Pregnancy-Related Anxiety and Impact of Social Media Among Pregnant Women Attending Primary Health Care.

Background Pregnant women go through physiological as well as psychological changes during pregnancy. Antenatal anxiety disorders are common, with proven adverse maternal and fetal outcomes. Anxiety increases the risks for prematurity and neurodevelopmental disorders. This study aimed to estimate the prevalence of pregnancy-related anxiety and the impact of social media among pregnant women in Al-Ahsa, Saudi Arabia. Materials and methods This observational cross-sectional study included pregnant women who were attending antenatal care (ANC) in primary healthcare centers between May and October of 2021 in Al-Ahsa, Saudi Arabia. For data collection, a structured self-administered questionnaire was distributed randomly to eligible pregnant women. The presence of pregnancy-related anxiety was assessed by using the 10-item Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), Arabic version. The impact of social media was measured through Social Media Engagement Questionnaire (SMEQ). Results Out of 823 pregnant women, 382 were eligible. Their mean age was 26.1 ± 10.9 years. Most of them (70.4%) had adhered to ANC. However, 32.1% had a history of miscarriage, and 6.7% had previous birth with congenital anomalies. The mean scores of pregnancy-related anxiety domains were 10.6 out of 15 for fear of giving birth, 8.7 for concern of own appearance, and 6.4 out of 12 for worries about bearing a handicapped child. More than half of the participants scored 28 out of 50 for pregnancy-related anxiety. The factors that were significantly associated with pregnancy-related anxiety were healthcare workers, first trimester, and unplanned pregnancy (P < 0.05). Social media engagement showed no correlation with anxiety. Conclusions The pregnancy-related anxiety level was average among pregnant women in Al-Ahsa, and fear of giving birth was the most common reason. Its predictors included early pregnancy, being a healthcare provider, and unplanned pregnancy. Pregnancy-related anxiety should be diagnosed early during routine ANC for better maternal and fetal outcomes.

Three-Territory DWI Acute Infarcts: Diagnostic Value in Cancer-Associated Hypercoagulation Stroke (Trousseau Syndrome).

BACKGROUND AND PURPOSE: DWI infarcts involving the bilateral anterior and posterior circulation suggest an embolic etiology. In the absence of an identifiable embolic source, we analyzed DWI lesions involving these 3 cerebral territories to determine the diagnostic value for ischemic infarction caused by cancer-associated hypercoagulation. MATERIALS AND METHODS: A retrospective analysis of all brain MR imaging studies at our institution from July 2014 to June 2015 was conducted, yielding 4075 studies. Of those, 17% (n = 709) contained the terms "restricted-diffusion" plus either "numerous," "innumerable," "multiple," or "bilateral." Of these 709 reports, 6% (n = 41) of DWI lesions involving 3 or more vascular territories of the bilateral anterior and posterior circulation were analyzed. RESULTS: Of the 41 patients, 19 separate etiologies were identified, the most frequent being malignancy-related infarctions (22% [n = 9]) and hypoxic-ischemic injury (12% [n = 5]). Only 2 patients had an indeterminate etiology. The most frequent etiology of infarctions not suspected clinically or radiographically was malignancy (P < .001). Infarctions of malignancy had a characteristic appearance, being nonenhancing, nonring-appearing clusters or single areas of restricted diffusion of 0.5-2 cm with a peripheral location or larger vascular territories, uncommonly in a watershed distribution, and with absence of diffuse cortical ribbon or deep gray nuclei involvement. CONCLUSIONS: Approximately 1 in 5 ischemic infarcts in patients with DWI lesions involving 3 vessel territories are malignancy related. In the absence of an identifiable embolic source, ischemic infarction with cancer-associated hypercoagulation accounts for 75% of cases. Cancer-associated hypercoagulation infarction should be considered, particularly when no other cause is apparent.

Formulation and bioavailability of controlled release salbutamol sulphate tablets using natural additives.

Salbutamol sulphate granules and physical mixtures were prepared using mastic with various natural additives. The prepared granules and physical mixtures were examined using IR and DSC. The obtained results indicate that there is no interaction between salbutamol sulphate and the formulation ingredients used. The physical properties and release behavior of the formulated tablets prepared from granules and physical mixtures were evaluated and showed good physical properties. The rate of drug release from tablets prepared from granules was found to be lower than that prepared from physical mixtures at fixed mastic concentration and the same additive. The rate of drug release decreased with increased mastic concentration in formulated tablets. Pectin and sodium alginate allowed the best controlled release rate of the drug. On the basis of the results obtained from the controlled release studies, selected sulbutamol formulations were subjected to an in vivo comparison with commercial sulbutamol tablets. The pharmacokinetic parameters AUC(0-24), C(max), and T(max) of sulbutamol from the selected formulation were determined after administration of a single oral dose of 8 mg and compared statistically using an ANOVA test. There was no significant difference in the AUC(0-24). On the other hand, there was a significant difference in the C(max) and T(max) between the commercial and the formulated tablets. These results demonstrate that the formulated tablets extended the time of the drug effect.

Stability, bioavailability, and ulcerative activity of diclofenac sodium-mastic controlled release tablets.

Controlled release tablets containing 50 mg diclofenac sodium (DS) and 40% mastic with other natural additives were prepared. Drug release was examined and stability was studied using non-isothermal and isothermal thermogravimetric analysis (TGA). The bioavailability of two controlled release tablet formulations was studied and compared to that of commercial tablets, and rabbit stomachs were also histologically examined 24 h after administration of the various tablets. Additives of pectin and sodium alginate indicated the controlled release profile of the drug. Non-isothermal TG revealed two stages of thermal decomposition for all formulations. Isothermal TG revealed that degradation of the drug in the tablet formulations follows first-order kinetics. The obtained degradation rate constants at various temperatures were plotted according to the Arrhenius equation. The degradation rate constant at 25°C was determined and used in estimation of shelf life. The obtained shelf lives of all formulations ranged from 3.38-4.92 years. In comparative studies with commercial tablets, the bioavailability of the drug from the two formulated tablets had no statistically significant difference in terms of the AUC and produced prolonged blood levels of DS with a delayed peak. The two controlled release tablet formulations resulted in no histological alterations in the stomach in terms of mucous surface cells and glands; in comparison, commercial tablets resulted in a disrupted mucous layer, necrotic ulcerations, hemorrhaging, and inflammatory cell infiltration along the base of the gastric glands.

[Facial palsy and central nervous system infection with varicella virus following adult chickenpox]. / Paralysie faciale et infection du système nerveux par le virus VZV après une varicelle de l'adulte.

INTRODUCTION: VZV virus-related peripheral neuropathies usually occur after shingles in adults and more rarely after chickenpox in childhood. CASE REPORT: A 54-year-old patient presented with a right VIIth nerve palsy following a chickenpox rash and recovered after antiviral treatment. CSF analysis revealed lymphocytic meningitis and the virus was identified by PCR. CONCLUSIONS: Although previous chickenpox was not found in the patient's past history, the probability of reinfection is likely. The virus can be assumed to affect the nervous system directly; the axonal or demyelinating mechanism of the neuropathy may be discussed.

Endoscopic control of gastric variceal bleeding with butyl cyanoacrylate in patients with schistosomiasis.

This trial represents the Egyptian experience in cyanoacrylate injection for hemostasis of bleeding gastric varices. One hundred patients with portal hypertension due to schistosomal hepatic fibrosis and/or posthepatitic liver cirrhosis were included. All patients presented with bleeding from gastric varices either fundal (80 patients) or inferior extension of esophageal varices (20 patients) were enrolled. Injection therapy was administered as the first active measure. No tamponade or drugs were used. Cyanoacrylate was mixed with lipid and injected through a hand-made probe. A mean of 3 (range 1-9) ampoules of cyanoacrylate were used per injection session. Bleeding stopped at the end of all sessions. Ten patients (12.5%) with fundal varices had rebleeding during the first 24 hours. Reinjection could control bleeding in 6 patients with a total success rate of 95%. Four patients were managed surgically. Fatal pulmonary embolism developed in one patient (1.25%) with fundal varix. Five more patients (6.25%) died from bleeding-related liver failure. In conclusion, injection of cyanoacrylate is highly satisfactory in controlling bleeding from both types of gastric varices.

Alpha feto-protein and albumin in ascitic fluid in hepatocellular carcinoma patients.

Alpha-feto-protein (AFP) is the most popular tumor marker for hepatocellular carcinoma (HCC). It is used in diagnosis and follow up of cases by estimating its rise in the serum. The aim of this work is to study the value of estimating AFP in ascitic fluid of HCC patients with ascites. This work is a case control study on 32 patients, including 22 cases with ascites and HCC and 10 control group with ascites due to liver cirrhosis without HCC. The level of AFP was estimated in serum and in ascitic fluid by Radio-immuno assay RIA. The serum ascites albumin gradient (SAAG) was assessed by measuring albumin in all samples using bromocresole green dye binding. Guided aspiration liver biopsy and ascitic fluid cytology was done, stained with H & E. It was found that, AFP level in serum was elevated in 72.7% of HCC patients, and in ascitic fluid was elevated 63.6% HCC patients. Also, there was a highly significant, direct positive correlation between elevation of AFP in serum and in ascitic fluid (r = 0.778). No elevation of AFP in serum and in ascitic fluid was detected in control group. Ascitic fluid cytology showed malignant cells in one case only. SAAG was significantly lower in the HCC group 0.83 gm/dl than the control group 2.43 gm/dl (p-value < 0.001). Elevation of AFP in ascitic fluid is of high importance in evaluation of HCC, and is as significant as serum and runs parallel to it. Estimation of AFP in ascitic fluid is much more significant in evaluation of HCC cases than ascitic fluid cytology.

The effect of microcapsule size on the oxidative decomposition of core material.

The factors that affect the size of microcapsules and the oxidation of their benzaldehyde core have been examined. The pH of the preparation changed the overall size of the microcapsules which reached a maximum diameter at pH 4.1. The size of the core droplets also varied with the preparative pH and their oxidation rate depended on the bulk droplet size rather than their surface area. A rapid oxidation of benzaldehyde associated with the microcapsule wall resulted in a preliminary peak in the oxidation curve. Explanations for these phenomena are discussed.