Endoscopic Third Ventriculostomy, Indications and Challenges

Endoscopic third ventriculostomy (ETV) allows the cerebrospinal fluid (CSF) to flow directly from the third ventricle through the fashioned ventriculostoma to the interpeduncular cistern, by passing the site of obstruction. In spite of the wide variety of indications where ETV is implemented, its success rate is still debatable especially in certain age groups, where it is most successful in adult patients with obstructive hydrocephalus and it has an identifiable failure rate in children less than 6 months of age. Several factors would affect the success rate of ETV, which are related to the patient’s age, pathology, and intraoperative findings. This chapter covers most of the current debates considering ETV

Expression of E-cadherin, N-cadherin, and Cytokeratin 18 and 19 in Placentas of Women with Severe Preeclampsia

BACKGROUND: Although the exact mechanism leading to preeclampsia is not fully understood, abnormal trophoblast invasion contributes to its pathogenesis. Keratins and cadherin are known to play roles in the regulation of trophoblast proliferation. However, studies describing the association between keratins, cadherin, and preeclampsia are limited. AIM: The current study was conducted to investigate the association of these proteins with severe preeclampsia in Sudanese women. METHODS: A case–control study was conducted at Madani Maternity Hospital, Sudan. The cases included women with severe preeclampsia (n = 56) and healthy pregnant women as controls (n = 56). The assessment of keratin and cadherin was performed using immunohistochemical staining. RESULTS: There was no significant difference between the two groups in their mean age or parity. We found no significant differences in the expression of the markers E-cadherin, N-cadherin, or cytokeratin 18 and 19 in the placentas from individuals with preeclampsia versus controls. The number of placentas with severe preeclampsia versus controls expressing the E-cadherin, N-cadherin, cytokeratin 18, and cytokeratin 19 markers was 46 (82.1%) versus 46 (82.1%) (p = 0.988), 54 (96.4%) versus 48 (85.7%) (p = 0.121), 4 (7.1%) versus 0 (0%) (p = 0.126), and 11 (19.6%) versus 11 (19.6%) (p = 0.532), respectively. There was also no significant difference in the intensity of staining of these four markers (Ecadherin, N-cadherin, and cytokeratin 18 and 19) between severe preeclampsia and control placentas. CONCLUSION: Together, these results indicate that in this setting, the expression of E-cadherin, N-cadherin, CK18, and CK19 is not associated with severe preeclampsia

Study the Influence of Treatment Interruptions in the Radical Irradiation of Breast Cancer

Hypofractionated radiotherapy (HFRT) in breast cancer treatment regimen (40 Grey /15 fractions/3 weeks) is more convenient for patients, especially those coming from remote areas to radiotherapy facilities and for healthcare providers, than conventional fractionation (50 Gy/25 fractions/5weeks). So the effect of radiotherapy interruption on treatment outcome (loco-regional control (LRC)& overall survival (OS)) during hypofractionated schedule is the issue of our study. Materials and Methods: We studied retrospectively 174 female patients with breast cancer who received PORT at the Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Egypt, from January-2012 to December-2016. We determined the treatment outcome (OS&LRC) from the follow-up (FU) of the studied patients, as the patient still survived or died, and recurrence till now occurred or not, and were estimated with the Kaplan-Meier (K-M) method and Logrank test, respectively. Then we calculated surviving fraction (SF) and tumor control probability (TCP) with regard to biologically effective dose (BED), for all patients, using breast cancer radiobiological parameters. Results: When comparing patients without radiotherapy gap with patients with radiotherapy gaps, the results showed a decrease in LRC rate in patients with radiotherapy treatment interruptions by 15 % (P=0.019, a significant value), but no detrimental effect on OS because of the very limited number of the studied patients. Curves of the relationship between (SF&OTT) and (TCP&OTT) confirmed the detrimental effect of unscheduled gap during radiotherapy fractions on the treatment outcome. Also we found a significant-P value for (marital status, start day of radiotherapy fractions, time, number, and duration of gaps); it means these factors affect LRC during radiotherapy interruptions.Conclusions: Interruptions during postoperative hypofractionated irradiation of 7breast cancer (40 Gy/15 fractions/3weeks) should be avoided and if they are inevitable, they should not be prolonged more than two days, as they will adversely affect the treatment outcome (LRC)

Comparative Pharmacodynamics of Ceftobiprole, Daptomycin, Linezolid, Telavancin, Tigecycline, and Vancomycin in the Treatment of Methicillin Resistant \u3cem\u3eStaphylococcus aureus\u3c/em\u3e: A Monte Carlo Simulation Analysis

Background/Objectives: Appropriate initial treatment choices for methicillin resistant Staphylococcus aureus (MRSA) infections are very critical. The aim of this study was to compare the ability of Ceftobiprole, Daptomycin, Linezolid, Telavancin, Tigecycline, and Vancomycin to achieve their requisite pharmacokinetic/pharmacodynamic (PK/PD) target against clinical MRSA isolates. Methods: Monte Carlo Simulations were performed to simulate the PK/PD indices of the investigated antimicrobials. Population Pharmacokinetic data and Pharmacodynamic indices were integrated into Monte Carlo Simulation routine with 10,000 iterations. Probability of target attainment (PTA) was estimated at MIC values ranging from 0.03-32 μg/ml to define the PK/PD susceptibility breakpoints. Cumulative fraction of response (CFR) was computed using MIC data from the Canadian National Ward (CAN-Ward) study collected in 2007, 2008 and 2009. Results: Analysis of the simulation results suggested the breakpoints of 8μg/ml for Ceftobiprole, 0.12 μg/ml for Daptomycin and Tigecycline, 0.5 μg/ml for Telavancin and 1 μg/ml for Linezolid and Vancomycin. The estimated CFR were 100, 66.5, 84, 89.1, 98.2, 60, 97.5 % for Ceft obiprole, Daptomycin (4mg/kg/day), Daptomycin (6mg/kg/day), Linezolid, Telavancin, Tigecycline, Vancomycin (2gm/day) and Vancomycin (3gm/day), respectively. Conclusions: Ceftobiprole and Telavancin have the highest probability of achieving favorable outcome against MRSA infections. The susceptibility results suggested a further reduction of the vancomycin breakpoint to 1 μg/ml

SIMULTANEOUS SPECTROPHOTOMETRIC DETERMINATION OF DICLOFENAC SODIUM, PARACETAMOL, AND CHLORZOXAZONE IN TERNARY MIXTURE USING CHEMOMETRIC AND ARTIFICIAL NEURAL NETWORKS TECHNIQUES

  Objective: The aim of this study is to develop and validate simple, accurate, and precise spectrophotometric methods for the simultaneous determination of diclofenac sodium (DIC), paracetamol (PAR), and chlorzoxazone (CHZ) in ternary mixture using chemometric and artificial neural networks (ANN) techniques.Methods: Three chemometric techniques include classical least squares (CLS), principal component regression (PCR), and partial least squares (PLS) in addition to cascade-forward backpropagation ANN (CFBP-ANN) were prepared using the synthetic mixtures containing the three drugs in methanol. In CLS, PCR, and PLS, the absorbances of the synthetic mixtures in the range 267-295 nm with the intervals Δλ=0.2 nm in their zero-order spectra were selected. Then, calibration or regression was obtained using the absorbance data matrix and concentration data matrix for the prediction of the unknown concentrations of DIC, PAR, and CHZ in their mixtures. In CFBP-ANN, two layers, sigmoid layer with 10 neurons and linear layer were found appropriate for the simultaneous determination of the three drugs in their ternary mixture.Results: The four proposed methods were successfully applied to the analysis of the three drugs in laboratory prepared mixtures and tablets with good percentage recoveries in the range of 98-102%. Relative standard deviation for the precision study was found <1%.Conclusion: The four proposed methods showed simplicity, accuracy, precision, and rapidity making them suitable for quality control and routine analysis of the cited drugs in ternary mixtures and pharmaceutical formulation containing them.Â

STRESS ANALYSIS COMPARING EFFECT OF TWO DIFFERENT CAD-CAM IMPLANT SUPERSTRUCTURE MATERIALS (IN-VITRO STUDY)

Purpose: This study was conducted to evaluate the micro-strain around dental implant using two different CAD/CAM crown fabricated materials through strain gauge analysis. Materials and Methods: Five dental implants were fixed in a 5 previously drilled solid rigid polyurethane test blocks in the edentulous area with neighboring abutments mesial and distal printed out using special 3D Dental printer, Cyanoacrylate adhesive was then used to fix the printed-out part on to the polyurethane test blocks, creating the bounded saddle replicas. Ten CAD/CAM screw retained crowns were fabricated; five Enamic crowns from vita enamic blocks, and five zirconia crowns from presintered katana zirconium blocks. Each crown was cemented to abutment and screwed over the implant fixture. Two strain gauges were installed on their corresponding prepared sites to measure the micro-strains in the medium surrounding the implant. For each tested implant, loads were applied by a universal testing machine, micro-strains were recorded with the strain gauges and stress distribution around the implant was statistically evaluated. Results: Micro-strain recording revealed a statistically significant difference in mean micro-strain recording applied in central fossa between Zirconia and Enamic, for both the buccal and lingual measurements, Enamic was significantly lower than Zirconia. Conclusion: The modulus of elasticity of restorative materials has a meaningful effect on forces applied to dental implant and transmitted to the supporting bone

Seminavis aegyptiaca sp. nov., a new amphoroid diatom species from estuary epilithon of the River-Nile Damietta Branch, Egypt

[EN] During a recent floristic–taxonomic study on the algal flora, including diatoms, from the estuary of the Damietta Branch of the Nile in Egypt, an interesting epilithic diatom species belonging to the genus Seminavis (Naviculaceae) was collected and investigated using both light and scanning electron microscopy. This new diatom species shares morphologically some taxonomic diagnostic features with other related taxa such as S. insignis, S. robusta, and S. ventricosa. However, it still differs by having ventral central striae that are shorter and more or less straight in the middle of the smaller frustules to be clearly radiate in the larger ones and then become geniculate and only radiate near the poles, the central raphe endings are externally more distantly spaced than in the similar species, the elongate central nodule is internally less prominent, and the areola density is much denser. Therefore, we here describe it as Seminavis aegyptiaca sp. nov. Hydrochemical analyses revealed that S. aegyptiaca commonly inhabits typical marine, with a weak tendency towards brackish water, habitats. It was found to be tolerant to meso–eutrophic, nutrient–enriched conditions, based on the data available on seasonal concentrations of N and P compounds. These findings not only contribute to the inventory of Egyptian diatoms, but also increase our understanding of the autecology and distribution of this relatively poorly–known diatom genusSIThis work was a part of the PhyBiO project funded by the Italian Ministry of Foreign Affairs and International Cooperation (MAECI) to the MUSE Post–Doc Abdullah A. Saber for the academic year 2018/201