The role of endoscopic ultrasound elastography in diagnosis of pancreatic lesions

Objective: To evaluate the accuracy of elastography in differentiating benign from malignant pancreatic masses for patients.Design: A prospective, consecutive, studySetting: Kasr Alini hospital department of internal Medicine , university of Cairo, Egypt.Subjects: Thirty patients had a solid-appearing pancreatic mass at conventional ultrasound, EUS and CT abdomen were included in the study.Results: A total of 30 patients were included in the study. The age of the Patients ranged between 38 and 70 years with a mean value of 54± 8.6 Years. The study included 22 (73.3%) males and eight (26.7%) females. The mean size of pancreatic masses was 35.6 ± 11.8 mm. The final diagnosis were pancreatic adenocarcinoma (n =25) papillary adenocarcinoma (n =1), papillary adenoma (n =2) and chronic pancreatitis ( n =2). The strain ratio was significantly higher among patient with pancreatic malignant tumour compare with those with inflammatory masses. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for elastograpgy to Differentiate malignant from benign pancreatic masses were: 88%, 80%, 95.6%, 57.14% and 86% respectively (area under receiver operating curve 0 .974).Conclusion: EUS elastography is a useful tool for differentiating malignant from benign pancreatic masses through objective evaluation of tissue stiffness

FORMULATION AND EVALUATION OF PROCHLORPERAZINE MALEATE SUSTAINED RELEASE FLOATING TABLET

Objective: The objective of this study was to formulate once daily sustained oral release floating tablet of prochlorperazine maleate, this floating tablet has many advantages like reduction in dosing frequency, increase bioavailability, enhance patient compliance, and improve drug solubility.Methods: The prochlorperazine maleate floating tablets were formulated by using hydrophilic swellable polymer and gas generating agent. In this study, 15 formulas were prepared with many variables in order to achieve an optimum dissolution and floating behaviour for the floating tablet. The all prepared formulas were tested for bulk density, tap density, angle of repose, Carr's Index, thickness, weight variation, hardness, friability, drug content, in vitro dissolution test, in vitro buoyancy, and swelling index.Results: Formula (F2) that contain 55% (w/w) hydroxypropyl methylcellulose k4M (HPMCK4M), 5 % (w/w) sodium bicarbonate (NaHCO3) have acceptable flow properties and compressibility index and good physical properties with floating lag time (16±0.57) seconds and total floating time (32±0.29) h with 100% release of prochlorperazine maleate at the end of 24 h. Fourier transform infrared spectroscopy (FTIR) study of optimum formula (F2) showed no chemical interaction between the drug and the excipients that used in the formula.Conclusion: It can be concluded that that the selected formula (F2) can be a promising formula for the preparation of gastro retentive floating drug delivery systems of prochlorperazine maleate

Isolation of Diterpenoids from Jatropha podagrica against Hepatitis C virus

One new lathyrane diterpenoid, Jatropodagrene (1) along with three known compounds have been isolated from the root bark of Jatropha podagrica. The structure of the new compound was established from its 1D and 2D NMR spectra and in comparison with data reported in previous literatures. Compound 1 was highly cytotoxic (98.86% inhibition) to the HCV virus, while compounds 2 (EC50, EC90, CC50 5.8, 33.1, 22.6 μg/mL, respectively) and 3 displayed significant anti HCV activity. This is the first report of the anti hepatitis C virus activity of lathyrane skeleton and J. podagrica.Keywords: Jatropha podagrica; medicinal plant; hepatitis C virus; extract; pure compound

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The Effect of The Utilitarian Need For the High Water Tanks Towers to Sustain Life in the City

The service system has become a necessity of life in modern cities to be the most basic necessities of modern humans, they constitute a major base, which is based on the sustainability of life in the city and a standard measured through the degree of well-being and progress of civilized peoples and their interaction with the surrounding environment, making the services sector as a need not be an option, whenever the cities widened in population and space whenever provision of services and upgrading the quality and quantity more pressing, which made the subject of the services takes the biggest area of the trends and thinking of urban planners and those who in charge of drawing the cities policies. Considering that the processing and transfer of the water system with all its components (stations – water tanks -transmission and distribution pipelines), it is one of the most important parts of the services systems in the city. It has become a key element of the arteries of the establishment of life, but for several considerations of most important ( like storage of water and supplied with constant pressure that balanced without wobbling at the peak daytime hours with the necessary provision of water to fight fires , as well as secured it to the sectors of city n the maintenance time of the parts of the water system or the occurrence of a failure, with the need to confirm the save and generate energy factor in renewable way). For this in whole and others, the elevated water towers cornerstone of the pillars of the water system was made that can be indispensable in providing outsourcing and distribution network , and on the grounds that the case study concerning our capital Baghdad and its suffering of the water distribution and pressure intermittent problems, this research aims to clarify the idea of the elevated water tanks have become an important actor and is a part of the process and transport of the water in the city's system, and that its presence in a thoughtful siting and storage capacities and sufficient numbers will reduce the cost of the service system and its problems and provides continuously a constant pressure is to rescue the city from the overtaking problems on the network, while avoiding the problems experienced by interruptions in the water supply process, especially in the summer, which will make the water tanks as a necessary structures and essential elements of attractions for recreational activities and benchmarks functions within the city

Some Biochemical and Hematological Parameters among Petrol Station Attendants: A Comparative Study

Objective. To describe selected biochemical and hematological parameters (blood picture, liver enzymes, and kidney functions) in petrol station attendants in Mansoura city. Methods. This is a comparative cross-sectional study. The exposed group included 102 petrol station attendants. They were compared to a matched group of healthy 102 male service and office workers at the Faculty of Medicine, Mansoura University. The results of blood picture, liver enzymes, and kidney functions were compared between both groups. Results. Mean Red Blood Cells (RBCs) count, hemoglobin level, and Hematocrit (HCT) level were significantly lower in petrol station attendants than the comparison group. All other blood picture parameters showed nonsignificant difference between both groups. Liver enzymes, renal functions, serum albumin, and total protein showed statistically nonsignificant difference between both groups except for alanine aminotransferase (ALT) which was significantly higher in petrol station attendants. Conclusions. Some laboratory parameters among petrol station attendants showed changes that could be attributed to workplace exposure and should be given attention at preemployment and periodic medical examination