Purpose:Sepsis is a common acute life-threatening condition that emergency physicians routinely face.Diagnostic options within the Emergency Department (ED) are limited due to lack of infrastructure,consequently limiting the use of invasive hemodynamic monitoring or imaging tests.The mortality rate due to sepsis can be assessed via multiple scoring systems,for example,mortality in emergency department sepsis (MEDS) score and sepsis patient evaluation in the emergency department (SPEED) score,both of which quantify the variation of mortality rates according to clinical findings,laboratory data,or therapeutic interventions.This study aims to improve the management processes of sepsis patients by comparing SPEED score and MEDS score for predicting the 28-day mortality in cases of emergency sepsis.Methods:The study is a cross-sectional,prospective study including 61 sepsis patients in ED in Suez Canal University Hospital,Egypt,from August 2017 to June 2018.Patients were selected by two steps:(1) suspected septic patients presenting with at least one of the following abnormal clinical findings:(a) body temperature higher than 38℃ or lower than 36℃,(b) heart rate higher than 90 beats/min,(c) hyperventilation evidenced by respiratory rate higher than 20 breaths/min or PaCO2 lower than 32 mmHg,and (d) white blood cell count higher than 12,000/μL or lower than 4000/μL;(2) confirmed septic patients with at least a 2-point increase from the baseline total sequential organ failure assessment (SOFA) score following infection.Other inclusion criteria included adult patients with an age ≥18 years regardless of gender and those who had either systemic inflammatory response syndrome or suspected/confirmed infection.Patients were shortly follow-up for the 28-day mortality.Each patient was subject to SPEED score and MEDS score and then the results were compared to detect which of them was more effective in predicting outcome.The receiver operating characteristic curves were also done for MEDS and SPEED scores.Results:Among the 61 patients,41 died with the mortality rate of 67.2％.The mortality rate increased with a higher SPEED and MEDS scores.Both SPEED and MEDS scores revealed significant difference between the survivors and nonsurvivors (p =0.004 and p ＜ 0.001,respectively),indicating that both the two systems are effective in predicting the 28-day mortality of sepsis patients.Thereafter,the receiver operating characteristic curves were plotted,which showed that SPEED was better than the MEDS score when applied to the complete study population with an area under the curve being 0.87 (0.788-0.963) as compared with 0.75 (0.634-0.876) for MEDS.Logistic regression analysis revealed that the best fitting predictor of 28-day mortality for sepsis patients was the SPEED scoring system.For every one unit increase in SPEED score,the odds of 28-day mortality increased by 37％.Conclusion:SPEED score is more useful and accurate than MEDS score in predicting the 28-day mortality among sepsis patients.Therefore SPEED rather than MEDS should be more widely used in the ED for sepsis patients.

Objectives: In Northern Africa, the region Egypt belongs to, about 10.7% of women are estimated to harbour cervical human papillomavirus (HPV) infection and 78.4% of invasive cancers are attributed to HPVs 16 or 18. We aimed at comparing HPV detection by ISH-PCR tissue with other conventional available cheaper techniques, finding which of them can be relied upon in a developing country like Egypt for HPV detection. Methods: Sixty patients were included. For them colposcopy, PAP smear, histopathology and detection of HPV using ISH PCR tissue and PCR swab were achieved. Results: PCR-ISH tissue was positive in 53.33%, 46.6% were negative. Pap smear was negative in 26 cases (43.33%) and 43 cases (56.67%) were positive. LSIL with perinuclear halo represented nearly half of the positive cases (16/34; 47.05%), 10 cases were diagnosed as HSIL, 4 cases as ASCUS and 4 as AGC. Histopathology was negative in 12 (20%) cases and 48 (80%) cases were positive. CIN I and CIN I+ koliocytosis represented half of the cases (30/60) and more than half of positive cases (30/48; 62.5%). Comparing the results of pap smear, histopathology, colposcopy and PCR swab with ISH PCR tissue, highly significant results were seen with sensitivity of 87.5%, 100%, 62.5% and 56.2% respectively but the specificity were 78.6%, 42.9%, 28.6% and 100% respectively. Conclusion: Conventional cytology and histopathology were sensitive tests for detection of HPV. This may help for early detection of cancer cervix in a developing country like Egypt. PCR swab showed the highest specificity and the lowest sensitivity.

Prolonged non-nutritive sucking habits have negative effects on child’s orofacial structures, physical, social and psychological wellbeing. The objectives of the present study were (1) to determine the prevalence of non-nutritive sucking habit in Saudi preschool children, (2) to assess the factors influencing the habit, (3) to determine mothers’ view on causes of non-nutritive sucking and their reasons to stop the habit and (4) to report methods used by the mothers in eliminating the habit. This cross-sectional observational study was conducted in the kindergartens in Abha and Khamis Mushayt cities. The sample included parents of 328 male and female preschool children. A pre-piloted self-administered questionnaire was used for data collection and the response rate was 85.4%. The prevalence of non-nutritive sucking habit was 46.6%; of these, pacifier sucking was 30.2% and digit sucking was 16.4%. There were significant differences with pacifier habit between mother’s educational status and sex (p=0.008 and p=0.002 respectively). The odds of pacifier habit were higher in females [OR=2.14, 95% CI (1.32, 2.52)] and mothers with higher university education [OR=1.67, 95% CI (1.03, 2.72)]. There were significant differences with digit sucking habit and mothers’ educational status (p=0.022). The odds of digit sucking habit was higher in mothers with intermediate and secondary education [OR=2.25, 95% CI (1.24, 4.07)]. Some mothers (37.90%) used non-nutritive sucking as solution to calm the crying child, while others (47.05%) wanted to stop the habit as it might affect the child’s dentition. Some mothers (37%) interrupted the habit physically, while only 10% had preferred to consult the dentist.
Fingersucking

Objective: To develop a new sandwich based lateral flow immunochromatographic strip for rapid detection of circulating Schistosoma mansoni antigen in serum and urine samples of patients with active schistosomiasis. Methods: This lateral flow immunochromatographic strip was prepared by using anti-Schistosoma mansoni soluble egg antigen monoclonal antibody conjugated gold nanoparticles (MAb-AuNPs) as antigen-detecting antibody, while crystalline material (MCM)-41-MAb bioconjugate was immobilized at the test line as antigen-capturing antibody. Both antigen capturing and detecting antibodies formed sandwich complexes with circulating Schistosoma mansoni antigen in the positive samples. Sandwich complexes immobilized at the test line gave distinct red color. The assay reliability was examined by using urine and serum samples of 60 Schistosoma mansoni infected patients, 20 patients infected with parasites other than Schistosoma, and 20 healthy individuals as negative controls. Results were compared with those obtained via sandwich enzyme linked immunosorbent assay (ELISA). Results: The detection limit of circulating Schistosoma mansoni antigen by lateral flow immunochromatographic strip was lower (3 ng/mL) than the detection limit by ELISA (30 ng/mL). The sensitivity and specificity of lateral flow immunochromatographic strip in urine samples were 98.3％ and 97.5％, respectively compared to 93.5％ and 90.0％ by ELISA. In serum samples, they were 100.0％ and 97.5％, respectively compared to 97.0％ and 95.0％ by ELISA. The strip test took approximately 10 min to complete. Conclusions: This new lateral flow immunochromatographic strip offers a sensitive, rapid, and field applicable technique for diagnosis of active schistosomiasis.

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification of different entheseal sites including the anterior longitudinal ligament of the spine. There is no documented information about DISH in Oman. This study determined the prevalence of DISH and associated factors among elderly subjects in a national tertiary care referral hospital in Oman. This retrospective study reviewed chest X-rays of all patients aged more than 50 years, referred to the radiology department of Sultan Qaboos University Hospital in the year 2016, based on the Resnick's criteria. The prevalence was expressed as proportions across age groups and sex. Chi-square test and logistic regression analysis was done to determine the association of the age and sex with DISH. A total of 1305 chest X-rays of patients were reviewed. The overall prevalence of DISH was 10%, with male to female ratio of 1.56:1. The odds ratio for males and increasing age were 1.63 (95% confidence interval [CI], 1.12–2.3; P<0.05) and 1.34 (95% CI, 1.14–1.58; P<0.001) respectively. The prevalence increased with age to maximum of 13% in the age group of ≤80. The pre-stage DISH prevalence was 9.3% and more frequently observed among males. Prevalence of DISH in the national tertiary care referral center in Oman is lower than in Jewish population, almost similar to Japanese, but higher than in Koreans. DISH prevalence is positively associated with age and sex. It is necessary to take appropriate precautionary measures to target the ageing population in Oman, especially elderly males.
Aged* ; Asian Continental Ancestry Group ; Female ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Logistic Models ; Longitudinal Ligaments ; Male ; Odds Ratio ; Oman* ; Prevalence* ; Referral and Consultation ; Retrospective Studies ; Spine ; Tertiary Care Centers* ; Tertiary Healthcare ; Thorax

Purpose: This in-vitro study evaluated and compared the color stability of 3D-printed and conventional heat-polymerized acrylic resins following aging, mechanical brushing, and immersion in staining medium. Materials and methods: Forty disc-shaped specimens (10 mm in diameter and 3 mm thick) were prepared from two 3D-printed [DentaBASE (DB) and Denture 3D+ (D3D)] and one conventional polymethylmethacrylate (PMMA) denture materials. The specimens were thermo-cycled, subjected to mechanical brushing, and were immersed in either coffee, lemon juice, coke, or artificial saliva (AS) to simulate one and two years of oral use. Color measurements of the specimens were recorded by a spectrophotometer at baseline (T0), and after one (T1) and two years (T2) of simulation. The color changes (ΔE) were determined and also quantified according to the National Bureau of Standards (NBS) units. Descriptive statistics, followed by factorial ANOVA and Bonferroni post-hoc test (α=.05), were applied for data analysis. Results: The independent factors, namely material, staining medium, and immersion time, and interaction among these factors significantly influenced ΔE (P <.009). Irrespective of the materials, treatments, and time, the highest and the lowest mean ∆Es were observed for PMMA in lemon juice (4.58 ± 1.30) and DB in AS (0.41 ± 0.18), respectively. Regarding the material type, PMMA demonstrated the highest mean ∆E (2.31 ± 1.37), followed by D3D (1.67 ± 0.66), and DB (0.85 ± 0.52), and the difference in ΔE between the materials were statistically significant (P <.001). All the specimens demonstrated a decreased color changes at T2 compared to T1, and this difference in mean ∆E was statistically significant (P <.001). Conclusion The color changes of 3D-printed denture resins were low compared to conventional heat polymerized PMMA. All the tested materials, irrespective of the staining medium used, demonstrated a significant decrease in ∆E values over time.

Purpose: This in-vitro study evaluated and compared the color stability of 3D-printed and conventional heat-polymerized acrylic resins following aging, mechanical brushing, and immersion in staining medium. Materials and methods: Forty disc-shaped specimens (10 mm in diameter and 3 mm thick) were prepared from two 3D-printed [DentaBASE (DB) and Denture 3D+ (D3D)] and one conventional polymethylmethacrylate (PMMA) denture materials. The specimens were thermo-cycled, subjected to mechanical brushing, and were immersed in either coffee, lemon juice, coke, or artificial saliva (AS) to simulate one and two years of oral use. Color measurements of the specimens were recorded by a spectrophotometer at baseline (T0), and after one (T1) and two years (T2) of simulation. The color changes (ΔE) were determined and also quantified according to the National Bureau of Standards (NBS) units. Descriptive statistics, followed by factorial ANOVA and Bonferroni post-hoc test (α=.05), were applied for data analysis. Results: The independent factors, namely material, staining medium, and immersion time, and interaction among these factors significantly influenced ΔE (P <.009). Irrespective of the materials, treatments, and time, the highest and the lowest mean ∆Es were observed for PMMA in lemon juice (4.58 ± 1.30) and DB in AS (0.41 ± 0.18), respectively. Regarding the material type, PMMA demonstrated the highest mean ∆E (2.31 ± 1.37), followed by D3D (1.67 ± 0.66), and DB (0.85 ± 0.52), and the difference in ΔE between the materials were statistically significant (P <.001). All the specimens demonstrated a decreased color changes at T2 compared to T1, and this difference in mean ∆E was statistically significant (P <.001). Conclusion The color changes of 3D-printed denture resins were low compared to conventional heat polymerized PMMA. All the tested materials, irrespective of the staining medium used, demonstrated a significant decrease in ∆E values over time.

Purpose:: Sepsis is a common acute life-threatening condition that emergency physicians routinely face. Diagnostic options within the Emergency Department (ED) are limited due to lack of infrastructure, consequently limiting the use of invasive hemodynamic monitoring or imaging tests. The mortality rate due to sepsis can be assessed via multiple scoring systems, for example, mortality in emergency department sepsis (MEDS) score and sepsis patient evaluation in the emergency department (SPEED) score, both of which quantify the variation of mortality rates according to clinical findings, laboratory data, or therapeutic interventions. This study aims to improve the management processes of sepsis patients by comparing SPEED score and MEDS score for predicting the 28-day mortality in cases of emergency sepsis. Methods:: The study is a cross-sectional, prospective study including 61 sepsis patients in ED in Suez Canal University Hospital, Egypt, from August 2017 to June 2018. Patients were selected by two steps: (1) suspected septic patients presenting with at least one of the following abnormal clinical findings: (a) body temperature higher than 38℃ or lower than 36℃, (b) heart rate higher than 90 beats/min, (c) hyperventilation evidenced by respiratory rate higher than 20 breaths/min or PaCO₂ lower than 32 mmHg, and (d) white blood cell count higher than 12,000/μL or lower than 4000/μL; (2) confirmed septic patients with at least a 2-point increase from the baseline total sequential organ failure assessment (SOFA) score following infection. Other inclusion criteria included adult patients with an age ≥18 years regardless of gender and those who had either systemic inflammatory response syndrome or suspected/confirmed infection. Patients were shortly follow-up for the 28-day mortality. Each patient was subject to SPEED score and MEDS score and then the results were compared to detect which of them was more effective in predicting outcome. The receiver operating characteristic curves were also done for MEDS and SPEED scores. Results:: Among the 61 patients, 41 died with the mortality rate of 67.2%. The mortality rate increased with a higher SPEED and MEDS scores. Both SPEED and MEDS scores revealed significant difference between the survivors and nonsurvivors (p = 0.004 and p < 0.001, respectively), indicating that both the two systems are effective in predicting the 28-day mortality of sepsis patients. Thereafter, the receiver operating characteristic curves were plotted, which showed that SPEED was better than the MEDS score when applied to the complete study population with an area under the curve being 0.87 (0.788-0.963) as compared with 0.75 (0.634-0.876) for MEDS. Logistic regression analysis revealed that the best fitting predictor of 28-day mortality for sepsis patients was the SPEED scoring system. For every one unit increase in SPEED score, the odds of 28-day mortality increased by 37%. Conclusion: SPEED score is more useful and accurate than MEDS score in predicting the 28-day mortality among sepsis patients. Therefore SPEED rather than MEDS should be more widely used in the ED for sepsis patients.

The cestode Taenia hydatigena uses canids, primarily dogs, as definitive hosts, while the metacestode larval stage cysticercus infects a range of intermediate hosts, including domestic animals such as goats, sheep, and pigs. Cysticercosis due to T. hydatigena has large veterinary and economic drawbacks. Like other taeniids, e.g., Echinococcus, intraspecific variation is found among the members of the genus Taenia. In Africa, few studies are available on the epidemiology and distribution of T. hydatigena, and even fewer studies are available on its genetic variation. In this study, we molecularly identified 11 cysticerci from sheep in Sudan and demonstrated the genetic variation based on the NADH dehydrogenase subunit 1 (nad1) and cytochrome c oxidase subunit 1 (cox1) mitochondrial genes. The isolates were correctly identified as T. hydatigena with more than 99% similarity to those in the GenBank database. Low diversity indices and insignificant neutrality indices were observed, with 3 and 2 haplotypes for the nad1 and cox1 genes, respectively. The results suggest the presence of unique T. hydatigena haplotypes in Sudan, as haplotypes with 100% similarity were not found in the GenBank database. With few available studies on the genetic variation of T. hydatigena in Africa, this report represents the first insights into the genetic variation of T. hydatigena in Sudan and constitutes useful data.