Value of fertility-sparing surgery for young females with epithelial ovarian cancer: a comparative study / Valor de la cirugía de preservación de la fertilidad en mujeres jóvenes con cáncer de ovario epitelial: un estudio comparativo

Resumen OBJETIVO: Comparar la cirugía radical con la cirugía conservadora de la fertilidad en mujeres con cáncer de ovario epitelial en estadio 1A-C con respecto a la tasa de recurrencia y las tasas de supervivencia. Además, evaluar los desenlaces reproductivos y obstétricos para las mujeres con cáncer de ovario epitelial en estadio I tratadas con una conducta conservadora de la fertilidad. PACIENTES Y MÉTODOS: Estudio prospectivo efectuado en pacientes con cáncer de ovario epitelial, estadio I, con edad ≤ 40 años. A las pacientes del grupo de preservación de la fertilidad se les practicó salpingooforectomía del lado del ovario afectado y una biopsia por incisión o escisión en cuña del ovario contralateral. A las pacientes del grupo de cirugía radical se les practicó la histerectomía total y salpingooforectomía bilateral. Para evaluar los desenlaces reproductivos y oncológicos se dio seguimiento a todas las pacientes durante cinco años. RESULTADOS: Se estudiaron 60 pacientes; las del grupo de cirugía de preservación de la fertilidad eran significativamente más jóvenes (30 ± 4 en comparación con 35 ± 5) (p < 0.001), el tamaño de sus tumores era más pequeño 3.4 ± 1.3 en comparación con 6.0 ± 2,6 (p < 0.001), de menor grado (p < 0.001). = 0.011), estadio más precoz (p < 0.001) y con más histología mucinosa que las pacientes del grupo de cirugía radical. No hubo diferencias estadísticamente significativas entre ambos grupos en cuanto a la recurrencia tumoral o las tasas de supervivencia. De 25 pacientes operadas para preservación de la fertilidad 18 de 25 intentaron quedar embarazadas. Se registraron 15 de 18 embarazos, incluidos 13 nacidos vivos, 1 aborto espontáneo y 1 muerte fetal intrauterina. CONCLUSIÓN: La cirugía conservadora de la fertilidad podría ser una alternativa adecuada a la cirugía radical para mujeres jóvenes con cáncer epitelial de ovario en estadio I.

Abstract OBJECTIVE: In the current study, we aimed to compare between radical surgery and fertility saving surgery in females with stage 1A-C EOC regarding recurrence rate and patients survival rates in addition to evaluating reproductive and obstetric outcomes for stage I EOC females who were managed by fertility saving surgery. PATIENTS AND METHODS: We prospectively identified 60 patients diagnosed with stage I EOC aged ≤ 40 years. Patients in the fertility-preservation group underwent salpingo-oophorectomy on the side of the affected ovary in addition to incisional biopsy or wedge excision of the ovary on the other side. Patients in the radical surgery group underwent total hysterectomy and bilateral salpingo-oophorectomy. We followed up all patients for 5 years to assess their reproductive and oncological outcomes. RESULTS: Patients in the fertility preservation surgery group were significantly younger (30 ± 4 versus 35 ± 5) (p < 0.001), their tumor sizes were smaller 3.4 ± 1.3 versus 6.0 ± 2.6 (p < 0.001), of lower grade (p = 0.011), earlier stage (p < 0.001) and has more mucinous histology than patients in the radical surgery group. There were no statistically significant differences between both groups regarding tumor recurrence or survival rates. Of 25 patients underwent fertility preservation surgery, 18/25 (72%) tried to get pregnant. 15/18 (83%) pregnancies were recorded, including 13 live births, 1 miscarriage, and 1 intrauterine fetal death. CONCLUSION: Fertility sparing surgery could be adequate alternative to radical surgery for young females with stage I EOC.

Microhardness and Ultrastructure of Demineralized Gamma-Irradiated Human Enamel after Diode Laser (980 nm) and Fluoride Surface Treatment

Abstract Quality of life drastically diminished after radiotherapy due to radiation induced oral complications. Fluoride was found to be helpful in decreasing the incidence of radiation caries; however it has not led to elimination of dental caries. Thus, new techniques containing low fluoride concentration or not containing fluoride at all, as laser irradiation, have been studied to prevent the beginning or progression of caries. So the purpose of this study is to investigate the effect of laser surface treatment with or without fluoride on microhardness and ultrastructure of demineralized gamma irradiated enamel; Thirty enamel slabs were allocated into three groups (n=10): G slabs were subjected to gamma irradiation only; GL slabs were subjected to gamma irradiation followed by diode laser and GFL slabs were subjected to gamma irradiation followed by fluoride then diode laser. Slabs were then exposed to demineralizing solution for 72 hours. Examination of slabs was performed using vickers microhardness test and scanning electron microscope; The lowest microhardness was recorded in group G, while inGL and GFL groups it significantly increased. Scanning electron microscope revealed a pronounced loss of central prism core and retention of prism peripheries in group G. Confluence of prismatic and interprismatic structures in GL slabs and irregular rough surface with prismatic boundaries conservation in GFL slabs were detected. Applying laser improved the microhardness and counteracted the adverse effect of gamma radiation. Adding fluoride before laser irradiation had a marked effect on microhardness..

Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair / Cetamina como adjuvante de bupivacaína em bloqueio do nervo infraorbitário para analgesia após correção de lábio leporino

Abstract Objectives: We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra-oral infra-orbital nerve block in children undergoing cleft lip surgeries. Methods: Sixty patients were randomly allocated into two groups (n = 30), Group B received infra-orbital nerve block with 2 mL of 0.25% Bupivacaine and Group BK received 0.5 mg.kg-1 Ketamine for each side added to 1 mL of 0.5% Bupivacaine solution diluted up to 2 mL solution to 0.25% Bupivacaine concentration. Assessment parameters included; hemodynamics, recovery time, time to first oral intake, postoperative Faces Legs Activity Cry Consolability (FLACC) scores, Four-point Agitation scores, analgesic consumption and adverse effects. Results: Patients in Group BK showed lower postoperative FLACC scores during all recorded time points (p < 0.0001). Two patients in Group BK versus 12 in Group B requested for postoperative rescue analgesia (p < 0.001). There were no differences between groups in time, minutes (min), to first request for rescue analgesia. Patients in Group BK reported lower analgesic consumption (366.67 ± 45.67 vs. 240.0 ± 0.0 mg, p < 0.04). The time to first oral intake was significantly reduced in Group BK (87.67 ± 15.41 vs. 27.33 ± 8.68 min, p < 0.001). Lower postoperative Agitation scores were recorded in Group BK patients that reached a statistical significance at 45 min (0.86 ± 0.11 vs. 0.46 ± 0.16, p < 0.04) and in the first hour (h) postoperatively (1.40 ± 0.17 vs. 0.67 ± 0.14, p < 0.003). Higher parent satisfaction scores were recorded in Group BK (p < 0.04) without significant adverse effects. Conclusions: The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra-orbital nerve block in children undergoing cleft lip repair surgeries.

Resumo Objetivos: Realizamos este estudo para avaliar a segurança e eficácia da analgesia com a adição de cetamina à bupivacaína em bloqueio do nervo infraorbitário, bilateral e extraoral, em crianças submetidas à cirurgia de lábio leporino. Métodos: Foram randomicamente alocados 60 pacientes em dois grupos (n = 30): o Grupo B recebeu bloqueio do nervo infraorbitário com bupivacaína a 0,25% (2 mL) e o Grupo BC recebeu bloqueio com cetamina (0,5 mg.kg-1) em cada lado, mais a adição de 1 mL de solução de bupivacaína a 0,5% diluída até 2 mL da concentração a 0,25%. Os parâmetros de avaliação incluíram: hemodinâmica, tempo de recuperação, tempo até a primeira ingestão oral, escores da escala FLACC (que avalia a expressão facial [Face], os movimentos das pernas [Legs], a atividade [Activity], o choro [Cry] e a consolabilidade [Consolability]), escores de agitação em escala de quatro pontos, consumo de analgésicos e efeitos adversos no pós-operatório. Resultados: Os pacientes do Grupo BC apresentaram escores FLACC mais baixos em todos os momentos mensurados no pós-operatório (p < 0,0001). Dois pacientes do Grupo BC versus 12 do Grupo B solicitaram analgesia de resgate no pós-operatório (p < 0,001). Não houve diferenças entre os grupos em relação ao tempo até a primeira solicitação de analgesia de resgate. Os pacientes do Grupo BC relataram consumo menor de analgésicos (366,67 ± 45,67 vs. 240,0 ± 0,0 mg, p < 0,04). O tempo em minutos (min) até a primeira ingestão oral foi significativamente reduzido no Grupo BC (87,67 ± 15,41 vs. 27,33 ± 8,68 min, p < 0,001). Escores mais baixos de agitação no pós-operatório foram registrados para os pacientes do Grupo BC, com significância estatística no tempo de 45 min (0,86 ± 0,11 vs. 0,46 ± 0,16; p < 0,04) e na primeira hora de pós-operatório (1,40 ± 0,17 vs. 0,67 ± 0,14; p < 0,003). Índices mais altos de satisfação dos pais foram registrados no Grupo BC (p < 0,04), sem efeitos adversos significativos. Conclusões: A adição de cetamina à bupivacaína acentuou a eficácia analgésica do bloqueio do nervo infraorbitário em crianças submetidas à cirurgia de correção de lábio leporino.

Effect of acute and chronic treatment of Cyclosporin A on liver and kidney functions in rats.

Cyclosporin A is a compound widely used as an immunosuppressive drug, particularly, in case of kidney transplantation to prevent rejection of transplanted organ. This study aimed to investigate the bad side effect of acute and chronic treatment with cyclosporin A on liver and kidneys by measuring liver enzymes and kidney function tests in serum. Male rats were used as experimental model in this study. The results of this study concluded that, chronic treatment with cycloosprin A leads to increase in serum urea, creatinine, and uric acid significantly compared to control, also, ALT and Alkaline phosphatase activities in serum were increased by chronic administration of cyclosporine A for four weeks. Decrease of serum albumin and total protein were observed significantly compared to control groups.

Development of sensitive molecular markers for detecting the genotoxicity induced by two pyrethroids insecticides, Cypermethrin and permethrin, to the Meditnerranean sole, Solea senegalensis (Kaup 1858).

The effects of two pyrethroid insecticides, cypermethrin and permethrin, on juvenile Senegalese sole, Solea senegalensis, were assessed. For this purpose, LC50 at 24 h and 72 h were determined as 500 μg L-1 and 900 μg L-1, respectively. The specimens were divided into 5 experimental groups exposed to: i) ethanol vehicle in sea water (control), ii) 1/25 of cypermethrin LC50 (20 μg L-1), iii) 1/10 of cypermethrin LC50 (50 μg L-1), iv) 1/25 of permethrin LC50 (36 μg L-1) and v) 1/10 of permethrin LC50 (90 μg L-1) during 10 days. At the end of the experiment, gill and hepatic samples were obtained for studying the expression patterns of different enzyme genes related to toxicity and osmoregulation, namely glyceraldehyde-3-phosphate dehydrogenases1 and 2 (GAPDH-1 and 2), and Na+, K+-ATPase subunits α and β (NKA α and β). Both pyrethroid insecticides enhanced gill GAPDH-1, NKA-α and NKA-β expressions. However, hepatic responses were less prominent. The low dose of cypermethrin decreased GAPDH-2 expressions. Also, the lowest permethrin dose decreased GAPDH-2 expression. These results indicate that pyrethroids induce some degree of oxidative stress in Solea senegalensis specimens led to an osmotic imbalance, activating -mainly at branchial level- different antioxidant and osmoregulatory enzyme genes.

Evaluation of awareness during elective cesarean section in two models of general anesthesia

This prospective randomized comparative study conducts in Assiut women's health hospital to asses awareness during cesarean section in two models of general anesthesia ,120 pregnant women between 37-10 weeks gestational age who underwent elective cesarean section under general anesthesia were randomly allocated into two groups, propofol group [n =60] received propofol 2.5 mg/ kg for induction followed by a continuous infusion of propofol of 0.2mg/ kg/ min The sevoflurane group [n-60] received propofol 2.5 mg/ kg for induction followed by sevoflurane 1% for maintenance. All patients had rapid sequence induction using succinyl-choline and endotracheal intubation, after delivery of the fetus all patients were received, l00microg fentanyl and 0.25mg/kg atracurium. Heart rates, blood pressures and -AAI-index values during significant events of surgery and anesthesia till delivery, induction to skin incision, to delivery and Apgar scores were recorded. The patients in the propofol group had significantly lower levels of hemodynamics [heart rate and mean arterial blood pressure] and AAI index. In conclusion propofol infusion as 0.2 mg/k/min after induction of general anesthesia with blouse dose [2.5mg/ kg until the end of surgery is effective in reducing the incidence of awareness in patients undergoing cesarean section .the use of this regimen was not associated with side effect of fetal outcome or delayed recovery

Value of morrow procedure in surgery of discrete membranous subaortic stenosis

Subuortic stenosis constitutes up to 20% of all farms of left ventricular outflow had [LVOT] obstruction in children. Although the resulting significant left ventricular hypertrophy and aortic insufficiency are clear indications for surgery, controversy persists whether to remove the membrane in symptom-free patients with an isolated membrane or not. In addition to the timing of surgical repair, the surgical technique remains an area of discussion. In this study, we try to evaluate the impact of early surgical interference as well as surgical technique on the early and mid-term outcome. 44 patients with a mean age of 9.26 years [range, 2.4-28 years] underwent surgical resection for discrete membranous subaortic stenosis [DMSS]. For the purpose of the study, the patients were divided into two groups. Group I consisted of 31 patients who underwent membranectomy combined with routine transoortic myectomy. Group II consisted 13 patients to whom only excision of the subaortic membrane was done [membranectomy] without any myotomy or myectomy. Group II was done in Assuit University Hospital between 2001 and 2003. Group I was done in Paediatric cardiothoracic surgery unit [Children Hospital. Assuit University] between 2009 and 2013, in early postoperative results, the mean LVOT gradient in group I was statistically significantly lower than that of group II [p=0.000]. Aortic regurge [AR] improved in all patients of group I but progressed in five patients of group H. Mid-term follow up showed better results in group I than group II early resection of DMSS, before development of significant left ventricular hypertrophy and aortic insufficiency is advisable. Resection of the obstructing membrane together with generous myectomy of the LVOT is a safe and effective treatment in terms of more significant reduction of LVOT gradient; both early and in mid-term follow up, with lower incidence of recurrence and significant improvement of associated aortic incompetence

Mirazid in treatment of three zoonotic trematodes in Beni-Sweif and Dakhalia governorates

A total of 60 patients with schistosomiasis [40], fascialiosis [15] and heterophyiasis [5] were selected Beni-Swejf and Mansoura Districts and subjected to history taking, clinical examination, Kato thick smear, sedimentation and hatching test [for schistosomiasis cases] at the beginning of the study, 2 and 3 months after treatment with Oleo-resin of Myrrh [Mirazid] in a dose of 10mg/kg/day for 6 consecutive days an hour before breakfast. The results showed a significant improvement in symptoms with minimal negligible or no side effects. The cure rates, 2 and 3 months after treatment were 80.7% and 11.8% for schistosomiasis, 93.3% and 6.6% for fascioliasis, and 100% for heterophyiasis. The clinical picture of schistosomiasis before treatments were easy fatigability, anorexia, nausea, vomiting, epigastria pain, abdominal distention, right upper guardant pain, colicky abdominal pain, left upper andlor lower guardant pain, abdominal rumbling, dysentery, diarrhea, rectal bleeding, constipation, and alternating bowel habit. Those of fascioliasis were abdominal distention, dripping of saliva, right upper guardant, colicky abdominal pain, weight loss, easy fatigability, intermittent jaundice, anorexia, nausea, vomiting, epigastria, left upper and/or lower quadrant pain, right layer quadrant pain, loin pain, abdominal rumbling, diarrhea, constipation, and alternating bowel habit The safety and efficacy of C. molmol extract in treating heterophyiasis [100%], fascioliasis [100%] and schistosomiasis [92.5%] were documented

Oxidative stress and immune-suppression in Toxoplasma gondii positive blood donors: implications for safe blood transfusion

The sero-markers of Toxoplasma gondii and oxidative stress [OS] were determined in a group of 260 blood donors attending blood banks in Greater Cairo. Twenty-four blood donors with the highest anti-T. gondii IgG titre were tested for IgG avidity. Of whom 4 [16.6%] had low IgG avidity antibodies, documenting recent infection, 6 [25%] had borderline avidity and 14 [58.3%] showed high avidity, ruling out recent infection. The plasma level of malondialdehyde [MDA] was significantly higher and activity of glutathione peroxidase [GSH-Px] and level of tocopherol [alpha, gamma, and lambda] fractions [P < 0.001] were lower in T. gondii-seropositive than in seronegative blood donors. This significant alteration in redox status between seropositive and seronegative donors suggested a degradation of their antioxidant enzymes caused by OS induced by increased free radicals attributable to toxoplasmosis infection. T. gondii infection also had a prominent influence on the association between OS biomarkers and immune-suppression status in seropositive donors

Experimental study on respiratory cryptosprodiosis

Cryptosporidiosis has a worldwide geographical and zoological distribution. Cryptosporidium baileyi oocysts were isolated from the bursa of Fabricius [BF] of 4 weeks-old of 100 broilers. Twenty five broiler chicks of 2 day old free from cryptosporidial infection were inoculated intratracheally at a dose of 1 x 10[6] chicks. Five chicks were sacrificed at 4[th], 8[th], 12[th], 16[th], and 20[th] day postinoculation. Selected tissues from bursa of Fabricius, cloaca, colon, caeci and tracheas were taken and examined directly by scraping technique for endogenous stages. The distribution of C. baileyi in different tissues in the case of intratracheal inoculation; trachea 23 [92%] chicks infected, bursa of Fabricius 21 [84%] chicks, Cloaca 5 [16%] chicks, Colon 1 [4%] chick and the caeci showing no infection. Daily examination of the intratracheal droppings inoculation was done at the 5[th] day and lasted for 18-20 days, the patent period

Improvement of solubility and dissolution rate of indomethacin by solid dispersions in gelucire 50/13 and PEG4000

The aim of this study was to prepare and characterize solid dispersions of water insoluble non steroidal anti-inflammatory drug, indomethacin [IND], with polyethylene glycol 4000 [PEG4000] and Gelucire 50/13 [Gelu.] for enhancing the dissolution rate of the drug. The solid dispersions [SDs] were prepared by hot melting method at 1:1, 1:2 and 1:4 drug to polymer ratios. Scanning electron microscopy [SEM], X-ray powder diffractometry [XRD] and differential scanning calorimetry [DSC] were used to examine the physical state of the drug. Furthermore, the solubility and the dissolution rate of the drug in its different systems were explored. The data from the XRD showed that the drug was still detectable in its solid state in all SDs of IND-Gelu and disappeared in case of higher ratio of IND-PEG4000. DSC thermograms showed the significant change in melting peak of the IND when prepared as SDs suggesting the change in crystallinity of IND. The highest ratio of the polymer [1:4] enhanced the drug solubility about 4 folds or 3.5 folds in case of SDs of IND-PEG or IND-Gelu., respectively. An increased dissolution rate of IND at pH 1.2 and 7.4 was observed when the drug was dispersed in these carriers in form of physical mixtures [PMs] or SDs. IND released faster from the SDs than from the pure crystalline drug or the PMs. The dissolution rate of IND from its PMs or SDs increased with an increasing amount of polymer

Early development of osteoporosis in male smokers with hypoandrogenism due to fascioliasis with or without schistosomiasis added by life style

The rnultifactor outcome of hypoandrogenemia with the impact of oxidative stress induced by glucose intolerance, fascioliasis with or without schistosomiasis and cumulative smoking influence on bone remodeling and the early development of osteo-porotic manifestations were studied. The effect on vascular endothelium immune mediated mechanisms and antioxidant capacity were monitored in cases of youth aged selected male smokers involving 20 with hypoandrogenemia who were either subjected to sedentary life style, glucose intolerance fascioliasis hepatic fibrosis [FHF] [G1] or without [G2] and GI after following 6 months therapy [G3]. Monitoring of clinical picture and biochemical assessments of osteoporotic indices [osteocolcin, bone alkaline phosphatase, parathyroid hormone, urinary cyclic AMP], hypoandrogenism [dehydroepiandrosterane sulphate or DHEAS and testosterone] glycemic determinant [insulin] immuno-inflammatory response [inter-leukein-6, tumor necrosis factor a, E-selectin, ceruloplasmin] smoking index [serum cotinine], total antioxidant capacity [AOC] and lipid peroxidation [malonedialdehyde] was done before and after 6 months therapeutic program involving supplement of DHEAS, mirazid, chromium picolinate, and megavit zinc alongside smoking cessation and physical exercise daily for at least 30 minutes. Treatment with Mirazid supplied as 10 mg/kg for 6 successive days resulted in 100% cure of fascioliasis whether single or combined with schistosomiasis

Infectious diseases presenting by fever and hepatomegaly

The present study included 51 patients presenting by infectious fever and hepatomegaly. They were admitted to Abbassia and Embaba Fever Hospitals. Patients were subjected to careful history, thorough clinical examination, complete blood picture, urine and stool examination, repeated blood, urine and stool cultures during fever spikes. Slide and tube agglutination test for typhoid and brucella fevers. Mononucleosis diseases were diagnosed by Monospot test, Epstein Barr IgM and G, Cytomegalovirus IgM and G and Toxoplasmosis by indirect fluorescent test. Abdominal U.S., C.T scan and bone marrow examination whenever needed. Fifty one cases included 31[61%] bacterial cases, 12 [23%] mononucleosis cases and 8 [16%] parasitic cases. Thirty one bacterial group included 11[35%] brucella cases, 7 [23%] extrapulmonary tuberculosis, 5 [16%] urinary tract infection, 4 [13%] gram negative septicaemia and 4 [13%] deep seated abscesses. Twelve cases of mononucleosis cases included 6 [50%] infectious mononucleosis, 4 [33%] cytomegalovirus and 2 [17%] toxoplasmosis cases. Eight cases of parasitological group included 4 [50%] malaria cases, 2 [25%] fasciola cases, 1 [12.5%] amoebic liver abscess and 1 [12.5%] due to kala azar. Two [4%] cases died in our series; 1 due to gram negative septicaemia and the other due to kala azar. Cases are discussed and interpreted

Multidrug resistant typhoid fever in Egypt

Typhoid fever is a global health problem, with an estimated 20 million cases and 700.000 deaths annually. In Egypt, since the beginning of the 1980s, there has been an increase prevalence of multidrug resistance to the first line antimirobials, such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole [TMP-SMX], shifting the drug of choice for the treatment of typhoid fever to fl uoroquinolones and third generation cephalosporins. Was to detect if multidrug resistant [MDR] typhoid fever is still a problem in Egypt after two decades of its widespread. Also, we studied if resistance had appeared to quinolones and third generation cephalosporins which were widely used for treatment of typhoid fever in the last fi fteen years. In the period between March 2006 and March 2007, thirty seven patients with positive blood culture for Salmonella typhi were included in this study. They were 23 [62%] males and 14 [38%] females with age range from 3 to 45 years [mean 19 +/- 8.2 years]. Drug sensitivity tests showed that 34 [92%] of Salmonella typhi isolates were sensitive to chloramphenicol and 24 [65%] and 23 [62%] isolates were sensitive to ampicillin and TMPSMX, respectively. Only one [3%] isolate was MDR to chloramphenicol, ampicillin and TMP-SMX. All isolates were sensitive to ciprofl oxacin and ceftriaxone. Forteen [38%] patients were treated with chloramphenicol and twenty three [62%] patients were treated with ceftriaxone. All patients were cured. The mean time of defervescence for ceftriaxone and chloramphenicol was 3.7 +/- 1.2 and 5.8 +/- 1.2, respectively. Ceftriaxone was signifi cantly associated with a shorter time of defervescence compared with chloramphenicol. There is marked reduction of prevalence of MDR Salmonella typhi isolates and marked increase of susceptibility of these isolates to chloramphenicol, returning it to be one of the drugs of choice for treatment of acute typhoid fever. No drug resistance to ceftriaxone and ciprofloxacin was reported after many years of using for treatment of acute typhoid fever. Ceftriaxone was significantly associated with short time of defervescence making it the drug of choice for treatment of severe and complicated cases of typhoid fever. Due to high degree of resistance to ampicillin and TMP-SMX they should not be used as first line drugs for treatment of acute typhoid fever

Physicochemical characterization of ibuprofen / hypromellose acetate succinate solid dispersions

The main purpose of this investigation was to evaluate hypromellose acetate succinate [HPMCAS], a cellulosic enteric coating agent, as a carrier in a solid dispersion [SD] of ibuprofen [IBN]. Solid dispersions of IBN were prepared by solvent evaporation at different polymer: drug weight ratios; 1:1, 1:3, 1:5, 1:10. The drug-carrier interactions in the solid state were investigated using scanning electron microscopy [SEM], infrared spectroscopy [IR], differential scanning calorimetry [DSC], and X-ray powder diffraction analysis [XRPD]. No important and well-defined chemical interaction was found between the drug and the polymer at various ratios indicating compatibility between the drug and the polymer. The solubility of IBN was not affected by the presence of the polymer. The in vitro release study was performed in 0.1 N HCI and phosphate buffer pH 7.4. The presence of IBN in the form of solid dispersion displayed slower release than that of physical mixture or pure drug. However, the SD showed high release rate, in phosphate buffer pH 7.4, particularly with high content of drug. The kinetic of drug release from SD was influenced by the dissolution medium and polymer concentration. The results indicated that, HPMCAS could be used as an enteric carrier for ibuprofen

Arthroscopic anterior cruciate ligament reconstruction with quadruple hamstring grafts

Arthroscopic anterior cruciate ligament reconstruction with quadruple hamstring grafts was performed for 26 patients with an average age of 27.5 years [range, 19 to 42]. Eighteen patients were male [69%] and eight patients [31%] were female. Fourteen left knees [54%] and twelve right knees [46%] were injured. All the patients had unilateral ACL insufficiency without other ligamentous injuries, and no patient had a history of previous knee surgery. The medial meniscus was injured in 5 knees, and the lateral meniscus in 3 knees. Average follow-up was 20 months [range; 15-30 months]. At 12 months after surgery, two patients had ruptured their graft. These two patients were excluded from further analysis and from the final results. According to Lysholm Knee Score, twenty one patients [87.5%] had good or excellent results. Overall IKDC assessment revealed that twenty two patients [91.7%] were assessed as normal or nearly normal. A grade 0 Lachman test [A] was demonstrated in 16 patients [67%]. Six patients [25%] had grade one laxity [B] and two patients [8%] had grade two laxity [C]. A grade 0 pivot shift testing [A] was demonstrated in 18 patients [75%]. The remaining 6 patients [25%] had a grade 1 pivot shift [B]. Anterior kneeling pain was present in 3 patients [12.5%] at the most recent follow-up. Hamstring pain was felt in 4 patients [16.7%]. Three patients had pain in the lower third of the hamstring muscles and one patient had pain in the middle third

Haemophilus influenzae meningitis at the Abbassia Fever Hospital 1982 to 2001

The aim of this work was to study the prevalence, clinical presentation, outcome of patients with H. influenza meningitis and to determine the efficacy and safety of new therapeutic regimens that could be used in the treatment of the disease and test the susceptibility of the isolates to different antibiotics. During the period from January 1982 to December 2001, 472 children with H. influenza meningitis were admitted to El-Abbassia Fever Hospital, Meningitis Ward in Cairo. The study indicated that H. influenzae is the main causative organism in Egypt accompanied high morality and morbidity rates. Although there has been no increase in the number of cases over the year, a steady increase in the resistance to the traditional drugs has occurred. Thus, it was recommended to use third generation cephalosporins for treatment and Hib vaccines in children

Evaluation of slide agglutination and widal agglutination tests in the diagnosis of acute enteric fever in Cairo

This study we compared the sensitivity, specificity, positive predictive and negative predictive values of Widal tube agglutination test and slide agglutination test, which was used in many fever hospitals for diagnosis of acute typhoid fever because of its simplicity and cheapness. This study included 25 normal controls, 153 diseased control patients [non-typhoidal] and 36 acute typhoid fever patients. The sensitivity, specificity, positive and negative predictive values for Widal tube agglutination test were 91.7%, 100% and 98% and for slide agglutination test were 86%, 83%, 55.4% and 97.7%, respectively. It was concluded from this study that Widal agglutination test is a valid test for diagnosis of acute typhoid fever in Egypt and that slide agglutination test is a rough screening test for suspected typhoid diagnosis which is valuable for exclusion and not for diagnosis

Patients with migraine headache role of MR imaging of the brain

To prospectively evaluate the role of MR imaging in cases of migraine headache and determine if there are associated brain parenchymal changes and to compare the incidence of these lesions in our study compared to the previous reports concerning the type of migraine, age and sex of the patients. Thirty-two patients with clinical diagnosis of migraine headache, with an average age of 29 years, were evaluated by MR imaging. Each patient was examined in the axial plane with long TR/short and long TE images. Eighteen patients also had additional T 1-W short TR/short TE MR scans, enhancement with gadopentate dimeglumine was used in four patients. Foci of high signal intensities in the deep white matter and periventricular regions were detected on T2 W MR images in four cases and a venous angioma in only two cases. Our study demonstrated that parenchymal brain abnormalities may be found in cases of migraine headache in only 12% of the included cases, while the previously reported studies have indicated that the parenchymal brain abnormalities may be found in up to 40% of patients with migraine headache, also the white matter changes were found in complicated cases of migraine headache and as the age of the patient advances compared to the other types of migraine and those less than 40 years and these white matter changes are non specific