Exploring internship nursing students’ perception of gerontological nursing competencies: A descriptive study at Cairo University Hospitals

Objective:This research study explores the perceptions of gerontological nursing competencies,attitudes toward older individuals,and the willingness to provide care for the elderly among internship nursing students.Materials and Methods:A convenience sample of 350 internship nursing students from Cairo University Faculty of Nursing participated in the study.Data were collected using a set of comprehensive tools,including personal data and work experience assessment,the Hartford geriatric nurse competency tool,Kogan’s attitudes toward old people scale,and the modified elderly patient care inventory.Results:Descriptive analysis revealed balanced gender representation,with 60%identifying as female.Seventy percent of participants reported prior experience in gerontological care.Self-assessed competency scores indicated moderate proficiency in communication,physiological changes,and functional status assessment.Areas such as pain management and restraint use demonstrated potential gaps in self-perceived skills.Attitudes toward older individuals were predominantly positive,and the willingness to provide care showed positive tendencies,with a minor degree of hesitation noted.Conclusion:The findings underscore the need for targeted interventions in nursing education to address competency gaps,enhance positive attitudes,and alleviate potential hesitations in caregiving for older individuals.As the elderly population continues to grow,nursing education programs must prepare future practitioners to deliver comprehensive and compassionate care tailored to the unique needs of older adults.

Cairo＇s Slums： A Ticking Time Bomb

Despite being one of the symbols of civilization throughout human history, Greater Cairo has many slum areas, hosting a population of three million people living in deteriorating conditions and lacking the basic human necessities. These slums represent a fertile environment for diseases caused by pollution in all its forms and are subject to crimes, rape and theft. There is a huge difference in the state of conditions when comparing the formally planned areas to the informally planned ones. People living in the formally planned settlements, like Nasr City, and in informal ones, like Ezbet El-Haggana, are similar to the kings and queens and slaves of legends. This paper tries to find solutions to the problem of slums and random areas.

Assessment of Urban Heat Island Using Remotely Sensed Imagery over Greater Cairo, Egypt

The Urban Heat Island (UHI) results in significant and sometimes dramatic increases in air temperature differences between the urban environment and its surrounding areas. The heat island structure may extend from the ground to the top of roofs and canopy levels above ground. The Urban Heat Island effect is a leading factor in a long list of human health problems which are expected to increase with the rapid growth of urban populations and projected future climate change. Urban heat island studies can be conducted through either direct measurements of air temperature using automobile transects and weather station networks or through measuring surface temperature using airborne or satellite remote sensing. In this study, UHI was investigated over the Greater Cairo during both summer and winter seasons over two different dates. Landsat 7 ETM+ data were used and the mono-window algorithm was applied in the study. Results emphasis that both types of heat islands exist in the study area i.e. the surface and the atmospheric heat islands. Temperature differences ranged between 0.5°C to 3.5°C and these are much related to the existing land use/covers. It could be concluded that expansion of urban areas in Greater Cairo has led to increased thermal radiation of land surface on the highly populated areas.

Study of Groundwater in Northeast Cairo Area, Egypt

This paper presents a comprehensive hydrogeologic view of the Quaternary aquifer in north eastern Cairo area, Egypt. The hydrogeologic, hydrochemical and isotopic features of the aquifer are determined to assess the groundwater geochemistry and quality for different uses. The groundwater in the aquifer is shallow and flows towards the heavily pumping areas (cultivated and industrial areas). The concentrations of total dissolved solids (TDS) vary considerably in the aquifer, ranging from 225.6 mg/L to 1219 mg/L. Wide variations in the concentrations of major ions, trace elements, nitrate, δ18O and δ2H are detected, indicating the variation in the geologic and recharge conditions. This further indicates the effect of natural processes (weathering, dissolution and ion exchange) as well as anthropogenic activities on the quality of groundwater. Moderate levels of contamination with nitrate, aluminum and manganese are recorded in the groundwater below the cultivated area. The contamination is linked to the extensive use of fertilizers for agriculture and the leakage of wastewater from improper sewage system. The computed nitrate pollution index reveals that about 69.69% of groundwater is safe for drinking, while the rest of groundwater is unsuitable. The calculated water quality index indicates that about 78.79% of groundwater is safe for human consumption and the rest of groundwater is poor for consumption because of the contamination with the high levels of manganese, total hardness, pH, sulphate, aluminum, and nitrate. The contaminated groundwater needs to be treated before consumption. Hence, periodic groundwater quality checks are recommended.

Truthfulness of the Existence of the Pelusium Megashear Fault System, East of Cairo, Egypt

The so-called Pelusium Megashear System (PMS), consists of echelon left-lateral megashears crossing Africa from the Nile-Delta since the Precambrian times. Although this system is questioned by some scientists, its existence is sup- ported by others. This research work provides evidences for the existence of the PMS near Egypt’s capital (Cairo city). Evidence is interpreted from gravity, magnetic, and seismological data, which proves that it has been in existence since 2800 BC [1]. To support the existence of this fault zone system, all available tectonic data are reviewed;new magnetic tilt derivative TDR map and recent fault plane solution map are introduced. Moreover available earthquake catalogue for historical and recent occurrences in and around the Pelusium zone is compiled. The collected recent and historical seismicity data is supporting the existence of PMS system. The faults excluded from magnetic maps were found to be in a good agreement with tectonic and gravity data introduced by some authors. Available fault plane solutions for old and recent earthquakes gave rise to the hypothesis that the PMS is right lateral shear system. Additionally, the Pelusium zone is evaluated for the rate of seismic activity. The hazards of these zones are studied by calculating the earthquake recurrence rates using Richter-Gutenberg formula (LogN = a – bM). A statistical method is applied to exclude the effect of lack of data due to little seismograph station in the early records, or lack of population density. The Pelusium Megashear fault system proved to be active at least in Egypt, however, it plays a role only over big time window, may be thousands of years to dissipate stresses accumulated within the west of Sinai Peninsula in the African Eurasian-Arabian plates. Finally integrated tectonic model including the effect of PMS is introduced to solve the complexity of intraplate tectonics in Northern Egypt.

Explanation of the Damage to the Royal Family’s Cemetery in Historic Cairo and Examination of the Building Materials

The cemetery of the royal family, who ruled Egypt from 1805 to 1952, is one of the masterpieces of the UNESCO World Heritage Site of Historic Cairo. It is a complex building from massive stone masonry walls supporting hemispherical domes and is very rich with the marble decorative elements. Unfortunately, it suffers nowadays from serious cracking due to on-going structural damage. Almost all the structural elements are cracked. Besides, the continuous rise in the groundwater table affects both its structural stability and aesthetics. A detailed inspection was carried out to identify and explain all the manifested damage by the structural elements of the cemetery. The differential settlement damage was found to be very noticeable in the form of many diagonal cracks that are active and threaten the overall stability of the cemetery. The construction history was investigated and found to have a clear effect on the noticed damage. Examination of the construction materials and deterioration products was carried out by inspecting representative samples of the stone, the marble, the mortar, the plaster and the salt. They were examined using different analysis techniques including the Polarized Microscope, the Stereo Microscope, the X-Ray Diffraction (XRD), and the Scanning Electron Microscope (SEM) provided with Energy-Dispersive X-ray spectroscopy (EDX) unit. This examination helped in identifying the type of the used stone, the mortar components, the types of salts affecting the structure, and the deterioration manifested by the marble. It seems that the cemetery needs an urgent conservation project to stop the deterioration and keep it safe for the next generations.

Modeling and Mapping of Urban Sprawl Pattern in Cairo Using Multi-Temporal Landsat Images, and Shannon’s Entropy

Cairo city, being the Egypt’s industrial and cultural center, has a problem of rapid urban sprawl. The city has an extremely high population density which is continuously increasing through informal settlements that grow by sprawling due to migration from the Nile Delta villages and the high population growth rates. The present study attempts to understand, detect and quantify the spatial pattern of Cairo’s urban sprawl using Shannon’s entropy and multi-temporal Landsat TM and ETM images acquired for the period from 1984 to 2013. Supervised classification was applied to extract the built-up areas and to measure the changes in the urban land-use class among the city wards. Shannon’s entropy was applied to model the city’s urban sprawl, trend and spatial change. The entropy values for the city’s electoral wards were modeled and used in an interpolation function to create an entropy surface (index) for each acquired temporal image. Such index indicates the spatial pattern of the urban sprawl and provides a visual comparison of the entropy phenomenon in such wards. Results indicate that Shannon’s entropy index increased from (1.4615) in year 1984 to (2.1023) in year 2013, indicating more dispersed urban growth, a sign of urban sprawl. The maximum entropy values are found in the eastern wards namely El Nozha, Awal Nasr District, Thany Nasr-District, El Salam, El Marg and El Bassatein. A regression analysis was carried for the population growth rate and the built-up areas. Findings help in understanding the sprawl patterns and dynamics among Cairo’s electoral wards and provide a visual comparison. The applied methodology provides explanations and facilitates tracing and measuring the urban sprawl which is needed by decision makers and city planners of mega cities.

The Impact of Clinical Pharmacist Interventions on Drug and Antibiotic Prescribing in a Teaching Hospital in Cairo

Background: The present study was undertaken to investigate the patterns of drug and antibiotics prescribing in a teaching hospital in Cairo, Egypt. Aim: to determine the impact of interventions on such trends in an attempt to rationalize drug use. Method: 1200 prescriptions and patients' records covering the months of January to December, 2011. Prescribing patterns were analyzed using WHO guidelines with regard to prescribing, patient care and health facility indicators. The same parame-ters were again assessed after distributing antibiotic guidelines and holding workshops activities directed towards rational drug use. Results: The number of hospital visits resulting in a prescription was significantly reduced from 94% to 86% (P-value <0.05) and in both cases none of the en-counters contained a generic drug. The average number of drugs per encounter was 2.7 and did not decrease significantly after intervention. A significant reduction was achieved in the number of prescriptions with antibiotics whereas reduction in encounters with injectable drugs was not statis-tically significant. Penicillins was the most commonly prescribed class of antibiotics and amoxicillin was the most frequently prescribed antibiotic. A significant reduction was observed in both en-counters with penicillin and the total of those with antibiotics. Analysis of prescriptions with anti-biotics revealed that penicillins, cephalosporins and erythromycin comprised 94% and 97% of all antibiotics prescribed before and after interventions respectively. Conclusion: The present results clearly indicated that interventions including distribution of antibiotic guidelines and running workshops and seminars on rational drug use to prescribers can lead to significant improvement in prescribing behavior.

Epidemiological and clinical characteristics of inflammatory bowel diseases in Cairo,Egypt

AIM: To study the natural history, patterns and clinical characteristics of inflammatory bowel diseases (IBD) in Egypt.

Intervention Retrofitting and Rehabilitation of Al-Gawhara Palace at the Saladin Citadel, Cairo, Egypt

Al-Gawhara Palace also known as Bijou Palace is located in the south of the Mosque of Muhammad Ali in Saladin Citadel in Cairo (Figure 1 and Figure 2). It was commissioned and constructed by Muhammad Ali Pasha in 1814. Al-Gawhara Palace is one of the most famous historical royal palaces in Egypt and the most important modern architectural heritage that reflects an important historical period of the Egyptian modern history—the period of the rule of the family of “Muhammad Ali Pasha”. The causes of structural deficiency of the palace could be attributed to many reasons and actions, mainly due to the earthquakes and seismic events (in particular the Dahshuor earthquake, in October 1992), degradation of drainage and feeding systems leading to water leakage, lack of awareness of the palace values, deterioration resulting from the use of old government agencies and the conflicts among authorities supervising historical buildings. The present study includes many phases: 1) the significance of the original building from the circumstances and date of construction;2) detailed studies of the architectural features and design of the building as well as construction type, methods and techniques of construction;3) characterization of the construction and building materials;4) stability analysis of the structure under static and the impact of seismic loadings;5) engineering measures for intervention retrofitting of the palace (this pilot study presents the main design studies for intervention retrofitting and the rehabilitation and re-employment of Al-Gawhara Palace, started from the static monitoring, old and modern documenting of the current state of preservation thorough the strengthening project implementation;6) the study also presents the reuse designs to convert the palace to be a national museum, for the purpose of preserving it by proposing the best means to apply the correct principles and criteria for reuse and employment in a manner that preserves its value through the functions that fit these deficiencies, and the appropriateness of the present function of the value of minors.

Maternal and Neonatal Outcome of Teenage Pregnancy at Al-Galaa Maternity Teaching Hospital, Cairo, Egypt

Backgrounds: Teenage pregnancies are generally considered as a high-risk however, sufficient data is lacking in the area, Cairo Egypt. We attempted to determine whether teenage pregnancies show poorer outcomes than adult-age pregnancies. Objectives: Finding out the prevalence of teenage pregnancy and its maternal and fetal outcome in comparison. Subjects and methods: A retrospective analytical case-control study was conducted on patients who had attended for delivery at Al-Galaa Maternity Teaching Hospital during the period of one year from March 2015 to February 2016. A total of included 538 patients aged 16 - 19 years as study group and adult age group: included 609 patients aged 25 - 29 years as the control group. The only primigravid was enrolled. The study records were retrieved for review. Comparisons were made between the two groups regarding maternal demographics, socioeconomic status, medical disorders, major antenatal complications, the outcome of labor, mode of delivery, and perinatal complications. Results: The prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered the significant prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value < 0.05 was considered significant. Teenagers had a lower antenatal care attendance (63.8% vs 76.7%;P = 0.001), a higher incidence of Eclampsia (2.1% vs 0%;P = 0.000), vaginal deliveries (70.1% vs 51.9%;P = 0.000). And a higher maternal ICU admission (1.4% vs 0.0.7%), and maternal death (0.5% vs 0%),especially in low socioeconomic. On the other hand, the adult group pregnancies had a higher incidence of gestational hypertension, gestational diabetes, and cesarean delivery. Conclusions: Teenager primigravid women should be considered as a high-risk pregnancy and thus require special medical attention to avoid adverse maternal and neonatal outcomes.

Low Dose Total Body Irradiation for Relapsed Low Grade Non-Hodgkin’s Lymphoma: Experience of National Cancer Institute, Cairo

Background and Purpose: The relapsed low grade non-Hodgkin’s lymphoma (LG-NHL) is currently?incurable disease and the optimal treatment regimen has not determined yet. Low dose total body irradiation (LTBI) provides an alternative mechanism of action against cancer cells rather than direct cell kill. The mode of action of LTBI is immune-modulatory effect, induction of apoptosis and?hypersensitivity to low radiation doses. The aim of our study is to evaluate the effect of LTBI on relapsed?LG-NHL and reporting our experience at National Cancer Institute, Cairo (NCI, Cairo). Material and Methods: Fifty eight patients with relapsed LG-NHL and received LTBI studied retrospectively.?LTBI dose was 1.6 Gy/8 fractions divided on 2 courses;each course 4 fractions treated over 4 days with 2 weeks rest between the 2 courses. Results: The median age is 54 years;65% of the patients are men. Forty (69%) patients had performance status of 2 or more. Twenty seven patients were stage II/III and 31 patients (53%) had stage IV disease. Twenty six (45%) patients had bulky disease more than 10 cm and 22 (38%) patients had B symptoms at the time of relapse. The?extranodal disease was present in 17 patients (29%) and 78% of the patients received?>3 regimens of chemotherapy before referral to LTBI. Twenty three patients received IFRT (mean dose 32 ± 4 Gy) to initially bulky sites after LTBI. Fourteen patients (24%) achieved complete remission (CR) while 45%, 21% and 10% had partial remission (PR), stable disease (SD) and progressive disease (PD) respectively. The median PFS duration was 14 months and the median OS duration?was 39 months. Stage VI,?>3 regimen of chemotherapy and bad response to LTBI (SD) affected?progression duration adversely (0.03, 0.05 and 0.01 respectively). The response to LTBI is the only factor affected the OS duration significantly. The 3-year PFS was 19% ± 9%, and 3-year OS was 45% ± 8%. Stage IV was the only factor affected the 3-year PFS significantly with p value 0.03. The hematological toxicity was the main side effect of LTBI. Eleven patients developed G3/4 anemia while 8 patients only developed G3/4 thrombocytopenia and 13 patients developed G3/4 leucopenia. Conclusion: The use of LTBI in patients with relapsed low grade NHL is a feasible, effective and tolerable treatment that is worthy of testing in a future with chemotherapy and Rituximab maintenance.

A Clinic-Epidemilogical Study of Cases of Locally Advanced Non Small Cell Lung Cancer (NSCLC) That Received Radiotherapy at NCI Cairo in the Period from 2001-2010

Purpose: This work was to study the clinic-epidemiological characteristics of patients with locally advanced NCSLC and to analyze their prognostic factors and also the results of different treatment modalities for local control and their effect on overall survival (OAS). Materials and Methods: This is a retrospective study including 121 patients with primary locally advanced NSCLC diagnosed between 2001 and 2010 at the radiotherapy department , National Cancer Institute, Cairo University, Egypt. Results: The study showed significant correlation between the tumor size 60, moderately differentiated tumors G2 and treatment outcomes;better locoregional control and better survival rates. On the opposite side poorly differentiated tumors G3, tumor size > 7 cm had the worst locoregional control and survival rates. The study also showed significant statistical correlation between treatment modality, locoregional control and survival rates. Patients who were treated by either concommitent chemo-radiotherapy or sequential chemo-radiotherapy had better local control compared to other patients who were treated by radical radiotherapy, and they also had the best survival rates among all the other treatment groups. The average 6 months OAS rates for all studied patients were 60.3% while 12 months survival rates were 38.8%. The median OAS was 7 months. Conclusions: From the present study, we concluded that concomitant chemo-radiotherapy is the treatment of choice for locally advanced non small cell lung cancer;also we concluded that better performance status and higher hemoglobin levels have better treatment outcome in these cases.

Clinico-pathological study and treatment results of 1009 operable breast cancer cases:Experience of NCI Cairo University,Egypt

Objective： This retrospective study was designed to evaluate ciinico-pathological data including stage, results of treatment, and prognostic factors which affect the overall survival ＆ disease free survival. Methods： This was a retrospective study carried out at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt on 1009 patients treated for primary breast cancer between 1999-2003. Results： The median follow-up was 68 months. Loco regional relapse occurred in 23 patients （2.3%） and distant relapse occurred in 203 patients （20.1%）. Both Ioco regional and distant relapse were reported in 32 patients （3.2%）. The disease free survival （DFS） at 3 and 5 years were 87% and 78% respectively, while OAS at 3 and 5 years were 96.4% and 91.4% respectively. Multivariate analysis of different prognostic factors showed that the independent bad prognostic factors in the study for disease relapse were positive lymph nodes （LNs, more than 10）, tumor size T3, T4 with significance of 0.0001 for each, and pathologic grade with significance of 0.003. Conclusion： The most important independent bad prognostic factors for relapse are positive LNs more than 10, tumor size T3, T4 and pathologic grade. The timing of radiotherapy affects the disease free survival significantly also it is recommended to analyze the group of patients with LNs negative using well designed randomized trials.

Dosimetric study comparing intensity modulated and conformal pelvic radiotherapy boost plans in locally advanced cancer cervix in NCI-Cairo

Objective:This study was to compare 5 field conformal technique to the intensity modulated radiotherapy (IMRT) 8 fields technique in boosting locally advanced cancer cervix cases after external beam radiotherapy with respect to target volume coverage and dose to normal tissues. Methods:We conducted a single institutional comparative dosimetric analysis of 10 patients with cancer cervix who was presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2012 to September 2012 and received a CRT boost in the place of planned brachytherapy after large field pelvic radiotherapy (PRT) with concurrent chemotherapy were retrospectively identified. All tumors were situated in the low central pelvis. Two plans were done for every patient; one using the 8 fields IMRT and the second one using 5 fields' 3DCRT the two techniques were then compared using dose volume histogram (DVH) analysis for the PTV, bladder, rectum and both femoral heads. Results:Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both plans while it was demonstrates that the 8 fields IMRT technique carried less doses reaching OARs (rectum, bladder, both femoral heads). Conclusion:From the present study, it is concluded that IMRT technique spared more efficiently OARs than CRT technique but both techniques covered the PTV adequately so whenever possible IMRT technique should be used.

A comparative dosimetric study of 3-dimensional conformal radical radiotherapy for bladder cancer patients versus conventional 2-dimensional radical radiotherapy in NCI-Cairo, Egypt

Objective: This study was to compare this multiple-field conformal technique to the 2-dimensional (2D) conventional technique with respect to target volume coverage and dose to normal tissues. Methods: We conducted a single institutional prospective comparative dosimetric analysis of 15 patients who received radical radiation therapy for bladder cancer presented to Radiotherapy Department in National Cancer Institute, Cairo (Egypt), in period between November 2011 to July 2012 using 3-dimensional (3D) conformal radiotherapy technique for each patient, a second 2D conventional radiotherapy treatment plan was done, the two techniques were then compared using dose volume histogram (DVH) analysis. Results: Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both (3D & 2D) plans while it was demonstrated that this multiple field conformal technique produced superior distribution compared to 2D technique, with considerable sparing of rectum and to lesser extent for the head of both femora. Conclusion: From the present study, it is recommended to use 3D planning for cases of bladder cancer especially in elderly patients as it produces good coverage of the target volume as well as good sparing of the surrounding critical organs.

Ground Penetrating Radar (GPR) Investigations for Architectural Heritage Preservation: The Case of Habib Sakakini Palace, Cairo, Egypt

A comprehensive Ground Penetration Radar (GPR) investigations and hazard assessment for the rehabilitation and strengthening of Habib Sakakini’s Palace in Cairo is presented herein, which is considered one of the most significant architectural heritage sites in Egypt. The palace located on an ancient water pond at the eastern side of Egyptian gulf besiding Sultan Bebris Al-Bondoqdary mosque is a place also called “Prince Qraja al-Turkumany pond”. That pond had been filled down by Habib Sakakini at 1892 to construct his famous palace in 1897. The integrated geophysical survey of the palace allowed the identification of several targets of potential archaeological and geotechnical engineering interest buried in fill and silty clay in the depth range between 100 - 700 cm. the methodological development focused on Multi-Fold (MF) Ground Penetrating Radar (GPR) imaging and subsurface characterization based on integrated velocity and attenuation analysis. Eight hundred sqm of Ground penetration Radar (GPR) profiling have been conducted to monitor the subsurface conditions. 600 meters are made in the surrounding area of the Palace and 200 sqm at the basement. The aim is to monitor the soil conditions beneath and around the Palace and to identify potential geological discontinuities, or the presence of faults and cavities. A suitable single and dual antenna are used (500 - 100 MHZ) is used to penetrate the desired depth of 7 meters (ASTM D6432). The GPR is used also detect the water table. At the building basement the GPR is used to identify the foundation thickness and soil-basement interface. As well as the inspection of cracks in some supporting columns, piers and masonry walls. The GPR also was used to investigate the floors and ceilings conditions and structural mapping. The results were validated by the geotechnical and structural surveys. All these results together with the seismic hazard analysis will be used for the complete analysis of the palace in the framework of the rehabilitation and strengthening works foreseen in a second stage.

Nano Particles and Nano Composites for Preservation of Historic Marble Minbars with Application on the Minber of Soliman Pasha Al-Khadim Mosque in Salah El-Din Citadel in Cairo, Egypt

Minbar, in Islam, the pulpit from which the sermon (khutbah) is delivered. In its simplest form, the minbar is a platform with three steps. Often it is constructed as a domed box at the top of a staircase and is reached through a doorway that can be closed. Soliman pasha Al-Khadim mosque in Salah El-Din citadel in Cairo is considered the first mosque with ottoman architectural style. This Minbar exposed to aggressive human intervention by mosque workers and archaeological crafts unity-ministry of antiquities in Egypt, to lose more of its historical and architectural values. Now this Minbar undergoes restoration process, they are removing all modern pigments and remains of last reconstruction in 2014 so we proposed some Nano particles and Nano composites for Preservation of it. The study started with the characteristics of the historic architectural elements of Mibars and their joining structural mortars in order to risk assessment and to define the necessary characteristics of the intervention retrofitting new materials, which will be used in the ongoing preservation work of these stucco architectural elements. To achieve such, several analyses and laboratory tests like ultra-sonic pulse method testing and uniaxial compression test were carried out to determine their basic, physical and mechanical properties, along with the microstructural properties determination using Mercury porosimeter. On the other hand, the morphological description, petrography, mineralogical and microstructural properties were determined using scanning electron microscope equipped by EDS, transmission electron microscopy TEM, polarizing light microscopy, XRD and XRF. The results proved the superiority of the samples that have been strengthened by nano lime concentration of 2% with Wacker OH 100 concentration in 5%.

A comparative dosimetric study of neoadjuvant 3D conformal radiotherapy for operable rectal cancer patients versus conventional 2D radiotherapy in NCI-Cairo

Objective:This study was to compare this multiple-field conformal technique to the AP-PA technique with respect to target volume coverage and dose to normal tissues.Methods:We conducted a single institutional prospective comparative dosimetric analysis of 22 patients who received neoadjuvant radiation therapy for rectal cancer presented to radiotherapy department in National Cancer Institute,Cairo in period between June 2010 to September 2011 using 3D conformal radiotherapy technique for each patient,a second radiotherapy treatment plan was done using an anteroposterior (AP-PA) fields,the two techniques were then compared using dose volume histogram (DVH) analysis.Results:Comparing different DVHs,it was found that the planning target volume (PTV) was adequately covered in both (3D & 2D) plans while it was demonstrates that this multiple field conformal technique produces superior distribution compared to 2D technique,with considerable sparing of bladder,ovaries and head of both femora.Conclusion:From the present study,it shows that it is recommended to use 3D planning for preoperative cases of cancer rectum so far it produces good coverage of the target as well as good sparing of the surrounding critical organs.

Surgical Approaches to Retrosternal Goiter, When Sternotomy Is Mandatory? National Cancer Institute Experience (NCI), Cairo University, Egypt

Background: Retrosternal goiters (RG) are those lesions extending to occupy the thoracic cavity. They carry a surgical risk due to distorted anatomy, the minimal access, and the potential for great vessels or pleural injury. No other effective therapeutic alternative to surgery exists. Cervicotomy is still the surgical approach of choice, although a form of sternotomy may always be necessary for field extension and safe gland delivery. Materials and Methods: This is a single institution combined retrospective & prospective study including retrospective analysis of all cases presenting to the NCI, Cairo University with RG candidate for surgery between Jan. 2008 until the end of Dec. 2012, and a prospective study of all cases with the same presentation presenting to the NCI between Jan. 2013 until the end of Dec. 2015. Data was collected from archive of patients at the statistical department. Aims: To study the clinico-pathological characteristics, the presentation, work-up, surgical approaches and postoperative complications of RG. Results: 42 patients were included & were divided into benign (34 patients, 80.9%) and malignant groups (8 cases, 19.1%). All patients (100%) were adults ranging (19 to 73 years) with mean 53.1 years. There was a female predominance (36 female, 85.7%) versus (6 males, 14.3%). Median duration of symptomatology was 23 months ranging (6 - 53 months). 23 patients (54.7%) were symptomatic while 19 cases (45.3%) accidently discovered. Mean tumor size was 9.97 cm in the benign group and 11.1 cm in the malignant group. 31 patients (73.8%) were euthyroid, 9 (21.4%) were thyrotoxic and 2 (4.7%) were hypothyroid. All patients (100%) underwent total thyroidectomy. The commonest approach was cervicotomy (33 cases, 78.6%), while a type of sternotomy was done in 9 cases (21.4%). 2 cases (4.7%) received postoperative radiation therapy & 4 cases (9.5%) received postoperative radioactive iodine. No perioperative mortality occurred & the overall morbidity was 6 cases (14.2%) in the benign group and 2 cases (4.7%) in the malignant group (4.7%). The median follow up period was 17.5 months. The median overall survival (OS) was 39.4 months and the median disease free survival (DFS) was 9.8 months for the malignant group. Conclusion: Cervicotomy is a safe favorable approach to remove a RG. Intraoperative field extension up to a form of sternotomy may be necessary for gland delivery with increasing operating time, hospital stay and morbidity. Postoperative morbidity is mainly due to the respiratory, recurrent laryngeal nerve palsy and hypoparathyroidism which is mainly increased when sternotomy is performed.