Objective: The aim of this study was to examine the relationship between chorioamnionitis and vascular malperfusion on placental pathology and intraventricular hemorrhage (IVH) in premature and small for gestational age (SGA) infants. Study design: A retrospective analysis of 263 infants ≤34 weeks gestation or ≤1800 g and their mothers was conducted by chart review for placental pathology and clinical data from 2014 to 2018. Unadjusted and adjusted odds ratios (OR) for the association of placental pathology with IVH were calculated. Result: Unadjusted OR showed an association between acute chorioamnionitis and IVH, but logistic regression analysis showed a non-significant adjusted OR between acute or chronic chorioamnionitis with IVH. Maternal vascular malperfusion was significantly associated with increased IVH when controlling for confounders. Conclusion: Placental maternal vascular malperfusion is associated with the development of IVH in premature and SGA infants when controlling for other confounders.

Objective:To evaluate the relationship between partial pressure of carbon dioxide (PCO2) during the first 3 days of life and retinopathy of prematurity (ROP) in extremely low birthweight (ELBW) infants. Patients and methods:A retrospective evaluation of data on ELBW infants were collected over a period of 4 years. Data during the first 72 hours of life was divided into six, 12-hour epochs. The average highest and overall means of PCO2, PO2, FiO(2,)and glucose were calculated for each epoch. Logistic regression analysis was used to determine the association between PCO(2)and ROP after controlling for covariables. Results:A total of 78 neonates were included: birth weight (BW) (703 +/- 157 g) and gestational age (25 +/- 1.4 weeks). A total of 45 out of 78 had ROP: stage 1 (N = 8), stage 2 (N = 26), stage 3 (N = 14), and plus (N = 4). The overall mean PCO(2)correlated with ROP in the first 72 hours of life (R = 0.31,p = .0069). This correlation was significant in epochs 2 (p = .049), 4 (p = .008) and 6 (p = .038). The average of the highest PCO(2)also correlated with ROP in the first 72 hours of life (R = 0.38,p = .0007). This correlation was significant in epochs 2 (p = .0115), 4 (p = .0011), 5 (p = .028) and 6 (p = .037). The correlation between the stage of ROP and PCO(2)was significant after controlling for PO(2)and glucose concentrations. Other variables that correlated with ROP were the overall means of FiO(2)(R = 0.23,p = .04), PO2(R = 0.39,p = .0005) and glucose (R = 0.39,p = .0004) as well as the average highest concentrations of FiO(2)(R = 0.26,p = .025), PO2(R = 0.38,p = .0008) and glucose (R = 0.34,p = .007). Conclusion:After controlling for confounding variables, ROP correlated with the overall means and average highest PCO2. ROP also correlated with FiO(2), PO(2)and glucose concentrations. Further studies are needed to define the safe PCO(2)range and the effect of PCO(2)on the normal development of the retina.

Quick Service Restaurants (QSRs) is always characterized by being intangible and highly affected by word of mouth. Sometimes word of mouth could result in either positive or negative rumours about the restaurants especially the brand ones. This study aims to measure both negative and positive impact of rumours on the popularity and image of quick service restaurant chains in Egypt. Three hundred questionnaire forms were distributed between customers of QSRs in Greater Cairo such as Burger King, Hardees, and KFC. The overall results indicated that the main cause of spreading rumours is the lack of accurate information from the chain's side. So, the best way for restaurant managers to avoid rumours is controlling their communication channels with their customers in an effective way, and addresses any negative rumor as quickly as they can.

Recursion and iteration are two key topics taught in introductory Computer Science. This is especially so for CS2 students, as CS2 is the course where recursion is typically taught and where control-flow concepts are solidified. When asked to solve a problem that could feasibly be solved with recursion or iteration, what do CS2 students choose to do? And how does this choice relate to the correctness of their code? This paper provides one answer to these questions through an analysis of student exam responses to a problem on finding deepest common ancestors in trees. We find that 19% of students choose to use iteration, 51% choose recursion, and 16% choose to combine both iteration and recursion. In terms of correctness, we find that students who choose iteration perform better than those who choose recursion and the combination of both. Additionally, we find concern in the number of students who seemingly do not understand what the question is asking. We end the paper with some comments on helping students choose an appropriate control-flow strategy and a discussion of this type of question on a final exam.

INTRODUCTION: Eccrine porocarcinoma (EPC) is a rare malignancy of eccrine sweat glands. It is often seen during the sixth to eighth decades of life. We report the first case of eccrine porocarcinoma arising on the abdomen of a 21-year-old patient with ulcerative colitis.CASE PRESENTATION: A 21-Year-old female presented to emergency department with a one month history of an enlarging mass over left lower abdomen. Abdominal examination revealed a slightly erythematous, nodular and non-mobile firm mass in left lower quadrant. There was superficial ulceration with slight serous discharge. CT scan of the abdomen and pelvis with contrast revealed a superficial cystic lesion over the anterior abdominal wall, provisionally diagnosed as sebaceous cyst. Incision and drainage were performed and on follow-up, no signs of healing were observed and the patient subsequently underwent surgical excision. Histopathological examination revealed an eccrine porocarcinoma.DISCUSSION: EPC is a rare and aggressive tumor. It may occur de novo or as a result of malignant transformation of an eccrine poroma. A long period of clinical history is often encountered. It usually occurs on the lower extremities followed by the, trunk, head and neck, and upper extremities. The clinical picture usually consists of a painless nodule or papule. Treatment is wide local excision. No strong evidence exists for adjuvant therapy. The risk of local recurrence is about 20%.CONCLUSION: High index of suspicion is required for diagnosis of EPC. Early diagnosis is achieved by histopathological examination and early definitive surgical excision leads to excellent results. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

In blunt trauma, diagnosis of small bowel injury is infrequent and accounts for less than 1.1% of blunt trauma admissions. Of those, only 0.3% are perforated.1 Isolated transection of the jejunum following blunt abdominal trauma has rarely been reported in literature.2,3 Most cases of small bowel perforations after blunt trauma occur as a result of motor vehicle crashes and falls from heights and are often associated with multiple injuries.4 This is a report of a 26year-old female that presented 14h after being involved in a motor vehicle crash and was found to have complete transection of her proximal jejunum with underlying mesenteric injury. Following the crash, the patient extricated herself from the vehicle, went home, and fell asleep with no significant complaints initially reported. She woke up hours later with severe abdominal pain and presented to our emergency department. CT was performed and revealed free fluid in the abdomen. Subsequently, an exploratory laparotomy was performed that revealed complete jejunal transection with underlying mesenteric injury. Isolated complete transection of the proximal jejunum should be considered in the evaluation of patients following blunt abdominal trauma, and presentation may be delayed up to 14h. To the best of our knowledge, this is the first case report of complete transection of the proximal small bowel following a motor vehicle crash with the longest delay in presentation reported in the literature.

Background Rift valley fever (RVF) is a re-emerging viral vector-borne disease with rapid global socio-economic impact. A large RVF outbreak occurred in Tanzania in 2007 and affected more than half of the regions with high (47 %) case fatality rate. Little is known about RVF and its dynamics. A cross sectional study was conducted to assess the knowledge, attitudes and practices regarding RVF in Kongwa and Kilombero districts, Tanzania. Methods We conducted a cross sectional survey among a randomly selected sample of individuals in 2011. We administered questionnaires to collect data on demographic characteristics, knowledge on symptoms, mode of transmission, prevention, attitudes and health seeking practices. Results A total of 463 community members participated in this study. The mean (±SD) age was 39.8 ± 14.4 years and 238 (51.4 %) were female. Majority of respondents had heard of RVF. However, only 8.8 % knew that mosquitoes were transmitting vectors. Male respondents were more likely to have greater knowledge about RVF. A small proportion mentioned clinical signs and symptoms of RVF in animals while 73.7 % mentioned unhealthy practices related to handling and consumption of dead animals. Thorough boiling of milk and cooking of meat were commonly mentioned as preventive measures for RVF. Majority (74.6 %) sought care for febrile illness at health facilities. Few (24.3 %) reported the use of protective gears to handle dead/sick animal while 15.5 % were consuming dead animals. Conclusion Our study highlights the need to address the limited knowledge about RVF and promoting appropriate and timely health seeking practices. Rift valley fever outbreaks can be effectively managed with collaborative efforts of lay and professional communities with a shared perception that it poses a serious threat to public and animal health. The fact that this study was conducted in “high risk transmission areas” warrants further inquiry in other geographic regions with relatively low risk of RVF.

Joy Lawn and colleagues used a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality from intrapartum-related neonatal deaths (birth asphyxia) by the year 2015.

Background: Asthma during pregnancy may compromise the well-being of the fetus and potentially impact an infant's birth weight via different mechanisms.Aims: 1) To assess the influence of asthma during pregnancy on the incidence of LBW outcomes in white non-Hispanic (WNH) and black non-Hispanic (BNH) women. 2) To identify other risk factors that affect low birth weight (LBW) (birth weight < 2500 g) outcomes among asthmatic women.Design/subjects: We conducted a retrospective analysis of compiled perinatal data on 17,073 patients including 9348 WNH and 7725 BNH women delivering at the George Washington University Hospital between 1990 and 2003. Univariate and logistic regression analyses were used to examine associations.Results: A total of 423 (2.5%) women had an asthma diagnosis, with a higher incidence in BNH women when compared to WNH women (3.4% vs. 1.7%. P < 0.001). In the WNH population, asthmatic women had higher incidences of gravidity. thyroid disease, and illicit drug use, whereas in the BNH population, asthmatic women had higher incidences of increased body mass index (BMI), and use of alcohol, tobacco and illicit drugs. After controlling for confounders in multiple logistic regression analyses, there was an association between asthma and LBW outcomes in BNH women (OR: 1.7, CI: 1.1-2.6,p = 0.01), but not in WNH women (OR = 0.99, CI = 0.5-2.2, p = 0.97).Conclusions: Asthma during pregnancy is a risk factor for LBW outcomes in BNH but not WNH women. The increased alcohol and illicit drug use in BNH women with asthma is an unexpected finding that deserves further study. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

Rift Valley fever (RVF) is an important viral zoonotic disease in Africa with periodic outbreaks associated with severe disease, death, and economic hardship. During the 2006-2007 outbreaks in Eastern Africa, postmortem and necropsy tissue samples from 14 animals and 20 humans clinically suspected of RVF were studied with histopathologic evaluation and immunohistochemical (IHC) assays. Six animal and 11 human samples had IHC evidence of Rift Valley fever virus (RVFV) antigens. We found that extensive hepatocellular necrosis without prominent inflammatory cell infiltrates is the most distinctive histopathologic change in liver tissues infected with RVFV. Pathologic studies on postmortem tissue samples can help establish the diagnosis of RVF, differentiating from endemic diseases with clinical manifestations similar to RVF, such as malaria, leptospirosis, or yellow fever.

BACKGROUND:During the Rift Valley fever (RVF) epidemic of 2006-2007 in eastern Africa, spatial mapping of the outbreaks across Kenya, Somalia, and Tanzania was performed and the RVF viruses were isolated and genetically characterized.METHODS:Following confirmation of the RVF epidemic in Kenya on 19 December 2006 and in Tanzania on 2 February 2007, teams were sent to the field for case finding. Human, livestock, and mosquito specimens were collected and viruses isolated. The World Health Organization response team in Kenya worked with the WHO's polio surveillance team inside Somalia to collect information and specimens from Somalia.RESULTS:Seven geographical foci that reported hundreds of livestock and >25 cases in humans between December 2006 and June 2007 were identified. The onset of RVF cases in each epidemic focus was preceded by heavy rainfall and flooding for at least 10 days. Full-length genome analysis of 16 RVF virus isolates recovered from humans, livestock, and mosquitoes in 5 of the 7 outbreak foci revealed 3 distinct lineages of the viruses within and across outbreak foci.CONCLUSION:The findings indicate that the sequential RVF epidemics in the region were caused by multiple lineages of the RVF virus, sometimes independently activated or introduced in distinct outbreak foci.

The role of low grade inflammation in the development of insulin resistance and type 2 diabetes was investigated in rats fed with high fat diet (FD) The possible effects of rosiglitazone and/or aspirin were studied in intact rats fed with HFD and on their isolated pancreas. Feeding rats with high fat diet for 8, 14 and 16 weeks increased level of inflammatory markers e.g. fasting serum C-reactive protein (CRP) level and percentage of neutrophils. This was associated with impaired glucose tolerance. Rosiglitazone and aspirin caused a significant improvement in oral glucose tolerance (OGT) and lipid profile during prophylaxis and treatment. Insulin resistance and inflammation were reduced in prophylaxis only. Rosiglitazone and aspirin increased insulin release from isolated perfused pancreas of normal and HFD fed rats. Combination of the two drugs abolishes their individual effects on OGT, insulin resistance and insulin release. Inflammation is a pathogenic factor in induction of insulin resistance. Aspirin or rosiglitazone is effective anti- inflammatory, insulin sensitizer and insulinotropic drug. Combination of the two drugs abolishes their beneficial effects.

A surveillance survey was conducted over a period of 12 months between September 2004 and August 2005 by the Tropical Medicine Department of Zagazig University in collaboration with Naval Medical Research Unit No. 3 (NAMRU-3), Egypt, to evaluate the role of ruminants as a reservoir host for Crimean-Congo haemorrhagic fever virus (CCHFV). A total of 1,022 serum samples from 313 cattle, 264 water buffalo (Bubalus bubalis), 270 sheep and 175 goats were included in the survey. All samples were collected from the Sharkia Governorate of Egypt and were examined for anti-CCHFV IgG. Of the total of 1,022 samples examined, 32 (3.13%) were positive to IgG ELISA. Out of 270 sheep examined, 17 (6.30%) were confirmed to have anti-CCHFV IgG with the highest titre recorded at 1:800. However, CCHFV-specific IgG-positive cases among the cattle, buffalo and goats were 3.83%, 0.38% and 1.14%, respectively. Positive cases in age group B (>or=2 years old) were significantly higher (p<0.001) than those in age group A (<2 years old) (5.7% versus 1.6%). Belbis City was found to have the highest number of positive cases compared to all other localities (p<0.001).

The influence of monensin (10 µmol/L) alone and in the presence of verapamil (3 µmol/L) or ouabain (1 mmol) and prazosin (1 µmol/L) or glibenclamide (10 µmol/L) were studied on the muscle tension of guinea pig aorta. Changes in tissue sodium, potassium and calcium ion contents of the aortic muscle produced by monensin in the presence of prazosin were evaluated. Monensin in normal Tyrode's solution containing prazosin caused an increase in the resting tension followed by a decrease and returned to normal values. Verapamil reduced the muscle tension induced by monensin. After ouabain, monensin induced sustained increase in the resting tension. Glibenclamide partially reversed the relaxant phase of monensin in presence of norepinephrine. The findings of the present study indicate that the contraction induced by monensin in guinea Pig aorta is due to the increased influx of calcium through voltage-dependent calcium Channels as well as through Na+ - Ca2+ exchange mechanisms. Monensin produced relaxation of guinea pig aorta in part through the increase in K+ permeability via opening of K+-ATP channels.