Self-Emulsifying Drug Delivery Systems: Easy to Prepare Multifunctional Vectors for Efficient Oral Delivery

Self-emulsifying drug delivery systems (SEDDS) have been mainly investigated to enhance the oral bioavailability of drugs belonging to class II of the Biopharmaceutics Classification System. However, in the past few years, they have shown promising outcomes in the oral delivery of various types of therapeutic agents. In this chapter, we discuss the recent progress in the application of SEDDS for oral delivery of protein therapeutics and genetic materials. The role of SEDDS in enhancing the oral bioavailability of P-glycoprotein and cytochrome P450 3A4 substrate drugs is also highlighted. Also, we discuss the most critical evaluation criteria of SEDDS. Additionally, we summarize various solidification techniques employed to transform liquid SEDDS to the more stable solid self-emulsifying drug delivery systems (s-SEDDS) that are associated with high patient compliance. This chapter provides a comprehensive approach to develop high utility SEDDS and their further transformation into s-SEDDS

Modeling of Tsunami Generation and Propagation by a Spreading Seismic Faulting in two Orthogonal Directions in Linearized Shallow-Water Wave Theory

The process of tsunami evolution during its generation in search for possible amplification mechanisms resulting from spreading of the sea floor uplift in the x-and y-direction is investigated under the effect of rupture velocities, uplift length and width and rise times. This study shows that focusing and amplification of tsunami amplitudes can occur in an arbitrary direction, determined by the velocities of spreading. Tsunami waveforms within the frame of the linearized shallow water theory for constant water depth are analyzed analytically by transform methods (Laplace in time and Fourier in space) for the spreading source model. We analyzed the normalized peak amplitude as a function of the propagated uplift length, width and the average depth of the ocean along the generation path. The amplification of tsunami amplitudes builds up progressively as time increases during the generation process due to wave focusing while the maximum wave amplitude decreases with time during the propagation process due to the geometric spreading and also due to dispersion. The normalized peak amplitudes were smaller when the slip-fault spreads in two orthogonal directions than the numerical values for one dimensional solution because of the interaction of the velocities. The maximum amplitude amplification is proportion to the propagation length and the width of the source model and inversely proportional with the water depth

Foreign body ingestion in children: unusual presentations and timely intervention

Background/purpose: Foreign body (FB) ingestion in children is very common. Children can ingest a wide variety of FBs. Most of the ingested FBs pass spontaneously through the gastrointestinal tract. Other FBs, especially uncommonly ingested objects, can present with complications and need intervention to be extracted. The aim of this study was to highlight the importance of timely intervention to extract these FBs.Patients and methods: Between November 2012 and October 2017, patients who presented to our department with variously ingested FBs were retrospectively reviewed to detect those who needed intervention (surgical or endoscopic) to extract these FBs.Results: During the specified time period, 480 patients with FB ingestion presented to our department. Out of these children, 12 patients ingested uncommon FBs or presented with symptoms of complications of impaction and needed intervention to extract these FBs. Three patients ingested multiple magnets. Three patients ingested pins which were impacted in and penetrated the duodenum. One patient ingested a screw which was impacted in the appendix. One patient ingested a sticky rubber toy which was impacted in the pylorus. One patient ingested hair (bezoar), which was also impacted in the pylorus. One patient ingested a disk battery which was impacted in and penetrated the esophagus, and all were surgically extracted. One patient had a slipped stent of repaired choanal atresia which was impacted in the gastroesophageal junction and one patient with repaired tracheoesophageal fistula ingested a stone which was impacted at the site of esophageal anastomosis, and both were endoscopically retrieved.Conclusion: Children who ingested uncommon FBs or presented late with symptoms of complications of impaction needed intervention (surgically or endoscopically) to extract these FBs.Keywords: foreign bodies, foreign body extraction, ingestion, magnets ingestion, pin ingestio

Recurrence after correction of acquired ankle equinus deformity in children using Ilizarov technique

To describe our Ilizarov technique for the treatment of acquired equinus deformity in children and to determine if compliance with continuous use of an ankle foot orthosis (after removal of the fixator and until skeletal maturity) can influence the severity of recurrence. A cohort of 26 children with post-traumatic or post-burn contractures producing an equinus deformity was followed up for a minimum of 2 years after skeletal maturity. Cases with a bony deformity and/or nerve injury were excluded from this study. All patients were managed by a percutaneous tendo-Achilles lengthening followed by application of an Ilizarov external fixator. Post-operative treatment was in the form of gradual correction at a rate of 0.5 mm per day. Correction started from the second postoperative day until an over-correction of 15 degrees dorsiflexion was achieved. Ankle range of movement was encouraged 4 weeks prior to removal of the external fixator. On removal of the fixator, a posterior splint was applied until substituted by an ankle foot orthoses (AFO). The AFO was used continuously during the first 2–3 months and at nighttime thereafter until skeletal maturity. Fifteen children were compliant with the use of the AFO until skeletal maturity and 11 non-compliant. We compared the recurrence and the size of deformity between the two groups. The rate of recurrence, degree of equinus at recurrence and number of episodes of external fixation surgery showed statistical significant differences (P < 0.01) between the groups. The Ilizarov technique for treatment of acquired equinus deformity secondary to soft tissue scarring is a safe and effective technique. The use of an AFO until skeletal maturity can decrease the risk and degree of recurrence

Effect of Adding Physiotherapy Program to the Conservative Medical Therapy on Quality of Life and Pain in Chronic Rhinosinusitis Patients

Objective To assess the effectiveness of combining physiotherapy techniques with conservative medical treatment in chronic rhinosinusitis (CRS) patients. Methods Sixty-eight volunteers with CRS were randomly assigned. Group A received only traditional medical treatment, whereas group B received a physiotherapy program that included pulsed ultrasound therapy, sinus manual drainage techniques, and self-sinus massage technique in addition to traditional medical treatment. Interventions were applied 3 sessions a week for 4 weeks. The rhinosinusitis disability index (RSDI) served as the main outcome indicator for assessing the quality of life, and the secondary outcome measure was the pressure pain threshold (PPT) using a pressure algometer. Results Wilcoxon signed rank test revealed a significant reduction (p<0.001) in total RSDI values from 71.08±1.13 pretest to 47.14±1.15 posttest for group A, while it decreased from 70.64±1.20 pretreatment to 31.76±1.04 posttreatment for group B; furthermore, Mann–Whitney U-test revealed a significant difference (p<0.001) in total RSDI values between both groups when comparing the change of the pre-post data values, it was 23.94±0.95 for group A and 38.88±0.67 for group B. The independent t-test revealed a highly statistically significant increase (p<0.001) in the PPT values in the experimental group compared to the control group. Conclusion The physiotherapy program which included pulsed ultrasound therapy, sinus manual drainage technique, and self-sinus massage technique in conjunction with conventional medical treatment was more beneficial for enhancing the quality of life and PPT than traditional medical treatment alone in CRS patients

Modeling of a pyrolysis batch reactor using COMSOL Multiphysics

Plastic Pyrolysis is a thermal degradation process; it offers an important alternative energy. The aim of this study is to model a batch reactor to be used for plastic pyrolysis. Consequently, four experiments with different heating and cooling cycles are done using an empty pyrolysis batch reactor and four temperatures are measured at different locations on the reactor. On the other hand, the empty reactor is modeled and several simulations are done, using COMSOL Multiphysics software, under the same experimental conditions. By comparing the temperatures obtained from simulation to those measured experimentally, it is noticed that the results are very close with a maximum error of 4%, hence the model is validated

The association of hamstring tightness with lumbar lordosis and trunk flexibility in healthy individuals: gender analysis

Objectives: The purpose of this study was to investigate if there is a relation between hamstring tightness and lumbar lordosis as well as trunk flexibility based on gender differences and to analyze the differences in hamstring tightness, lumber lordosis and trunk flexibility in healthy adults.Methods: One hundred young healthy adults were recruited and distributed into 2 equal groups according to gender: group A (female group) and group B (male group). Hamstring tightness (HT) was measured by Active Knee Extension (AKE) test and Straight Leg Raise (SLR) test, the angle of lumbar lordosis was measured with a flexible ruler from standing position and trunk flexion flexibility (TFF) was measured by Fingertip-to-Floor Test.Results: There was a significant correlation between TFF and both measures of HT (SLR, p = 0.001; AKE, p = 0.001) in females. While, there was a non-significant correlation in males (SLR, p = 0.900; AKE, p = 0.717). Moreover, there was a non-significant correlation between lumbar lordosis and HT measures in both groups as (p &gt; 0.05). Furthermore, there were significant differences between males and females in hamstring flexibility, TFF and lumbar lordosis as (p &lt; 0.05).Conclusion: Gender differences in the relationship between hamstring tightness and trunk flexion flexibility are significant. However, there was no significant difference between males and females in the relationship between hamstring tightness and lumbar lordosis

Combination of Human Amniotic Fluid Derived-Mesenchymal Stem Cells and Nano-hydroxyapatite Scaffold Enhances Bone Regeneration

BACKGROUND: Human amniotic fluid-derived stem cells (hAF-MSCs) have a high proliferative capacity and osteogenic differentiation potential in vitro. The combination of hAF-MSCs with three-dimensional (3D) scaffold has a promising therapeutic potential in bone tissue engineering and regenerative medicine. Selection of an appropriate scaffold material has a crucial role in a cell supporting and osteoinductivity to induce new bone formation in vivo. AIM: This study aimed to investigate and evaluate the osteogenic potential of the 2nd-trimester hAF-MSCs in combination with the 3D scaffold, 30% Nano-hydroxyapatite chitosan, as a therapeutic application for bone healing in the induced tibia defect in the rabbit. SUBJECT AND METHODS: hAF-MSCs proliferation and culture expansion was done in vitro, and osteogenic differentiation characterisation was performed by Alizarin Red staining after 14 &amp; 28 days. Expression of the surface markers of hAF-MSCs was assessed using Flow Cytometer with the following fluorescein-labelled antibodies: CD34-PE, CD73-APC, CD90-FITC, and HLA-DR-FITC. Ten rabbits were used as an animal model with an induced defect in the tibia to evaluate the therapeutic potential of osteogenic differentiation of hAF-MSCs seeded on 3D scaffold, 30% Nano-hydroxyapatite chitosan. The osteogenic differentiated hAF-MSCs/scaffold composite system applied and fitted in the defect region and non-seeded scaffold was used as control. The histopathological investigation was performed at 2, 3, &amp; 4 weak post-transplantation and scanning electron microscope (SEM) was assessed at 2 &amp; 4 weeks post-transplantation to evaluate the bone healing potential in the rabbit tibia defect. RESULTS: Culture and expansion of 2nd-trimester hAF-MSCs presented high proliferative and osteogenic potential in vitro. Histopathological examination for the transplanted hAF-MSCs seeded on the 3D scaffold, 30% Nano-hydroxyapatite chitosan, demonstrated new bone formation in the defect site at 2 &amp; 3 weeks post-transplantation as compared to the control (non-seeded scaffold). Interestingly, the scaffold accelerated the osteogenic differentiation of AF-MSCs and showed complete bone healing of the defect site as compared to the control (non-seeded scaffold) at 4 weeks post-transplantation. Furthermore, the SEM analysis confirmed these findings. CONCLUSION: The combination of the 2nd-trimester hAF-MSCs and 3D scaffold, 30% Nano-hydroxyapatite chitosan, have a therapeutic perspective for large bone defect and could be used effectively in bone tissue engineering and regenerative medicine

The diagnostic accuracy of intraoperative frozen section biopsy for diagnosis of sentinel lymph node metastasis in breast cancer patients: a meta-analysis

: Sentinel lymph node (SLN) sampling is important for evaluating the nodal stage of breast cancer when the axillary nodes are clinically free of metastasis. The intraoperative frozen section (IFS) of SLN is used for lymph node assessment. This meta-analysis aims to provide evidence about the diagnostic accuracy and the applicability of IFS of SLN in breast cancer patients. Data were collected by searching PubMed, Cochrane, Scopus, and Web of Science electronic databases for trials matching our eligibility criteria. The statistical analysis included the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and pooled studies' diagnostic odds ratio outcomes. The analyses were conducted using the Open Meta-analyst software. This meta-analysis pooled the results of 110 studies. The overall sensitivity of IFS for SLN metastasis was 74.7%; 95% CI [72.0, 77.2], P < 0.001. It was 31.4% 95% CI [25.2, 38.3], P < 0.001 for the micro-metastasis, and 90.2%; 95% CI [86.5, 93.0], P < 0.001 for the macro-metastasis. The overall specificity was 99.4%; 95% CI [99.2, 99.6], P < 0.001. The overall positive likelihood ratio was 121.4; 95% CI [87.9, 167.6], P < 0.001, and the overall negative likelihood ratio was 0.226; 95% CI [0.186, 0.274], P < 0.001. The overall diagnostic odds ratio of IFS for diagnosing SLN metastasis was 569.5; 95% CI [404.2, 802.4], P < 0.001. The intraoperative frozen section of SLN has good sensitivity for diagnosing breast cancer macro-metastasis. However, the sensitivity is low for micro-metastasis. The specificity is very satisfactory