Prosthetic maintenance assessment for implant fixed complete dentures and implant overdentures: a randomized clinical trial / Avaliação da manutenção protética para próteses totais fixas suportadas por implantes e Overdentures: um ensaio clínico randomizado

Objective: The rehabilitation choice for the edentulous patients usually lies between the fixed and removable prosthetic options. The treatment decisions are affected by many factors where complications and maintenance needs are both considered crucial factors, in addition to the cost effectiveness of the chosen treatment. Material and Methods: This study was applied on 44 edentulous patients, where 22 patient for each group were enrolled in the outpatient clinic of prosthodontics, Cairo University as per a set of eligibility criteria. Four inter-foraminal implants were installed for all eligible participants. Three months later, healing abutments were used for soft tissue preparation prior to the fabrication of the final prosthesis. A prosthetic treatment option was then randomly allocated to obtain two equal groups via computer generated randomization program; Group. A received telescopic implant overdentures, and Group. B received screw retained dentures. All Complications (Screw loosening or fracture, tooth or denture base fracture and mucositis) were reported after overdenture insertion along the follow up period (1, 6, 9 and 12 months respectively). Results: The frequency of the screw loosening for hybrid overdentures where (59.1%) compared to (27.3%) of telescopic prosthesis at 12 months follow up period (p=0.035), mucositis reporting at 6m interval had shown the highest frequency in both groups (Group A (54.5%), Group B (81.8%), (p=0.045), all other reported complications that lack statistical significance either within the same group or between both groups at different time intervals. Conclusion: Both treatment modalities; telescopic implant overdenture and hybrid fixed screw-retained are reliable for restoring the completely edentulous arches, the decision whether to make a fixed or removable implant denture shall be guided with the patient preference together with the dentist assessment in relation (AU)

Objetivo: A escolha da reabilitação para pacientes edêntulos geralmente recai entre próteses fixas e removíveis. As decisões de tratamento são afetadas por muitos fatores onde as complicações e as necessidades de manutenção são consideradas critérios cruciais, além do custo-efetividade do tratamento escolhido. Material e Métodos: Este estudo foi aplicado em 44 pacientes edêntulos, onde 22 pacientes para cada grupo foram matriculados no ambulatório de prótese dentária da Universidade do Cairo de acordo com um conjunto de critérios de elegibilidade. Quatro implantes interforaminais foram instalados para todos os participantes elegíveis. Três meses depois, pilares de cicatrização foram utilizados para preparação dos tecidos moles antes da fabricação da prótese final. Uma opção de tratamento protético foi então alocada aleatoriamente para obter dois grupos iguais por meio de andomização gerada através programa de computador. O Grupo A recebeu overdentures de implantes telescópicos e o Grupo B recebeu dentaduras fixas parafusadas sobre os implantes. Todas as complicações (afrouxamento ou fratura do parafuso, fratura da base do dente ou da prótese e mucosite) foram relatadas após a inserção da overdentures ao longo do período de acompanhamento (1, 6, 9 e 12 meses, respectivamente). Resultados: A frequência do afrouxamento do parafuso para Overdentures híbridas (59,1%) em comparação com (27,3%) da prótese telescópica no período de acompanhamento de 12 meses (p=0,035), o relato de mucosite no intervalo de 6 meses mostrou a maior frequência em ambos os grupos (Grupo A (54,5%), Grupo B (81,8%), p=0,045, todas as outras complicações relatadas foram sem significância estatística dentro do mesmo grupo ou entre os dois grupos em intervalos de tempo diferentes. Conclusão: Ambas as modalidades de tratamento; overdentures sobre implantes telescópicos e próteses híbridas fixas parafusadas são confiáveis para reabilitar as arcadas completamente edêntulas. A decisão de fazer uma prótese fixa ou removível sobre implantes deve ser guiada pela preferência do paciente juntamente com a avaliação do dentista em relação ao estado geral do paciente e sua saúde bucal. (AU)

Oral misoprostol solution in comparison to vaginal misoprostol for induction of labour in a randomized controlled trial

Background: With more than 15% of all gravid women requiring prostaglandins in cervical ripening and labour induction. However, evidence is not clear about the preferred route or dose of the drug. So, this study was designed with objectives to compare the induction delivery interval and safety of titrated oral misoprostol solution with vaginal misoprostol for labour induction in term primigravida women.Methods: This randomized controlled clinical trial was conducted on a total of 100 patients randomly selected among primigravida at term women undergoing induction of labour for obstetric or medical indication for labour induction in Ain Shams University Maternity Hospital. They were divided into two Groups: Group I: patients undergoing induction of labour using misoprostol oral solution and Group II: patients undergoing induction of labour using vaginal misoprostol.Results: Oral misoprostol solution has less induction delivery duration and less side effects than vaginal misoprostol. The induction-delivery time with the oral route compared to the vaginal one (15.2 versus 20.3 hours respectively) with significant p-value (<0.001).Conclusions: Titrated oral misoprostol is safe and effective for labour induction in primigravida patients with unfavorable cervix.

Elettaria Cardamom Extract Synergistically Enhaning Sorafenib-Induced Apoptosis in HepG2 Cells

Introduction: Liver cancer is ranked as the second most common cause of death globally as a result of its poorprognosis. It can be treated with sorafenib, but its use is limited due to its toxicity and adverse reactions. Lowerdoses of sorafenib with other complementary agents are recommended to minimize toxicity. Cardamom seeds areone of the most common ingredients of Indian and Chinese traditional medicine, and different studies havesuggested that cardamom extract can display anti-cancer activities. Aim: this study aims to investigate theefficiency of Elettaria Cardamom Extract (ECE) on enhancement of Sorafenib-induced apoptosis in HepG2.Methods: Human liver cancer cell line (HepG2) were exposed to increasing concentrations of individual andcombined treatments of Sorafenib and ECE for 24 h. The viability of cells was examined using MTT Assay.Clonogenicity and cell migration assays were carried out. Reactive oxygen species (ROS) generation andmitochondrial membrane potential (MMP) level were determined by DCFH-DA and JC-1 dye, respectively.Agarose gel electrophoresis and comet examinations were carried out to estimate the DNA damage. Results:Combined treatment of ECE with sorafenib suppressed the proliferation, colony formation and cell migration ofHepG2 cells more than the sorafenib did alone. The half maximal inhibitory concentration (IC50), after 24h ofincubation were 15 µM of sorafenib and 9 and 7.3 µM of sorafenib enhanced by 5 and 10 µg / 100 µl of ECErespectively. HepG2 treated cells displayed biochemical features of apoptotic cell death. The combined treatmentincreased the ROS production, reduced the level of MMP, increased Comet tail length and induced DNAfragmentation more than sorafenib did alone. Conclusions: These findings demonstrate that ECE enhanced thesorafenib effect in HepG2 cells and suggest that the ECE may be a promising agent for reducing sorafenib sideeffects in hepatocellular carcinoma (HCC).

Hepatoprotective activity of Dypsis lutescens against D-galactosamine-induced hepatotoxicity in rats and its phytoconstituents

Objective: To isolate and identify the polyphenolic constituents of Dypsis lutescens, and evaluate the hepatoprotective activity of the ethanolic extract of Dypsis lutescens leaves. Methods: Hepatoprotective, antioxidant and anti-inflammatory effects of two doses of Dypsis lutescens ethanolic leaf extract were investigated in five groups of six rats each administered with the ethanolic extract of Dypsis lutescens leaves. Liver function parameters were assessed, histopathological study was carried out, the anti-inflammatory mediators and the antioxidant potential in the liver tissues were evaluated. In addition, the total ethanolic extract of Dypsis lutescens leaves was subjected to different chromatographic separation techniques to yield ten phenolic compounds. The isolated compounds structures were spectroscopically elucidated. Results: Hepatoprotective activity of Dypsis lutescens ethanolic extract was estimated for the first time and showed significant activity against histopathological changes induced by D-galactosamine in liver. The extract improved the liver functions. Compared to the D-galactosamine group, the architecture of the liver in the treated groups was improved in the histopathological examination. These results proved the hepatoprotective activity of Dypsis lutescens and its ability in attenuating liver oxidative damage and inflammation. Phytochemical investigations of the total extract afforded ten compounds from the genus Dypsis. Conclusions: The alcoholic extract of Dypsis lutescens exerted potential hepatoprotective action, maintaining liver health and functions.

Hepatoprotective activity of Dypsis lutescens against D-galactosamine-induced hepatotoxicity in rats and its phytoconstituents

Objective: To isolate and identify the polyphenolic constituents of Dypsis lutescens, and evaluate the hepatoprotective activity of the ethanolic extract of Dypsis lutescens leaves. Methods: Hepatoprotective, antioxidant and anti-inflammatory effects of two doses of Dypsis lutescens ethanolic leaf extract were investigated in five groups of six rats each administered with the ethanolic extract of Dypsis lutescens leaves. Liver function parameters were assessed, histopathological study was carried out, the anti-inflammatory mediators and the antioxidant potential in the liver tissues were evaluated. In addition, the total ethanolic extract of Dypsis lutescens leaves was subjected to different chromatographic separation techniques to yield ten phenolic compounds. The isolated compounds structures were spectroscopically elucidated. Results: Hepatoprotective activity of Dypsis lutescens ethanolic extract was estimated for the first time and showed significant activity against histopathological changes induced by D-galactosamine in liver. The extract improved the liver functions. Compared to the D-galactosamine group, the architecture of the liver in the treated groups was improved in the histopathological examination. These results proved the hepatoprotective activity of Dypsis lutescens and its ability in attenuating liver oxidative damage and inflammation. Phytochemical investigations of the total extract afforded ten compounds from the genus Dypsis. Conclusions: The alcoholic extract of Dypsis lutescens exerted potential hepatoprotective action, maintaining liver health and functions.

Experimental murine model of intra-abdominal infections caused by some non-albicans Candida species

Background: Even though intra-abdominal candidiasis (IAC) has been increasingly recognized, with associated high morbidity and mortality rates, its pathogenesis remains poorly understood. This model aims to study the pathogenicity and invivo susceptibility of non-albicans Candida species associated with IAC in human in order to predict the frequency of infections, outcome of clinical disease and response to antifungal therapy. Methodology: Both immunosuppressed and immunocompetent female CD-1 mice were challenged intraperitoneally with 5 x 108 CFU/ml inoculum of five non-albicans Candida strains; Candida glabrata, Candida parapsilosis, Candida lipolytica, Candida tropicalis and Candida guilliermondii. Mice were closely observed for symptoms. Treated groups received voriconazole (40 mg/kg/day) or micafungin (10 mg/kg/day) 24 hours after infection depending on invitro susceptibility results. Survival rate, mean survival time and fungal tissue burdens were recorded for all groups. Results: All infected groups developed hepatosplenomegaly, peritonitis and multiple abscesses on intra-abdominal organs and mesenteries. C. glabrata and C. lipolytica represented the most and the least virulent strains respectively in terms of survival rate, mean survival time and fungal burden in both immunosuppressed and immunocompetent models. Following treatment, all immunocompetent animals survived the entire duration of experiments (0% mortality rate), while mortality rate was relatively high (20-60%) in immunosuppressed mice. Treatment failed to eradicate the infection in immunosuppressed mice despite significant decrease of the fungal burden and increase mean survival time. Conclusion: This study reports an increasing pathogenicity of non-albicans Candida species, with persistent infection among immunosuppressed animals

Evaluation of topoisomerase II, ki-67, and P53 expression in non-muscle-invasive urothelial carcinoma and their clinical significance

Background: Transurethral resection of tumor is the main treatment of non-muscle-invasive urothelial carcinoma, but it is associated with high rate of recurrence and/or progression and this arouses the need for adjuvant therapy. Topoisomerase II (Top II), KI-67, and P53 are proliferation and cell cycle regulation markers that may predict tumor response to therapy. Aim: This study aimed to assess Top II, KI-67, and P53 expression and their effect on clinical outcome and response to therapy of non-muscle-invasive urothelial carcinoma. Materials and Methods: Fifty cases of non-muscle invasive urothelial carcinoma were collected; Top II, KI-67, and P53 expression was evaluated. Patients received treatment then tumor recurrence was correlated with the expression of previous markers. Results: There was a significant association between high Top II score, P53, and KI-67 and high tumor grade (P = 0.0001, 0.001, and 0.0001), submucosal infiltration (P = 0.0001 and 0.01), and recurrence (P = 0.01, 0.001, and 0.001). Conclusion: Top II, P53, and KI-67 may predict tumor response to therapy and the clinical outcome in non-muscle-invasive urothelial carcinoma.

Radioprotective, antioxidant and antitumor efficacy of Annona muricata L. leaf extract

Ionizing radiation is known to induce oxidative stress, which can damage critical cellular macromolecules and/or modulate gene expression pathways. This study investigated the effect of Annona muricata L. (AM) leaf extract against whole body gamma-irradiation induced oxidative damage in the lung and kidney tissues and determined the antitumor activity of AM using Ehrlich ascites carcinoma (EAC) bearing mice and different tumor cell line. Administration of AM (100 mg/kg, by tube) prior to irradiation (6 Gy) significantly attenuated serum lipid profiles, decreased malondialdehyde and total nitrate/nitrite levels, DNA fragmentation and significantly increased caspase-3 and superoxide dismutase activity, glutathione content and expression of glutathione peroxidase in the lung and kidney tissues compared with irradiated group. AM interestingly increased survival rate and decreased tumor volume of EAC-bearing mice more than the irradiated group. It was found to be selectively cytotoxic in vitro to tumor cell lines (PC3, MCF7, HELA, H1299 and A549). In conclusion, AM extract exhibits potential antitumor activity and attenuates radiation-induced toxicity by preventing oxidative stress and preserving the antioxidant activities.

Anti-inflammatory role of piperine against rat lung tissue damage induced by gamma-rays

Background: Radiation induced acute lung damages are refractory side effects in lung cancer radiotherapy [RT]. Prospective study investigates the possible role of piperine [Pip] as anti-inflammatory agent against gamma-rays-induced lung tissue lesions in an applicable rat model

Materials and Methods: Fifty-six Sprague-Dawley rats were divided into four groups: Control, rats were administered the vehicle by gastric tube for 6-weeks, Pip-treated, [each rat received 40mg Pip/kg body-weight; once daily, orally for 6weeks], irradiated, [animals subjected to a single dose of whole body gamma-rays [12Gy], and Pip-treated and irradiated, [each rat received the Pip-dosages, then one hour later after the last treatment, rats were exposed to 12Gy gamma-rays

Results: The administration of Pip to rats pre-irradiation was significantly abolish the radiation-induced alleviation in lungs catalase [CAT] and glutathione peroxidase [PGx] activities and reduced glutathione [GSH] content and significantly limited the elevation in serum tumor necrosis factor-alpha [TNF-alpha], interleukin-1beta [IL-1beta] and interleukin-6 [IL-6] levels compared to irradiated group. The histopathological findings in lung tissues of irradiated group, showed partial desquamation of bronchiolar epithelial with peri-bronchiolar round cell infiltration and serous exudates, in some cases lung presented sero-fibrinous pneumonia with emphysema and collapse of some alveoli with thickness of inter-alveolar septa, while in Pip-treated and irradiated group, lung tissues showed minimum injury with or without few degenerative changes

Conclusion: Pip acts as a potent scavenger of free radicals to prevent and/or ameliorates the harmful effects of gamma-rays. To our knowledge, this is the preliminary report of Pip mediated gamma-rays induced lung inflammation in-vitro

Maternal and fetal outcomes in women undergoing caesarean section under general and spinal anesthesia

Background: Both spinal and general anaesthesia used for caesarean section have certain advantages and disadvantages and there is no method which is completely ideal. The most important factors for choice of anaesthesia are; pregnant systemic problems and wishes, the urgency of the operation, and the surgeon and the anesthetists experience

Aim of the Work: These studies aimed at comparing maternal and fetal outcomes in women undergoing elective caesarean section and have spinal anaesthesia with those having general anaesthesia

Subjects and Methods: This study was carried out at Ain Shams University Maternity Hospital during the period from December 2017 to August 2018 after approval of the hospital health ethical committee. It included 186 patients who had C.S and were subdivided into 2 groups according to a randomization scale. On the day of the operation, each randomly received a closed opaque envelope for the selection of the procedure [spinal versus general]

Results: We noted that the mean haemoglobin and haematocrit values at the 24th hour were higher in the spinal anaesthesia group. The estimated blood loss volume was significantly higher in the general anaesthesia group. The median apgar score at the first and the fifth minutes were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer in the spinal anaesthesia group

Conclusion and Recommendations: General anaesthesia could be thought the quickest anaesthesia method in an emergency since it avoids the possibility of a failed regional block. Meanwhile, it is associated with higher possibility of blood loss and low Apgar score. Thus, using spinal anaesthesia for elective caesarean section is recommended provided that adequate maternal hydration is established and sparing general anaesthesia for emergency caesarean sections or whenever spinal anaesthesia is contraindicated [e.g. coagulopathy, sever thrombocytopenia, anticoagulation or sever degree of malformation of spine]

Correlation between t stage of the tumor and tumor behavior in locally advanced head and neck squamous cell carcinoma

Background: Head and neck cancer [HNC] represents more than 550,000 cases annually. It accounts for 380,000 deaths every year. Despite aggressive treatment, only 35% to 55% of patients who present with locally advanced HNC remain alive and free of disease 3 years after standard curative treatment. Thirty percent to 40% of patients develop locoregional recurrences, and distant metastases occur in 20% to 30%. Most recurrences appear quickly within 2 years of initial treatment and an additional 10% of patients will have evidence of distant metastases at the time of first presentation

Purpose: To retrospectively determine the prognostic effect of T stage in locally advanced head and neck cancer

Patients and Methods: This study retrospectively analyzed 40 patients diagnosed with locally advanced head and neck cancer. Patients were diagnosed by a tissue biopsy and they were staged by endoscope and CT neck or MRI neck with contrast. They received their treatment and were followed up every 3 months by CTs

Results: We found a statistically significant correlation between T stage and both PFS and OS in HNC [95%, CI 1.00 - 3.10, p=0.04 and 95% CI 1.01 - 2.65, p=0.05 respectively]. We did not find any other statistically significant correlation between other patients’ sub-groups such as age, gender, smoking, affected site, stage, lymph node infiltration, receiving induction chemotherapy, receiving radiotherapy with or without chemotherapy, and response to treatment and between PFS and OS

Conclusion: This study confirmed that the T stage of the tumor is an important prognostic factor in locally advanced head and neck cancer

Prognostic value of platelet to lymphocyte ratio in patients with non-small cell lung cancer

Background: The prognostic value of Platelet-to-lymphocyte ratio [PLR] in patients with non-small-cell lung cancer [NSCLC] is still indistinct. We conducted this study to assess the prognostic significance of pretreatment PLR in patients with unresectable NSCLC

Aim of the Work: to assess the prognostic significance of pre-treatment PLR in patients with NSCLC

Material and Methods: we retrospectively reviewed 130 patients treated for NSCLC with definitive/palliative chemotherapy and/or radiotherapy in Ain-Shams University hospital, Clinical Oncology department between January 2014 and December 2016. Pre-treatment CBC was available for the 130 patients to calculate PLR by dividing the absolute platelet count by the absolute lymphocytic count

Results: Out of 130 patients with available pre-treatment complete blood picture, population age ranged from 23 to 87 years. Male to female ratio was 4.8:1. Adenocarcinoma presents 51% of cases. Unresectable stage II and stage III present 2% and 27% respectively, while Stage IV presents 69%. Using a cut-off value of 150, high PLR>150 was significantly associated with poor overall survival [OS] [median OS: 10.33 months; 95% CI: 6.23-14.42], compared to patients with PLR<150; [median OS: 24.63 months, 95% CI: 11.5-37.76, p=0.008], but not PFS. In multivariate analysis, PLR>150 was an independent poor prognostic factor for OS; [HR=1.9, 95% CI; 1.092-3.3, p=0.023]

Conclusion: High PLR is associated with poor OS in patients with unresectable NSCLC

Predictive and prognostic impact of tumor-infiltrating lymphocytes [cd8+] in breast cancer treated with neoadjuvant chemotherapy

Background and Objectives: the use of neoadjuvant chemotherapy [NAC] in breast cancer induces a pCR in only 30-35% of patients. We canft depend only on clinical and pathological factors to distinguish the patients who have no chance of a pCR or not. Moreover, the NAC scenario is the perfect setting to study possible changes in TIL levels. Tumor-infiltrating lymphocytes [TIL] [CD] 8+ are essential components of tumor-specific cellular adaptive immunity. However, only few studies have addressed the significance of [CD8+] TIL in patients with breast cancer

Patients and Methods: we assessed the stromal and intratumral TIL, CD+8 in pretreatment core biopsy by immuohistochemistry [IHC] in 45 patients with breast cancer received neoadjuvant anthracyclin and docetaxel chemotherapy. CD8 classified into high or low according to the inter quartile range. Tumors with >/= 50% intratumoral or stromal lymphocytes were designated lymphocyte predominant breast cancer [LPBC]

Results: we found statistically significant correlation with high CD8 and DFS and smaller tumor residual [95% CI, 18.6-22.9; P= 0.01] and [p=0.003] respectively. But there was no significant difference regarding pCR or OS between high and low groups

Conclusion: this study confirmed that the CD8 TIL is an important prognostic and predictive factor in breast cancer

Protective role of ferulic acid against the damaging effect induced by electromagnetic waves on rat liver and intestine tissues

Background: the increasing use of mobile phones in daily life causes many concerns about their effects on human health. Therefore, this work was designed to study the effects of exposure to 1800 MHz electromagnetic waves [EMW] on the liver and intestine of male albino rats and the protective role of ferulic acid [FA] against these harmful effects

Materials and Methods: twenty-four male albino rats were randomly divided into four groups as follows: 1] control group, 2] treated group given FA, 3] irradiated group exposed to 1800 MHz EMW and 4] treatedirradiated group given FA then exposed to EMW. Biochemical analysis and histopathological examination were performed

Results: a significant increase in serum activities of alanine transaminase and aspartate transaminase, and serum levels of interleukin [IL]-6 and tumor necrosis factor-alpha was shown in the irradiated group, while IL-10 was significantly decreased. There was a significant decrease in lactate dehydrogenase and total antioxidant capacity in the tissues of liver and intestine of this group as well as some histopathological changes. All these serum and tissues parameters and histopathological changes were improved in the group treated with FA before exposure to EMW

Conclusion: prolonged exposure to EMW emitted from mobile phones might produce harmful effects in the liver and intestinal tissues of albino rats. These effects can be prevented by FA administration, which may be protective against tissue damage induced by EMW through the suppression of oxidative stress

Role of the first trimester maternal serum high sensitivity C-Rreactive protein and second trimester placental volume measurement by 3D Doppler ultrasound in early detection of pre-eclampsia

Background: pre-eclampsia [PE] is a disorder of pregnancy characterized by the onset of high blood pressure and a significant amount of protein in the urine. It affects 2-8% of pregnancies worldwide. Complications include impaired liver function, kidney dysfunction, visual disturbances and red blood cell Breakdown. PE continues to be a major cause of maternal and fetal mortality. Thus, efforts at discovering reliable prediction models to identify those at risk at an early stage are critical. And since Placental maldevelopment plays a pivotal role in the pathogenesis of PE, therefore, evaluation of the placental volume and vascular flow indices using different techniques can contribute in the prediction of adverse pregnancy outcomes

Aim of the Work: to assess the ability of high sensitivity c reactive protein [Hs CRP] and 3D power Doppler of placental volume and vascular flow indices to predict Preeclampsia

Patients and methods: this is a prospective cohort study by multi operators conducted on 200 women with singleton pregnancy who underwent screening for eligibility and eventually included with respect to the inclusion criteria. The study has been done during the period from October 2015 till December 2016. 1st trimesteric serum level of HsCRP detection tests, 1st trimesteric abdominal ultrasonographic examination and 2nd trimesteric color-Doppler techniques were done and placental volume was measured and Follow up at delivery to confirm Pre-eclampsia has followed. Study Outcomes included the development of hypertention, limb edema or other of pre-eclampsia complication. Data were statistically analyzed using IBM[copyright sign] SPSS[copyright sign] Statistics version 23

Results: HsCRP was significantly [P

Conclusion: there was a statistically significant correlation between first-trimester HsCRP and the 2nd trimester placental volume and its vascular indices in the prediction of complications of uteroplacental insufficiency. Further studies with large number of patients have to be carried out to reach conclusive evidence of the significance Doppler in prediction of pre-eclampsi, .and HsCRP

Magnesium in intensive care unit: a review

Aim of the work: there is an increased interest in the role of magnesium ions in clinical medicine, nutrition and physiology. Magnesium affects many cellular functions, including transport of potassium and calcium ions and modulates signal transduction, energy metabolism and cell proliferation. Magnesium deficiency is not uncommon among the general population: its intake has decreased over the years. Magnesium derangement results in various symptoms and signs; magnesium supplementation or intravenous infusion may be beneficial in various diseased states; so this review aimed to highlight the physiology of magnesium in humans, the derangement of magnesium in the form of hyper and hypomagnesemia, their clinical picture and the clinical and therapeutic uses of magnesium in the critical ill patients

Methods: references were obtained from Medline, Google Scholar and Ovid from 1960 to 2017. All categories of articles [clinical trials, reviews, or metaanalyses] on this topic were selected

Conclusion: magnesium is a critical physiological ion; it has many known indications in anesthesiology and intensive care because of its interactions with drugs used in intensive care. Intensive care specialists need to have a clear understanding of the role of this important cation. Magnesium is gaining recognition as a clinically important electrolyte in intensive care and emergency medicine .Recent clinical trials and case reports increase interest of magnesium as an effective therapeutic agent for potentially life-threatening problems such as torsade de pointes, digitalis toxicity, bronchospasm and alcohol withdrawal, subarachnoid hemorrhage, acute myocardial infarction, preecalmsia , eclamsia ,hypertension , diabetes , metabolic syndrome and cardiac arrhthymias

Simultaneous determination of ciprofloxacin hydrochloride and metronidazole in spiked human plasma by ultra performance liquid chromatography-tandem mass spectroscopy.

Ciprofloxacin HCl (CIP) and Metronidazole (MET) are antibacterial drugs used in combination for treatment of mixed aerobic/anaerobic infections. An UPLC-MS/MS method was developed for the simultaneous estimation of CIP and MET in spiked human plasma using sildenafil citrate as an internal standard (IS). Protein precipitation was used for analyte extraction. The chromatographic separation was completed within 6 min using a mobile phase of 0.1% formic acid in water and acetonitrile (70: 30, v/v), Zorbax C18, 100 x 4.6 mm, 3.5 μm analytical column, at a flow rate of 0.5 mL min-1. Multiple reaction monitoring (MRM) transitions were measured in the positive ion mode. Validation of the method showed standard curves to be linear in the range of 10-4000 ng mL-1 for CIP and 30-12000 ng mL-1 for MET with mean correlation coefficient exceeding 0.999. In human plasma, CIP and MET were stable for at least 36 days at –70 ± 5 °C, 6 hours at ambient temperature and after three freeze thaw cycles. After extraction from plasma, the samples were stable in auto sampler at 22 °C for 6 hours. The method was simple, specific, sensitive, precise, accurate and suitable for bioequivalence and pharmacokinetic studies.

Preparation and characterization of two new forced degradation products of letrozole and development of a stability-indicating RP-LC method for its determination

Two new hydrolytic products of letrozole were identified and proved to be true degradation products obtained by alkaline and acidic degradation of the drug. The acid and amide forms of the nitrile groups of letrozole were prepared and identified by IR and mass spectroscopic techniques. Subsequently, a simple, precise and selective stability-indicating RPLC method was developed and validated for the determination of letrozole in the presence of its degradation products. Letrozole was subjected to alkali and acid hydrolysis, oxidation, thermal degradation and photo-degradation. The degradation products were well isolated from letrozole. The chromatographic method was achieved usinggradient elution of the drug and its degradation products on a reversed phase Zorbax Eclipse C18 column [100mm x 4.6mm, 3.5microm] using a mobile phase consisting of 0.01M KH[2]PO[4] and methanol at a flow rate of 1mL min[?1]. Quantitation was achieved with UV detection at 230nm. Linearity, accuracy and precision were found to be acceptable over the concentration range of 0.01-80microgmL[-1]. The proposed method was successfully applied to the determination of letrozole in bulk, plasma and in its pharmaceutical preparation

UPLC-MS/MS Determination of Aceclofenac and Diclofenac in Bulk, Dosage forms and in At-line Monitoring of Aceclofenac Synthesis.

Aim: The derivatization product of diclofenac (DCL), aceclofenac (ACL), is a non-steroidal anti-inflammatory drug (NSAID) which causes faster and extended action with reduced gastrointestinal (GI) inflammation. The detection of DCL in ACL bulk and pharmaceutical products indicates incomplete synthesis and hydrolysis. In this article we have developed a UPLC-MS/MS method for analysis of ACL and DCL. The method was designed as an at-line monitoring tool for process analytical technology (PAT) application to ACL synthesis. The method was also applied for analysis of ACL and DCL in bulk and tablets. Methodology: Isocratic elution was performed on a UPLC C18 column (2.1 x 50 mm, 1.7 μm) using a mobile phase consisting of acetonitrile, water and formic acid (80:20:0.5, v/v/v). Flow rate was 0.2 mL/min and total run time was 1 min. Auto-sampler temperature was maintained at 5ºC to prevent any further degradation of ACL. Electrospray positive ionization (ESI +Ve) in multiple-reaction monitoring mode (MRM) was used for the simultaneous determination of ACL and DCL. Monitoring was performed at [M+H]+ 354.23: 250.09 and 296.13:250.1 m/z; respectively. The method was validated according to ICH guidelines Q2(R1). Results: The linearity range was 20 – 3000 ng/mL for both drugs. The developed method was accurate and precise (RSD<2%) for the determination of ACL and DCL in single solution (99.65±1.33 and 100.37±1.02 for ACL and DCL; respectively) and laboratory prepared mixtures (101.01±1.07 and 100.45±1.54 for ACL and DCL; respectively). The method was applied to Bristaflam® and Cataflam® tablets and the recovery was 100.95±0.18 and 99.15±0.62; respectively. The average recovery from reaction mixture was101.21±0.06 and 98.89±0.64 for ACL and DCL; respectively. Conclusion: The proposed UPLC-MS/MS method is valid for at-line monitoring of ACL and DCL during PAT application to ACL synthesis and drug determination in bulk and tablets.

Pharmacological Effect of Panax ginseng Extract Standardized with Ginsenoside Rg3 on Mating Behavior of Male Rats Treated with Dopamine Antagonists.

Aim: The aim of this study was to evaluate the effects of Panax ginseng extract standardized with ginsenoside Rg3 (PGRg3) on the mating behavior of sexually active or inactive male rats treated with dopamine antagonists. Methodology: Animals were treated with PGRg3 (50,150 and 450mg/kgb.w) with or without dopamine antagonists. The penile erection, motor activity and stretching-yawning episode were evaluated in animals treated with PGRg3 alone or in combination with lisurode or SND 919. Testosterone and sperm counts were also evaluated in different treatment groups. Results: The results showed that (-) Eticlopride counteracted PGRg3-induced penile erection but not motor hyperactivity. PGRg3 treatment enhanced lisuride-induced behavioral effects. Moreover, PGRg3 plus SND 919 showed a marked stretching-yawning behavior compared to the animals received SND 919 alone. PGRg3 also succeeded to increase testosterone level and sperm count in a dose dependent fashion. Conclusion: It could be concluded that DAD2 receptors are involved in PGRg3-induced mating behavior and testicular function improvement. PGRg3 could be used to improve sexual function and mating behavior in people suffering from erectile dysfunction.