Choosing between the modified Ravitch and Nuss procedures for pectus excavatum: Considering the patients's perspective.

INTRODUCTION Pectus excavatum (PE) is the most common paediatric chest wall deformity. The majority of patients are treated for cosmetic purposes, with the modified Ravitch and Nuss procedures the most commonly performed. We tested the preferences of healthy individuals over their choice of procedure. METHODS The study was conducted from February to August 2014. A five-item illustrated questionnaire was administered to teenagers and young adults aged 14-26 years over their willingness to seek medical advice if they had PE, provided its cosmetic appearance was the only complaint. They were asked about their preference over the modified Ravitch and Nuss procedures, with the surgical details for both procedures explained by medical professionals, alongside illustrated outcomes. RESULTS Two hundred and two healthy individuals were interviewed. The median age was 19.5 years (14-26 years) and 141 (69.8%) were male. Sixty seven (33.2%) participants refused any intervention, while 11 (5.4%) initially wanted an intervention but refused after understanding the surgical procedures available. Of the 135 respondents who chose surgical correction, 84 (62.2%) preferred the modified Ravitch operation, while 51 (37.8%) preferred the Nuss procedure. The main reason for choosing the modified Ravitch technique was not having something metal in the chest, while most participants who chose the Nuss procedure felt that it was "cosmetically better". CONCLUSIONS Patients have preferences over the choice of procedure for PE repair that can affect the treatment decision. Paediatric and thoracic surgeons should therefore be experienced in performing both procedures.

Micronucleus assay as a biomarker for chromosome malsegregation in young mothers with Down syndrome children.

The aim of the present study is to test the susceptibility of chromosome 21 malsegregation in young mothers of Down syndrome children using combined micronucleus (MN) assay and FISH analysis. The present study included 62 Egyptian young mothers (age < 30 y) who were divided into 22 mothers of DS offspring and 40 age matched controls. All subjects were subjected to chromosomal analysis, micronucleus assay, and FISH analysis. High statistical significant difference was found between mothers of Down syndrome (MDS) and the controls in the MN percentage (P=0.034). Also there was high statistical significant difference between MDS and the controls in the percentage of positive malsegregation (P =0.0001). The specificity of combined MN% with FISH was 90%, while the sensitivity was 63.6%. Combined MN-FISH test is highly specific but moderately sensitive in assessing the risk of having children with DS in young mothers.

Formulation of an antispasmodic drug as a topical local anesthetic.

Mebeverine hydrochloride, a spasmolytic agent on GIT smooth muscles, was reported to have a local anesthetic effect. Thus, it was desired in this study to formulate mebeverine HCl into a gel that could be used locally in the treatment of different oral painful conditions. Poloxamer 407 (P-407) was used as the base for this gel. Different additives were used to enhance drug release from the preparation while others were used to enhance the residence time for the preparation. Different formulae were characterized in terms of drug release and mucoadhesion. The formula which has shown the best compromise between the aforementioned parameters was selected for clinical evaluation in comparison to Lidocaine HCl gel and rheologically examined. The best drug release enhancer was cetrimide (0.005%, w/w), while hydroxypropylcellulose (0.5%, w/w) as a mucoadhesive additive has shown the best compromise between fast drug release and mucoadhesion. The gel formula (G) has shown a better pain reduction efficiency (p=0.0078) and longer duration (p=0.0313) than Lidocaine HCl gel. Histopathological examination has shown no change in the inflammatory cells count of rat oral mucosa. Therefore, it could be concluded that (G) is very promising as a local anesthetic preparation for the treatment of different oral painful conditions.

Effect of film composition and various penetration enhancers concentrations on prazosin release from acrylic polymeric films.

An investigation was conducted to evaluate the effect of changing the Eudragit RL 100 ratio and the influence of different penetration enhancers in various concentrations on the release of prazosin from Carboset 525:Eudragit RL 100 polymeric films using improved Franz diffusion cells, to choose the most suitable polymeric film ratio, the most appropriate enhancer and its optimum concentration to be used to achieve the maximum release of the drug. The results show that prazosin release from polymeric films containing Carboset 525:Eudragit RL 100 in a 1:1 ratio was significantly (p < 0.05) higher than from films in a 1:0.25 ratio and non-significantly (p > 0.05) higher than from those containing 1:0.5, 1:3 polymer ratios and non-significantly lower from those containing 1:4 polymer ratios. The addition of various enhancers, n-decyl alcohol (7, 9 and 11% w/w), Azone (4, 6 and 8% w/w) and Cineole (7, 9, 11 and 14% w/w) significantly (p < 0.05) enhanced the prazosin release from these polymeric films containing the two polymers in a 1:1 ratio. The best concentrations of these enhancers were 11% n-decyl alcohol, 9% Cineole and 8% Azone. The formulations containing these concentrations of the enhancers are being further studied for drug release through rabbits skin. It was found that using either of these enhancers in these concentrations resulted in a significant (p < 0.05) increase in the amount of prazosin transported across the skin. On the other hand these enhancers did not show any significant (p > 0.05) difference between them. The mechanism of drug release from the polymeric films was further studied using water vapor permeability (W.V.P.), the permeability constant (P) and differential scanning calorimetry. The enhancers were found to increase the W.V.P. and the permeability constant (P) and the results were in very good agreement with the effect of enhancers on the in-vitro drug release. The DSC thermograms showed that the enhancers physically interacted with either or both of the polymeric film materials and prazosin which could be one of the reasons for the improvement in the release of the drug from these polymeric films.

A high hepatitis E virus (HEV) seroprevalence among unpaid blood donors and haemodialysis patients in Egypt.

BACKGROUND/AIMS: The aim of this study was to determine the frequency of hepatitis E virus (HEV) infection among unpaid blood donors and haemodialysis patients in Egypt and to find out any possible relationship between HEV and HCV. METHODS: Serum samples collected from 95 unpaid blood donors and 96 haemodialysis patients were screened for HEV and HCV antibodies by enzyme immunoassay techniques. RESULTS: The prevalence of anti-HEV IgG was 45.2% (43/95) in blood donors and 39.6% (38/96) in haemodialysis patients. Anti-HEV IgG was found in 69.2% (18/26) and 28.6% (20/70) in haemodialysis patients positive and negative for HCV, respectively. CONCLUSION: This study emphasizes that HEV is endemic in Egypt and tends to accumulate in certain groups showing evidence of hepatitis C virus infection as in haemodialysis patients suggesting either shared parenteral risk or increased sensitivity to HEV coinfection; that is to say a possibility of combined route of transmission for HEV.

Reaction of isatin with thiocarbohydrazide: a correction.

Heterocycles containing the indole ring system include some novel pharmacologically active compounds. Isatin and its N-acetylisatin are extremely versatile intermediates in the construction of a variety of heterocyclic systems when reacted with thiosemicarbazide derivatives. Literature survey revealed various interesting reactions of thiocarbohydrazide with cyclic ketones, cyclic 1,2-diketones and isatin.

Crystallographic study of rhinoliths.

Five nasal stones were extracted from five patients. The etiology and clinical picture have been discussed. The stones were analysed by a crystallographic method, using an X-ray diffraction technique. Their composition was identified as calcium phosphate.

Effect of fluorophenylalanine on bacteriophage MS2 replication.

A concentration of 10 mug of fluorophenylalanine per ml added to a chemically defined medium reduced by 100-fold the number of bacteriophage MS2 produced on Escherichia coli C3000 and increased the latent period. Fluorophenylalanine was most effective when added concurrent with infection. Addition of a 10-fold greater concentration of phenylalanine reversed the inhibition caused by fluorophenylalanine. Radioactive fluorophenylalanine was incorporated into the coat protein. The four phenylalanine-containing chymotryptic peptides are not equally accessible to fluorophenylalanine. Only two of the peptides are highly labeled by fluorophenylalanine. Incorporation of fluorophenylalanine decreased the specific infectivity and the rate of adsorption but did not increase the sensitivity of the whole virus to ribonuclease. MS2 ribonucleic acid (RNA) functioned as messenger RNA for the incorporation of both phenylalanine and fluorophenylalanine in a cell-free incorporating system from E. coli.