Effect Of Different Formulation Variables On Release Characteristics Of Gastro-Floating Microspheres Of Ethyl Cellulose/Carbopol 934p Encapsulating Sorafenib

Objective: The aim of this study is to prepare floating hollow microspheres encapsulating Sorafenib (SFN) to enhance its oral bioavailability.  Methods: Gastro-floating hollow adhesive microspheres containing SFN were produced by using an emulsion solvent evaporation technique with ether and ethanol as solvents. Ethyl cellulose and carbopol 934P were used as the encapsulating carriers. The effects of formulation parameters like, solvent volume ratio, and drug to polymer ratio (D: P ratio), encapsulation efficiency percentage EE%, floating percentage, and release of SFN after 12 h (Rel12) were investigated and analyzed using a (32) full factorial design. Results: The floating percentage of the microspheres was found to be 76.5%. The in vitro drug release from these hollow microspheres followed the Higuchi model equation. The in vivo results showed that approximately 1.96-fold improvement in the relative bioavailability of the microspheres compared with that of the commercial tablet.  Conclusion: The results demonstrate that the hollow microspheres with good gastro-floating ability are a promising delivery system to enhance SFN bioavailability.

Retrospective study on the effectiveness and indications of different types of flaps used for reconstruction of head and neck

Defects following head and neck surgery can be closed by direct closure when the defect is small, and where local conditions dictate that there is enough lax tissue. Flowever, for larger defects or in situations when direct suture is not applicable, surgical defects may be filled by free grafts, local flaps, pedicled flaps which may be either axial or musculocutaneous, or by using free tissue transfer. This study was conducted in attempt to clarify the success rate of different types of flaps in common use for head and neck reconstruction, the effectiveness of different flaps in terms of functional and esthetic results and which flap is the best for certain defects in head and neck region. In this retrospective study, among the patients with head and neck cancer treated in The Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University, in the period from Jan.2004 to Dec.2009, patients whom post ablative defects needed to be reconstructed by flaps were only included. Patients whom defects were repaired either without flaps or by other means of reconstruction [e.g. gastric pull up] were excluded. The flaps among this study were compaired in terms of flap survival and functional outcomes [speech intelligibility, early starting of oral intake and cosmetic appearance]. This study was conducted upon 38 patients, they were 9 [23.68%] females and 29 [76.31%] males with a mean of age of 61 years [range 36- 84 years]. According to the site of the defect needed to be reconstructed after ablation of the primary lesion, patients were divided into three groups: 1-Patients with defects in the oral cavity and oropharynx which resulted from resection of malignant tumors involving or extending into oral cavity and oropharynx [26 patients] [Gl]. 2-Patients with defects in the hypopharynx which resulted from resection of cancer involving the hypopharynx [8 patients] [G2]. 3- Patients with post maxillectomy defects following resection of sinonasal cancer [4 patients] [G3]. In this study all defects resulted from resection of primary lesions were reconstructed immediately after ablation. As regarding patients with oral and oropharyngeal defects [n-26], the most common flap that was used in reconstruction was the pectoralis major myocutaneous flap [PMMF], that was used in ten patients followed by the radial forearm fasciocutaneous free flap that was used in seven patients, transverse rectus abdominas myocuianeous [TRAM] flap that was used in four patients, the fibula osseocutaneous free flap that was used in three patients and lastly the scapula free flap which was used in two patients. For hypopharyngeal defects [n=8], reconstruction was done in all patients with the free jejunal flap except in a single patient that was performed with the pectoralis major myocutaneous flap. In patients with craniosinonasal defects [n4], the TRAM flap was used in four patients to seal the oro-riasal communication and-the fascia lata for reconstruction of the anterior skull base defects. Overall evaluation of different types of flaps for reconstruction of head and neck defects revealed that radial forearm free flap and PMMF is the best two choices in terms of flap survival and functional outcome for reconstruction of oral cavity defects, free jejunal flap gave fair results for reconstruction of the hypopharynx and finally the TRAM flap isn't the best choice for reconstruction of the maxillary defects. Radial forearm free flap and pectoralis major myocutaneous flap [PMMF] are the best choice for reconstruction of oral cavity defects

Health-related quality of life of chronic hepatitis c patients attending the outpatient clinics of Assiut University Hospital

Kgypl has possibly the highest chronic hepatitis C [CMC] prevalence in the world, which has been associated with decreased health-related quality of life [HRQoL]. Aim: The aim of the present study was to identify the most important predictors of HRQoL of CMC patients attending the outpatient clinics in Assiut city. HRQoL of 200 CMC patients and 200 age-and sex-matched normal subjects, was assessed by the validated Arabic version of the Medical Outcome Study Short Form Health Survey 36 [SF-36]. All patients were interviewed using a semi-structured questionnaire to assess the factors that could affect their HRQoL. Validated reliable instruments were used lo assess depression, illness-related stigma and disease related worries. HKQoL scores of CMC patients [age 40.43 +/- 12.11, 82.5% males] were significantly lower than age and sex matched controls. The most important predictors of the physical summary score of SF-36 were; depression [beta = 0.611, P = 0.000] and the presence of co-morbidities [beta =- 0.218, P - 0.000].while for the menial summary score, the most important predictors were; depression [beta =- 0,651. P=0.000] and illness-related stigma [beta= 0.222, P = 0.000]. Other factors such as age. Sexual dysfunction, interferon therapy and work affection by CMC illness showed a weaker, but nevertheless statistically significant relationship with HRQoL of CHC patients. The study found that patients with chronic hepatitis C had lower HRQoL than the healthy controls, and, depression, co-morbiditics, illness-related stigma were the most important predictors of their iower HRQoL. The results its of this study would assist healthcare personnel to introduce modifications in patient care protocols with relevance to patient needs

Ventilator associated pneumonia: incidence and risk factors in a university hospital

Ventilator associated pneumonia [VAP] is a type of nosocomial pneumonia associated with increased morbidity and mortality. Awareness about the risk factors can be used to implement simple and effective preventive measures.To determine the factors associated with development of VAP and its mierobial profile among patients admitted to ICUs. A nested case-cohort study was conducted at Al-Hussein university hospital in Cairo city, Egypt for a period of 6 months from the 1[st] of March 2013 to the end of August 2013. Patients who were on mechanical ventilation [MV] for more than 48 hours were monitored at frequent intervals fordevelopment of VAP. Samples obtained by endotracheal aspiration were ccultured on Blood agar -Chocolate agar - MacConkey agar, plates of which were incubated at 37c for 24 hours. The isolated organism was identified by morphological and biochemical identification. Of the 73 samples which were taken from endotracheal tubes of the patients, 42 cases were diagnosed as VAP with an incidence rate of 57.5%. Early onset VAP occurred in 36 [85.7%], while late onset VAP was observed in the remaining 6 patients [14.3%]. Escherichia coli [40.5%] followedby Klebsiella pneumonia [23.8%] were the most commonly isolated pathogens. Univariate analysis showed that the duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H[2] blocker use were the risk factors associated with VAP [p < 0.05], Logistic regression revealed duration of MV as an independent risk factor for VAP. The incidence of ventilator pneumonia is high in our study. VAP was significantly related to duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H[2] blocker use

Knowledge, attitude and practice of Hadhramout university students about dengue fever, Al-Yemen

The study aimed to assess the knowledge, Attitude and practice of Hadhramout university students about Dengue fever [DF]. Descriptive research design was used. The study was carried out at Hadhramout University that is located in Al-Mukalla city, 4 collages were taken randomly to collect the necessary data. 679 students were chosed from the previous mentioned faculties by systematic random sample technique. Two tools were used for data collection, the first was a self administrated questionnaire sheet and the second tool was the Likert scale. The study revealed that [78.5%] of the students had a fair knowledge about the vector. The main sources of information as stated by the students were television and posters and brochures. The vast majority of students [96.3%] had adequate score of practice [>/= 60%], while [98.1%] of the students had positive attitude [>/= 60%] about DF. Low significant positive correlation between knowledge, attitude and practice of students about DF was noted. Recommendations: educational programs should be directed and organized to all students from different educational levels to increase the community participation in the combat of the disease

Epidiological study of depressive disorders among patient attending outpatient clinics of Assiut University Hospital

Depression is a common mental health problem, seen frequently in general medical settings. Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension. To estimate the percentage of depressive disorders among patients attending outpatient clinics of Assiut University Hospitals, and to study the possible risk factors underlying these depressive disorders. This cross-sectional study was conducted during one year period from June 1[st] 2006 to May 31[st] 2007. 2034 subjects aged 15 and above were screened for depression using Beck Depression Inventory [BDI] scale. Subjects who scored 4 or more were further evaluated through psychiatric sheet especially prepared for the present work. Psychiatric diagnosis was made on the basis of DSM-IV TR criteria. Patients were also subjected to Suicidality sheet of the MINI plus and Sheehan Disability Scale. Depression was found in 202 subjects representing 8.8% of the whole sample, with 167 patients [82.7%] were classified as having major depressive disorders, 28 patients [13.9%] were assessed to have depressive disorder NOS [26 patients [12.9%] with minor depression and only 2 patients [1%] with postpartum depression], 5 patients [2.5%] were diagnosed with dysthymic disorder and finally 2 patients [1%] with bipolar disorder, depressive episode. Depression was significantly higher among female subjects, highly educated and literate individuals, non-working males and among divorced/widowed/separated individuals. Depressive disorders were also significantly higher among patients with Dcertain medical conditions [e.g. malignancy, disfiguring conditions, autoimmune conditions, renal diseases and hepatic diseases] and among those who had more medical conditions. The degree of impairment is significantly higher among patients with moderate and severe depression and particularly in patients with severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression and particularly among patients with severe depression with psychotic features. Depression is a common mental health problem, seen frequently in general medical settings and necessitates close psychiatric attention and management

Summative assessment of under graduate medical student's performance in physiology by structured oral examination.

To evaluate the importance and efficiency of structured oral examination (SOE). This is a retrospective study, has been designed to compare the newly adopted structured oral examination (SOE) with that of the traditional oral examination (TOE). This study was conducted at the department of physiology during the year 2006, on 607 2nd year medical students of Mymensingh Medical College and 106 students from some other medical colleges who appeared in the first professional examination under Dhaka University from 2003-2006. For this purpose, scores achieved by the students in physiology in first professional examination for 4 successive years (2003-2006) were analyzed. The examinations in (2003-2004) and (2005-2006) were conducted under TOE and SOE respectively. Mean score achieved in SOE and TOE was 67+/-.02 and 57+/-.003 respectively. The difference is statistically significant. The pass percentage in SOE is 94.70% and 90.3% in TOE and the difference is significant. Maximum number of students in SOE attained score in the range of 60-69 but in TOE scores attained by maximum frequency fall in the range of 50-59. This observation indicates improvement in student's performance by quality and success rate in SOE. Therefore SOE is a more effective, skill full technique and superior to TOE in assessing student's competency and cognitive ability. The need and skill of SOE over the TOE in assessing oral part of examination has been proved.

Comparative effects of the two angiotensin converting enzyme inhibitors perindopril and ramipril on brain dopamine content in rats

The existence of brain rennin-angiotensin system [RAS] is well established and it may affect cognitive function and movement disorders. It has been suggested that manipulation of brain angiotensin could be a new therapeutic tool to modulate brain dopamine level, abnormalities of which are implicated in a wide range of conditions including extrapyramidal movement disorders, depression, appetite control, schizophrenia and arousal. In this work, we studied the changes in behavior and brain dopamine content under the effect of two lipophilic ACEIs, perindopril and ramipril, used orally daily for one week in normal rats. Other rat groups were then given single subcutaneous reserpine injection [5 mg/kg] to study the effect of pre-treatment with the ACEIs on the reserpine-induced akinesia, neurobehavioral changes and depleted brain dopamine. In normal rats, although perindopril increased dopamine content in the three brain regions examined, ramipril had no effect on striarum but there were no significant differences between the two ACEIs in their effects on frontal cortex and midbrain. Neither perindopril nor ramipril caused neurobehavioral effects. Both drugs reduced the reserpine-induced akinesia and behavioral changes and antagonized the reserpine-induced brain dopamine depletion. We concluded that chronic ACEIs therapy can influence dopamine level and this is a class effect depending on tissue penetration and crossing BBB

Concomitant administration of the selective cox-2 inhibitor, nimesulide, and vitamin E, comared to indomethacin in experimental animals

This study was designed to assess the safety and efficacy of the selective COX-2 inhibitor, nimesulide, in comparison with the non-selective COX inhibitor, indomethacin. The potentiation of the anti-inflammatory activity of nimesulide by concomitant administration of the anti-oxidant. vitamin E, was also investi- gated. The anti-inflammatory effect was tested in 24 rats by the cot- ton pellet granulomatous test. Animals were arranged into four equal groups. The first group received no drugs and served as control. The other three groups were treated with indomethacin [2 nig/kg b.w.], nimesulide [4 nig/kg b.w.] and nimesulide in combination with vitamin E [each in a dose of 4 mg/kg b.w.], respectively. All drugs were given orally once daily for two weeks. The extent of inhibition of granulomatous formation by the test drugs was taken as a measure of antiinflamniatory activity. it was found that nimesulide alone possessed a significantly less anti-inflammatory activity compared to that of indometha cin. However, concomitant administration of vitamin E with nimesulide produced a significant increase in the anti-inflammatory activity of nimesulide so that it became more than that of indomethacin alone. The analgesic effect of the test drugs was evaluated in mice. Acetic acid was injected i.p. in a dose of 0.5 ml of 1% concentration to induce abdominal constrictions [Writhing test]. Forty mice were divided into four equal groups. The first [control] group was treated with 0.5 ml saline; the second with indomethacin [2 ing/kg b.w.]; the third with nimesulide [4 mg/ kg b.w.] and the fourth with nimesulide plus vitamin E [4 mg/ leg b.w. each]. Each drug was given as a single intramuscular injection half an hour before conducting the Writhing test The average number of abdominal constrictions per minute [Writhing Response: WR] was calculated between the 10th and 14th minutes after acetic acid injection. Reduction of this WR was taken as a measure of analgesic activity of the tested drugs. Indomethacin induced a significant analgesic effect while nimesulide induced a iess analgesic activity. Simultaneous vitamin E administration did not add to the analgesic activity of nimesulide. To study the potential gastric toxicity, tests were performed using ten times the therapeutic doses of indomethacin [20 mg/ kg b.w.] and nimesuiide [40 mg/kg b.w.] in normal fasting albino rats, each given as a single oral dose. Nimesulide administration was not associated wish gastric uiceration while indomethacin produced high incidence of gastric uiceration. In conclusion, from the present data, it couid be recommended that the selective COX-2 inhibitor, nimesulide, is a safer but less effective analgesic anti-inflammatory agent, compared with indomethacin. However, combined with vitamin E, the anti-inflammatory efficacy of nimesulide is increased. Thus, this combination could provide the double benefit of good anti-inflammatory activity beside inducing no appreciable gastric adverse effects, if any at all, when compared with the traditional NSAID, indomethacin

Effect of rofecoxib [a new selective cox-II inhibitor] on plasma insulin level and pancreatic free hydroxyl radicals in diabetic rats

This study is designed to demonstrate the effect of a newly introduced selective COX-2 inhibitor, Rofecoxib, on streptozoto-cin-induced diabetes and whether it possesses an anti-oxidant effect or not. The effects of this drug were compared to those of the relatively selective COX-I inhibitor, indomethacin. The animals were divided into four groups, twenty rats each. The first group served as normal control; the second group received streptozotocin alone [45 ing/kg, i.p.] while the remaining two groups were given the same dose of streptozotocin after being treated orally for ten days with either 2.5 nig/kg/day of "Rofecoxib" [in the third group] or 1 mg/kg/day of indomethacin [in the fourth group]. Statistical analysis of the results revealed that animals treated with streptozotocin [STZ] alone exhibited significant plasma insulin reduction [both basal and half an hour after glucose load] while those treated with Rofecoxib showed insignificant reduction in plasma insulin level following STZ, in comparison to the control group. Histopathological changes revealed dial in the STZ group, there was depletion of insulin secretory granules while in the Rofecoxib group, they appear more or less normal. In the STZ group, there was a significant rise in the pancreatic malondialdehyde [MDA] level while in the Rofecoxib group there was insignificant elevation following streptozotocin, in comparison to control group. Treatment of animals with indomethacin [the 4 group] failed to protect them against the destructive effects of streptozotocin. It is concluded that, in contrast to indomethacin, Rofecoxib has beneficial effects in insulin dependent diabetes mellitus [IDDM] both by its modulatory effects on insulin secretion and its antioxidant properties

Ecto and endoparasites in primary school pupils in El-Ghanayem city, Assiut governorate, upper Egypt

Ecto and endoparasites are still of the public health problems in Egypt. This is particularly true among school pupils who are exposed to the parasitic infections or infestations by autoinfection or by contact. In this paper, 400 primary school pupils, in El-Ghanuyem City, Assiut Governorate, Upper Egypt, were examined [6-11 years old]. Their examination revealed pediculosis [30%], scabies [1.25%], Schistosomiasis haematobium [8.5%], entamoebiasis [8.75%], giardiasis [14%], taeniasis saginata [0.25%], ascariasis [1.75%], enterobiasis [31%], hymenolepiasis nana [9.75%] and Schistosomiasis mansoni [0.75%]. It was concluded that schoolchildren are at-risk group, as they spend long time outside their homes in a crowded area. Besides, they may transfer parasites to their families, particularly those transmitted by contact and autoinfection

Prevalence of glycosuria in rural areas in two upper egyptian governorates - a community - based study

The known caseload of diabetes worldwide is increasing at an alarming rate, its prevalence had tripled in six years. Early diagnosis is more important than tight control to contain fast rising worldwide costs of the disease in terms of life and wealth. A simple blood or urine test could detect early diabetes mellitus. This work aimed to measure the prevalence of diabetes mellitus in a wide geographic rural area in two Upper Egyptian Governorates in a community based study [cross-sectional]. A random sample of 3756 urine specimens was examined by means of dipsticks. The overall prevalence of glucosuria was 4.82%, the age of 35 years or more was the most vulnerable one for it. Multiple regression analysis of possible variables related to glucosuria beside age were leucocyturia and proteinuria

Threatened preterm labour: can biophysical profile predict its outcome?

Sixty pregnant women between 28-37 weeks with threatened preterm labor were evaluated by the ultrasound to determine the role of biophysical profile in the prediction of outcome of preterm labor. Out of the 60 women, 24 cases delivered prematurely. Out of these 24 women, 20 cases delivered within 48 hours of cessation of fetal breathing movements. For prediction of preterm labor, there was no correlation between the total score of biophysical profile and the rate of preterm labor; while there was a significant correlation between the absence of fetal breathing movements and the occurrence of preterm labor

Surgical treatment of Cranio-facial Neurofibromatosis

Craniofacial neurofibromatosis may cause severe soft tissue deformity together with pulsating exophthalmos. The orbital cavity is often enlarged, and the greater wing of the sphenoid bone is usually absent, the eye is proptotic and blind. In these situations, enucleation of the blind eye with soft tissue excision and orbital reconstruction, followed by replacement with a suitable prosthesis, are recommended. Eight patients with localized craniofacial neurofibromatosis were treated surgically, the results were satisfactory only in two patients, acceptable in four and unsatisfactory in two. This reflects the difficulty in treating the lesion and the need for multiple operative sessions

Nasal low dose ketamine combined with midazolam for paediatric premedication

Sixty Children aged from three to six years scheduled for tonsillectomy or bilateral insertion of tympanotomy tubes under general anaesthesia were studied. The patients were randomly allocated into two groups where group [A] received a combination of intranasal ketamine [2 mg/kg] and midazolam [0.1 mg/kg] and group [B] received placebo [normal saline]. Anaesthesia was induced with 5% halothane and 100% 02 via face mask, subjects given intranasal combination of ketamine-midazolam were more likely to separate willingly from their parents at or before 10 minutes compared to patients given placebo. 60% of patients given this combination separated at 4 minutes compared to 20% of patients given placebo. The quality of subsequent halothane induction was excellent in 70% of patients given this combination and adequate in the remaining 30%. In 70% of patients given placebo induction was unacceptable. There were no incidents of any behavioral changes or psychological disturbances in patients given this intranasal combination. No statistically significant difference as regards recovery time was recorded between both groups. It can he concluded that nasal low dose ketamine combined with midazolam provides an effective paediatric premedication with regard to sedation and mask acceptance. It has rapid action with no prolongation of recovery time and no instances of emergence phenomena. Nasal ketamine- midazolam combination offers an alternative to intramuscular or per rectum routes for preanaesthetic sedation in young children aged from three to six years

Antifertility activity of a medicinal plant of the genus Andrografis wall (family Acanthaceae). Part II.

Six weeks old male and female mice belonging to Wister strain were put on diets supplemented to the extent of 0.75% by the powdered stem of A. peniculata Nees for one, two, three and four weeks and the effect on fertility and gestational period was observed. Significant reduction in fertility was observed after three and four weeks of feeding in the group containing the treated males and the untreated females. In the same group the gestation period was also prolonged after four weeks of feeding. There was virtually no change in fertility and gestational period in the treated females and the untreated males during any stage of the experiment.