Gaitmap-An Open Ecosystem for IMU-Based Human Gait Analysis and Algorithm Benchmarking

Goal: Gait analysis using inertial measurement units (IMUs) has emerged as a promising method for monitoring movement disorders. However, the lack of public data and easy-to-use open-source algorithms hinders method comparison and clinical application development. To address these challenges, this publication introduces the gaitmap ecosystem, a comprehensive set of open source Python packages for gait analysis using foot-worn IMUs. Methods: This initial release includes over 20 state-of-the-art algorithms, enables easy access to seven datasets, and provides eight benchmark challenges with reference implementations. Together with its extensive documentation and tooling, it enables rapid development and validation of new algorithm and provides a foundation for novel clinical applications. Conclusion: The published software projects represent a pioneering effort to establish an open-source ecosystem for IMU-based gait analysis. We believe that this work can democratize the access to high-quality algorithm and serve as a driver for open and reproducible research in the field of human gait analysis and beyond.

Influences of high vs. low-intensity exercises on muscle strength, function, and quality of life in post-COVID-19 patients with sarcopenia: a randomized controlled trial

OBJECTIVE

The aim of this study was to compare the effectiveness of high vs. low-intensity exercise training on muscle strength, physical function, and quality of life in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease (CKD).

PATIENTS AND METHODS

82 subjects were randomized into 2 groups: high intensity (HIG, n=42), which received high-intensity resistance training, and low intensity (LIG, n=40), which conducted low-intensity aerobic activities. Exercises were performed for 30 min, 3 times per week for 6 weeks. A handheld dynamometer, pinch press, and 1 min sit-to-stand (STS) test were used to assess muscle strength. Modified physical performance test and sarcopenia Quality of Life questionnaire (SAR-QoL) were used to assess function and quality of life, respectively. Measures were collected before and at the end of the treatment program.

RESULTS

Participants were similar at baseline. The within-group comparisons demonstrated statistically significant improvement in both HIG and LIG groups in all outcome measures (p<0.001). Between groups, comparisons revealed statistically significant better achievements with high effect size in Modified Physical Performance Test (MMPT) (p<0.001, d=1.28), handgrip (p<0.001, d=3.6), STS (p<0.001, d=2.38), and SAR-QoL (p<0.001, d=3.24) in favor of the HIG. On the other hand, pinch press strength was equally improved in both groups (p=0.09, d=0.36).

CONCLUSIONS

High-intensity exercise is better than low-intensity exercises in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease regarding muscle strength, physical function, and quality of life.

Association between cognition and gait in multiple sclerosis: A smartphone-based longitudinal analysis

BACKGROUND

Gait and cognition impairments are common problems among People with Multiple Sclerosis (PwMS). Previous studies have investigated cross-sectional associations between gait and cognition. However, there is a lack of evidence regarding the longitudinal association between these factors in PwMS. Therefore, the objective of this study was to explore this longitudinal relationship using smartphone-based data from the Floodlight study.

METHODS

Using the publicly available Floodlight dataset, which contains smartphone-based longitudinal data, we used a linear mixed model to investigate the longitudinal relationship between cognition, measured by the Symbol Digit Modalities Test (SDMT), and gait, measured by the 2 Minute Walking test (2 MW) step count and Five-U-Turn Test (FUTT) turning speed. Four mixed models were fitted to explore the association between: 1) SDMT and mean step count; 2) SDMT and variability of step count; 3) SDMT and mean FUTT turning speed; and 4) SDMT and variability of FUTT turningt speed.

RESULTS

After controlling for age, sex, weight, and height, there were significant correlations between SDMT and the variability of 2 MW step count, the mean of FUTT turning speed. No significant correlation was observed between SDMT and the 2 MW mean step count.

SIGNIFICANCE

Our findings support the evidence that gait and cognition are associated in PwMS. This may support clinicians to adjust treatment and intervention programs that address both gait and cognitive impairments.

Awareness and knowledge of breast cancer rehabilitation among Saudi Arabia physical therapists

OBJECTIVE

This study aimed to evaluate the physical therapists' knowledge and awareness of breast cancer, treatment modalities, contraindications, and clinical guidelines.

SUBJECTS AND METHODS

A cross-sectional survey was conducted from December 2020 to May 2021 in Saudi Arabia. The sample size was determined using the Raosoft sample size calculator, which indicated the need for 67 participants. All physical therapists of both sex in private and public hospitals in Ha'il and non-Ha'il regions were included in the study. Data was collected by a structured Google form questionnaire, consisting of 4 main domains with a maximum score of 43.

RESULTS

57 physical therapists participated in the current study, out of which 31 were from the Ha'il region (42.1% male, 57.9% female) with a mean age of 29±7 years and a mean experience 6±7years. The referral of breast cancer patients was only 22.8%. Interestingly only 22.8% of the hospital has specific setups for oncology rehabilitation, and 12.3% have reported positive about continuing professional development (CPDs) workshops for breast cancer organized by their hospitals. 5.3% of patients with breast cancer are aware of the benefit of oncology rehabilitation, while 22.8% of patients come for follow-up sessions in the rehabilitation department. According to multiple regression, only gender was statistically significant for prediction, p<0.05. Females increased the mean score by 5.996 more than males. Female therapists are 38.2% more aware than males.

CONCLUSIONS

Although physical therapists have a low level of knowledge and an average level of awareness, with a higher number of women than men, attitudes toward physical therapy are quite high, and the profession is practiced exceptionally well.

A randomized controlled trial examining the impact of low vs. moderate-intensity aerobic training in post-discharge COVID-19 older subjects

OBJECTIVE

Post-COVID-19 patients complained of pain, fatigue, breathlessness, and reduction in quality of life which required planned intervention. This study aimed to compare the impact of 10 weeks of low vs. moderate-intensity aerobic training on physical fitness, psychological status, and quality of life in post-COVID-19 older subjects.

PATIENTS AND METHODS

72 patients were randomized into 3 equal groups, moderate-intensity exercise (MIG, n = 24), low-intensity exercise (LIG, n = 24), and control group (CG, n = 24). The exercise was done 40 min/4 times per week for 10 weeks. We measured exercise capacity using the six-minute walking test, 1 min sit-to-stand test, post-COVID-19 functional scale (PCFS), and quality of life using the SF-36 questionnaire and HAMILTON Anxiety and Depression Scale (HADS).

RESULTS

There was no difference between groups regarding the demographic and most clinical characteristics of the subjects. Compared with CG there were statistically significant improvements in studying groups (MIG and LIG) with (p < 0.05) in most outcomes and the improvement was higher in MIG than in LIG in most outcomes.

CONCLUSIONS

10-week moderate-intensity and low-intensity aerobic training programs are effective with superior effect to moderate-intensity. Moderate-intensity aerobic exercise is more effective and feasible in post-discharge COVID-19 older subjects regarding exercise capacity, quality of life, and psychological status than low-intensity aerobic exercise.

Impact of the COVID-19 Pandemic on Elderly Medical Admissions and Outcomes in a Tertiary Hospital in Northeastern Nigeria: A Comparative Retrospective Study

BACKGROUND

The coronavirus infectious disease 2019 (COVID-19) has been shown to be more lethal in the elderly (>65 years), especially those with co-morbidities. This study examined the impact of the pandemic lockdown period on trends in elderly medical admissions and deaths.

METHODOLOGY

This is a retrospective study of elderly medical admissions and deaths in the medical wards of a Nigerian hospital. Data for the months of March, April, May, June, and July of 2020 was compared to the same months before (2019) and after (2021). Analysis was done using STATA version 15.0.

RESULTS

During the study period, two hundred and seventy-six elderly patients were admitted, with a mean age (±SD) of 73.4 ± 7.4 years. The most common diagnoses at admission were chronic kidney disease (CKD) (26.85%, n=74) and hypertensive heart disease (HHD) (21.7%, n=60). The highest admission was in 2021, with a total of 99 (35.9%). Overall, 60 mortalities were recorded, with a proportional mortality rate of 21.7%, which was highest in 2020 (25.0%) and lowest in 2021 (17.1%). There was no difference between the mortality rates of 2019 versus 2020 (P=0.82) and 2020 versus 2021(P=0.18). Sepsis (35.0%) and CKD (25.0%) were the major contributors in 2019.

CONCLUSION

CKD and HHD were the most common diagnoses at admission, whereas sepsis, CKD, and CVD were the commonest causes of death. The Covid-19 pandemic did not significantly alter the elderly admission pattern in our setting.

Effect of twelve-week concurrent aerobic and resisted exercise training in non-dialysis day on functional capacity and quality of life in chronic kidney disease patients

OBJECTIVE

Several researchers have evaluated the impact of exercise training on patients with chronic kidney disease (CKD). However, few studies have evaluated the impact of concurrent training (aerobic and resisted exercise) on non-dialysis days on the functional capacity and quality of life (QOL) of such patients. Our current study evaluated the effects of concurrent training on functional capacity and QOL of patients with CKD.

PATIENTS AND METHODS

Forty-three patients, aged ≥ 25 years, were recruited in this randomized study. They were divided into intervention and control groups (22 per group). The intervention group received concurrent aerobic and resistance exercises (three sessions per week for twelve weeks on alternative days). The control group continued their regular lifestyle practices and medical treatment without any exercise intervention. Before and after twelve weeks of training, the participant's functional capacity and quality of life (QOL) were measured.

RESULTS

Compared to the control group, the intervention group displayed a significant improvement in the distance walked in the 6-minute walk test and sit-to-stand test (STS1/s and STS-60) with p<0.001; furthermore, a significant improvement was observed in physical function, body pain, general health, role functioning/physical, vitality, and social functioning (p<0.05) of QOL assessed with the SF-36 questionnaire.

CONCLUSIONS

The twelve-week concurrent aerobic and resistance exercise training had a positive impact on functional capacity and QOL in CKD patients. Concurrent exercise training should be recommended as an interventional modality in physical therapy and rehabilitation protocols in CKD patients.

Anxiety, depression and stress among internally displaced persons and host community in an armed conflict region: A comparative study

This study compares the psychological profile of Internally Displaced Persons (IDPs) and individuals living in host communities in the war-affected setting. We conducted a cross-sectional survey from October-November 2019. Subjects were recruited from six IDPs camps and the surrounding host communities within the metropolis of Maiduguri, Nigeria by convenience sampling. Data were collected using the Hausa version of Depression Anxiety Stress Scale-21, and analysed by logistic regression using adjusted odds ratio (AOR) at 95% Confidence Interval (CI). A total of 562 subjects were recruited. Living in IDP camp was the most significantly predictor of depression, anxiety, and stress. The common predictors were living in an IDP camp, and marital status (separated). Aged 18-29years was a protective factor compared to those ≥50years. Living in IDP camps, separated from partners, lack of education and pre-conflict employment were significant predictors of depression, anxiety and stress.

A Yoga Exercise App Designed for Patients With Axial Spondylarthritis: Development and User Experience Study

BACKGROUND

Besides anti-inflammatory medication, physical exercise represents a cornerstone of modern treatment for patients with axial spondyloarthritis (AS). Digital health apps (DHAs) such as the yoga app YogiTherapy could remotely empower patients to autonomously and correctly perform exercises.

OBJECTIVE

This study aimed to design and develop a smartphone-based app, YogiTherapy, for patients with AS. To gain additional insights into the usability of the graphical user interface (GUI) for further development of the app, this study focused exclusively on evaluating users' interaction with the GUI.

METHODS

The development of the app and the user experience study took place between October 2020 and March 2021. The DHA was designed by engineering students, rheumatologists, and patients with AS. After the initial development process, a pilot version of the app was evaluated by 5 patients and 5 rheumatologists. The participants had to interact with the app's GUI and complete 5 navigation tasks within the app. Subsequently, the completion rate and experience questionnaire (attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty) were completed by the patients.

RESULTS

The results of the posttest questionnaires showed that most patients were already familiar with digital apps (4/5, 80%). The task completion rates of the usability test were 100% (5/5) for the tasks T1 and T2, which included selecting and starting a yoga lesson and navigating to an information page. Rheumatologists indicated that they were even more experienced with digital devices (2/5, 40% experts; 3/5, 60% intermediates). In this case, they scored task completion rates of 100% (5/5) for all 5 usability tasks T1 to T5. The mean results from the User Experience Questionnaire range from -3 (most negative) to +3 (most positive). According to rheumatologists' evaluations, attractiveness (mean 2.267, SD 0.401) and stimulation (mean 2.250, SD 0.354) achieved the best mean results compared with dependability (mean 2.000, SD 0.395). Patients rated attractiveness at a mean of 2.167 (SD 0.565) and stimulation at a mean of 1.950 (SD 0.873). The lowest mean score was reported for perspicuity (mean 1.250, SD 1.425).

CONCLUSIONS

The newly developed and tested DHA YogiTherapy demonstrated moderate usability among rheumatologists and patients with rheumatic diseases. The app can be used by patients with AS as a complementary treatment. The initial evaluation of the GUI identified significant usability problems that need to be addressed before the start of a clinical evaluation. Prospective trials are also needed in the second step to prove the clinical benefits of the app.

Impact of miR-155 (rs767649 A>T) and miR-146a (rs57095329 A>G) polymorphisms in System Lupus Erythematosus susceptibility in an Egyptian cohort

OBJECTIVE

Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory disease. miR-155 and miR-146a were expressed in many autoimmune diseases such as rheumatoid arthritis. The aim of this study was to examine miR-155 rs767649 and miR-146a rs57095329 polymorphisms in SLE susceptibility in an Egyptian cohort and to investigate the correlation between them and clinical data and disease activity.

PATIENTS AND METHODS

The two SNPs were analyzed in 120 patients with SLE and 100 healthy controls using RT-PCR.

RESULTS

The TT genotype and T allele of miR-155 rs767649 were associated with a significant increase in the risk of SLE, particularly in females. On the other hand, miR-146a (rs57095329) polymorphism was not associated with SLE risk. The AT/TT genotypes of miR-155 rs767649 showed higher distributions among patients with higher SLEDAI and nephritis.

CONCLUSIONS

This study had demonstrated for the first time the association between miR-155 rs767649 and the risk of development of SLE in an Egyptian cohort, mostly in females.

Inertial sensor-based gait parameters reflect patient-reported fatigue in multiple sclerosis

Background

Multiple sclerosis (MS) is a disabling disease affecting the central nervous system and consequently the whole body’s functional systems resulting in different gait disorders. Fatigue is the most common symptom in MS with a prevalence of 80%. Previous research studied the relation between fatigue and gait impairment using stationary gait analysis systems and short gait tests (e.g. timed 25 ft walk). However, wearable inertial sensors providing gait data from longer and continuous gait bouts have not been used to assess the relation between fatigue and gait parameters in MS. Therefore, the aim of this study was to evaluate the association between fatigue and spatio-temporal gait parameters extracted from wearable foot-worn sensors and to predict the degree of fatigue.

Methods

Forty-nine patients with MS (32 women; 17 men; aged 41.6 years, EDSS 1.0–6.5) were included where each participant was equipped with a small Inertial Measurement Unit (IMU) on each foot. Spatio-temporal gait parameters were obtained from the 6-min walking test, and the Borg scale of perceived exertion was used to represent fatigue. Gait parameters were normalized by taking the difference of averaged gait parameters between the beginning and end of the test to eliminate inter-individual differences. Afterwards, normalized parameters were transformed to principle components that were used as input to a Random Forest regression model to formulate the relationship between gait parameters and fatigue.

Results

Six principal components were used as input to our model explaining more than 90% of variance within our dataset. Random Forest regression was used to predict fatigue. The model was validated using 10-fold cross validation and the mean absolute error was 1.38 points. Principal components consisting mainly of stride time, maximum toe clearance, heel strike angle, and stride length had large contributions (67%) to the predictions made by the Random Forest.

Conclusions

The level of fatigue can be predicted based on spatio-temporal gait parameters obtained from an IMU based system. The results can help therapists to monitor fatigue before and after treatment and in rehabilitation programs to evaluate their efficacy. Furthermore, this can be used in home monitoring scenarios where therapists can monitor fatigue using IMUs reducing time and effort of patients and therapists.

Hypothyroidism: morphological and metabolic changes in the testis of adult albino rat and the amelioration by alpha-lipoic acid

BACKGROUND

The objective of this study is to evaluate the influence of carbimazole- induced hypothyroidism on the testes of adult albino rats and the probable protective effect of alpha-lipoic acid (ALA).

MATERIALS AND METHODS

The rats were divided into four groups; control group, ALA group, carbimazole, and carbimazole + ALA groups. Rats were exposed to ALA (60 mg/kg body weight) or carbimazole (1.35 mg/kg body weight), or both, administered via gavages for 30 days.

RESULTS

Morphometric analysis revealed a significant decrease in tubular diameter, germinal epithelium thickness, and interstitial space as compared to the controls. Also, rats exposed to carbimazole showed a significant decline in testicular weight, sperm motility, and count. Additionally, deterioration of the testicular architecture was observed. ALA supplementation resulted in a significant improvement in the tubular diameter and germinal epithelium thickness, but no significant improvement regarding interstitial space was observed. Another observation was the significant decline in serum testosterone and follicle-stimulating hormone (FSH) in the carbimazole group, indicating reduced steroidogenesis. A significant reduction in reduced glutathione content was detected in the testes of the carbimazole group compared with the controls, while malonaldehyde concentration significantly increased. Conversely, ALA supplementation ameliorated the toxicity induced by hypothyroidism as illustrated by enhanced reproductive organ weights, testosterone, luteinizing hormone, and FSH levels, testicular steroidogenesis, and oxidative stress parameters.

CONCLUSIONS

Hypothyroidism altered testicular antioxidant balance and negatively affected spermatogenesis. On the other hand, ALA through its antioxidant properties alleviated testicular toxicity in carbimazole-exposed rats.

Perceived sources of stress amongst dental students: A multicountry study

AIMS

The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries.

METHODS

A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05.

RESULTS

Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress.

CONCLUSION

The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.

Development and evaluation of a live attenuated camelpox vaccine from a local field isolate of the virus

A strain of camelpox virus (CMLV) isolated in the Sudan was attenuated by serial passage in Vero cell monolayers for use as a future vaccine strain. The safety and potency of passage 115 virus (designated Sudan CMLV/115) was tested. Camels inoculated with CMLV/115 showed no clinical disease or skin lesions, developed low-level antibodies and cell-mediated immune response and resisted challenge with virulent wild-type CMLV. Field testing of the candidate vaccine showed that the developed vaccine induces immune response and is safe for young and pregnant camels.

Evaluation of serum squamous cell carcinoma antigen as a novel biomarker for diagnosis of hepatocellular carcinoma in Egyptian patients

BACKGROUND

Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world. In Egypt, HCC was reported to account for about 4.7% of chronic liver disease (CLD) patients. Squamous cell carcinoma antigen (SCCA) has been reported to be strongly expressed in HCC tissue hampering its extensive use in clinical practice.

AIM

To evaluate the clinical usefulness of serum SCCA levels as a serological marker for early detection of HCC among high-risk patients compared to AFP.

MATERIALS AND METHODS

The study comprised of three groups. Group A included 30 patients with CLD diagnosed based on clinical, laboratory, and ultrasonographical investigations; group B included 49 patients with HCC diagnostically confirmed by spiral CT, elevated alfafetoprotein (AFP), and/or liver biopsy; and group C, the control group, included 15 healthy subjects matched for age and sex. All groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including liver functions, viral markers, and AFP and SCCA estimation using ELISA technique.

RESULTS

This study revealed a highly significant difference between patients with HCC, CLD, and controls regarding serum SCCA levels (5.138 +/- 7.689, 1.133 +/- 0.516, and 0.787 +/- 0.432 ng/ml, respectively). SCCA level was persistently elevated in patients with HCC with normal AFP levels representing its useful role in early detection and follow-up of patients treated for HCC. The area under the curve (AUC) of SCCA was 0.869 (95% CI 0.783-0.929), the cut-off value was established at 1.5 ng/ml with sensitivity of 77.6% and specificity of 84.4%). The difference between AUC of SCCA and that of AFP was 0.09 which mounted statistical significance.

CONCLUSIONS

SCCA could represent a useful tool as a marker for detection of HCC.

Effect of temperature increase from 55 to 65 degrees C on performance and microbial population dynamics of an anaerobic reactor treating cattle manure

The effect of a temperature increase from 55 to 65 degrees C on process performance and microbial population dynamics were investigated in thermophilic, lab-scale, continuously stirred tank reactors. The reactors had a working volume of 31 and were fed with cattle manure at an organic loading rate of 3 g VS/l reactor volume/d. The hydraulic retention time in the reactors was 15 days. A stable reactor performance was obtained for periods of three retention times both at 55 degrees C and 65 degrees C. At 65 degrees C methane yield stabilized at approximately 165ml/g VS/d compared to 200 ml/g VS/d at 55 degrees C. Simultaneously, the level of total volatile fatty acids, VFA, increased from being below 0.3 g/l to 1.8-2.4 g acetate/l. The specific methanogenic activities (SMA) of biomass from the reactors were measured with acetate, propionate, butyrate, hydrogen, formate and glucose. At 65 degrees C. a decreased activity was found for glucose-, acetate-, butyrate- and formate-utilizers and no significant activity was measured with propionate. Only the hydrogen-consuming methanogens showed an enhanced activity at 65 degrees C. Numbers of cultivable methanogens, estimated by the most probable number (MPN) method, were significantly lower on glucose, acetate and butyrate at the increased operational temperature, while the numbers of hydrogenotrophic methanogens remained unchanged. No viable propionate-degrading bacteria were enriched at 65 C. Use of ribosomal oligonucleotide probes showed that an increase in temperature resulted in a decreased contribution of the rRNA of the domain bacteria from 74-79 to 57-62% of the universal probe, while the rRNA of the domain archaea, increased from 18-23 to 34-36%.

Host Status of Thirteen Acacia Species to Meloidogyne javanica

Thirteen indigenous and exotic Acacia species grown in Saudi Arabia were evaluated for their host status for Meloidogyne javanica in pot tests both in the growth chamber and under outdoor conditions. In both experiments, 21-day-old seedlings were transplanted individually into 15-cm-diam. plastic pots containing a steam-sterilized mixture of equal parts loam and sandy loam. Seedlings were inoculated with 5,000 M. javanica eggs/plant 30 days later. After 120 days, fresh root weight, disease index (1-9 scale), the number of eggs/pot (Pf), eggs/g fresh root, and a reproductive factor (Rf) were determined. Results of both the growth chamber and the outdoor tests were similar. Species were grouped into host suitability categories according to Rf, and they were also grouped into resistance categories based on the sum of gall index, gall size, and percentage of the root system that was galled. Only A. salicina was a poor host and was resistant to M. javanica. Acacia farnisiana, A. gerrardii subsp. negevensis var. najdensis, and A. saligna were excellent hosts and highly susceptible. Both A. nilotica and A. stenophylla were classified as good hosts and highly susceptible, while A. ampliceps, A. ehrenbergiana, A. gerrardii subsp. negevensis var negevensis, A. sclerosperma, A. seyal, A. tortilis, and A. tortilis subsp. spirocarpa were also good hosts but were classified as susceptible rather than highly susceptible. This is the first report on the susceptibility of Acacia species to M. javanica in Saudi Arabia, including some new hosts worldwide.

Bond strengths of maxillary anterior base metal resin-bonded retainers with different thicknesses

PURPOSE

This study evaluated the effect of three different thicknesses of base metal resin-bonded retainers on retention/resistance.

MATERIAL AND METHODS

Three ivorine teeth, a central incisor, lateral incisor, and canine, were prepared to receive resin bonded retainers. Fifteen metal replicas of prepared teeth were made (five for each tooth morphotype). A total of 45 metal retainers were cast in three different thicknesses, 0.3, 0.5, and 0.7 mm, with 15 for each thickness. Retainers were cemented to metal die replicas with Panavia EX luting agent. After 24 hours, forces to dislodge the retainers were applied at 45 degrees to the vertical mesiodistal plane at the proximolingual line angle.

RESULTS

An increase in thicknesses resulted in elevation of dislodging forces that were almost linear for the three thicknesses of canine retainers. The central incisor exhibited the greatest increase in resistance to dislodgment between retainers that were 0.3 and 0.5 mm thick, whereas increased thickness for the lateral incisor retainer resulted in minimal or no benefit.

Etiology and clinical features of acute epididymo-orchitis

Seventy-nine patients presenting with acute epididymo-orchitis (AEO) were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, serological, biochemical, imaging, and endoscopic studies were undertaken to look for urinary tract infection (UTI), brucellosis, gonorrhea, diabetes mellitus (DM), bladder outflow obstruction (BOO), and other urinary tract pathology (UP). Thirty-nine patients also underwent, on their urethral scrapings, the direct immunofluorescence test with monoclonal antibodies (DIF) for Chlamydia trachomatis. The mean age was 44 +/- 20.4 years (median = 40 years) and 43% of the patients were married. Only one patient had urethritis, which nongonococcal. Thirty-five percent presented with pyrexia and only one had brucellosis. Fifty-three percent had significant pyuria but only 22 patients (285) had bacteriuria and E. coli was the etiological agent in 19/22 patients (86%). Eleven out of 39 patients (28%) were positive for Chlamydia trachomatis. BOO, UP, and DM were encountered in 25%, 12.5% and 10%, respectively, but no obvious cause was detected in 26 (33%) patients. Recurrent AEO, abscess formation and bacteremia occurred in 21.5%, 4%, and 1%, respectively. Recurrent AEO was significantly more common in married patients than in single patients (P<0.05) and BOO was significantly more common in patients above the age of 50 years. It is concluded that an underlying cause of AEO could be identified in only two-thirds of the patients. In the remaining one-third, the etiology continues to be obscure and investigations for viral and fastidious infections may be of help in future studies. Endoscopy and urodynamic studies for BOO can be restricted to the elderly patients to cut down the cost of management of this fairly common emergency.

Immunoglobulins in patients with atopic dermatitis due to mites infestation in Qualyobia Governorate, Egypt

Atopic dermatitis (A.D.) is a hereditary and distinct form of eczema which may be associated with other atopic manifestations. The aetiopothogenesis of A.D. is unknown and it is widely accepted that both intrinsic and extrinsic factors are involved. House dust mites (HDM) are of great medical importance in causing allergic manifestations in human being. In the present work, a total of 30 A.D. patients with different ages of both sexes were examined for the immunoglobulins level as compared to control group. The IgG, IgM, IgA & IgE were higher in the patients than in the controls. These differences were highly significant in the IgE. On the other hand, IgA showed no significant increase.

Isolation of three species of mites from house dust of atopic dermatitis patients in Qualyobia Governorate, Egypt

Dermatitis or inflammation of the skin caused by an outside agent, is a condition with many causes. It may result from direct irritation of the skin by a substances (chemical or insecticide) or it may be an allergic reaction to a particular substance that has been in contact with the skin as soap or detergent or insect urticating hairs; injected as insect saliva or faeces or sting or taken by mouth as food or drug. In general, treatment of dermatitis depends mainly upon the cause. In the present study, three species of mites were isolated from the dust collected from houses of atopic dermatitis patients. These mites were Dermatophagoides pteronyssinus, Ornithonyssus bacoti and Haemogamasus pontiger. The former species was the predominant one which is known to produce the most potent allergen. It was concluded that house dust mites are one of the aetiological factors of atopic dermatitis and that genera of mites other than Dermatophagoides may be considered as allergen in house dust mites.

Induction of chromosomal aberrations and sister chromatid exchange in vivo and in vitro by the insecticide cypermethrin

The induction of chromosomal aberrations and sister chromatid exchange in vivo in mouse spleen and bone marrow as well as in vitro in cultured mouse spleen cells by the insecticide 'Cypermethrin' (cis-trans 1:1) was investigated. The percentage of chromosomal aberrations in the spleen and in the bone marrow as almost the same and reached its maximum 6 h following i.p. injection. The aberrations induced were chromatid and chromosome gaps, fragments and tetraploidy. The insecticide caused a significant and dose-dependent increase in the frequency of sister chromatid exchanges (SCEs) in mouse bone-marrow cells: it reached 11.12 +/- 0.05 per cell after treatment with Cypermethrin at 300 mg kg-1 body wt. compared with 3.7 +/- 0.14 per cell and 4.4 +/- 0.26 per cell in the solvent and control, respectively. The percentage of viable cells in mouse spleen cell cultures reached 87.4% and 99.9% relative to the control after treatment of the cell cultures with 10(-3) and 10(-7) Cypermethrin, respectively. All the tested concentrations of Cypermethrin (0.25-400 micrograms ml-1) induced a high percentage of metaphases with chromosomal aberrations after 4 h of treatment. The mean frequency of SCEs per cell reached 15.1 +/- 0.05 after treatment with Cypermethrin at 4.00 micrograms ml-1 compared with 8.6 +/- 0.23 and 5.9 +/- 0.39 in the solvent and control, respectively. The results indicate that Cypermethrin is genotoxic in mouse spleen and bone marrow as well as in cultured mouse spleen cells.

Human blood groups in Dakahlya, Egypt

New data on blood groups among Egyptians (Dakahlya province) are obtained by studying eight blood group systems: ABO, Rhesus, MNSs, Kell, Duffy, Kidd, P and Lewis. Comparing our results with the data reported in neighbouring countries, we found in Egypt a high frequency of B, NS, cDe and K genes, a moderately high frequency of P and the presence of Fy gene. The Egyptian population appears as a mixture of African, Asiatic and Arabian characteristics.

In vivo adherence and colonization of Vibrio cholerae strains that differ in hemagglutinating activity and motility

A scanning electron microscopic study was carried out to compare the in vivo pathogenicity of two strains of Vibrio cholerae in an adult rabbit ligated-gut test model. V. cholerae C5 (serotype Ogawa, biotype El Tor), a motile strain possessing hemagglutinating activity in vitro, and C21 (serotype Ogawa, classical biotype), a nonmotile strain possessing no hemagglutinating activity, were tested. Tissue samples from small intestinal loops were examined 3, 6, 9, and 12 h postinoculation. Contradictory to most published data, neither hemagglutinating activity nor motility appeared to be essential prerequisites for the pathogenesis of cholera in the experimental animal model used: nonmotile hemagglutinin-negative strain C21 adhered to and colonized the small intestine at least to the same extent as did motile hemagglutinin-positive strain C5. Maximum colonization was seen at 9 h postinoculation for both strains. C5 and C21 vibrios caused comparable damage to the villi of the small intestine. The villous epithelium showed only mild changes during the first 9 h postinoculation. However, after 12 h the epithelium was seriously damaged concomitant with a decrease in the number of vibrios. Many villi showed partial or total denudation, owing to repelled epithelium, leaving a bare basal lamina with only some to moderate numbers of vibrios attached. Since similar changes were induced by pure cholera enterotoxin, these changes were likely the result of excessive fluid accumulation. From this study it is concluded that, at least in the animal model used, factors other than hemagglutinating activity and motility may also play a role in the association of V. cholerae with the small intestinal surface.

Occurrence of bacterial pollution indicators in Boulti (Tilapia nilotica Linn.) fish

A study was made for the occurrence of coliform and streptococcal groups on the skin surface (32 samples), gills (32 samples), intestinal tract (4 samples) and raw fish flesh (4 samples) and raw fish flesh (4 samples) of Boulti fish (Tilapia nilotica Linn.), a fresh water fish caught from Nasser's Lake in Aswan. Streptococcus group was detected in 13 samples taken from fish surface, 12 samples out of 32 swabs from gills. All intestine samples and raw fish flesh were positive for the streptococcus group. Coliform organisms were detected at nearly 43% of skin or gill samples, 100% of intestine and raw fish flesh samples.

Effect of varicocele on sperm respiration and metabolism

Semen samples from 41 infertile male patients (30 with varicocele and 11 controls) were examined, lactic and pyruvic acids were measured and the oxygen consumption was determined. Decreased sperm count, diminished motility, decreased lactic acid concentration and oxygen consumption were noticed among the varicocele patients as compared to controls. Pyruvic acid concentration was slightly increased in the varicocele group. It was concluded that a decrease in lactic dehydrogenase activity may be one of the abnormalities in the semen of varicocele patients.

Boulti (Tilapia nilotica Linn.) fish paste. 1. Preparation and chemical composition

Boulti fish (Tilapia nilotica Linn.) from Naser's lake in Aswan was converted to a ready marketable product (paste) in aluminium tubes. The quality of the product was ascertained by chemical indices. The product has a good flavour and can be kept for 5 weeks without undesirable changes. It is concluded that the production of fish paste in aluminium tubes is one of the possibilities of converting fish to precooked product.

Boulti (Tilapia nilotica Linn.) fish paste. 2. Bacteriological studies of the raw fish and the produced paste

Total viable bacterial count reached 10(9) per gram of raw fish. It was decreased to 10(7) in fish paste and increased to 10(8)-10(9) after storage at 2-4 degrees C for 5 weeks. It was observed that fish paste showed higher counts when preserved in polyethylene bags than in aluminum tubes.

Genetic studies in azoospermic patients with the Klinefelter pattern of testicular biopsy

82 male patients presenting functional azoospermia and klinefelter pattern of testicular biopsy were subjected to genetic, histopathologic, anthropometric and clinical studies. With finer methods of analysis, heterogeneity, within a disorder previously thought to represent one entity is usually revealed. Results of the present investigation suggest that sex chromatin counts cannot substitute chromosomal analysis for the discover of mosaiscism. The study also showed a marked phenotypic overlap between the X-chromatin positive Klinefelter disease and the X-chromatin negative Klinefelter syndrome. This overlap occurs both at the clinical level, documented by anthropometry and histopathologic findings in the testicular biopsy, emphasizing the importance of cytogenetic studies. Cases without the chromosomal aberration in whom we suspect environmental etiology may be described a sphenocopies of the genetic disorder.

Disseminated intravascular coagulation after surgical excision of cavernous hemangioma

This report describes the clinical course of a child who had excision of several symptomatic cavernous hemangiomas. Disseminated intravascular coagulation resulted in severe postoperative bleeding. DIC was treated successfully with heparin.

Local male hormonal therapy in male infertility: a preliminary report

The therapeutic effect of local infiltration of the testis by testosterone crystalline suspension was studied in 18 cases of severe oligozoospermia. Evaluation was done by semen analysis follow-up, and results were correlated with preoperative testicular biopsies. About 40% of the cases showed improvement of sperm count and/or motility. Testicular biopsies of responding cases showed mild inhibitory changes, such as sloughing or partial spermatogenic arrest at late stages, while cases with tubular hyalinization or spermatogenic arrest at the stage of spermatogonia showed no response. The method proved to be simple, safe, and promising.

Comparative evaluation of laparoscopy and hysterosalpingography in infertile patients

A comparative study of hysterosalpingography (HSG) and laparoscopy in the investigation of infertility is presented. From 1973-1977, 352 cases were investigated with both HSG and laparoscopy. In 57.67% of the cases there was complete agreement between HSG and laparoscopy. The study included 168 cases of unexplained infertility and 184 cases with abnormal hysterosalpingographic findings. Pelvic adhesions were demonstrated in 151 cases by laparoscopy as compared to 76 cases in which its presence was only suspected by HSG. Laparoscopy revealed a 57.14% of associated pelvic pathology in cases of unexplained fertility. The present study concludes that laparoscopy as compared to HSG is not only more informative, but also more accurate and conclusive.

Arginine catabolism by Mycoplasma meleagridis and its role in pathogenesis

A thin-layer chromatography technique was used to study the arginine metabolism of Mycoplasma meleagridis. The technique reflected the enzyme activity of the dihydrolase pathway through detection of readily visible end products on X-ray film. Strains of M. meleagridis differing in their pathogenicity for turkeys did not vary in arginine metabolism. In addition, no significant difference was observed in plasma arginine concentrations between M. meleagridis-infected and uninfected poults. It was concluded that the pathogenesis of M. meleagridis infection in turkeys was not based on its competition with the host for arginine.

Is postoperative proximal decompression a necessary complement to elective colon resection?

Postoperative nasogastric suction is not a necessary complement to elective colon resection. We studied two groups of patients who had elective colon resection: nasogastric suction was used in the postoperative management of 53 patients, while 23 patients were managed without nasogastric suction. The morbidity and mortality rates were comparable in the two groups.

Acute peroneal compartment syndrome in a well conditioned athlete: report of a case

A case report of acute peroneal compartment syndrome occurring in a 25-year-old male softball player is presented, in which neuropraxia of the common peroneal nerve occurred within 8 hr after onset and in which complete recovery occurred after fasciotomy was done 13 hr after onset of symptoms. A plea is made for early diagnosis and complete fasciotomy carried out as a surgical emergency. This must be accomplished if results previously reported, indicating permanent disability in 80%, are to be improved.

Morphology and growth cycle of Mycoplasma meleagridis viewed by scanning-electron microscopy

The three-dimensional structure of Mycoplasma meleagridis strain RY-39A was studied by scanning-electron microscopy. The morphologic forms observed between 12 hours and 7 days suggest that the organism undergoes a sequential metamorphosis in its development. Single rounded forms in lag phase give rise to larger cells and filaments in the log phase, which fragment into coccus forms in the late stationary phase.

Bilateral testicular biopsy in men with varicocele

Fifty-two infertile men with varicoceles were subjected to bilateral testicular biopsy to detect the effect of the varicocele on each testis. The results indicate that varicocele can result in infertility primarily through sloughing of immature cells or through arrest of spermatogenesis at the spermatid or primary spermatocyte stage. The effect is bilateral but is more marked on the varicocele side. However, the presence of a varicocele could not explain the infertility of seven men with normal biopsies and of four men with a normal biopsy on the varicocele side and arrest on the other side.

Hypglycaemia in paediatric anaesthesia: The influence of metoclopramide and oral maltose in paediatric surgical patients

A safe and effective way to prevent the development of hypoglycaemia in young children during general anaesthesia is to give drinks sweetened with maltose 2 hours before operation. Metoclopramide (Maxolon) is injected intramuscularly to hasten absorption. The postoperative blood sugar in the maltose-treated group (28 patients) was 100+/-22-21 mg/ml (5-5+/-1-232 mmol/litre) and significantly higher ( P less than 0-0005) than in the starved group (22 patients).

Mesenteric supernumerary ovary

Following is a report and a review of literature concerning the supernumerary ovary. Up to now only 7 cases have been reported, and our case appears to be the eighth. The anatomic situation in this case was unusual since it was found in the mesentery. Of the cases previously reported, 2 have been associated with benign cystic teratoma.

Bacteriophage typing of Salmonella. I. Isolation and host range study of bacteriophages

A series of bacteriophages, lytic for bacteria belonging to the genera Escherichia and Salmonella, were isolated. The phages were isolated from fecal samples, intestinal contents of turkey poults, and carrier cultures of S. typhimurium, S. typhimurium var copenhagen, S. heidelberg, and E. coli. The feasibility of using different habitats as sources of Salmonella phages was evaluated. The carrier cultures were the most promising source for phages active on the serotypes for which the phages were sought. A host range study of the isolated phages was made. Eight phages were selected to develop a phage typing scheme for S. typhimurium, S. typhimurium var copenhagen, and S. heidelberg.