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Abstract : Diabetes mellitus is a group of metabolic disorders characterized by the presence of hyperglycemia in the absence of treatment. The heterogeneous aetio-pathology includes a defect in insulin secretion, action, or both. Periostin is a matricellular protein that is a member of the fasciclin (fasc) family and has structural similarities with the transforming growth factor—β inducible protein and insect axon guidance fasciclin1. The objective of this study was to comparison of the serum level of periostin in patients with T2DM and control to assess if there is an association of periostin with diabetic control in diabetic patients and to study the effect of age and duration of disease on the serum level of periostin. In the present study, included 175 participants categorized into two main categories; 89 patients with type 2 diabetes mellitus as cases, and 86 healthy individuals matched for both age and sex with cases. Body weight, height, and waist circumference were measured and body mass index was calculated for each participant. Overnight fasting blood samples (5-7ml) were collected. A part of (2ml) from each drawn sample was dispensed in a tube containing K3EDTA to measure glycated hemoglobin. The rest of the blood samples were placed in a serum separator tube, they were centrifuged to get the serum to measure fasting blood glucose, lipid profile, and periostin.

Abstract : The development of chronic kidney disease (CKD) is one of the most common conditions comorbid with chronic obstructive pulmonary disease (COPD). The aim of the study was assessment of renal blood flow in patients with COPD with and without CKD. 142 patients with COPD of 2-4 degrees were examined. The assessment of renal blood flow was carried out using the ultrasound by color Doppler mapping. All examined patients were divided into 2 study groups: Group I consisted of 71 patients with COPD with eGFR > 60 ml / min / 1.73m2, group II consisted of 71 patients with COPD with eGFR ≤60ml/min/1.73m2. The progression of kidney dysfunction in patients with COPD was accompanied by a significant decrease in exercise tolerance, worsening of the clinical condition of patients according to the clinical assessment scale and COPD assessment test with a decrease in the functional activity of patients. In COPD patients with CKD, changes were also noted at the level of the lobar and segmental renal arteries, characterized by a significant increase in pulsatile and resistance indices as well as there was a decrease in speed indicators during diastole, systole, and the average blood flow velocity. The COPD patients with renal dysfunction had changes noted at the level of the lobar and segmental renal arteries, characterized by a significant increase in pulsatility and resistance indices. Moreover, there was a decrease in speed indicators during diastole, systole, and the average blood flow velocity.

Abstract : The number of patients being treated for end stage renal disease (ESRD) increased worldwide at a significant high rate. the Prevalence of ESRD in Egypt has amplified, Chronic kidney disease-mineral and bone disorders (CKD-MBD) are predominant in patients undergoing maintenance dialysis. Evaluate morning hemodialysis compared to night hemodialysis as regard to Bone Mineral Disease, hemodialysis adequacy and complete blood count allowing to participate in improving the outcome of hemodialysis(HD) patients. Cross-sectional study was conducted on 60 patients who settled in our dialysis units at Nephrology and UrologyUnit/ Minia University Hospital at both morning dialysis shift at (8am: 12pm) and evening shift (5pm: 9pm). There were statistically significant difference between the two hemodialysis shifts as regard to period of hemodialysis and number of medications taken by them and number of sessions per week and in corrected Calcium level (p value= 0.001 ,0.007, 0.014 and 0.031 respectively). Night hemodialysis was significantly higher in patients living in urban areas and Prevalence of uncontrolled diabetes (p< 0.001& 0.028 respectively). There were statistically significant differences between the morning and night hemodialysis patients regarding to period of hemodialysis, number of medications ,number of sessions per week and corrected Calcium level.

Abstract : To evaluate the effect of periosteum preservation approach in endoscopic sinus surgery on subantral bone augmentation in patients with the maxillary sinus pathology. The results of subantral bone augmentation of 245 patients who underwent surgery for the paranasal sinus pathology (chronic rhinosinusitis, fungus ball and maxillary sinus cysts) were studied. In 146 patients endoscopic sinus surgery was performed with periosteum preservation approach (main group), and 99 patients underwent traditional surgery (control group). The total proportion of patients who had the perforation of the Schneiderian membrane during subantral augmentation in the group with endoscopic sinus surgery according to the traditional method was 21.21%, which is significantly higher than in patients who underwent surgery in accordance with the periosteum preservation principles – 9.59% (p<0.05). The frequency of application of periosteum restore technologies in subantral augmentation was significantly higher in the control group (49.49%) compared with the main group (24.66%) (p<0.05). The frequency of other complications after subantral augmentation in patients who underwent surgery according to the traditional method was 20.59%, which is significantly higher than in patients with periosteum preserving principles – 10.27% (P<0.05). A reduction in the frequency of complications in subantral bone augmentation, provided that the principles of periosteal preservation in sinus surgery are observed, can be associated with low traumatization of the periosteum, and therefore the preservation of its elastic features with the avoidance of tight adhesions between the periosteum in the area of elevation and the underlying bone.

Abstract : In certain nations, surrogacy helps couples conceive. Surrogacy is still illegal and unregulated in Indonesia. Surrogacy is a way for childless couples to escape divorce. Surrogacy is regarded as more successful than other reproductive procedures. This paper tries to answer how the policy of legal protection for the fulfilment of couples' rights to obtain offspring with a surrogacy agreement; and how the implementation of a surrogacy agreement in the context of legislative reform in Indonesia can ensure legal certainty. This study is socio-legal. Werner Menski's Legal Pluralism theory is Constructivist-based. Discussion results show numerous crucial points: First, legal protection is a state of law's subjection to its inhabitants' humanity. A law must contain fairness, certainty, and expediency. Married couples who do not have children can be protected by law in Indonesia so that they can have offspring through a surrogacy agreement using a surrogate mother with the legal policy that if the wife has a uterine abnormality, her uterus was removed due to treatment for other diseases or has heart or lung disease that can harm the pregnant woman. Second, regarding the implementation of a surrogacy agreement in the context of legal reform in Indonesia with comparative studies of law in other countries regarding surrogacy, the authors offer only one type of Gestational surrogacy with the steps starting with building awareness that the purpose of the law is justice, stability, and prosperity.