Short-term outcomes of laparoscopic-assisted colectomy versus open colectomy in patients with colonic carcinoma: a prospective randomized study

Introduction: The second most common cause of cancer-related mortality is colorectal cancer, and laparoscopic-assisted colectomy (LAC) has gained popularity among surgeons as an alternative to the conventional approach, which is open colecrtomy (OC). The differences between LAC and OC in terms of short-term outcomes have not been well documented, and the aim of the present work is to compare the short-term outcomes of both procedures. Materials and Methods: The present prospective study comprised 164 participants submitted to LAC (n = 82) and OC (n = 82) at the Helwan and Zagazig University hospitals between January 2018 and January 2022. We collected and analyzed demographic data, surgical data, and the short-term outcomes. Results: The LAC group had a significantly lower estimated amount of blood loss, shorter hospital stay, lower rates of incisional surgical site infection, and fewer cases of burst abdomen postoperatively, but with a considerably longer operative time (30.3 minutes) than the OC group. Conclusions: Our findings show that LAC is favorable option to OC, with superior outcomes. (AU)

Impact of ZrO2 nanoparticles addition on flexural properties of denture base resin with different thickness

PURPOSE@#This study aimed to evaluate the effect of incorporating zirconium oxide nanoparticles (nano-ZrO 2 ) in polymethylmethacrylate (PMMA) denture base resin on flexural properties at different material thicknesses. @*MATERIALS AND METHODS@#Heat polymerized acrylic resin specimens (N = 120) were fabricated and divided into 4 groups according to denture base thickness (2.5 mm, 2.0 mm, 1.5 mm, 1.0 mm). Each group was subdivided into 3 subgroups (n = 10) according to nano-ZrO2 concentration (0%, 2.5%, and 5%). Flexural strength and elastic modulus were evaluated using a three-point bending test. One-way ANOVA, Tukey’s post hoc, and two-way ANOVA were used for data analysis (α = .05). Scanning electron microscopy (SEM) was used for fracture surface analysis and nanoparticles distributions. @*RESULTS@# Groups with 0% nano-ZrO2 showed no significant difference in the flexural strength as thickness decreased (P = .153). The addition of nano-zirconia significantly increased the flexural strength (P < .001). The highest value was with 5% nano-ZrO2 and 2 mm-thickness (125.4± 18.3 MPa), followed by 5% nano-ZrO2 and 1.5 mm-thickness (110.3 ± 8.5 MPa). Moreover, the effect of various concentration levels on elastic modulus was statistically significant for 2 mm thickness (P = .001), but the combined effect of thickness and concentration on elastic modulus was insignificant (P = .10). @*CONCLUSION@# Reinforcement of denture base material with nano-ZrO2 significantly increased flexural strength and modulus of elasticity. Reducing material thickness did not decrease flexural strength when nano-ZrO2 was incorporated. In clinical practice, when low thickness of denture base material is indicated, PMMAano-ZrO2 could be used with minimum acceptable thickness of 1.5 mm.

Bio-guided Isolation of Natural Iron Chelators from Mangifera indica Leaves and their Comparative Study to Desferal®

Through bio-guided isolation, two natural iron chelators were isolated from Mangifera indica L. leaves, identified as mangiferin (1) and iriflophenone-3-C-β-D-glucoside (2). Their iron-chelating activity was compared to that of Desferal® using bipyridyl assay and EDTA as a standard. Mangiferin showed the highest activity with IC50 value of 0.385 mM (162.85 μg/mL). Furthermore, two combinations of mangiferin with Desferal® (M-D) and iriflophenone-3-C-β-D-glucoside (M-I) were evaluated. The results showed that mangiferin potentiated the iron chelation activity of Desferal® about 46%, also that M-I combination is a promising candidate formula for iron chelation therapy. In addition, mangiferin and Desferal-iron complexes were prepared and characterized by IR, UV, and Mass spectra to compare their mode of chelation to iron. Their structural stability was studied by DFT calculations. Furthermore, they displayed increased ABTS antioxidant activity when bound to iron as compared to their free form, which enhances their pharmacological importance.

Impact of ZrO2 nanoparticles addition on flexural properties of denture base resin with different thickness

PURPOSE@#This study aimed to evaluate the effect of incorporating zirconium oxide nanoparticles (nano-ZrO 2 ) in polymethylmethacrylate (PMMA) denture base resin on flexural properties at different material thicknesses. @*MATERIALS AND METHODS@#Heat polymerized acrylic resin specimens (N = 120) were fabricated and divided into 4 groups according to denture base thickness (2.5 mm, 2.0 mm, 1.5 mm, 1.0 mm). Each group was subdivided into 3 subgroups (n = 10) according to nano-ZrO2 concentration (0%, 2.5%, and 5%). Flexural strength and elastic modulus were evaluated using a three-point bending test. One-way ANOVA, Tukey’s post hoc, and two-way ANOVA were used for data analysis (α = .05). Scanning electron microscopy (SEM) was used for fracture surface analysis and nanoparticles distributions. @*RESULTS@# Groups with 0% nano-ZrO2 showed no significant difference in the flexural strength as thickness decreased (P = .153). The addition of nano-zirconia significantly increased the flexural strength (P < .001). The highest value was with 5% nano-ZrO2 and 2 mm-thickness (125.4± 18.3 MPa), followed by 5% nano-ZrO2 and 1.5 mm-thickness (110.3 ± 8.5 MPa). Moreover, the effect of various concentration levels on elastic modulus was statistically significant for 2 mm thickness (P = .001), but the combined effect of thickness and concentration on elastic modulus was insignificant (P = .10). @*CONCLUSION@# Reinforcement of denture base material with nano-ZrO2 significantly increased flexural strength and modulus of elasticity. Reducing material thickness did not decrease flexural strength when nano-ZrO2 was incorporated. In clinical practice, when low thickness of denture base material is indicated, PMMAano-ZrO2 could be used with minimum acceptable thickness of 1.5 mm.

Bio-guided Isolation of Natural Iron Chelators from Mangifera indica Leaves and their Comparative Study to Desferal®

Through bio-guided isolation, two natural iron chelators were isolated from Mangifera indica L. leaves, identified as mangiferin (1) and iriflophenone-3-C-β-D-glucoside (2). Their iron-chelating activity was compared to that of Desferal® using bipyridyl assay and EDTA as a standard. Mangiferin showed the highest activity with IC50 value of 0.385 mM (162.85 μg/mL). Furthermore, two combinations of mangiferin with Desferal® (M-D) and iriflophenone-3-C-β-D-glucoside (M-I) were evaluated. The results showed that mangiferin potentiated the iron chelation activity of Desferal® about 46%, also that M-I combination is a promising candidate formula for iron chelation therapy. In addition, mangiferin and Desferal-iron complexes were prepared and characterized by IR, UV, and Mass spectra to compare their mode of chelation to iron. Their structural stability was studied by DFT calculations. Furthermore, they displayed increased ABTS antioxidant activity when bound to iron as compared to their free form, which enhances their pharmacological importance.

Role of MRI in the Detection and Monitoring of Lower Limb Osteonecrosis after Chemotherapy in Pediatric Patients with Acute Lymphoblastic Leukaemia

Background:Magnetic resonance imaging (MRI) is the technique that demonstrated the highest sensitivity and specificity in the early diagnosis of osteonecrosis. It allows detecting initial typical signal intensity alterations of the bone marrow when other examinations showed nonspecific findings or even no alterations at all. The aim of this study is to assess the role of magnetic resonance imaging in detection and monitoring osteonecrotic lesions in pediatric patient with acute lymphoblastic leukemia after chemotherapy.Materials and Methods: This prospective study was performed on 30 pediatric patients ranged from 4 to 18 years with acute lymphoblastic leukemia on chemotherapy or after 3months from ending chemotherapy with symptoms suspicious for osteonecrosis (i.e., articular pain). All patients were explained about the procedure to be done. MRI study of whole lower limbs was done for all patients.Results:In the present study all patients were symptomatic. 24\30 patients (80%) had hip pain, 25\30 patients (83.3%) had knee pain and 8\30 patients (26.7%) had limping. We reported that knee pain was the most common complaint representing 83.3% of patients. 11\30 patients (36.7%) had no MRI findings. 19\30 patients (63.3%) had different positive findings; 4 patients (13.3%) had non -articular osteonecrosis (ON) only with no joint involvement (bone infarction), 2 patients (6.7%) had avascular necrosis of femoral head epiphysis without bone infarction and 13 patients (43.3%) had combined bone infarction and avascular necrosis with Joint involvement. Follow up by MRI was done for all patients (30 patients), 27 patients showed no change in MRI findings, one patient progressed from avascular necrosis of the femoral headepiphysis without deformity to avascular necrosis of the femoral head epiphysis with deformity. The other two patient showed regressive course.Conclusion:We concluded that MRI study is mandatory for early detection and monitoring of lower limb osteonecrosis in pediatric patients with acute lymphoblastic leukemia under or after chemotherapy.The radiologist and clinician must do MRI lower limbs routinely and follow up MRI after 4-6 months to first MRI due to some patients had regressive or progressive findings

Common Drugs with Effective Off-Label Uses

The term off-label drug use (OLDU) is utilized broadly in the medical literature. It is a polarizing term since it may be related to incredible advantage or harm to patients. OLDU is defined as drug uses that not included in the indications or dosage regimens listed in the drug labeling. The main issue with off-label use is that there is insufficient information supportsthe use ofthe drug so this review aims to give brief information about some common drugs with effective and useful off-label uses based on scientific study and to encourage the researcher toprovidesufficientinformation for the physician and health care providersaboutoff-label uses to decrease the risk of harm to the patients. There are many drugs with various off-label uses that play an important role clinically such as using atorvastatin in chronic heart failure (CHF) due to its pleiotropic action also it can show a significant reduction in the frequency of hospitalization due to CHF exacerbation. However, that make off-label uses an important is several diseases do not have approved drugs, partly because the diseases are rare or conducting clinical trials and marketing the drug for such diseases may not be gainful.

Large retroperitoneal dermoid cyst in a 55 year old lady: a rare case report

Retroperitoneal cysts are usually rare asymptomatic lesions but may present with unspecific symptoms depending on the size, location and complications such as hemorrhage, infection, or rupture. A 55-year-old lady presented with complaints of non-obstructed umbilical hernia. CT scan of abdomen and pelvis was done suggestive of a large cystic non-enhancing thin walled lesion of size 27×15 cm in right lumbar region. Intraoperatively, there was a large mesenteric cyst from retroperitoneum of size 25×15 cm, extending from right iliac fossa up to right hypochondrium. A confirmatory diagnosis of dermoid cyst was made following histopathology. Retroperitoneum is a rare site for dermoid cyst. Retroperitoneal cysts which develop within the retroperitoneal space are rare intra-abdominal tumours with an incidence of 1 per 1,40,000. The incidence of recurrence for retroperitoneal cysts is higher than with other forms of cysts because their proximity to major blood vessels and other organs makes them difficult to completely excise. Surgical resection is indicated to establish a diagnosis and prevent eventual complications. Complete excision of tumour is necessary due to the risk of malignancy. After complete surgical resection the 5 years survival rate is nearly 100%.

Electrohydrodynamic atomization, a promising avenue for fast-dissolving drug delivery system: Lessons from tadalafil-loaded composite nanofibers

The utilization of electrospinning in drug delivery has thrived in recent years, with the ability to incorporate drugsand enhance dissolution; this technique is employed to improve the dissolution of poorly water-soluble selectivephosphodiesterase-5 inhibitor, tadalafil. The strategy involved direct electrospinning of tadalafil/polyvinylpyrrolidoneand polyethylene oxide (PEO) solution. The optimization process included a 32 full factorial design based on theinfluence of polymers concentration as independent variables on the electrospun yield, loading efficiency, nanofibersdiameter, number of beads, and in vitro release. Optimization studies revealed the negative influence of bothpolymers on the electrospun yield, while the loading efficiency and in vitro dissolution rate were reduced by the PEOconcentration solely. The higher polymer concentrations were favorable for the declination of beads number, and adriving factor for fiber diameter reduction. Further physicochemical characterization of the optimized formulationrevealed the presence of the drug in an amorphous state or molecular dispersion within the polymer matrix. In vitrodissolution studies revealed about 81.5% ± 8.34% release in less than 2 minutes compared to a negligible dissolutionof free drug. From the derived outcomes, the electrohydrodynamic spun tadalafil-loaded nanofibers pave the way fordissolution enhancement for insoluble low bioavailability class II drugs.

Clinical Study on Findings of Ultrasound and Computed Tomography Scan in the Diagnosis of Ovarian Mass Lesions

Background: Ultrasonography (USG) is a simple and noninvasive diagnostic tool that gives lots of data to accurately characterize most of the ovarian mass lesions with a sensitivity and specificity of 88–96% and 90–96%, respectively. However, the presence of significant variability in the terminology and definition of USG findings has led to the need for more standardization and uniformity in adnexal USG. Computed tomography (CT) scan is used primarily in patients with ovarian malignancies, either to assess disease extent before surgery or as a substitute for second-look laparotomy. Moreover, spiral CT has several advantages such as its rapidity and possibility of identifying all potential sites of peritoneal implants or lymphadenopathy as well as of the primary tumor site. Aim of the Study: The study was to the clinical findings of both USG and CT scan of abdomen and pelvis in the accurate diagnosis of ovarian mass lesions. Materials and Methods: A total of 104 patients with mass lesions of the ovary were included and subjected to USG and CT scan of abdomen and pelvis. Transabdominal and transvaginal USG studies were undertaken in all the patients. USG findings and CT scan findings were observed recorded and analyzed. Ovarian pathologies were categorized as benign, malignant, and metastasized and the results of CT and USG were compared. Observations and Results: A total of 104 patients with ovarian mass lesions attending the Radiology Department of a Tertiary Teaching Hospital in Kerala were included in the study; patients were aged between 18 and 68 years with a mean age of 42.46 ± 5.70 years. Patients aged between 19 and 58 years accounted for more than 80% of the entire subjects. Hemorrhagic cyst was the most common mass lesion diagnosed in this study and accounted for 28 (26.92%) patients. Tubo-ovarian abscess accounted for 19/104 (18.26%) of the total cases. This was followed by mucinous cystadenoma 17/104 (16.34%), serous cystadenoma in 13/104 (12.50%) cases, polycystic ovarian disease in 11/104 (10.57%), mature cystic teratoma in 7/104 (6.73%), simple cyst in 6 (5.76%), Brenner tumor in 2/104 (1.92%), and endometrioma in 1/104 (0.96%) patients. Conclusions: CT scan and USG are two excellent noninvasive methods to differentiate ovarian mass lesions from benign and malignant lesions and both imaging techniques seemed to be comparable in differentiating malignant from benign ovarian tumors. CT scan was more sensitive than USG, but sonography is more specific than CT scan in diagnosis of malignant lesions. USG has high positive predictive value as compared to CT scan to diagnose malignant lesions.

Effect of SiO2 and Al2 O3 nanoparticles on wear resistance of PMMA acrylic denture teeth / Efeito das nanopartículas de SiO2 e Al2 O3 na resistência ao desgaste de dentes em acrílico PMMA para prótese

Objetivo: Este estudo teve como objetivo avaliar a resistência ao desgaste de dentes em acrílico para próteses contendo nanopartículas de dióxido de silício (nano-SiO2 ) e dióxido de alumínio (nanoAl2 O3 ). Material e Métodos: O material em polimetilmetacrilato (PMMA) foi utilizado para fabricar 84 amostras (n=10) contendo nano-SiO2 e nano-Al2 O3 nas concentrações 0,1% em peso, 0,3% em peso e 0,5% em peso de pó acrílico. Uma máquina de teste de desgaste de dois corpos e um microscópio digital foram usados para medir as mudanças na perda de peso e rugosidade da superfície, respectivamente. Testes de ANOVA a um fator e testes de comparações múltiplas de Tukey foram utilizados para análise dos dados (α = 0,05). Resultados: O material modificado com nano-SiO2 demonstrou um aumento significativo na perda de peso em comparação com o material acrílico artificial convencional (p ˂ 0,05) enquanto o material modificado com nano-Al2 O3 demonstrou aumento não significativo na perda de peso, exceto no subgrupo 0,5% (p < 0,05). Não há diferenças significativas em relação à alteração da rugosidade após a simulação de desgaste entre todos os grupos testados (p > 0,05). Conclusão: As nanopartículas de nano-Al2 O3 exibem menos efeito negativo que o nanoSiO2 , podendo ser usado com cautela, se necessário. (AU)

Objective: This study aimed to evaluate the wear resistance of acrylic denture teeth containing silicon dioxide (nano-SiO2 ) and aluminum dioxide (nano-Al2 O3 ) nanoparticles. Material and Methods: Poly methyl methacrylate (PMMA) denture tooth material was used to denture tooth material was used to fabricate 84 specimens (n=10) containing nano-SiO2 and nano-Al2 O3 in concentrations 0.1wt%, 0.3wt%, and 0.5wt% of acrylic powder. A two-body wear testing machine and digital microscope were used to measure the changes in weight loss and surface roughness respectively. One-way ANOVA and pair-wise Tukey's post-hoc tests were used for data analysis (α = 0.05). Results: Nano-SiO2 modified teeth material demonstrated a significant increase in weight loss in comparison conventional artificial acrylic teeth material (p ˂ 0.05) while nanoAl2 O3 modified teeth material demonstrated non-significant increase in weight loss except for 0.5% subgroup (p ˂ 0.05). There is no significant differences regarding roughness change after wear simulation among all tested groups (p > 0.05). Conclusion: Nano-Al2 O3 nanoparticles exhibit less negative effect than nano-SiO2 so; it could be used with caution if necessary. (AU)

Oral trans-mucosal dexmedetomidine for controlling of emergence agitation in children undergoing tonsillectomy: a randomized controlled trial / Dexmedetomidina transmucosa oral para controle da agitação ao despertar em crianças submetidas a amigdalectomia: ensaio clínico randomizado

Abstract Objectives: Emergence agitation is a negative behavior commonly recorded after pediatric tonsillectomy. We investigated the efficacy of preoperative premedication with oral transmucosal buccal dexmedetomidine on the incidence and severity of emergence agitation in preschool children undergoing tonsillectomy under sevoflurane anesthesia. Methods: Ninety patients aged (3-6 years), ASA I‒II were enrolled into three groups (n = 30) to receive oral transmucosal dexmedetomidine 0.5 µg.kg-1 (Group DEX I), 1 µg.kg-1 (Group DEX II) or saline placebo (Group C). Our primary endpoint was the Watcha agitation score at emergence in PACU. Secondary outcomes were preoperative sedation score, intraoperative hemodynamics, postoperative Objective Pain Scale (OPS) and adverse effects. Results: The patients' demographics, preoperative sedation scores and extubation time showed no difference between groups. Significant differences between groups in incidence and frequency distribution of each grade of Watcha score were evident at 5 minutes (p= 0.007), 10 minutes (p= 0.034), 30 minutes (p= 0.022), 45 minutes (p= 0.034) and 60 minutes (p= 0.026), postoperatively with significant differences between DEX I and II groups. DEX groups showed lower OPS scores at 5 minutes (p= 0.011), 10 minutes (p= 0.037) and 30 minutes (p= 0.044) after arrival at PACU, with no difference between DEX I and II groups. Patients in DEX II group exhibited lower intraoperative mean heart rate at 15 min (p= 0.020), and lower mean arterial pressure at 30 minutes, (p= 0.040), 45 minutes (p= 0.002) and 60 minutes (p= 0.006) with no significant differences between groups in other time points. Conclusion: This study demonstrates the clinical advantage and the simple technique of oral transmucosal DEX premedication for emergence agitation in preschool children undergoing tonsillectomy under sevoflurane anesthesia compared with saline placebo. Trial registration Clinical Trials.gov trial registry: NCT02720705.

Resumo Objetivos: A agitação ao despertar da anestesia é um comportamento negativo comumente registrado após amigdalectomia pediátrica. Avaliamos a eficácia da pré-medicação com dexmedetomidina via transmucosa oral no pré-operatório sobre a incidência e gravidade da agitação ao despertar em crianças pré-escolares submetidas à amigdalectomia sob anestesia com sevoflurano. Métodos: Noventa pacientes entre três e seis anos e estado físico ASA I-II foram incluídos em três grupos (n = 30) para receber 0,5 µg.kg-1 ou 1 µg.kg-1 de dexmedetomidina via transmucosa oral (Grupo DEX I e Grupo DEX II, respectivamente) ou solução salina (Grupo C). O desfecho primário foi o escore de agitação ao despertar medido com a escala de Watcha na SRPA. Os desfechos secundários foram escore de sedação pré-operatória, hemodinâmica intraoperatória, escore OPS (Objective Pain Scale) e efeitos adversos no pós-operatório. Resultados: A demografia dos pacientes, os escores de sedação pré-operatória e o tempo de extubação não apresentaram diferença entre os grupos. Diferenças significativas entre os grupos na distribuição da incidência e frequência de cada grau do escore de Watcha foram evidentes aos 5 minutos (p = 0,007), 10 minutos (p = 0,034), 30 minutos (p = 0,022), 45 minutos (p = 0,034) e 60 minutos (p = 0,026) no pós-operatório, com diferenças significativas entre os grupos DEX I e II. Os grupos DEX apresentaram escores OPS mais baixos aos 5 minutos (p = 0,011), 10 minutos (p = 0,037) e 30 minutos (p = 0,044) após a chegada à SRPA, sem diferença entre os grupos DEX I e II. Os pacientes do grupo DEX II apresentaram menor frequência cardíaca média aos 15 minutos de intraoperatório (p = 0,020) e menor pressão arterial média aos 30 minutos, (p = 0,040), 45 minutos (p = 0,002) e 60 minutos (p = 0,006), sem diferenças significativas entre os grupos em outros momentos. Conclusão: Este estudo demonstra a vantagem clínica e a técnica simples da pré-medicação com DEX por via transmucosa oral para agitação ao despertar em crianças pré-escolares submetidas à amigdalectomia sob anestesia com sevoflurano, comparado à solução salina. Registro do estudo: Clinical Trials.gov trial registry: NCT02720705.

Knowledge, Attitudes and Perception toward Radiation Hazards and Protection among Dental Professionals in Riyadh, Kingdom of Saudi Arabia

Introduction: Radiation hazards are harmful, and it becomes precarious when there is a professional negligence or ignorance. Objectives: To evaluate the knowledge, attitude and perception among dental students and dental practitioners toward dental radiation and to assess the difference in knowledge between dentists, dental staff and dental students. Materials and methods: The study was comprised of 550 participants. The information was collected from each participant through structured questionnaire consisting of 39 close-ended questions. Statistical analysis: Chisquare to test the association of knowledge, attitudes and perception (KAP) with gender, occupational sector and educational qualification and one way analysis of variance to compare the difference in means of KAP between the three different groups of professionals and gender. Results: Out of the 550 dental professionals who participated in the study, 293 (53%) were dental students, 83 (15%) were dental staff and 174 (32%) were dentists. Dental students showed higher KAP values towards radiation hazards protection followed by dentists and dental staff. Conclusion: From the results obtained in this study, it was noted that the KAP level with regard to radiation protection was higher among dental students compared to dentists, and the least KAP value was found with dental staff.

Preemptive nebulized ketamine for pain control after tonsillectomy in children: randomized controlled trial / Uso preventivo de cetamina nebulizada para controle da dor após amigdalectomia em crianças: estudo randômico e controlado

Abstract Objectives The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg-1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg-1) and saline placebo. Methods One hundred children aged (7-12) years were randomly allocated in four groups (n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg-1 (Group K-IV), Nebulized Ketamine 1 mg.kg-1 (Group K-N1) or 2 mg.kg-1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative. Results The mean time to first request for rescue analgesics was prolonged in K-N1 (400.9 ± 60.5 min, 95% CI 375.9-425.87) and K-N2 (455.5 ± 44.6 min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5 ± 86.1 min, 95% CI 282.9-354.1) and Group C (68.3 ± 21.9 min, 95% CI 59.5-77.1; p < 0.001), with a significant difference between K-N1 and K-N2 Groups (p < 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced in Group K-IV (672.6 ± 272.8 mg, 95% CI 559.9-785.2), Group K-N1 (715.6 ± 103.2 mg, 95% CI 590.4-840.8) and Group K-N2 (696.6 ± 133.3 mg, 95% CI 558.8-834.4) compared with Control Group (1153.8 ± 312.4 mg, 95% CI 1024.8-1282.8; p < 0.001). With no difference between intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p < 0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects. Conclusion Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine.

Resumo Objetivos A administração de cetamina por via inalatória através de nebulizador é relativamente nova e os estudos sobre este assunto são escassos. Nosso objetivo foi investigar a eficácia analgésica da cetamina nebulizada (1 e 2 mg.kg-1) administrada 30 minutos antes da anestesia geral em crianças submetidas à amigdalectomia eletiva, em comparação com cetamina intravenosa (0,5 mg.kg-1) e placebo (soro fisiológico). Métodos Cem crianças entre 7-12 anos foram randomicamente alocadas em quatro grupos (n = 25) e receberam: soro fisiológico para controle (Grupo C); 0,5 mg.kg-1 de cetamina intravenosa (Grupo C-IV); 1 mg.kg-1 de cetamina nebulizada (Grupo C-N1); 2 mg.kg-1 de cetamina nebulizada (Grupo C-N2). O desfecho primário foi o consumo total de analgésicos de resgate nas primeiras 24 horas de pós-operatório. Resultados O tempo médio para a primeira solicitação de analgésicos de resgate foi prolongado nos grupos C-N1 (400,9 ± 60,5 min, IC 95% 375,9-425,87) e C-N2 (455,5 ± 44,6 min, IC 95% 437,1-473,9) em comparação com o Grupo C-IV (318,5 ± 86,1 min, IC 95% 282,9-354,1) e o Grupo C (68,3 ± 21,9 min, IC 95% 59,5-77,1; p < 0,001), com uma diferença significativa entre os grupos C-N1 e C-N2 (p < 0,001). O consumo total de paracetamol IV nas primeiras 24 horas de pós-operatório foi reduzido no Grupo C-IV (672,6 ± 272,8 mg, IC 95% 559,9-785,2), Grupo C-N1 (715,6 ± 103,2 mg, IC 95% 590,4-840,8) e Grupo C-N2 (696,6 ± 133,3 mg, IC 95% 558,8-834,4) em comparação com o Grupo C (1153,8 ± 312,4 mg, IC 95% 1024,8-1282,8; p < 0,001). Não houve diferença entre os grupos de cetamina intravenosa e nebulizada (p = 0,312). Os pacientes dos grupos de cetamina intravenosa e nebulizada apresentaram escores VRS pós-operatórios menores, em comparação com o Grupo C (p < 0,001), sem diferenças entre os grupos C-IV, C-N1 ou C-N2 e sem efeitos adversos significativos. Conclusão A administração preventiva de cetamina nebulizada foi eficaz no alívio da dor pós-amigdalectomia. Cetamina nebulizada pode ser considerada como uma via alternativa eficaz à cetamina IV.

Epidemiologic Profile and Predictors of Fatty Liver: A Hospital-Based Study

Background:Non-alcoholic fatty liver is the most common cause of chronic liver disease with increasing prevalence globally.Settings and Design:The current study is an analytical case control study; conducted in ultrasonography outpatient clinic of Cairo University Hospital.Materialsand Methods:150 consented fatty liver cases and 564 controls were screened for fatty liver infiltration using abdominal ultrasonography. Receiver Operating Characteristics (ROC) curve analysis was performed to explore the discriminant ability of the developed model.Results:Among cases, Age, sex and residence matching contributes 32.7%, 36% and 31.3% mild, moderateand severe degree of fatty liver respectively. Cases showed significantly higher body mass index(BMI), waist circumference (WC), total cholesterol, triglyceride, low density lipoprotein(LDL), and lower high density lipoprotein (HDL) than controls. Casesdemonstrated higher prevalence of hypertension(11.3%vs 8.3% respectively), and significantly higher prevalence of diabetes(22% vs. 9.2%)(p=0.03).Severe fatty liver cases were significantly older and had significantly higher WC, BMI, significantlyhigher association with diabetes mellitus, significantly higher levels of total cholesterol, triglycerides and LDL than non-severe degree cases. The significant predictors of sever fatty liver were BMI, total cholesterol and LDL (P = <0.001, R2= 0.543).Conclusion:The developed regression equation expressed good validation and calibration. It utilizes an algorithm that can quickly and easily address patients with fatty liver. It would useful as a fast, inexpensive primary screening tool for severe fatty liver.

A Survey to Assess Quality of Life of Gastro‐Oesophageal Reflux Disease (GERD) Patients in Saudi Arabia

Gastrointestinal Esophagus Ailment is a chronic disease that usually results in complications. GERD symptomsinclude chest pain, acid regurgitation, heartburn, nausea, chronic cough, asthma, and hoarseness. A considerablenumber of research studies have shown that old age, obesity, drug and substance abuse are significant factorsthat exacerbate the present condition. The findings from the present research study illustrate that the conditionhas a major impact on psychological problems. Precisely, the consequences of the condition appeared to vary indifferent age groups. In particular, this difference was determined with chi-square while taking into considerationthe existing variables. Furthermore, the results ascertained that some variations were registered in terms ofseveral factors that differ significantly across gender. Eating pattern between males and females also emerged asa major factor in the research study. The difference is also evident in the age group category as the age group18-25 shares different sentiments in various aspects.

The effect of nanodiamonds on candida albicans adhesion and surface characteristics of PMMA denture base material - an in vitro study

Abstract Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.

Evaluation of stress ulcer prophylaxis benefits and outcomes: a simple literature review

Background: One of the commonest complications in critically ill patients is stress related mucosal disease [SRMD]. It can be associated with increase in the risk of development of overt gastrointestinal bleeding. As a result, a lot of literatures have been done to evaluate the pathogenesis that stands behind it's development, and assessment of the measures that can be used to lower the risk of it's 'occurrence

Aim of the Work: In this review we aimed at discussing the pathogenesis that stands behind stress ulcer development, Also, discussing the role of anta- acid as a prophylaxis against harms and benefits. In addition to providing an intensive study that analyzed the recent literatures considered this field of study

Methodology: A comprehensive search was done using biomedical databases; Medline, and Pubmed, for studies concerned with assessment of stress ulcer prophylaxis. Keywords used in our search through the databases were as; ''stress ulcer'', ''stress ulcer prophylaxis'', ''stress ulcer in ICU patients''

Conclusion: Stress related mucosal disease is associated with increase in the risk of clinically overt gastrointestinal bleeding. As a result, patients who require mechanically ventilation for more than 48 h and those with a manifest of coagulopathy are highly recommended for having stress ulcer prophylaxis [SUP]. Anta- acid such as Proton Pump Inhibitors [PPIs] and histamine 2 receptor antagonists [H2RA] help in prevention of gastrointestinal bleeding, but did not have any effect on mortality risk reduction. Still further prospective randomizes trials needs to be done to evaluate our scientific research survey to guide the physicians in making a decision about the use of SUP in ICU patients

Insulin-like Growth Factor Binding Protein-1/ alpha-fetoprotein versus Placental alpha microglobulin-1 for diagnosis of premature fetal membranes rupture.

Objectives: To compare insulin-like growth factor binding protein-1/alpha-fetoprotein (IGFBP-1/AFP) to placental alpha microglobulin-1 (PAMG-1) for diagnosis of premature fetal membranes rupture (PROM). Methods: 220 pregnant women ≥ 37 and < 39 weeks` gestation studied and classified into two groups; study group (PROM) and control group (no PROM). Examination of the studied women followed by abdominal ultrasound (TAS) and sterile vaginal speculum examination to visualize amniotic fluid leaking and for collection of samples for fern, nitrazine, AmniSure® and AmnioQuick® Duo+ tests on admission. Results: The sensitivity and specificity of AmnioQuick® Duo+ test to detect PROM was 93.6% and 86.4%; respectively compared to 95.5% and 89.1%; respectively for AmniSure® test, 72.7% and 80.9%; respectively for fern test and 76.4% and 83.6%; respectively for nitrazine test. PPV, NPV and accuracy of AmnioQuick® Duo+ test to detect PROM were 87.3%, 93.1% and 90%; respectively compared to 89.7, 95.1% and 92.3%; respectively for AmniSure® test, 79.2%, 74.8% and 76.8%; respectively for fern test and 82.4%, 77.97% and 80%; respectively for nitrazine test. AmnioQuick® Duo+ and AmniSure® tests had higher sensitivity, specificity, predictive values and accuracy to detect PROM compared to conventional diagnostic tests. Conclusion: AmnioQuick® Duo+ test for detection of IGFBP-1/AFP was rapid, accurate bedside test better than the individual conventional diagnostic tests and has same accuracy and performance like AmniSure® test.