Sirolimus Ointment for Facial Angiofibromas in Individuals with Tuberous Sclerosis Complex.

BACKGROUND: Facial angiofibromas affect most patients with tuberous sclerosis complex. They tend to progress, can cause recurrent bleeding and facial disfigurement, and have significant psychological effects. We reviewed the effectiveness and safety of topical sirolimus ointment 0.1%. We also assessed the effect of treatment on quality of life. METHODS: We report our experience in using sirolimus ointment in 14 patients with TSC (9 children and 5 adults). The impact of sirolimus ointment was monitored with digital photography, dermatological review using a validated Facial Angiofibroma Severity Index (FASI), and quality of life assessments using the questionnaires PedsQL for children and SF36 for adults. RESULTS: The FASI scores were improved in 12/14 cases after six months' treatment, and improvement was more likely in children (median FASI scores of improvement after treatment were 3 points for children and 1 for adults). Proxy-reported PedsQL scores for the total psychosocial domain improved significantly in the children in the cohort with treatment. CONCLUSIONS: Sirolimus ointment 0.1% administered once a day was effective in treating facial angiofibromas. It appears to be safe and well tolerated and to have a positive impact on patients' quality of life. It appeared to be most beneficial when started in childhood

Validating and assessing the reaction of medical students toward team-based learning

The aim of this study was to evaluate the psychometric properties of tools �Team-Based Learning Student Assessment Tool�, Classroom Engagement Survey (CES) and to assess the reaction of learners toward TBL sessions at Tehran University of Medical Sciences. This descriptive study was done in 2013. The first step was to assess the reliability and validity of the tools. TBL-SAI questionnaire include 39 items, and CES consists 8 items. The validity was assessed through Delphi rounds by experts and reliability, through internal consistency and Test-Retest approach. Then, the reaction of medical students (N=78) was assessed concerning the aspects of team-based learning sessions through TBL-SAI and CES. The data were analyzed through descriptive tests. Our results have study confirmed the TBL-SAI and CEA validity. The tools �reliability was approved through: TBL-SAI Cronbach's alpha=0.79, CES Cronbach�s alpha=0.71 and TBLSAI ICC=0.82, CES ICC=0.75. The result of the second phase showed the TBLSAI scores of participation were appropriate concerning TBL session (159.60�12.89) According to confirmed validity of tools, these can be used in researches related to team-based learning in Iran. It could facilitate assessing the learners� reaction of team-based learning studies at Iranian medical science universities. In the present study, the reaction of students who participate in TBL sessions had been positive and their participation, satisfaction, and accountability had been improved. � 2016 Tehran University of Medical Sciences. All rights reserved

Analisis Pelaksanaan Kegiatan Peningkatan Peranan Wanita Menuju Keluarga Sehat Sejahtera (P2wkss) di Desa Lipai Bulan Kecamatan Kerumutan Kabupaten Pelalawan Periode 2012-2013

Development success is largely determind by the ability of officials in formulating policy or program to be implemented by government officials in the community groups that participate jointly implement programs or policies that have been decided who should be endorsed or supported by the existing infrastuctureWith the precision of government see the potential developed by a region, as well as the construction carried out did not result in new problems it is necessary environmental conditions been created for a well-ordered society with the creation of gender equality therein. This is necessary in order to avoid overlapping in the implementation of policies implemented.In this study, the method used is qualitative approach. Whereas the data analysis technique used is describing a situation or event. This research was conducted in Pelalawan district sub-district village Kerumutan Lipai Bulan. Whereas the object of this study in the implementation of an integrated program implemented in the village P2WKSS Lipai Bulan. With the focus on the development program launched by the government district seen from the factors that influence the success of the programs impelemented Lipai Bulan this village. Theory used is the theory advanced by Budi Winarno.After doing some research, the writer can see the success factors that are owned by the district respresented by agency child protection women's empowerment and family planning in implementing an integrated program P2WKSS namely the availability of regulation, the district government's cooperation with the private sector, adequate resources, facilities and infrastructure, then the last one is the budget. With these factors there is also a great good governance in the implementation of programs that do

Environmental Hazards in the El-Temsah Lake, Suez Canal District, Egypt

Chemical and biological analyses were integrated using remote sensing GIS techniques to evaluate the environmental pollution of El-Temsah Lake, in the Suez Canal, in order to provide critical data to enhance development planning and economic projects within the study area. Fifty-six samples were collected from seven sites in the lake from July 2005 to May 2006. Samples were collected in each of four seasons, and included 28 surface sediment samples and 28 water samples. Sediment samples were analyzed for Fe, Pb, Ni, Co, Cu, Mg, K and Na. The results showed an increase in beach sediment pollution from summer to winter. Taxonomic analysis of phytoplankton samples revealed 102 taxa, including 56 Bacillariophyceae, 8 Chlorophyceae, 18 Dinophyceae and 20 Cyanophyceae. Chlorophyll a concentrations ranged from 0.3 to 26 µg l-1, with the highest values during the winter and lowest values during the summer. These results suggest that beach sediment pollution is highest in the winter and, at the same time, the water quality conditions in El-Temsah lake favor oxidation conditions which maximize phytoplankton productivity. In contrast, sediment pollution and phytoplankton productivity are lowest during summer, which also corresponds to more alkaline water conditions. The images were rectified and analyzed by ERDAS IMAGINE 8.9. A 1968 topographic map and enhanced 2005 Landsat Thematic Mapper images (30 m resolution) were utilized to determine the coastline positions using ERDAS Imagine 8.9. Image processing techniques were applied using ENVI 4.2 to analyze the ETM+ image data. Image enhancement was applied. Image data was enhanced spectrally to verify surface water pollution detected from chemical and biological analyses and to detect the sources of untreated domestic, industrial and agricultural waste water. In general, the lake has been subjected to successive shrinking due to human activities, primarily through extensive building along the shoreline. The uncontrolled growth of cities is associated with seismic hazards, affecting on buildings and infrastructures, mostly due to insufficient knowledge of earthquakes activity. Seismic epicentres were recorded along the Suez Canal from 1904 to 2006. Widespread moderate to micro earthquakes were identified around the western side of the lake, with scattered events along the eastern side. In general, water pollution in El-Temsah Lake has been mitigated over the last decade due to successive dredging and improved water treatment. Most of untreated water was discharged along the western side of the lake. The eastern part of the lake is less polluted and is, therefore, more suited for fishing, tourism, urban planning and navigation activities, although higher use of eastern portion of the lake could accelerate water and sediment quality deterioration in that region

Pemanfaatan Kulit Manggis (Garcinia Mangostana L) Sebagai Formulasi Tablet Anti Kanker Yang Praktis Dan Ekonomis

Based on data from the World Health Organization (WHO 2010) deadly disease cancer is number two in the world after heart disease. Therefore, there is need for intensive treatment to overcome these health problems, as proclaimed in the draft long-term development of health of the Republic of Indonesia. One of the plants can be used as an anticancer is mangosteen, Garcinia mangostana L. This plant contains a compound-mangostin xanthone especially play a role in cancer treatment with antioxidants that work crate scavenge free radicals so that a non-radical compounds. Required best alternative in tablet dosage that use more practical and economical as the innovation of the preparation syrups tend to be more complicated and expensive. The method used in this study using the literature method. From the discussion carried out could be concluded that mangosteen peel extract (Garcinia mangostana L) is effective for the treatment of cancer with good stability and a practical and economical, so is very potential to be accepted by society

Beyond 'Global Production Networks': Australian Fashion Week's Trans-Sectoral Synergies

When studies of industrial organisation are informed by commodity chain, actor network, or global production network theories and focus on tracing commodity flows, social networks, or a combination of the two, they can easily overlook the less routine trans-sectoral associations that are crucial to the creation and realisation of value. This paper shifts attention to identifying the sites at which diverse specialisations meet to concentrate and amplify mutually reinforcing circuits of value. These valorisation processes are demonstrated in the case of Australian Fashion Week, an event in which multiple interests converge to synchronize different expressions of fashion ideas, actively construct fashion markets and enhance the value of a diverse range of fashionable commodities. Conceptualising these interconnected industries as components of a trans-sectoral fashion complex has implications for understanding regional development, world cities, production location, and the manner in which production systems “touch down” in different places

Kadmium dan Efeknya terhadap Ekspresi Protein Metallothionein pada Deadema Setosum (Echinoidea; Echinodermata)

Logam berat kadmium (Cd) bersifat karsinogen, mutagenik dan teratogenik pada beberapa jenis hewan. Ketika berada di dalam sel, Cd akan menginduksi berbagai jenis mekanisme signal transduksi serta mengaktifkan banyak gen. Salah satu efek langsung yang ditimbulkan oleh Cd adalah mengganggu proses homeostasis sel. Mekanisme homeostasis sel terlaksana dengan keberadaan protein metallothionine (MT) yang berperan sebagai protein pengikat logam dan mengurangi efek toksik. Tujuan dilakukan penelitian ini adalah untuk mengetahui konsentrasi Cd pada kompartemen tubuh Deadema setosum sekaligus mengkaji efek Cd terhadap ekspresi protein metallothionein pada D. setosum. Hasil analisa kandungan Cd dalam kompartemen tubuh D. setosum menunjukan rerata kadar Cd bervariasi namun pada cangkang (0.67) < duri (0.75) < gonad (1.35) < usus (1.63). Hasil pemulasan imonohistokimia menggunakan antibodi rabit anti MT-1 D. setosum menunjukan sel yang mengekspresikan MT-1 berwarna coklat. Ekspresi protein MT-1 pada gonad, usus, dan hepar menunjukan perbedaan morfologi sel, dimana Cd yang terakumulasi pada setiap sel tergat tergantung pada jenis dan fungsi organ selnya