Abundance and Annual Distribution of Freshwater Snails and Some Trematode Cercariae at Damietta Governorate, Egypt.

In addition to being a good food source, freshwater snails are considered one of the positively and negatively influencing invertebrates on the environment. Several biotic and abiotic factors are thought to affect the distribution and the dynamics of these snails. Freshwater snails are the most dominant and conspicuous individuals of the freshwater biota in Damietta Governorate. In this study, freshwater snails were collected monthly from 5 geographically and environmentally different sites at Damietta Governorate at the north of Egypt during June 2017-May 2018. Seven snail species; Lanistes carinatus, Lanistes varicus, Pila wernei, Segmentorbis angustus, Melanoides tuberculata, Biomphalaria alexandrina, and Gabbiella senoriansis, were identified. Lanistes carinatus was the most abundant species (56.4%) in the collection sites. Besides, Al-Inaniyyah village had the highest snail species abundance and variety. The abundance of the most recorded species varied seasonally; the highest abundance was recorded during summer while the lowest was during winter. The abundance of some snail species correlated positively or negatively with some physico-chemical parameters; water temperature, dissolved oxygen, conductivity, total dissolved salts, and electrical conductivity. Two types of trematode cercariae; gymnocephalus cercariae and xiphidiocercariae, were harvested from Lanistes carinatus. The highest prevalence of both cercarial types was detected during summer. The correlation between the prevalence of both cercarial types and the physico-chemical parameters were determined. Xiphidiocercariae were the most predominant cercarial type in Damietta Governorate. Our findings suggest that the invasion of some freshwater snails is likely to be the cause of the low prevalence or complete absence of some medically important intermediate snail hosts. We recommend further characterization of the distribution of freshwater snails and the interrelationships among them in Egypt, and suggest a controlled use of selected snail species to combat their medically important analogues.

Rapid pain relief using transdermal film forming polymeric solution of ketorolac.

CONTEXT: Ketorolac is one of the most potent nonsteroidal anti-inflammatory drugs and is an attractive alternative to opioids for pain management. OBJECTIVE: Development and evaluation of transdermal ketorolac film forming polymeric solution. MATERIALS AND METHODS: Eudragits(®) RLPO, RSPO and E100 as well as polyvinyl pyrrolidone K30 dissolved in ethanol were used as film forming solutions. In vitro experiments were conducted to optimize formulation parameters. Different permeation enhancers were monitored for potentiality of enhancing drug permeation across excised pigskin. RESULTS: The use of 10% oleic acid, Lauroglycol(®) 90 or Azone(®) with 5% Eudragit(®) RSPO, showed the highest enhancement effect on ketorolac skin permeation and showed faster analgesic effect compared to the ketorolac tablet. The formula comprising 5% Eudragit(®) RSPO and 10% Lauroglycol(®) 90 showed the greatest pharmacodynamic effect and thus was subjected to pharmacokinetic studies. The pharmacodynamic and pharmacokinetic results didn't run paralleled to each other, as the ketorolac tablets showed higher plasma concentrations compared to the selected ketorolac transdermal formulation. This might be due to the induction of analgesia by the available ethanol in the transdermal preparation. CONCLUSION: Optimized transdermal ketorolac formulation showed marked ability to ensure fast and augmented analgesic effect that is an essential request in pain management.

Statistical analysis of the factors influencing the recurrence of urinary bladder cancer after radical cystectomy

Objective To evaluate the risk factors influencing the recurrence of urinary bladder cancer; and to predict the probability of recurrence within two years after radical cystectomy. Patients and Methods Between 1986 and 1994; 857 patients were admitted at the Urology and Nephrology Center of Mansoura University; Egypt; for treatment of bladder malignancy by radical cystectomy. The number of male patients was 682 (80) versus 175 females (20) with a mean age of 49 years (range 18 - 90 years). The median follow-up period was 38 months (range 0.03-138 months). Histopathology revealed squamous carcinoma in 440 patients (51); transitional carcinoma in 223 patients (26); adenocarcinoma in 94 patients (11) and mixed (two or more) types in 100 patients (11.7). Most of the patients presented with advanced-stage disease (defined as P3 or P4): 611 patients (71) had stage P3; 68 patients (6) stage P4. Bilharzial ova were seen in 80of the specimens; while regional lymph nodes were involved in 16of the cases. Results Cancer-related mortality was encountered in 199 patients (23.2) and mortality from unknown causes in 54 patients (6.3). Fifty-five patients (6.3) were alive with recurrence. Univariate and multivariate analysis of the survival rates showed that lymph node involvement (P = 0.0000); tumor grade (P = 0.0017); pathological stage (P = 0.0008); sex (P = 0.0005); urinary diversion (P=0.0080) and histopathology (P=0.0253) significantly influenced the recurrence-free survival after radical cystectomy. The 5-year survival rate was 61.7; and the 5-year hazard rate was 48.3. Using the logistic regression model for estimating and predicting the probability of recurrence within two years after radical cystectomy; we found that only one variable (lymph node involvement) had a significant effect on the prediction of the probability of recurrence. Conclusion These findings suggest that positive lymph nodes; tumor grade; stage; sex; urinary diversion and histopathology of tumor cells are independent predictors of survival in patients with bladder cancer. Positive lymph nodes are the most important indicators for recurrence in general and especially for predicting the probability of recurrence within two years after radical cystectomy