GARANTIR O DIREITO DAS CRIANÇAS À EDUCAÇÃO: EQUILÍBRIO ENTRE RESPONSABILIDADE LEGAL E A ARBITRARIEDADE DA AUTORIDADE PARENTAL

In Saudi Arabia, the right to education for children is considered of utmost importance through the official education system, which provides a legal framework to protect them. This system mandates the provision of basic education for all children without any discrimination. and it is essential for parents to actively participate in this field by cooperating with educational authorities and providing a supportive environment for children's learning. Despite these legal guarantees, there remain challenges related to effectively implementing these policies, and there may be instances of arbitrariness or negligence in providing education by parents. Therefore, establishing effective mechanisms for monitoring implementation and holding responsible parties accountable is necessary. Additionally, emphasis is placed on raising awareness about children's rights and the importance of obtaining a good education within society. Consequently, ensuring this right requires integrated efforts between the government and civil society to improve the quality of education and its provision.  Na Arábia Saudita, o direito à educação das crianças é considerado da maior importância através do sistema de ensino oficial, que proporciona um quadro jurídico para as proteger. Este sistema obriga à oferta de ensino básico a todas as crianças sem qualquer discriminação e é essencial que os pais participem ativamente neste domínio, cooperando com as autoridades educativas e proporcionando um ambiente favorável à aprendizagem das crianças. Apesar destas garantias legais, continuam a existir desafios relacionados com a aplicação efectiva destas políticas, podendo haver casos de arbitrariedade ou negligência na prestação de educação por parte dos pais. Por conseguinte, é necessário estabelecer mecanismos eficazes de controlo da aplicação e de responsabilização dos responsáveis. Além disso, a tónica é colocada na sensibilização para os direitos das crianças e para a importância de obter uma boa educação na sociedade. Consequentemente, a garantia deste direito exige esforços integrados entre o governo e a sociedade civil para melhorar a qualidade do ensino e a sua oferta

Učinak ketoprofena na koncentraciju u plazmi i farmakokinetičke pokazatelje ciprofloksacina u pilića

Ciprofloxacin (CFX) and ketoprofen (KPN) are used widely in combination in veterinary interventions for bacterial infections, so in this study the effect of KPN was studied on the efficacy of CFX, by measuring its plasma concentration and pharmacokinetic parameters in 7-10 day-old chickens. The analgesic median effective dose (ED50) of KPN was determined to be 1.62 mg/kg, IM, in the chickens. The preferable analgesic dose of KPN to be used with CFX was 4 mg/kg, IM, which differs significantly from KPN 2 mg/kg, IM,. The CFX plasma concentrations alone (8 mg/kg, IM) measured at different times (0.5, 1, 2, 4 and 24 hours) were 3.31, 3.60, 3.21, 2.70 and 0.17 μg/mL while its concentration was elevated by 53, 54, 90, 107 and 418 % when coadministered with KPN (4 mg/kg, IM) to 5.05, 5.53, 6.10, 5.59 and 0.88 μg/mL in the chickens, respectively. CFX pharmacokinetic parameters, such as the area under the curve (AUC), the area under the moment curve (AUMC), mean residence time (MRT), half-life (t1/2β), Tmax, and Cmax increased when KPN was coadministered with CFX by 129, 289, 70, 49, 100 and 69 %, whereas the elimination rate constant (Kel), the volume of distribution at steady state (Vss) and clearance (Cl) decreased by 36, 34 and 58 %, respectively. It was concluded that coadministration of KPN alters the plasma concentration and the pharmacokinetic parameters of CFX, suggesting that the CFX dose can be reduced when used with KPN to achieve the desired concentration of CFX in the plasma, as an antibacterial for treatment of infected animals.Kombinacija ciprofloksacina (CFX) i ketoprofena (KPN) u širokoj je upotrebi u veterinarskom liječenju bakterijskih infekcija. Ovo je istraživanje provedeno kako bi se ustanovio utjecaj KPN-a na učinkovitost CFX-a mjerenjem njegove koncentracije u plazmi i farmakokinetičkih pokazatelja u pilića starih između 7 i 10 dana. Procijenjeno je da je prosječna doza analgetičke učinkovitosti (ED50) KPN-a u pilića 1,62 mg/kg, intramuskularno. Poželjna analgetička doza KPN-a bila je 4 mg/kg, intramuskularno, što se znakovito razlikuje od doze KPN-a od 2 mg/kg, intramuskularno,koja se daje s CFX-om. Koncentracije CFX-a u plazmi (8 mg/kg, im.) u različitim vremenima mjerenja (0, 5, 1, 2, 4 i 24 sata) bile su 3,31, 3,60, 3,21, 2,70 i 0,17 μg/mL, a primijenjene zajedno s KPN-om (4 mg/kg, im) porasle su za 53, 54, 90, 107 i 418 % i iznosile 5,05, 5,53, 6,10, 5,59 i 0,88 μg/mL. Farmakokinetički pokazatelji CFX-a, koji uključuju područje ispod krivulje (AUC), područje ispod krivulje momenta (AUMC), prosječno vrijeme zadržavanja (MRT),poluživot (t1/2β), Tmax, i Cmax, porasli su kad je KPN primijenjen s CFX-om za 129, 289, 70, 49, 100 i 69 %, dok su se konstanta brzine eliminacije (Kel), volumen distribucije u stabilnom stanju (Vss) i klirens (Cl) smanjili za 36, 34 i 58 %. Zaključeno je da zajednička primjena KPN-a i CFX-a mijenja koncentraciju u plazmi i farmakokinetička svojstva CFX-a. Navedeno upućuje na to da bi se doza CFX-a mogla smanjiti kad se primjenjuje u kombinaciji s KPN-om, pri čemu se postigla željena koncentracija CFX-a u plazmi kao antibakterijskog lijeka za zaražene živoitnje

Surgical treatment for locally advanced lower third rectal cancer after neoadjuvent chemoradiation with capecitabine: prospective phase II trial

<p>Abstract</p> <p>Introduction</p> <p>Treatment of rectal cancer requires a multidisciplinary approach with standardized surgical, pathological and radiotherapeutic procedures. Sphincter preserving surgery for cancer of the lower rectum needs a long-course of neoadjuvant treatments to reduce tumor volume, to induce down-staging that increases circumferential resection margin, and to facilitate surgery.</p> <p>Aim</p> <p>To evaluate the rate of anal sphincter preservation in low lying, resectable, locally advanced rectal cancer and the resectability rate in unresectable cases after neoadjuvent chemoradiation by oral Capecitabine.</p> <p>Patients and methods</p> <p>This trial included 43 patients with low lying (4–7 cm from anal verge) locally advanced rectal cancer, of which 33 were resectable. All patients received preoperative concurrent chemoradiation (45 Gy/25 fractions over 5 weeks with oral capecitabine 825 mg/m²twice daily on radiotherapy days), followed after 4–6 weeks by total mesorectal excision technique.</p> <p>Results</p> <p>Preoperative chemoradiation resulted in a complete pathologic response in 4 patients (9.3%; 95% CI 3–23.1) and an overall downstaging in 32 patients (74.4%; 95% CI 58.5–85). Sphincter sparing surgical procedures were done in 20 out of 43 patients (46.5%; 95% CI 31.5–62.2). The majority (75%) were of clinical T₃disease. Toxicity was moderate and required no treatment interruption. Grade II anemia occurred in 4 patients (9.3%, 95% CI 3–23.1), leucopenia in 2 patients (4.7%, 95% CI 0.8–17) and radiation dermatitis in 4 patients (9.3%, 95% CI 3–23.1) respectively.</p> <p>Conclusion</p> <p>In patients with low lying, locally advanced rectal cancer, preoperative chemoradiation using oral capecitabine 825 mg/m², twice a day on radiotherapy days, was tolerable and effective in downstaging and resulted in 46.5% anal sphincter preservation rate.</p

Efficacy of Leflunomide Compared to Methotrexate in the Treatment of Moderate to Severe Plaques Psoriasis: A Randomized Controlled Clinical Trial

Introduction: Psoriasis is a chronic inflammatory autoimmune skin disease. Several treatment options are available including topical and systemic options. Methotrexate was the main systemic medication in treating severe psoriasis, yet adverse events can limit its use. Leflunomide is an isoxazole derivative that inhibits the synthesis of pyrimidines, and subsequently inhibits RNA and DNA synthesis. Objective: As available data directly comparing MTX to leflunomide in psoriasis are lacking, this double blinded study was designed to compare the efficacy of methotrexate versus leflunomide in the treatment of moderate to severe psoriasis.  Methods: The study included 40 patients (25 males and 15 females) with chronic plaque psoriasis, s. Patients were randomly assigned to one of two equal groups, group A for subcutaneous methotrexate injections and group B for leflunomide (loading dose 100mg daily for the first 3 days then 20 mg daily for 3 months. Disease severity was determined by psoriasis area and severity index (PASI) score before and at the end of treatment The treatment response was evaluated at the baseline and weeks 4, 8 and 12 PASI score. Results: Both groups were matching at the baseline in aspects of gender, age, disease duration and PASI scores Both medications yielded comparable results with no significant difference between both groups in PASI score neither in side effects.. Conclusion: Leflunomide can be as effective as methotrexate in treatment of moderate to severe psoriasis

Clinical characteristics of triple negative breast cancer in Egyptian women: a hospital-based experience

Purpose: Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer with poor prognosis despite the high rates of response to chemotherapy. We aim to study the clinical features, factors influencing recurrence and survival outcomes of TNBC patients.Methods: We retrospectively studied the charts of patients with biopsy proven TNBC treated at The Clinical Oncology Department Ain-Shams University between 2009 and 2012.Results: One hundred and forty five patients fulfilled the eligibility criteria. The incidence of TNBC was 10.5% - 15% with a mean of 12% of all breast cancer patients. The follow-up duration ranged from six months to four years. The age range was 26 to 78 years. Infiltrating ductal carcinoma represented 93.1% of the pathologic types. 87% of patients were free of metastases (M0) at presentation. Clinical stages II and III represented 38 and 39.5% of the patients. 66% of patients had modified radical mastectomy. Following surgery, 77.5% of patients received adjuvant chemotherapy while 61% of the patients had adjuvant radiation therapy. Anthracyclines based chemotherapy was given to 52% of patients. Disease-free survival (DFS) of the M0 patients at 20 and 30 months was 92% and 80% respectively. Relapse occurred in 23% of M0 patients. After a mean duration of DFS of 15.1 months, the most common sites of metastases for relapsed M0 patients were pulmonary (44.8%), bone (41.4%), and locoregional (13.8%). The median overall survival (ORS) of patients was 18 months (1 - 45 months), whereas for the M1 group of patients the median ORS was 9 months (2 - 29 months).Conclusion: The incidence, pathological characteristics, and clinical behavior of TNBC were similar to what is mentioned in the literature. Adding taxanes to the chemotherapy protocols and using postoperative radiotherapy were both associated with a significant increase in the mean period of DFS, while did not significantly affect the ORS

Fixed gonadotropin-releasing hormone antagonist protocol versus gonadotropin-releasing hormone agonist long protocol in patients with polycystic ovary syndrome treated for intracytoplasmic sperm injection cycles

Background: Women with polycystic ovary syndrome (PCOS) are at risk of developing ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. Use of GnRH antagonist in the general sub fertile population is associated with lower incidence of (OHSS) than agonists and similar probability of live birth but it is unclear. Our Objective was to compare the fixed GnRH antagonist and GnRH agonist long protocols in patients with PCOS undergoing IVF.Methods: In this randomized controlled trial (RCT), 200 patients with PCOS were randomly allocated in two groups: long GnRH (n = 100) and fixed GnRH antagonist protocol (n = 100).           Results: There is significant difference was observed in chemical pregnancy rate (46.0% versus 31.0%), and clinical pregnancy rate (43.0% versus 29.0%) in agonist and antagonist protocols, respectively. Duration of stimulation was significantly higher in agonist group (13.58 versus 12.381 days), respectively.  Total number of ampoules of gonadotrophin is comparable in both groups (t=1.914, p=0.057).Conclusions: The use of GnRH antagonists is more advantageous than GnRH agonists in relation to shorter duration of stimulation thus allowing a reduction in the treatment time that makes COS less costly and better patient compliance. In this study GnRH agonist shows higher pregnancy rate than antagonist, so larger studies needed to clarify their roles

The relation between of insulin like growth factor II and endometrial carcinoma

Background: Endometrial cancer is the most common gynecologic malignancy in the United States and the fourth most common cancer in women. The need of a soft marker that can be used with CA-125 tumor marker for early detection of endometrial cancer and to predict late stages and advanced histopathological grades and to specify the cases who will be managed by complete surgical staging including para aortic and pelvic lymphadenectomy is of great importance. The aim of the study was to evaluate the role of insulin like growth factor 2 in endometrial carcinoma and to correlate it with different histopathological grades of the disease.Methods: This study was applied on sixty patients with abnormal uterine bleeding and were divided into two groups, Group A included 30 cases of endometrial carcinoma, while Group B included 30 cases complaining of abnormal vaginal bleeding due to other causes as a control group. Serum samples were taken from all patients and estimation of IGF-2 serum levels using ElISA technique was done. Comparison of IGF-2 serum level between both groups and correlation of its levels with different histopathological grades of endometrial cancer group were done.Results: As regard comparison between both groups and ILGF2 serum level, study results demonstrated that ILGF2 levels ranged between 600.0-1440.0 ng/ml and 40.0-560.0 ng/ml with the mean of 781.33 ng/ml±196.45 and 336.0 ng/ml±212.86 for cases Group A and control Group B respectively. There was a statistically significant difference between the two studied groups regarding ILGF2 serum level (p<0.001). As regards correlation between histopathological grades and ILGF-2 serum level in cases Group A, the study revealed a strong positive correlation.Conclusions: ILGF-2 can be used as a serum marker for endometroid adenocarcinoma of the body of the uterus and to predict its higher histopathological grades

Clinical pattern of pediatric ocular trauma in a tertiary referral center

Background: Pediatric ocular trauma may be a major source of lifelong visual morbidity and disability. Objective: To report on the different types of ocular injury in children in a tertiary referral center. Participants and settings: Children presenting with ocular trauma to the casualty department of the pediatric ophthalmology unit of Alexandria Main University Hospital in Alexandria, Egypt. Methods: The study was conducted from June to December 2018. Upon admission, thorough history was obtained from the attending person(s), and thorough ophthalmic examination was performed. Appropriate treatment was subsequently provided to every case (though not the scope of the current study). Results: A total of 146 children (from a total of 436 patients, 33.5%) (103 males, 70.5%) presented with various types of ocular injuries. The mean age ± standard deviation of the injured children was 98.1 ± 56.4 months. Study participants were almost equally distributed between within and outside of the city of the study locale, with a predominance of patients from urban areas in Alexandria (30%) and from rural areas outside of Alexandria (35.6%). Seventy percent of the care providers of the study children were manual workers. The places of the incidents were almost equally distributed between household (40%) and external environment with a slight predominance of the later (50%). Conclusions: Ocular injuries represent one-third of all ocular injuries in the study locale. Ocular injuries in children occur with an almost equal distribution in both urban and rural areas and in both household and external environments. Mechanical trauma was the most common cause of trauma