Physicomechanical properties and release characteristics of ketorolac trometh-amine from chitosan films: effect of inclusion of different polyols plasticizers

The film-forming ability of chitosan polymer loaded with ketorolac tromethamine [KT] was evaluated. Films were prepared by a casting/solvent evaporation technique from plasticizer - free and plasticizer containing aqueous solutions. Glycerol, sorbitol, and 1-erythritol were used as plasticizers. Solid state of the films was studied by powder X-ray diffractometry [PXRD], and differential scanning calorimetry [DSC]. The plasticizing efficiency was evaluated by measuring the physicomechanical properties as modulus of elasticity, tensile strength, percent of elongation and swelling ratio. The medicated films - plasticized or free - were clear and colorless. A plasticizer concentration of 20% [w/w of polymer weight] was sufficient to obtain flexible films with all tested samples. X-ray diffration patterns and DSC thermograms indicated an amorphous state of the films independent on the type of the plasticizer used. The results have showed that, incorporation of different polyols as plasticizer s improves the consistency and the physicomechanical properties of the films. The plasticizers effect was dependant on the hydrophilicity and chemical structure of both plasticizer and polymer. The release profile of the drug was also significantly increased by addition of polyols as plasticizers. Moreover, the drug release pattern was found to follow Higuchi-diffusion model

Prostaglandin E [2] level in patients with liver cirrhosis with and without hepatorenal syndrome

Eighty subjects were selected for this study, 65 of them were patients of liver cirrhosis [43 males and 22 females] and 15 of them were normal individuals as a control group [11 males and 4 females]. All the 80 subjects were subjected to full clinical assessment, biochemical liver profile, kidney profile, abdominal ultrasonography and estimation of plasma prostaglandin E2 [PGE2]. It was found that PGE2 was significantly increased in cirrhotic patients and this increase was more in ascitic than non-ascitic patients and more in Child C patients than in other Child classes, but there is evident marked significant drop in PGE2 level with the development of hepatorenal syndrome [HRS]. It was concluded that the increase of the vasodilator PGE2 in cirrhotic patients is a protective factor against the catastrophic effect of increased vasoconstrictor mediators characteristic of liver cirrhosis and the drop of PGE2 could be a causative factor in pathogenesis of HRS as it drops leaving the kidney under the vigorous effect of vasoconstrictors. The study postulated a new formula which might be more sensitive for the prediction of HRS

multivariate analysis of prognostic factors in patients with acute lymphoblastic leukemia

In this study, 31 patients with newly diagnosed acute lymphoblastic leukemia [ALL] were included. Their clinical and laboratory data were analyzed in order to determine the possible correlation between clinical presentation, morphologic subclasses, cytochemical reactions, immunological phenotypes and cytogenetic findings. The correlation between each of the previous parameters and the response to therapy was also examined. It was concluded that the extension of the classification of acute lymphoblastic leukemia to include clinical, morphological, immunophenotypic and cytogenetic analysis assisted in better prognostic outlook

Experience with the management of mesenteric aneurysms

Mesenteric artery aneurysms represent a rare but very interesting clinical entity. Despite their rarity they comprise a challenging vascular problem as regards diagnosis and treatment. We have managed six mesenteric anuerysms, four involving the SMA and the other two involving the IMA. There were five males and one female patient. The presentation included acute abdominal pain in four cases, haematemesis in one case and abdominal mass in the remaining aneurysm. Surgical treatment was carried out in all six including ligation of the two IMA aneurysms, as well as two SMA aneurysms. Reconstruction was performed in the remaining two SMA aneurysms. Surprisingly, no complications [apart from ARDS in one patient] were recorded in all six cases

effect of population density food level and competition on growth and metamorphosis in larval Egyptian toad, bufo regularize

Growth and metamorphosis of Bufo regularis tadpoles under two levels of population density, two levels of food and with or without competitors [the green toad, Bufo viridis] were investigated using a replicated pond system. High food supplements accelerated growth with or without competitors. The presence of competitors depressed growth, even under conditions of high food. Also, the larvae grew much better under conditions of low population density than high one in either high or low food levels with or without competitors. The tadpoles raised under high food metamorphosed earlier than those raised under low one. Survival was variable within treatments, and also was highest in high food levels. Field observations as well as laboratory treatments with competitors revealed that B. viridis commenced metamorphosis and left water before B.regularis

Treatment results of radical radiation therapy for early glottic carcinoma

To evaluate the effect of host; tumour and treatment-related parameters that might influence the local control; of early squamous cell carcinoma of the glottis treated with radiotherapy. Seventy patients with T1-T2 NOMO squamous cell carcinoma of the glottic larynx were retrospectively analyzed with a minimum 2-years follow-up. All patients were treated daily with telecobalt unit at 2 GY per fraction to doses of 60-70 GY [median 64]. The following factors were analyzed through uni and multivariate analysis; age: sex; smoking: histologic type and grade; T-extent; anterior commissure invovement: field size: total dose given: overall treatment time and salvagve therapy. The initial treatment response [CR] were 97.8% and 76% while the 5-year local control rates were 82.2% and 56% for T1 and T2 lesions, respectively. On univariate analysis, the recieved total dose was a significant factor for both initial response and local control. Initial response and local control for T1 lesions were 100% and 90%, if total dose given > 60 GY. The corresponding values for T2 lesions were 79% and 63% [P< 0.0001;< 0.001 for T1 and > 0.05 for T2]. Better response and control rates were seen among T1 and T2 patients completed their therapy within

Pollution of ground water by mercury and its residues in chicken tissues

The aim of this study was to investigate the relationship between mercury concentration in well water and its residues in chicken tissues in particular areas of Abees, Alexandria Governorate. The concentration of mercury in ground water, beside in liver, kidney, muscle tissues and blood samples of 12 chickens from four poultry production farms was estimated using atomic absorption spectrophotometer. The highest mercury concentration levels were observed in the kidney followed by the liver in detectable levels samples. The level of mercury in ground water was undetectable of 81 micro g/L. There is no doubt that the relationship of mercury accumulation levels in kidney and those in liver tissues were proportionally correlated. The rate of mercury accumulation is independent of the intake level and the toxic level could be reached eventually, even at a very low intake level. It is evident therefore that even very small concentration of mercury in environment may cause health risks affect exposures

Infection in the ischemic diabetic foot: optimum management

46 diabetic patients with lower limb ischemia and superadded foot infection [group 1] were managed by an aggressive approach of revascularization and foot debridement. They were compared with two groups of patients: An equally matched group of diabetic patients with limb threatening ischemia and without foot infection [group 2] and an equally matched group of non-diabetic patients with limb threatening ischemia [group 3]. There was no significant difference in the limb salvage rates among the 3 groups: Group 1 [65.6%], group 2 [63.8%] and group 3 [70.1%] at 2 years. Moreover, foot infection in the diabetics was not accompanied by a higher incidence of wound infection at the sites of vessel exposure. This justified the aggressive approach though the hospital stay was longer [average 46.6 days] than if they had done a primary amputation

Effect of environmental pollution by some pesticides on the mortality rate and behaviour of the Nile bolti, tilapia nilotica

Adult Tilapia nilotica were exposed to water containing different concentrations of three types of insecticides pollutants including methomyl, cypermethrin and malathion. These pollutants are currently used and contaminate the Egyptian waterways. Survival and behaviour were the responses used for measuring the toxic effects. The data indicate that the mortality rate increased with the increase of toxic dose and exposure time and therefore, the survival percentage decreased with the increase of insecticide concentration. The order of toxicity of the three used pesticides is arranged in a descending manner as methomyl, cypermethrin and malathion repectively. From the TLm measurements, the 24 h. LC[50] in Tilapia nilotica was 0.16, 0.58 and 0.80 mg.l[-1] for methomy1, cypermethrin and malathion respectively. The behaviour pattern of the toxicant fishes was found to be in the form of hyperexcitation followed by a state of unbalance and a reduction in activity till death occurred

Axillopoliteal and aortopopliteal bypass two case reports

Two cases of aortopopliteal and axillopopliteal bypass grafts done for limb salvage are reported. These extra anatomical bypass grafts are valuable in patients who cannot otherwise undergo anatomical bypass grafts

Acute non-traumatic thrombotic ischemia: diagnosis and strategy of management

This study includes 118 patients [131 limbs] with acute non traumatic thrombotic ischaemia of the lower extremities, constituting 41.6 percent of the total number of cases of acute ischaemia admitted during the same period of the study. The two major causes of acute thrombotic ischaemia were atherosclerosis [58.5 percent] and arteritis [39 percent] Distinction from acute embolic ischaemia was achieved on clinical grounds as well as by arteriography [only in non threatened limbs]. The plan of management of viable limbs was initial heparinisation followed by urgent exploration [of the first impalpable pulse] of threatened limbs [31.4 percent], without prior arteriography. The management of non threatened limbs was arteriography followed by surgery, in the majority of cases [71.4 percent], thrombolysis [14.3 percent], or continuation of conservative treatment [14.3 percent]. The overall results are satisfactory with a limb salvage rate of 54.6 percent, amputation rate of 29.4 percent and mortality rate of 15.9 percent

Alpha-2B-interferon in head and neck cancer

Alpha-2b-interferon had demonstrated a different activity in advanced refractory of relapsing solid tumors and in particular tumors of head and neck. Because of the reported synergism between interferon and different treatment modalities [including cytotoxic agents], a trial of 31 patients with advanced head and neck cancer was conducted utilizing alpha-2b-interferon [interon A]. Interon A was given as a single [in 7 patients] or in combination with other treatment modalities [in 24 patients]. Administration of interon A was either perilesionally [in 17 patients] or intravenously [in 14 patients] in a dose of one million IU. daily for a planned minimum 4 weeks, then 3 times weekly for 3 weeks. The overall remission [partial and complete] was seen in 13/24 [54%] of patients in the combined treatment group and in 2/7 [28.6%] of patients treated with interferon alone. Response duration was 7 and 44 months, respectively. The most common side effects were flu-like symptoms; fatigue and pyrexia which could be ameliorated by acetaminophen. Statistically, there was no significant difference observed between patients treated by interferon alone or in combination with other treatment modalities, as regard response rate; duration of response or effect of prior therapy, yet, considering the high risk characteristics of this group of patients [61% relapse or refractory after prior therapy, and 39% had advanced disease], in addition to the small-sized sample of this group; these preliminary results suggest that interferon may have an active role in treatment of head and neck cancer patients with an acceptable degree of toxicity

Venous injuries

The experience met with in the management of 76 cases of venous injuries [both major abdominal and extremity veins] is presented in this study. The majority of cases [52.6%] were diagnosed secondary to the associated arterial injury. 25% percent were diagnosed by the presence of excessive bleeding and nonpulsating hematoma [17.1%]. Repair of the injured veins was done in the majority of cases [89.4%] mostly by lateral suture or autogenous vein patch [46.6%]. Ligature or nonoperative management was done in 10.6% in special situations. The overall incidence of complications was low, mild oedema [[9.2%], major morbidity [11.8%] and mortality [2.6%] and occurred mainly in patients who had their veins ligated

Upper extremity ischemia [acute and chronic]

88 patients with upper extremity ischemia [acute and chronic] were the subject of this work. They included 3 groups: - Acute embolic ischemia [59.1%]. - Arterial non embolic occlusive disease [27.3%]. - Thoracic outlet syndrome [13.6%]. Embolic cases were easily diagnosed, due to the presence of the cardiac cause, and were managed by catheter embolectomy. Arterial occlusive lesions were more commonly due to arteritis [54.2%] than atherosclerosis [45.8%]. For central lesion [innominate and subclavian arteries] extra-thoracic procedure as axillo-axillary and carotid subclavian by passe were prefered over the direct intra-thoracic procedures. Axillobrachial occlusions were manged by saphenous vein by passes. 4 cases were managed conservatively they had very mild ischemic symptoms. Compression of the subclavian artery at the thoracic outlet was managed via the supraclavicular approach, by excision of the stenosed segment and the post stenotic dilatation and prosthetic graft replacement. The results of management was satisfactory

Acute mesenteric ischemia

A retrospective study of 38 cases with mesenteric ischemia is presented. It included 12 cases [31.6%] with embolism, 9 cases 23.7% with arterial thrombosis, 3 cases [7.9%] with non occlusive infarction and 14 cases [36.8%] with venous occlusion. Preoperatively the main problem was delay in diagnosis as the classic clinical picture was present in only 52.6% of cases. The plan of treatment was to revascularize the intestine, whenever possible in mesenteric arterial occlusion by embolectomy or bypass graft and, to resect frankly gangrenous bowel with primary anatomosis. A second look was done after revascularization of long bowel segments especially when bowel of questionable viability was left behind and in selected cases of mesenteric venous occlusion. The overall mortality was 47.4%, highest in nonocclusive mesenteric ischemia and lowest in mesenteric venons occlusion

value of booster dose for local residual primary lesion of nasopharyngeal carcinoma

Twenty two patients with nasopharyngeal carcinoma with a documented residual lesion in the nasopharynx at 66 GY [clinically and/or pathologically] were studied. Booster dose 10-14 Gy was given in 14 patients while 8 patients did not receive the boost. The value of booster dose was reflected favourably upon the overall response rate and its duration and on the disease free survival rates. Among 14 patients received the boost, 3 have partial remission for a median 18 months and 11 patients have complete remission for a median 30 months. For the 8 patients left unboosted only one patients maintained a complete remission for 30 months; 3 patients have partial remission for a median 15 months and 4 patients with stationary disease for 12 months. The total local recurrence, rates of both groups of patients were 21.4% [3/14] and 87.5% [7/8], respectively. Local recurrence was relatively high among patients with primary well to moderately differentiated epitheliomas than poorly to un-differentiated ones, even in boosted patients. The disease-free survival rate for the whole study group was 50% at 36 months with a median follow-up period and overall survival of 27 and 14.5 months for the patients with and without primary boosting, respectively. Disease free-survival rate was significantly higher for the boosted than non-boosted patients [80% and 13% at 20 months, respectively], and with 73% disease free-survival at 36 months for the boosted patients. From this-study, we believe that booster dose for residual lesion in the nasopharynx [better pathologically proved] is necessary to improve the local control and the disease-free survival of patients

role of doppler ultrasound in the management of chronic venous insufficiency of the lower limb

The role of the Doppler flow meter in the management of chronic venous insufficiency was assessed by comparing its results with those of venography. The two main parameters were the detection of venous incompetence and obstruction. The sensitivity of the Doppler to detect patency of the deep system was 100% for the femoral vein. 95.5% for the popliteal vein and 77.79%.for the posterior tibial vein. The sensitivity to detect incompetence of the saphanofemoral junction and the below knee perforators were 75% and 94.1% respectively. By identification of obstruction and incompetence of the deep system, with a high degree of accuracy it aided in the differentation between primary and secondary varicose veins.This is important since the management of both conditions are different