Al-Azhar University Research Articles

Compliance of thyroid nodules through ultrasound-guided trucut/core needle biopsy with Thyroid imaging, reporting, and data system score and surgical pathology

Background and Aim The ultrasound-guided trucut/core needle biopsy (CNB) has been effectively used as a supplemental approach for the assessment of thyroid nodules. We aimed to evaluate the diagnostic value of the ultrasound-guided trucut needle biopsy of thyroid nodules in correlation with Thyroid imaging, reporting, and data system (TIRADS score). Patient and methods Between November 2020 and November 2021, this prospective study had been carried out at Al-Azhar University Hospital, Assiut, in the department of general surgery and diagnostic and interventional radiology. There were 50 patients in this study, All of them had clinically suspected thyroid nodules. Results The mean age of patients involved in the current research was 43.9±11.7 years. Females represented 92% of the study groups, while males made up just 8%. There was no considerable variation in the prevalence of diabetes mellitus (DM) or hypertension among the study groups. The most prevalent diagnosis in the normocalcemic group (39.63%) was simple goiter, while in the hypocalcemic group was malignancy (44.44%). In terms of preoperative diagnosis, there was a substantial diversity among the 2 groups. Conclusion Thyroid CNB used as an alternative choice for cases with a previous non-diagnostic or indeterminate diagnosis, but is presently being recommended as a first-line method for identification of thyroid nodules in selected cases. Accuracy of CNB in thyroid nodules is high with low rate of drastic effects.

Non Vitamin k Antagonist Oral Anticoagulation Assessment in Non Valvular Atrial Fibrillation Using Transcranial Doppler Ultrasonography

<i>Background</i>: Warfarin with optimized international normalization ratio (INR); is significantly affect the Micro embolic signals (MES), in many studies. Non vitamin k antagonist oral anticoagulants (NOACs) are recently approved for stroke prevention in non valvular AF. In contrast to Warfarin; effect of NOACs on MES is not yet fully researched. <i>Aim</i>: To determine the effect of NOACs on MES, in comparison to warfarin in non valvular AF, to reflect the potential embolization risk. <i>Methods</i>: The incidence and number of MES was studied in patients with non valvular AF. Two groups in the current study; the first, patients were put on warfarin with INR levels were optimized to (2-3), and considered as a control group. The second; patients were put on NOAC (rivaroxaban, 15 mg /day). Study patients were recruited from cardiology outpatient clinics and departments (Al-Azhar University hospitals; Cairo and New Damietta, Egypt). Patients of the both groups were subjected to MES detection and counting by transcranial Doppler ultrasonography (TCD) monitoring. <i>Results</i>: MES did not detected in 22.5% in study groups; no statistically significant differences between study groups. The incidence and number of MES; within the warfarin group; MES were detected in (30 patients, 75%), while within the rivaroxaban group (32 patients, 80%). The average number of MES; in group one were (11.65 ±7.20), and in group two (11.50 ±7.20), with no significant statistical difference also. <i>Conclusion</i>: The effect of warfarin and NOAC use is not statistically different and Rivaroxaban is not inferior to warfarin.

HUBUNGAN INTENSITAS PENGGUNAAN SMARTPHONE DENGAN KUALITAS HIDUP PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM AL-AZHAR ANGKATAN 2019

Students of the Faculty of Medicine, Al-Azhar Islamic University, since the pandemic, lecture activities have been carried out using an online system so that the use of smartphones will certainly increase. Besides that, most students will use smartphones as a diversion of boredom which makes students use smartphones outside of academics with high intensity so that it has a negative effect, both from disrupting concentration, sleep quality to interfering with their quality of life. Research objectives to find out the relationship between the intensity of smartphone use and the quality of life of students of the Al-Azhar Islamic University Faculty of Medicine class of 2019. Research method observational analytic research with a cross-sectional study design. The sampling technique used purposive sampling. The research was conducted at the Al-Azhar Islamic University Medical Faculty on January 21, 2023. The research sample was 81 respondents. The data obtained were analyzed using the chi-square correlation test. The results showed that the intensity of smartphone use was high with a very bad quality of life, namely 25 (30.9%) and respondents who had a low intensity of smartphone use with a very bad quality of life, namely 4 (4.9%). Based on the results of the analysis using Chi Square, a p-value of 0.006 (p-value &lt;0.05) means that Ho is rejected, thus indicating that there is a relationship between the intensity of smartphone use and the quality of life of FK Unizar students Class of 2019 Conclusion: There is a relationship between the intensity of smartphone use and quality of life.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN HEALTH SEEKING BEHAVIOUR PADA GEJALA DEMAM DI MAHASISWA ANGKATAN TAHUN 2019 DAN 2020 FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM AL-AZHAR

Background: Health-seeking behavior is the behavior of an individual who is experiencing health problems to obtain treatment so that the health problems experienced are cured or reduced. A person's decision to seek treatment is very likely to be influenced by various factors such as individual, environmental, cultural factors, to perceptions of their health problems. The search for treatment needs to be carried out starting from underlying health problems such as fever symptoms to severe health problems. The health belief model is a concept commonly used to find out an individual's perception of whether or not they accept their health condition. The four main variables in the concept of the health belief model are perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Objective: To determine the factors associated with Health-seeking behavior in symptoms of fever in students of the Faculty of Medicine, Al-Azhar Islamic University, class of 2019 and 2020. Methods: Observational analytic quantitative study with a cross-sectional study design. The sampling technique was determined by random sampling method and the samples in this study were students of the Al-Azhar Islamic University Medical Faculty in 2019 and 2020. The data obtained was analyzed by the Chi Square test with a significance value (p ≤ 0.05). Results: Of the 120 research samples, 79.17% of students who sought treatment when suffering from fever symptoms had 43.4% perceived susceptibility, 30.8% perceived severity, 85.8% perceived benefits, and 14.5% perceived barriers. Obtained p value = 0.705 (p &lt;0.05) for the relationship between perceived susceptibility and health-seeking behavior, p = 0.014 (p &lt;0.05) for the relationship between perceived severity and health-seeking behavior, p = 0.952 (p &lt;0, 05) for the relationship between perceived benefits and health-seeking behavior, and p = 0.000 (p &lt;0.05) for the relationship between perceived barriers and health-seeking behavior. Conclusion: The results of the bivariate test show that perceived severity and perceived barriers in college students are significantly related to treatment-seeking behavior. Meanwhile, students' perceived susceptibility and perceived benefits statistically did not have a significant relationship to health-seeking behavior in students in the 2019 and 2020 batches of the Faculty of Medicine, Al-Azhar Islamic University.

Combined Mud-Cooling, MPD Techniques Enable HP/HT Drilling in Egypt

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 210252, “Drilling the Deepest HP/HT Onshore Exploration Well Using a Combination of Mud-Cooling and MPD Techniques: A Field Case Study From the Nile Delta of Egypt Targeting a Mesozoic Carbonate Platform,” by Mahmoud El-Husseiny, Egyptian Natural Gas Holding Company, and Taher Elfakharany, Al-Azhar University. The paper has not been peer reviewed. _ The complete paper reviews the successful application of a mud-cooling and managed-pressure-drilling (MPD) system in a high-pressure/high-temperature (HP/HT) well to explore the potential of the Mesozoic carbonate platform with a pressure ramp and narrow mud-weight window (NMWW) in the Nile Delta. The constant bottomhole pressure (CBHP) variation of MPD in combination with mud cooling was used to drill from the middle of the pressure ramp to the target depth, maintaining the mud-inlet temperature at approximately 50°C. Geological Targets and Geohazards The primary objective of Well T-1 is the edge of a Mesozoic carbonate platform. These carbonates are expected to be high-energy shallow marine deposits with fair reservoir properties (20–50% net-to-gross, 5–10% porosity). The secondary objectives are turbiditic sandstone channels of the Oligocene. These sandstones are expected to have 9–20% porosity and 50–300 md permeability. Potential Middle and Late Miocene geohazards include pressure rampup associated with losses, kicks, and borehole degradation, including tight holes, overpull, and caves; and reported sticking and hangup events. The HP domain begins below approximately 4000 m. Potential Oligocene to Paleocene geohazards include NMWWs associated with losses, kicks, and simultaneous gains and losses (ballooning); borehole degradation, including tight holes, overpull, and caves; and sticking and hangup events. The HP and HT domains begin below approximately 4500 m. Potential Mesozoic carbonate geohazards include possible losses of fractured and pressure-regressed carbonates. Mud-Cooling Technique Concept and Equipment The mud cooler consists of two circuits. In the first, hot mud is circulated through a dual mud cooler using a centrifugal pump. Because of heat exchange through the plate heat exchanger, the mud is cooled and transferred back into the active mud system. The discharge of cold mud takes place upstream of the point where the suction of hot mud occurs. In the second circuit, a fluid mixed with water and glycol is circulated between a dual air cooler and the dual mud cooler using a dedicated pump. When passing through the plate heat exchanger, this mixture of water and glycol is evacuated. When this mixture returns to the dual air cooler, it is cooled using high-performance ventilators. The mud-cooling system features 16 ventilators. The efficiency of the mud-cooling system is adjusted with a number of operated ventilators. The mud-cooling units used in this well consist of two dry air coolers and two sets of air fans (Fig. 1), with each set containing 24 fans. A mixture of 10% glycol and water was used as a cooling fluid.

Middle Mesial Canals Prevalence percentage and Its Configuration type with "Egyptian subpopulation" by CBCT

The Aims of This Study: were to detect the middle mesial canals (MMCs) prevalence in mandibular 1st molars, its configuration type, and its percentage of incidence with age by Cone-Beam Computed Tomography (CBCT) analysis. Methods: CBCT scan of 1650 patients were observed between January 2021 to February 2022 were collected using the CBCT imaging system from the database of the department of oral radiology, faculty of dental medicine, Al-Azhar University - Assiut branch. CBCT scan images were analyzed by Sidexis software. CBCT images were examined to detect the following: (1) The percentage of incidence frequency of the MMCs, (2) MMCs classification, and (3) Frequency of occurrence of MMCs according to age. Results: The incidence frequency percentage of the presence of MMCs among the Egyptian population was 10.79 % (208/1926) with no statistically significant due to gender, While MMCs configuration types showed 77% (160/208) confluent anatomy merging with either the mesio buccal or mesio lingual canals, 16.3% (34/208) fin anatomy and only 6.7% (14/208) showed independent MMCs with separate orifices and apical foramen. lastly the incidence frequency percentage of the presence of MMCs decreases with age. Conclusions: The MMCs prevalence in mandibular 1st molars among some Egyptian population was 10.79%, and CBCT scan is helpful way to detect the presence of MMCs.

Insektisida Nabati Kulit Durian (Durio zibethinus murr) dan Jahe (Zingiber 0fficinale) Untuk Mengendalikan Larva Kumbang Tanduk (Oryctes rhinoceros) Di Laboratorium

Durian and Ginger Peel Vegetable Insecticides to Control Horn Beetle Larvae The aim of this study was to determine the effectiveness of the use of durian peel extract and ginger extract to control horn beetle larvae (O. rhinoceros). This research was conducted at the Laboratory of the Faculty of Agriculture, Al-Azhar University. The study used a Completely Randomized Design (CRD) Non Factorial consisting of 3 levels, as follows: D0J0 (Control), D1 (15 ml of durian peel extract L.air-1), D2 (20 ml of durian peel extract L.air-1) , D3 (25 ml durian peel extract L. water-1), J1 (15 ml ginger extract L. water-1), J2 (20 ml ginger extract L. water-1), J3 (25 ml ginger extract L. water -1). Parameters observed were the proportion of mortality of O. rhinoceros larvae and time of initial death (LT50). The results of the study showed that the proportion of mortality of O. rhinoceros larvae to treatment had a significant effect, while the proportion of mortality was significantly different with all treatments. The fastest initial time of death occurred in treatment D3, namely 1,293 HSA in the range 1,248–1,328 HAS.

The Impact of Developing Scientific Research in Higher Education Institutions on Achieving Sustainable Development under the Corona Pandemic

The research aimed to identify the impact of developing scientific research in higher education institutions on achieving sustainable development under the Corona pandemic. The descriptive analytical method was used and data was obtained through a questionnaire that was distributed to a sample (210) employees randomly selected from four Palestinian universities: Al-Azhar University, Isra University, University of Palestine and Gaza University. The study results revealed that the application of developing scientific research and sustainable development in the universities under study received a high degree of respondents’ assessment. There was a direct statistically significant relationship between the scientific research development and the level of promoting sustainable development in the universities. There were also no statistically significant differences between the mean scores of promoting sustainable development in these universities due to the variable of the university, while there were statistically significant differences between the mean scores of promoting sustainable development in the universities due to the variable of gender, in favor of females, as female faculty members seek to prove themselves as other faculty members who are no less competent in this field. The study concluded with a set of recommendations, including the need to establish a national authority for scientific research to be concerned with the quality and evaluation of scientific research in universities and subscribing to foreign databases and sources that provide help to researchers.

Ultrasonographic and Hysteroscopic assessment of Uterine Cavity post Myomectomy

Background: Growth of the uterus's smooth muscles and connective tissue is known as uterine fibroids. They are viewed as the most widely recognized harmless growth of the pelvis. Moderate a medical procedure stays the primary methodology for the board of uterine myomas. Myomectomy is viewed as a significant choice for ladies who want future childbearing or essentially need to protect their uterus. Objective: The review's goal was to assess the uterine cavity using hysteroscopic and ultrasonographic devices. Methods: A planned (observation) logical plan was utilized in this review. Our research was had 50 patients that chosen from the short-term gynecological facility, (Al-Hussien and Sayed Galal Hospital at Al-Azhar University). Results: our review pointed to assess uterine hole using hysteroscopic and ultrasonographic devices. This research was had 50 patients was chosen from the short-term gynecological facility, (Al-Hussien and Sayed Galal Hospital at Al-Azhar University); with similar incorporation and rejection standards. Conclusion: From our review we could reason that hysteroscopy further develops results 3-4D ultrasound imaging it's not as of now accessible in all units, its utilization has huge ramifications regarding cost and preparing. Saline implantation then again might be embraced effectively utilizing different devoted frameworks or changes of promptly accessible less expensive catheters, for example, Intra-uterine Insemination catheter.

COVID-19 Vaccination Perception and Acceptance Among Female Medical and Nursing Students at Al-Azhar University, Egypt.

There are still many concerns related to various types of COVID-19 vaccines, which may result in individuals' hesitancy presenting a problem for public health authorities to achieve coverage for population immunity. As trustworthy health-care workers, medical and nursing students' perception towards COVID-19 vaccines may greatly influence the future population's uptake of vaccines; however, studies related to the vaccine acceptance rates among them are limited. To identify the perception of medical and nursing students toward COVID-19 vaccines and the factors acting either as motivators or barriers to be vaccinated. A cross-sectional comparative study was conducted on 500 undergraduate students aged ≥18 years from medical and nursing faculties. Data were collected via a semi-structured self-administered questionnaire that consisted of questions on general characteristics of the participants and source of information about the vaccine. Also, it includes items assessing the perception and acceptance of COVID-19 vaccines. Descriptive statistics, chi-squared, t-test and multiple logistic regressions were performed using SPSS version 22. Positive perception was detected among more than half of overall students. Although medical students had significant higher positive perception toward COVID-19 vaccines than nursing students (54.9% vs. 41.1%, p <0.05), they were more hesitant to get vaccinated than nursing students (25.7% vs. 19.6%, p >0.05). While, medical students had a higher intention to encourage family members or friends to get vaccinated than did nursing students (47.7% vs .43.8%, respectively) (p >0:05). Furthermore, participants were more likely to accept vaccination if they reported higher levels of positive perception especially for vaccine safety and increasing recovery rate. Academic medical and nursing leaders should consider female students' vaccine concerns, and future efforts are needed to reduce their hesitancy and raise awareness about vaccinations that may eventually improve perception and acceptance of COVID-19 vaccines.

Efficacy of Repetitive Transcranial Magnetic Stimulation on spasticity in Egyptian Multiple Sclerosis Patients

Background; One of the most common neurologic disorders is multiple sclerosis. To improve quality of life, many tools have been employed. Repetitive transcranial magnetic stimulation (rTMS) is a new established technique to treat spasticity and improve the outcome of rehabilitation program in various neurologic conditions. Aim and objectives; To assess the effect of high frequency rTMS on improving spasticity in a sample of Egyptian MS patients. Patients and methods; 40 patients were recruited from the MS unit at Al-Azhar University hospitals with established diagnosis of MS and spasticity. Recruitment started from beginning of Jan, 2022 for 6 months. Patients were then randomly allocated into two groups: Study Group: 20 patients received 12 sessions of high frequency (HF) rTMS over the period of 3 weeks, followed by physical therapy (PT) for 30 minutes. rTMS protocol: Contralateral primary motor cortex (M1) was the site of stimulation. 1500 pulses (50 pulses per train with total 30 trains) per session with an intensity of 90% of the resting motor threshold at a frequency of 10 Hz were received. Each train had duration of 30 sec with inter- train delay of 25 seconds. Control Group: 20 patients received only physical therapy (PT) of 30 minutes over the period of 3 weeks). Results: The both groups received their medical treatment and physiotherapy. Compared with the control group, the study group had a statistically significant improvement. Conclusion: High frequency r-TMS could be beneficial in reducing spasticity and enhancing motor recovery in Egyptian MS patients.

Effect of hydrostatic venous dilatation during creation of arterio-venous fistula on maturation of hemodialysis access

Background: Objective of AV access creation is furnish an available vascular structure with enough blood stream that can be cannulated for satisfactory dialysis. Ultrasonographic assessment is considered a standard strategy for each medical procedure of AVF creation. It determines utilized AVF work monitoring, in post-operative period. Objective: To review and discuss the advances of the effect of hydrostatic venous dilatation during intra operative arteriovenous fistula creation in end stage renal disease patients and its effect on maturation of the fistula guided by preoperative and post operative Duplex assessment. Patients and methods: This prospective study performed on 40 patients presented in vascular surgery department at, Al-Azhar university hospitals (Al-Hussin and Bab -Alsheryah Hospitals). Patients were monitored regularly in dialysis unit, data collected included patient demographics, comorbidities, any previous vascular access, type of anatomical site of current AVF, details of operative procedure exact expected time and functional maturation. Patient selectively directed surgical AVF creation with Estimated Glomerular Filtration Rate (e-GFR)

Evaluation of Fistula Laser Closure (FiLaC) in Management of High Trans- sphincteric Fistula- in- ano

Background: As a revolutionary sphincter-preserving approach, Wilhelm proposed "Fistula Laser Closure" (FiLaC) in 2016. It uses a radial emitting laser probe and had an initial rate of success of 81.8 percent in 11 patients with a median follow-up of 7.4 months. Aim of the study: To analyze the Fistula Laser Closure (FiLaC) technique's efficacy in treating high trans-sphincteric fistulas in ano, look at the procedure's effects on anal continence, and predictors of success. Patients and methods: This prospective cohort research was conducted between April 2021 and November 2021 on 20 patients with high transsphincteric fistula in ano at the Department of Surgery at Al-Azhar University Hospitals, Cairo, Egypt. Patients received care using the Fistula Laser Closure (FiLaC) procedure, and they were monitored for at least six months after surgery. Results: There was substantial variation between simple and complicated fistula as regards hospital stay, Early incontinence, pain score and patient satisfaction (p

Stroke as a presenting symptom of COVID-19; A study of risk factors, characteristics and outcomes in a sample of Egyptian patients

Background; It is not known whether COVID-19 associated stroke patients have worse functional and vital outcomes than those without infection. Aim and objectives; To compare between COVID-19 associated stroke and non-COVID-19 stroke patients as regard risk factors, characters and outcome. Patients and methods; In a prospective study, 297 patients diagnosed clinically and radiologically as stroke and admitted to emergency department and stroke unit of Al- Azhar University hospitals were recruited in the period from beginning of December, 2021 to the end of May, 2022. They were classified into ischemic stroke (IS), Cerebral venous thrombosis (CVT), Subarachnoid hemorrhage (SAH), and Intracerebral hemorrhage (ICH) groups. Workup for COVID-19 was done in each group followed by comparison between both groups. Results: We evaluated 297 patients and 46 (15.4%) had COVID-19 infection. In IS group, Age, HTN and previous cerebrovascular stroke were significantly lower, large vessel occlusion, Median baseline National Institutes of Health Stroke Scale score (NIHSS) and serum ferritin were significantly higher, in COVID-19 associated IS group. Also, COVID-19 associated IS had a worse outcome regarding Median Modified Rankin Scale (MRS), hemorrhagic transformation and mortality rate. According to TOAST classification, cryptogenic subtype was significantly higher in COVID-19 associated IS group. Lymphocytes (%) was significantly lower, D-dimer was significantly higher, in COVID-19 patients in all stroke groups. Conclusion: Patients with COVID-19 associated ischemic stroke have more severe strokes, worse functional outcome and a higher mortality than those without infection.

Comparison of palatal volume and surface changes between bone-borne and tooth-tissue-borne maxillary expansion on cone beam computed tomography digital cast models.

To compare the changes of palatal volume and area in patients treated with tooth-tissue-borne palatal expanders (conventional Haas) and miniscrew-supported palatal expanders (modified Haas). The sample included casts of 22 patients treated as part of a clinical study at the Department of Orthodontics, Al-Azhar University, to correct their crossbite malocclusion. Patients were divided equally into two groups upon arrival. The first group, with a mean age of 12 years and 6 months, received the miniscrew-supported palatal expander. The second group, with a mean age of 12 years and 2 months, received the Haas design-palatal expansion appliance. Pre- and post-expansion dental casts were cone beam computed tomography scanned and the slices were constructed into 3D volumes. Fully automated superimposition was done for pre- and post-expansion 3D models. Palatal volume and area were determined, and all measurements were carried out blindly. Paired t-test was used to assess the mean differences within each group and Welch's t-test was applied to assess the mean changes between the two groups. Shapiro-Wilk test was used to test for the normality of the data. There were no statistical differences in volume changes either within each group or between the groups. Although area changes were statistically significant within each group, the difference between the groups was not significant. Changes that result from the use of either method to expand the upper arch occur primarily in the shape of the palate, but not in its size.

Comparison between Serum Beta -Trace Protein and Soluble α-Klotho as Early Predictors of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Background: Diabetes mellitus (DM) is a systemic disease with serious micro- and macro-vascular complications. Beta-trace protein (BTP), a novel low-molecular weight glycoprotein and α-Klotho (α-KL) that are promising biomarkers of diabetic nephropathy (DN). Further, the upregulation of α-KL (internal or external) seems to protect the kidneys from renal insults. The aim of this study was to compare between serum BTP and soluble α- KL as early predictors and prognostic biomarkers of diabetic nephropathy in patients with type-2 diabetes. &#x0D; Patients and methods: This was a prospective study, which was carried out at the department of internal medicine, DFM, Al-Azhar University between January 2020 to January 2022. It included 60 patients with type-2 diabetes mellitus, who were divided into three equal groups, and a comparison group (control group) of 20 apparently healthy individuals.&#x0D; Results: There was highly statistically significant difference between the four groups regarding Albumin/creatinine ratio (p&lt;0.05), BTP (p&lt;0.001) and soluble α-klotho (p&lt;0.001). Soluble α klotho was negatively correlated with BTP, both of these markers was significantly correlated with Albumin/creatinine ratio.&#x0D; Conclusion: Both BTP and soluble α-klotho can be used as early predictors and biomarkers for diabetic nephropathy in type 2 diabetes mellitus.

Occupational Risk Factors of Sleep Disorders among Resident Physicians in AL-Azhar University Hospitals in Cairo "Descriptive Analytical Cross-Sectional Study"

Occupational Risk Factors of Sleep Disorders among Resident Physicians in AL-Azhar University Hospitals in Cairo "Descriptive Analytical Cross-Sectional Study"

Microbial Infections in Diabetic Foot Ulcers at Al-Azhar University Hospital, New Damietta, Egypt

Microbial Infections in Diabetic Foot Ulcers at Al-Azhar University Hospital, New Damietta, Egypt

Sustainable and Green Academic Buildings in Al-Azhar University: Case Study

Egypt's Vision 2030 adopted a strategy for sustainable development (SDS), The primary goals of sustainable design are to decrease resource depletion, including energy, water, and raw materials, and to mitigate environmental damage caused by buildings and facilities over their lifetime; create better building environments, also referred to as green buildings. This paper presents the situation of current implementation state of a green strategy in Egyptian universities based on sustainability international rankings, such as the UI Green Metric world ranking. This paper considers the implications of implementing a green university's strategy. it has been interested in the use and apply even a few appropriate green approaches in Al-Azhar University and trying to integrate and link them to the Egyptian country's comprehensive strategy for sustainable development, this provides an assurance that the situation will improve soon. This case study focuses on implementing green initiatives in higher education academic university building to achieve sustainability by providing green indicators that are linked to the economic, social, and environmental dimensions of sustainability focusing on energy, education, and environmental pillars mentioned in Egyptian Vision. This study proposes a smart building implementation criteria based on using efficient LED lighting system introduces energy saving tacking environmental reduction effect for Co2 based on applying Leed rating system standard as energy and environmental design leadership, also design of a solar system as a generation unit supplying a apart for the proposed academic sustainable building electrical loads, and represent it as a penetration of a renewable energy sources (RES) for green campus in AL-Azhar University.

Diagnostic accuracy of Uterine Artery Doppler Velocimetry in Patients with Placenta Previa

Background; The placenta previa (PP) is an obstetric problem in which the placental tissue is improperly located inside the lower uterine segment. Aim and objectives: was to see how effective uterine artery Doppler velocimetry was in detecting unusually morbidly adhering placentas in patients who had had one or more prior caesarean sections with placenta previa. Subjects and methods; Cross-sectional research of 100 patients was undertaken in the Department of Gynecology and Obstetrics, El- Sayed Galal Hospital, AL- Azhar University. Result; Our results showed highly statistically significant correlation between the presence of abnormal lacunae and histopathological confirmation (P-value > 0.001). In addition, the overall Sensitivity, specificity, PPV, NPV and accuracy were 90%, 100%, 100%, 64.2%, 91.6%. This criterion showed very high sensitivity and specificity with very high positive predictive value and accuracy to become the most important criteria, Conclusion; As a result of this, we conclude that the accuracy of abnormal placental lacunae, loss of the reto-placental clear zone, myometrial thinning, and utero-vesical hypervascularity are the most critical ultrasound criteria for diagnosing placenta accreta in patients who had a previous CS with a placenta previa overlying the previous uterine scar.