Fayoum University

Background/Objectives: Diabetic peripheral neuropathy (DPN) and Charcot foot (CF) represent progressive and disabling neuropathic complications of type 2 diabetes mellitus (T2DM). Circulating microRNAs and inflammatory cytokines may reflect underlying molecular alterations associated with disease progression and offer potential value for discriminating between stages of diabetic neuropathic complications. This study aimed to evaluate circulating miRNA expression profiles and inflammatory cytokine biomarkers in T2DM patients with and without neuropathic complications and to assess their potential non-invasive utility as combined biomarkers for differentiating disease stages and identifying molecular patterns associated with progression from T2DM to DPN and CF. Methods: The study included the following four groups: healthy controls, T2DM patients without complications, T2DM patients with DPN, and T2DM patients with CF. Expression profiles of five miRNAs (miR-19b-3p, miR-451a, miR-199a-3p, miR-146a-5p, and miR-93-5p) were quantified using qPCR. Inflammatory cytokine biomarkers including NLRP3, TNF-α, NF-κB, IL-1β, caspase-3, and Serpin E2 were measured using ELISA assays. Results: Distinct expression patterns of both miRNAs and inflammatory cytokine biomarkers were observed across diabetic neuropathy stages. Several miRNAs demonstrated significant dysregulation in DPN and CF compared with T2DM patients without complications. Correlation analyses revealed stage-specific patterns of interaction between inflammatory cytokines and miRNAs, indicating coordinated molecular alterations across different stages of diabetic neuropathic complications. Conclusions: These findings suggest that combining circulating miRNA and inflammatory marker profiles may improve the discrimination of CF from other diabetic neuropathic stages and may support clinical assessment when conventional diagnostic methods remain unclear. However, prospective longitudinal studies are required to determine their value for risk prediction and disease progression.

Medical students frequently experience health problems but often resort to self-medication instead of consulting a doctor. This practice may be influenced by various factors and is associated with serious health risks. This study aimed to assess the prevalence, predictors, and contributing factors for self-medication during illness among medical students in Egypt. A cross-sectional study was conducted among 1,128 medical students from seven public universities across three regions of Egypt. Data on self-medication practices, self-reported reasons, and associated factors were collected using an online survey distributed through university-affiliated channels. Binary logistic regression analysis was used to identify factors associated with self-medication for illness. Self-medication for illness during the past year was reported by 66.6% of participants. In univariate analysis, significant predictors included older age (Crude Odds Ratio (COR) = 1.55, 95% CI: 1.21, 1.99), advancing academic year (COR range: 1.69–2.60 vs. first-year students), having a part-time job (COR = 1.68, 95% CI: 1.04, 2.73), and having a chronic illness (COR = 1.75, 95% CI: 1.11, 2.76). Self-medication was also associated with confidence in self-diagnosis (COR = 1.66, 95% CI: 1.28, 2.16), barriers to healthcare access (COR = 1.55, 95% CI: 1.21, 2.00), discrimination in healthcare settings (COR = 1.40, 95% CI: 1.01, 1.95), and delaying healthcare-seeking (COR = 1.77, 95% CI: 1.32, 2.38). In multivariable analysis, significant predictors included advancing academic year (Adjusted Odds Ratio (AOR) = 1.71, 2.26, 95% CI: 1.14, 4.03), confidence in self-diagnosis (AOR = 1.63, 95% CI: 1.25, 2.13), delaying healthcare-seeking (AOR = 1.54, 95% CI: 1.13, 2.10), and experiencing barriers to healthcare access (AOR = 1.31, 95% CI: 1.00, 1.72). The most common self-reported reasons for self-medication was lack of time (43.4%) and convenience (42.5%). A substantial proportion of Egyptian medical students rely on self-medication during illness, influenced by academic progression, confidence in self-diagnosis, and healthcare access barriers. Addressing these factors is crucial to promoting safer healthcare-seeking behaviors among future physicians. Not applicable.

For individuals with breast cancer, oncoplastic breast surgery (OBS), is considered an innovative technique of breast conservative surgery (BCS), has emerged as the recommended substitute for mastectomy. BCS and mastectomy have been shown to have comparable locoregional control and overall survival in randomized trials. In order to ensure oncological safety and improved aesthetic results, Extreme Oncoplasty, a development in the field of oncoplasty, has given hope for patient to achieve ultimate conservation before mastectomy. From October 2021 to May 2023, fifty patients fulfilling our eligibility criteria underwent extreme oncoplasty for breast cancer have been included in the current study. Reduction mammoplasty (superomedial, superiolateral and inferior pedicle), upper matrix rotational flap, and Passot’s technique were our adopted surgical techniques. One year following surgery, short-term aesthetic results were objectively assessed using Breast Cancer Conservative Treatment (BCCT) core program. Our study has included 50 cases with age range from 35 to 61 years (mean 52.28 ± 6.3). 38 patients presented with tumor size more than 5 cm not responding to the neoadjuvant therapy for downsizing and 12 patients presented with multifocal lesions. The total aesthetic results according to the BCCT core software were good in 52% (26 cases), fair in 34% (17 cases) and poor in 14% (7 cases). Our study has reported two cases of recurrence (4%) one year after surgery which were managed via mastectomy. According to short-term follow-up, extreme oncoplasty is oncologically safe. To provide patients with advanced or multifocal breast cancer with extreme oncoplasty as a viable alternative, large-scale research are needed to validate these first findings.

Rough graphs have emerged as a significant mathematical tool for modeling imprecise and incomplete information within graph-structured data. By leveraging rough set theory, these structures manage uncertainty through the construction of lower and upper approximations, providing a robust framework for analyzing vague or ambiguous networks. Despite the growing body of literature on rough graphs, a consistent and comprehensive theoretical foundation remains elusive. In this paper, we critically review existing partition-based approaches and identify persisting structural inconsistencies in their foundational definitions, such as the generation of invalid subgraphs and hanging edges. To address these gaps, we propose a unified, topologically consistent framework. Inspired by the theory of rough relations, we generalize vertex-based rough graphs to settings where the vertex set is granulated by a covering rather than a strict partition. Furthermore, we introduce three novel types of edge-based rough graphs derived from coverings of the edge set, demonstrating that our approach inherently preserves subgraph validity. Synthesizing these two perspectives, we propose hybrid rough graph models that establish a comprehensive multi-granulation environment for both the vertex and edge universes. Finally, we illustrate the practical utility of our proposed models through applications in social network analysis and protein-protein interaction (PPI) networks, highlighting their effectiveness in isolating core communities and identifying boundary nodes.

Acute flank pain during pregnancy presents a diagnostic challenge due to physiological hydronephrosis and the need to avoid ionizing radiation. Clinicians require reliable, non-invasive imaging strategies that guide management and minimize unnecessary intervention. To evaluate high-resolution ultrasonography, including Doppler resistive index (RI) measurement, as a structured decision tool for differentiating etiologies of acute flank pain during pregnancy and guiding management. Retrospective cohort study including 87 pregnant women presenting with acute flank pain between May 2022 and December 2023.Patients underwent detailed clinical, laboratory, and high-resolution US evaluation: B-mode grading of hydronephrosis, renal parenchymal and perinephric assessment, ureteric and bladder evaluation, and intrarenal arterial Doppler RI measurement. Clinical parameters including pain severity, fever, and inflammatory markers (CRP, WBC) were integrated to support imaging findings Ultrasonographic findings were correlated with clinical course and management outcomes. Hydronephrosis was detected in 96.5% of patients, predominantly right-sided (77%). Hydroureteronephrosis with Collecting system wall thickening and edema suggestive of inflammation was the most common etiology (75%). Urolithiasis was detected in 23% of patients, high grade obstruction confirmed in 11.5%. Patients with high grade obstruction had elevated intrarenal RI (≥ 0.72; mean 0.78), whereas those with physiological ureteral compression had normal RI with preserved ureteric jets. Conservative management succeeded in 91% of cases; 9% required surgical intervention. High-resolution US combined with Doppler RI provides a safe, reproducible, and management-oriented decision algorithm for acute flank pain in pregnancy. It differentiates physiological from pathological obstruction, supports conservative management in most patients, and identifies those requiring timely intervention.

This study aims to examine the relationship between urban design and patterns of social behavior in rural and urban communities, with a focus on how built environments influence social interaction and the sense of community belonging. The study employs a comparative approach that combines a theoretical analysis of urban and behavioral concepts with a field study involving data collection from population samples in an urban area and a rural village. The study highlights the differences between the two environments regarding the impact of urban design on social behavior. In urban settings, urban design appears to enhance interaction in public spaces such as parks, squares, and pathways, whereas in rural settings, cultural and local social factors are closely linked to the importance of traditional shared spaces in strengthening social ties. The research also emphasizes the role of urban design in shaping daily behaviors and social interactions and provides recommendations to promote integration between urban design and social needs in both environments. This study contributes to understanding how urban design can be guided to enhance social cohesion while considering the differences between rural and urban contexts, and it opens avenues for future research on the relationship between the built environment and social behavior in diverse settings