Purpose: Vascular endothelial dysfunction is well established in type 2 diabetes. Interleukin-12 (IL-12) and endoplasmic reticulum (ER) stress  are up-regulated in type  2  diabetic patients and  animal models of  type  2 diabetes.  However, the role and  underlying mechanisms of IL-12 and the ER stress CHOP in endothelial dysfunction are not fully understood.Methods: We generated double knockout mice between db−/db− and p40IL-12−/− mice (db−/db−p40-IL−12-/-) and endoplasmic (ER) stress-CHOP−/− mice (db−/db−CHOP-/-). We performed a glucose tolerance test (GTT) to determine the effect of IL-12 and ER stress CHOP on glucose metabolism. We assessed the endothelial function and determined the phosphorylation level of eNOS, Akt, AMPK, and the expression of ER stress (CHOP, BIP), and oxidative stress (Nox2 and Nox4 and NADPH oxidase activity).Results: The results showed that GTT was improved in db-/db−p40-IL−12-/- and db−/db−CHOP-/- suggesting IL-12 and CHOP as parts of a  mechanism  involved  in  the  development  of  type  2  diabetes.  The  microvascular  endothelial  dysfunction  in  db−/db− mouse  is associated  with  decreased  phosphorylated  eNOS,  Akt,  AMPK,  and  increased  CHOP,  BIP,  Nox2,  and  Nox4  expressions. Interestingly, disrupting IL-12 and ER stress CHOP in db−/db− mice significantly improved endothelial function, increased survival markers expression and decreased ER and oxidative stress.Conclusion: Using a genetic approach, these findings provide evidence that IL-12 and ER stress CHOP play a significant role in microvascular endothelial dysfunction in type 2 diabetes.

Background

Elderly patients have higher risks for complications during Ramadan fasting. Educating patients is essential for fasting safely.

Aim

To evaluate the impact of pre-Ramadan education in reducing risk of hypoglycemia and achieving glycemic control in elderly.

Methods

A prospective study carried out in outpatients clinics of Internal Medicine department in Assiut university hospital. It included 316 type 2 diabetic patients who intended to fast. They were grouped into 2 groups; < 65 years and ≥ 65 years patients. The patients received pre-Ramadan individual education sessions. A semi-structured questionnaire was used to collect the data to stratify the risk of fasting. The study was carried out in 3 phases. Assessment of hypoglycemia and biochemical parameters after the education was the primary outcome.

Results

Fasting blood glucose decreased during and after Ramadan in elderly significantly (p = 0.0001 …

Purpose

We compared the arthroscopic wafer procedure (AWP) and ulnar shortening osteotomy (USO) for treatment of idiopathic ulnar impaction syndrome in terms of clinical, functional improvement and time of return to work.

Methods

This single-center study was conducted at an academic level 1 referral center between 2014 and 2020. Sixty patients with idiopathic ulnar impaction syndrome were prospectively randomized to treatment with either AWP or USO. At the final follow-up, patients were evaluated by the Disabilities of the Arm, Shoulder, and Hand; the Modified Mayo Wrist Score; the visual analog scale for pain; wrist range of motion; and grip strength. Also, the time of return to work and complications were reported.

Results

The mean follow-up periods were 22 ± 5.7 months in the AWP group and 21.1 ± 5.3 months in the USO group. All patients in the USO group achieved union by 12 weeks. At the final follow …

Objective: When more than one primary tumor presents in the same patient, multiple
primary malignancies (MPMs) are diagnosed. The incidence of MPMs has increased due to the
progress in diagnosis and treatment of malignant tumors. MPMs are a clinical situation defined as the
diagnosis of more than one histologically proven tumor within the same patient. The recent advances
in diagnostic modalities, treatment, in addition to the cancer screening programs led to a substantial
rise in the incidence of MPMs. Management of patients with MPMs is highly challenging and highlights
the role of multidisciplinary tumor board management.
Patients and Methods: This report represents the clinicopathological features of 8 patients
with MPMs from 2018 to 2021. We used Warren and Gate’s criteria of classification of MPMs as
synchronous or metachronous.
Results: A total of 2145 patients with malignant tumors presented to our Department from 2018
to 2021, while cases with histologically proven MPMs represented (0.37%) of the total cohort of patients.
The mean age of the patients was 59.87 years. The male to female ratio was 1:1 (Figure 1). Solid
tumors were the predominate in 6 cases (75%) as the first tumor, and as the second one in 7 patients
(87.5%), while hematological tumors presented only in 2 cases (25%) as the first primary tumor and
in 1 patient (12.5%) as the second tumor (Figure 2, 3). Hodgkin Disease (HD) and breast cancer represented
the most common primary tumors in (50%) and (25%) cases, respectively, while breast cancer
was diagnosed as a second tumor in (25%) of the patients. Metachronous MPMs constituted (75%) of
cases, while 25% of cases were synchronous (Figure 4, 5).
Conclusions: The MPMs are proven not to be a rare diagnosis and is forecasted to show a steady
increase in the incidence based on the progress in the diagnostic procedures. Meticulous follow up and
the tackling of patients’ symptoms are imperative in the early detection and proper management.

Introduction

This study aimed to evaluate the phonatory function of recovered COVID-19 survivors. The universal outbreak of COVID-19 led to the occurrence of otolaryngological manifestations that raised concerns about the assessment of the phonatory function in recovering patients.

Methods

This is a prospective, cross-sectional, case-controlled study carried out on 364 laboratory-confirmed non-critical COVID-19 survivors and 100 as healthy controls. The study participants were classified into two groups according to the disease severity. Group1 comprised 212 survivors who recovered from pneumonia and group 2 was made up of 152 survivors of severe pneumonia. All patients were subjected to an auditory perceptual assessment of the voice (APA) and Maximum Phonation Time (MPT) measurements.

Results

Phonasthenic manifestations were significantly more frequent in COVID-19 survivors than in controls (P …