunotherapy (manufactured at the allergen immunotherapy preparation unit at Mansoura University) was given in suitable bottles with a dropper mechanism that permits comfortable dosing under the tongue. The physician recommended that the patient put the drops under his/her tongue and leave the drops beneath the tongue for 2 minutes before swallowing. This was repeated every 3 days, with the drop number and concentration gradually rising. Results: After 2 months of follow-up, 65.8% responded partially to the symptom score and 26.3% responded completely to the medication score. There was a significant decline in the symptom and medication scores from the baseline scores (p<0.0001). After 4 months of follow-up, 95.8% responded partially to symptom scores and no one has not responded; 54.2% responded completely to medication scores; and 81% of studied patients had no side effects. However, the most frequent side effect was a sore throat. Conclusion: Our nondaily schedule of sublingual immunotherapy is tolerable, safe, and effective in patients with allergic rhinitis and bronchial asthma.
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Handover Management Based on Loca-tion Based Services in F-HMIPv6 Net-works
( Heba Nashaat ),( Rawya Rizk ) 한국인터넷정보학회 2015 KSII Transactions on Internet and Information Syst Vol.9 No.12
In this paper, a new mathematical scheme of Macro Handover Management (MHM) in F-HMIPv6 networks based on Location Based Services (LBS) is proposed. Previous schemes based on F-HMIPv6 protocol usually suffer from three major drawbacks: First, They don`t exploit the information about the user mobility behavior in order to reduce handover effects. Second, they only focus on the micro mobility level. Third, they don`t consider the quality of service (QoS) of the traffic. The proposed MHM scheme avoids these drawbacks using the available information about Mobile Node (MN) such as user mobility patterns and MN`s velocity to predict handover and improve network`s QoS. It also takes the traffic type in consideration since it presents a major factor in locating QoS for the user. MHM is analyzed and compared with the F-HMIPv6. The results show that MHM improves the performance in terms of packet delivery cost, location update cost, and handover latency. The design of MHM comprises software package in the MN in addition to a hardware part in the network side. It has implications for communication, design, and pricing of mobile services.
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Heba R. Gaber,Mahmoud I. Mahmoud,Jenniffer Carnell,Anita Rohra,Jeffrey Wuhantu,Sandra Williams,Zubaid Rafique,W. Frank Peacock IV 대한응급의학회 2019 Clinical and Experimental Emergency Medicine Vol.6 No.3
Objective Few studies have prospectively evaluated the diagnostic accuracy and temporal impact of ultrasound in the emergency department (ED) in a randomized manner. In this study, we aimed to perform a randomized, standard therapy controlled evaluation of the diagnostic accuracy and temporal impact of a standardized ultrasound strategy, versus standard care, in patients presenting to the ED with acute dyspnea. Methods The patients underwent a standardized ultrasound examination that was blinded to the team caring for the patient. Ultrasound results remained blinded in patients randomized to the treating team but were unblinded in the interventional cohort. Scans were performed by trained emergency physicians. The gold standard diagnosis (GSDx) was determined by two physicians blinded to the ultrasound results. The same two physicians reviewed all data >30 days after the index visit. Results Fifty-nine randomized patients were enrolled. The mean±standard deviation age was 54.4±11 years, and 37 (62%) were male. The most common GSDx was acute heart failure with reduced ejection fraction in 13 (28.3%) patients and airway diseases such as acute exacerbation of asthma or chronic obstructive pulmonary disease in 10 (21.7%). ED diagnostic accuracy, as compared to the GSDx, was 76% in the ultrasound cohort and 79% in the standard care cohort (P=0.796). Compared with the standard care cohort, the final diagnosis was obtained much faster in the ultrasound cohort (mean±standard deviation: 12±3.2 minutes vs. 270 minutes, P<0.001). Conclusion A standardized ultrasound approach is equally accurate, but enables faster ED diagnosis of acute dyspnea than standard care.
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QoS-aware Cross Layer Handover Scheme for High-Speed vehicles
( Heba Nashaat ) 한국인터넷정보학회 2018 KSII Transactions on Internet and Information Syst Vol.12 No.1
High-Speed vehicles can be considered as multiple mobile nodes that move together in a large-scale mobile network. High-speed makes the time allowed for a mobile node to complete a handover procedure shorter and more frequently. Hence, several protocols are used to manage the mobility of mobile nodes such as Network Mobility (NEMO). However, there are still some problems such as high handover latency and packet loss. So efficient handover management is needed to meet Quality of Service (QoS) requirements for real-time applications. This paper utilizes the cross-layer seamless handover technique for network mobility presented in cellular networks. It extends this technique to propose QoS-aware NEMO protocol which considers QoS requirements for real-time applications. A novel analytical framework is developed to compare the performance of the proposed protocol with basic NEMO using cost functions for realistic city mobility model. The numerical results show that QoS-aware NEMO protocol improves the performance in terms of handover latency, packet delivery cost, location update cost, and total cost.
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