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This paper is concerned with a right truncated Topp-Leone compound Pareto Type II-gamma distribution RTTL-CPIIG (θ, α, β, c) with its mathematical forms of reliability function (rf), hazard rate function h(x), reversed hazard function (rhf), cumulative hazard function Htl(x), the approximate mean and variance, Mode, quantile and median are in this paper. Reliability and hazard rate function are obtained. The maximum likelihood method is used to estimate the parameters numerically. Simulation is used to represent the performance of the suggested distribution.

Patellofemoral pain syndrome (PFPS) is the most common knee problem that affects the knee in adulthood. It is more common in females twice than in males. It has a multifactorial etiology. The effect of the combination of manual therapy and hip and knee exercises is unconfirmed till now. Therefore, the aim of this study is to investigate the effect of adding manual therapy to knee and hip exercises on pain intensity, self-reported and objective knee function, hip abductors, hip external rotators, and knee extensor strength in addition to calf, and hamstring flexibility in patients with PFPS. This was a double-blind study. Fifty-nine adult patients with PFPS matched with eligibility criteria were sequentially recruited from an outpatient clinic, and faculty students were enrolled in this study and randomized by a generated Excel sheet into two groups either control (30 patients) or manual therapy (29 patients) group. The control group received stretch and open and closed kinetic chain strength exercises, while the manual therapy group received the same exercises as the control plus patellar mobilization, iliotibial band release, and deep friction massage of lateral retinacula. This treatment was performed in the outpatient clinic for 12 sessions in 4 weeks. Fifty-three patients had only been analyzed at the end of treatment. The primary outcomes were knee pain intensity and self-reported knee function. The secondary outcomes were hip and knee muscle strength, calf and hamstring flexibility, and a step-down test. All outcomes were measured before and after 4 weeks of treatment immediately by a blind assessor. Comparing between and within groups were performed using the Multivariate analysis of variance (MANOVA) test. The mean age was 22.64 ± 3.71 years for control group, 21.92 ± 2.39 years for manual therapy group. Both treatment protocols showed significant reduction of pain (ascending ( p  < 0.001; CI: (14.85–39.44)), descending ( p  < 0.001; CI: (15.95–30.62)), squatting ( p  < 0.001; CI: (15.00-38.07)) and sitting ( p  < 0.001; CI: (13.49–37.87))) for control group, while (ascending ( p  < 0.001; CI: (20.37–39.07)), descending ( p  < 0.001; CI: (12.72–32.80)), squatting ( p  < 0.001; CI: (28.98–51.66)) and sitting ( p  < 0.001; CI: (16.72–42.24))) for manual therapy group, improvement in knee function (Kujala: ( p  < 0.001; CI: (-17.02—8.76))) for control group while (Kujala: ( p  < 0.001; CI: (-21.32—12.19))) for manual therapy group, hip and knee muscle strength and flexibility ( p  < 0.05). However, there were non-significant differences between groups in all dependent variables ( p  > 0.05). Manual therapy added to hip and knee exercises may have the same effect as hip and knee exercises without superiority to one of them. Manual therapy improved patients’ clinical outcomes, including pain and function disability, with a higher percentage of change than exercises only. Clinical trial registration : www.clinicaltrials.gov (NCT05665452). Date: 27/12/2022 .

The prime objective of the current investigation is to evaluate a promising alternative method for disinfection wastewater using a novel electro-oxidation unit. The study focused on determining the best-operating conditions from a techno-economic point of view to be applied to continuous flow simulating actual disinfection modules. The treatment unit consisted of a Plexiglas container with a 3 L volume containing nine cylindrical shape electrodes (6 graphite as anode and 3 stainless steel as a cathode) connected to a variable DC power supply. Determination of the best operating parameters was investigated in batch mode on synthetic wastewater by studying the effect of contact time, current density (CD), total dissolved solids concentration (TDS), and bacterial density. Moreover, the continuous mode experiment was considered on real wastewater from an agricultural drain and the secondary wastewater treatment plant effluent before chlorination. The batch mode results revealed that the best applicable operational conditions that achieved the complete removal of E. coli were at a contact time of less than 5 min, TDS of 2000 mg/L, and CD of 4 mA/cm 2 . Application of these conditions on the continuous mode experiment indicated the complete removal of all bacterial indicators after 5 min in the drainage wastewater and after 3 min in the secondary treated wastewater. Physico-chemical characterization also suggested that no chlorine by-products displaying the hydroxide ion formed due to water electrolysis is the main reason for prohibiting the growth of pathogenic microbes. The electrical consumption was calculated in the continuous mode and found to be 0.5 kWh/m 3 with an operational cost of about 0.06 $/m 3 , including the cost of adding chemicals to increase the TDS. The results proved that this novel electro-oxidation unit is a robust and affordable disinfection method for complete bacterial removal from wastewater and is more environmentally benign than other conventional disinfection methods.

Mixed phenotype acute leukemia (MPAL) is a rare type of leukemia with a limited number of studies conducted to characterize its clinical spectrum and most importantly the best treatment modality. MPAL blasts show more than one phenotype either myeloid/monocytic with T- or B-lymphoid or extremely rare triple lineage associated phenotypic markers. This study aimed to characterize MPAL cases with special emphasis on comparing adult and pediatric age groups, exploring treatment regimens, and clinical outcome. Among 2571 acute leukemia patients, 102 MPAL cases fulfilling the 2008/2016 WHO diagnostic criteria of MPAL were recruited in the study. The incidence of MPAL was 4% of acute leukemia patients. Pediatric cases were 54 (53%) while adults were 48/102 (47%). Myeloid/B-lymphoid phenotype was found in 86/102 (84%), with BCR-ABL fusion gene transcript detected in 14/102(13.7%) patients. ALL-like treatment showed better response rates as compared with the myeloid based regimen (p = 0.001). MPAL behaves in a manner that resembles in clinical features, their lymphoid progenitor counterpart leukemias both in adults and pediatric patients with superior treatment response to ALL-like regimen, especially in adults.

Background COVID-19 has serious consequences on different body systems particularly the respiratory system with its impact on pulmonary function, exercise capacities, and physical activities. This study aimed to investigate the long-term effect of COVID-19 on pulmonary function, exercise capacities, and physical activities in patients with non-severe COVID-19. Methods 160 individuals were selected to participate in a cross-section study. Group-I: 80 male and female patients with non-severe COVID-19 at least 3 months after the recovery time. Group-II: 80 male and female matched (non-infected with COVID-19) participants. The spirometer, six-minute walk test (6MWT), and International Physical Activity Questionnaire (IPAQ) were used to assess pulmonary function, exercise capacities, and physical activities respectively. The Kolmogorov-Smirnov test was used to test normality of data. The Mann-Whitney and independent t-tests were used to compare the significant differences between both groups. Results The results show significant differences in FVC & FEV 1 of the pulmonary function, exercise capacities, and physical activities of the work & transportations between both COVID-19 and matched groups p-value = (0.001 & 0.001, 0.001 and 0.005 & 0.012) respectively. Conclusion Pulmonary function, exercise capacities, and physical activities are negatively influenced by COVID-19 as long-term consequences indicating the need for extended health care, and prescription of proper rehabilitative training programs for non- severe COVID-19 patients whatever their severity degree of infection or history of hospitalization. Outcome reflections of the current results raise awareness of physical therapists to the importance of the proper rehabilitative training programs for non-severe COVID-19 patients.

Objectives Patients with rheumatoid arthritis (RA) frequently experience dysphagia but limited studies analyzed it. This study aimed to assess swallowing in RA patients by Fiber optic Endoscopic Evaluation of Swallowing (FEES). Methods It was a cross-sectional study that included 30 patients diagnosed with RA and complaining of dysphagia. All patients were subjected to patient interviews and bedside swallowing screening and examined by FEES using different food consistencies: thin fluids, 5 mL and 10 mL, semisolids, and solids. The Mansoura Fiberoptic Endoscopic Evaluation of Swallowing Residue Rating Scale (MFRRS) and the 8-point penetration-aspiration scales were used to interpret FEES findings and assess swallowing efficiency and swallowing safety. Results The most reported symptoms were foreign body sensation (90.0%), xerostomia (80.0%), chewing problems (76.7%), teeth problems (70.0%), and self-feeding difficulty (53.3%). Most of these patients reported changing eating habits like using fluids with solids (73.3%) and increasing their meal time (60%). All patients had negative bedside swallowing screening. FEES revealed that the anatomy and the physiology of swallowing were normal, the larynx was normal, and MFRRS revealed that most of the patients had no residue for different food consistencies. No penetration or aspiration was detected in the thirty patients. Conclusion Data obtained from the study not only provided compelling evidence regarding the high prevalence of current swallowing disorders among individuals diagnosed with rheumatoid arthritis but also confirmed the importance of direct assessment and the need of more concern regarding dysphagia related to RA.

This study aims to evaluate the impact of red LED irradiation on the viability, proliferation, colonogenic potential, markers expression along with osteogenic and chondrogenic differentiation of dental pulp stem cells. DPSCs were isolated from sound human permanent teeth using enzymatic digestion method and seeded with regular culture media. Cells at P4 were irradiated using red LED Light (627 nm, 2 J/cm2) and examined for growth kinetics, and multilineage differentiation using the appropriate differentiation media. The irradiated groups showed an increase in cellular growth rates, cell viability, clonogenic potential, and decrease in population doubling time compared to the control group. Cells of the irradiated groups showed enhanced differentiation towards osteogenic and chondrogenic lineages as revealed by histochemical staining using alizarin red and alcian blue stains. Photobiomodulation is an emerging promising element of tissue engineering triad besides stem cells, scaffolds, and growth factors.

Background COVID-19 has serious consequences on different body systems particularly the respiratory system with its impact on pulmonary function, exercise capacities, and physical activities. This study aimed to investigate the long-term effect of COVID-19 on pulmonary function, exercise capacities, and physical activities in patients with non-severe COVID-19. Methods 160 individuals were selected to participate in a cross-section study. Group-I: 80 male and female patients with non-severe COVID-19 at least 3 months after the recovery time. Group-II: 80 male and female matched (non-infected with COVID-19) participants. The spirometer, six-minute walk test (6MWT), and International Physical Activity Questionnaire (IPAQ) were used to assess pulmonary function, exercise capacities, and physical activities respectively. The Kolmogorov-Smirnov test was used to test normality of data. The Mann-Whitney and independent t-tests were used to compare the significant differences between both groups. Results The results show significant differences in FVC & FEV 1 of the pulmonary function, exercise capacities, and physical activities of the work & transportations between both COVID-19 and matched groups p-value = (0.001 & 0.001, 0.001 and 0.005 & 0.012) respectively. Conclusion Pulmonary function, exercise capacities, and physical activities are negatively influenced by COVID-19 as long-term consequences indicating the need for extended health care, and prescription of proper rehabilitative training programs for non- severe COVID-19 patients whatever their severity degree of infection or history of hospitalization. Outcome reflections of the current results raise awareness of physical therapists to the importance of the proper rehabilitative training programs for non-severe COVID-19 patients.

Introduction: Toxoplasma gondii is an intracellular protozoan that may disrupt the traditional cell barriers against cancer, allowing the accumulation of oncogenic mutations over time. Our research aimed to explore the relationship between T. gondii infection and tumor development. Methodology: The anti-T. gondii IgG and IgM antibodies were tested for156 patients with tumors (51 with breast cancer, 20 with hepatoma, 20 with larynx carcinoma, 20 with squamous cell carcinoma of bone, 16 with lymphoma, 13 with brain tumor, 4 with bladder cancer and 12 with benign uterine tumor) and 90 healthy controls by using electrochemiluminescence immunoassay. Tissue specimens were collected from T. gondii seropositive cases for histological and immunohistochemistry (IHC) examinations. Results: The seroprevalence of human toxoplasmosis in the Sharkia Governorate, Egypt is significantly correlated with various types of tumors: breast cancer in 49 subjects (96.1%), and squamous cell carcinoma of bone in 16 subjects (80%). It was also present in nine cases of brain tumors. Anti-Toxoplasma IgG was detected in seven cases of liver tumors and one-quarter of bladder cancer. The anti- Toxoplasma IgM was present in three patients with benign uterine tumors, one patient with a bone tumor and two patients with breast cancer. Toxoplasma cysts were detected in immunostained brain sections. Conclusion: The correlation between T. gondii infection and tumors was established by this study indicating a significant emerging role of human toxoplasmosis in the etiology or existence of particular types of tumors.

Background Complex regional pain syndrome (CRPS) is a chronic condition following inciting events such as fractures or surgeries with sensorimotor and autonomic manifestations and poor prognosis. This review aimed to provide conclusive evidence about the sensory phenotype of CRPS based on quantitative sensory testing (QST) to understand the underlying pain mechanisms and guide treatment strategies. Databases Eight databases were searched based on a previously published protocol. Forty studies comparing QST outcomes (thermal, mechanical, vibration, and electric detection thresholds, thermal, mechanical, pressure, and electric pain thresholds, wind-up ratio, mechanical pain sensitivity, allodynia, flare area, area after pinprick hyperalgesia, pleasantness after C-tactile stimulation, and pain ratings) in chronic CRPS (adults and children) versus healthy controls were included. Results From 37 studies (14 of low quality, 22 of fair quality, and 1 of good quality), adults with CRPS showed: (i) significant loss of thermal, mechanical, and vibration sensations, significant gain of thermal and mechanical pain thresholds, significant elevation of pain ratings, and no difference in wind-up ratio; (ii) significant reduction of pleasantness levels and increased area of pinprick hyperalgesia, in the affected limb. From three fair-quality studies, adolescents and children with CRPS showed loss of cold detection with cold hyperalgesia in the affected limb. There was moderate to substantial overall heterogeneity. Conclusion Diffuse thermal and mechanical hypoesthesia with primary and secondary hyperalgesia, enhanced pain facilitation evidenced by increased area of pinprick hyperalgesia, and elevated pain ratings are dominant in adults with CRPS. Adolescents and children with CRPS showed less severe sensory abnormalities.