Thoracoscopic excision of asymptomatic posterior mediastinal ganglioneuroma. A case series study

Background Posterior mediastinal ganglioneuroma is the most frequent type of neurogenic tumors, and usually it is asymptomatic. The surgical approach to excise it may differ from center to center based on the surgeon's experience as well as the size of tumor. We aim to present our center's experience and short-term outcomes in surgical excision of posterior mediastinal ganglioneuroma. Methods This retrospective case series study, from June 2019 till December 2022, included 9 asymptomatic patients with mean age of 31± 5 years who expressed lesion in the posterior mediastinum. The mean size of the tumor was   5.3±3.6 cm in maximal dimensions.  Results There were 7 males and 2 females with mean age was 31± 5 years,  the excision by video-assisted thoracoscopy (VATS)  was  employed in 8 patients and conventional thoracotomy was carried out in 1 case.  The mean operative time was 57±14 minutes with mean operative blood loss 50±10 ml. The mean postoperative chest tube drainage was 120±80 ml and no complications related to the procedures were observed. The average time of hospital stay after VATS treatment was 2 days, while after thoracotomy it was 5 days and patient suffered from ptosis that eventually recovered after 1 month with supportive treatment. Histopathological examination confirmed benign nature of ganglioneuroma in all cases. Conclusions Thoracoscopic excision of asymptomatic posterior mediastinal neurogenic tumor is safe, feasible and reduces postoperative pain, however, open technique might be considered for large-sized tumor to minimize the possible complications

Two Chromatographic Methods for the Determination of Some Antimigraine Drugs

Two stability indicating chromatographic methods were proposed for the determination of almotriptan, eletriptan, and rizatriptan, in presence of their acid degradation products. The first method is a quantitative densitometric thin layer chromatography. The developing systems were; acetonitrile: methanol: dichloromethane: ammonia (10:6:3:1 v/v), ethyl acetate: methanol: ammonia (15:4:1 v/v), and methanol: acetonitrile: ammonia (9:4:1 v/v) for almotriptan, eletriptan and rizatriptan respectively. The TLC plates were scanned at 235 nm. Linear relationships were obtained over concentration ranges (5–50 μg/spot) for almotriptan and rizatriptan, and (5–60 μg/spot) for eletriptan. The second method based on the separation and determination of the studied drugs, using RP-HPLC technique. The separation was achieved on C18 Hypersil column, elution was carried out using phosphate buffer pH 3: methanol: acetonitrile (2: 1:1 v/v) at flow rate 2 mL/min and UV detection at 235 nm. Linear relationships were obtained over concentration ranges (10–200 μg/mL) for almotriptan and eletriptan, and (10–180 μg/mL) for rizatriptan. The chromatographic methods were successfully applied for the determination of each of the studied drugs in pure form, tablet form, and in laboratory prepared mixtures with their acid degradation products

NDM-559: EXPERIMENTAL INVESTIGATION OF TWO-WAY CONCRETE PANELS EXPOSED TO IMPACT LOAD

Protecting existing and new structures from potential terrorist attacks and accidents is becoming an essential consideration in the design of most structures. Building façade is the first layer exposed to external loading, thus it acts as the first line of defence against external loads. Precast concrete panels are mostly used in external building\u27s façade for modern construction, and therefore their resistance to other dynamic loads such as impact load needs further evaluation. This paper presents the results of an experimental research on two-way reinforced concrete panels as well as thin ferrocement concrete panels under impact loading. The impact test apparatus used is versatile enough to test large variety of specimens modeling façade units. The performance of the panels under impact load is evaluated in terms of: the failure mode; the maximum impact loads sustained by the panels; the number of impact loads up to failure; the maximum load transmitted to the supporting frame; and the strain induced in the panels. The effect of the different design parameters including the reinforcement amount, spacing and location across the panel thickness on the dynamic response of the panel to impact load are considered. Results clearly showed the significant effect of reinforcement on the overall resistance to impact loading. This research outcomes provide a better understanding of the performance of concrete panels under impact loading that can help enhancing structural design under such loads

Hepatic Arterial Therapy with Drug-Eluting Beads in the Management of Metastatic Bronchogenic Carcinoma to the Liver: A Multi-Institutional Registry

Introduction. There has been limited information reported on the use of hepatic arterial therapy in liver dominant hepatic metastases arising from lung cancer. The aim of this study was to evaluate the safety and efficacy of hepatic arterial therapy in the treatment of liver dominant hepatic metastases arising from lung cancer. Methods. Thirteen patients underwent a total of 30 treatment sessions with Drug-Eluting Beads. Eight of the thirteen received only doxorubicin DEB (17 of the total treatments), and four patients received Irinotecan DEB (7 of the total treatments). Results. The planned preprocedural dosage was a median of 75 mg (range 19–200), with total hepatic dose exposure being a median of 150 mg (range 0–458), with a technical success rate of 97% in all 29 treatments. There were 4 adverse events related to treatment, but no evidence of hepatic insufficiency. Overall 6-month and 12-month response rates were 50%. After a median followup of 24 months, the median overall survival in this cohort was 14 months (range 7–48 months). Conclusion. Drug-eluting beads loaded with doxorubicin (DEBDOX) or irinotecan (DEBIRI) can be safely and effectively used in treatment of patients with liver predominant metastatic disease from lung cancer

Methylene tetrahydrofolate reductase (MTHFR) gene polymorphisms in rheumatoid arthritis patients: Correlation with serum osteopontin levels and disease activity

AbstractBackgroundRheumatoid arthritis (RA) is a systemic, chronic inflammatory disease with genetic predisposition. Osteopontin (OPN) is overexpressed in RA and plays a key role in the perpetuation of synovitis. Not all RA patients show the same level of response to methotrexate (MTX) suggesting genetic variations in the drug-metabolizing enzymes.Aim of the workTo detect methylene-tetra-hydrofolate reductase (MTHFR) 677C/T and 1298A/C gene polymorphisms in RA patients treated with MTX and to investigate the relationship with serum OPN levels and disease activity.Patients and methods62 RA patients and 21 healthy controls were included. Serum OPN was measured using ELISA. Genotyping of MTHFR gene was carried out by polymerase chain reaction-restriction fragment length polymorphism. Disease activity score in 28 joints (DAS28) and the modified health assessment questionnaire (MHAQ) were assessed.ResultsThe patients’ age was 42.7±12.7years, F:M (4.6:1) and a disease duration of 5.7±4.6years. Their DAS28 was 4.1±1.6 and the MHAQ (median 1; range 0–2.3). Serum OPN levels in RA patients (median 8.8; range 4–44.5ng/ml) were significantly higher than in control (5.6; 2.1–10.9) (p=0.002). In RA patients, serum OPN significantly correlated with the duration of morning stiffness (p=0.009), ESR (p<0.0001) and DAS28 (p<0.0001). MTHFR (677C>T) polymorphisms significantly correlated with MHAQ (p=0.012) while (1298A>C) polymorphisms significantly correlated with tender joint count (p=0.04). OPN levels were higher among patients with MTHFR (1298A/C) AC genotype (8.9; 4.1–33.9ng/ml), while in those with (677C>T) polymorphisms it was higher among those with CT genotype (8.9; 4.1–44.5).ConclusionSerum OPN level relates with the degree of rheumatoid activity

Pain behavior of people with intellectual and developmental disabilities coded with the new PAIC-15 and validation of its Arabic translation

Pain management necessitates assessment of pain; the gold standard being self-report. Among individuals with intellectual and developmental disabilities (IDD), self-report may be limited and therefore indirect methods for pain assessment are required. A new, internationally agreed upon and user-friendly observational tool was recently published—the Pain Assessment in Impaired Cognition (PAIC-15). The current study’s aims were: to test the use of the PAIC-15 in assessing pain among people with IDD and to translate the PAIC-15 into Arabic for dissemination among Arabic-speaking professionals. Pain behavior following experimental pressure stimuli was analyzed among 30 individuals with IDD and 15 typically developing controls (TDCs). Translation of the PAIC followed the forward–backward approach; and reliability between the two versions and between raters was calculated. Observational scores with the PAIC-15 exhibited a stimulus–response relationship with pressure stimulation. Those of the IDD group were greater than those of the TDC group. The overall agreement between the English and Arabic versions was high (ICC = 0.89); single items exhibited moderate to high agreement levels. Inter-rater reliability was high (ICC = 0.92). Both versions of the PAIC-15 are feasible and reliable tools to record pain behavior in individuals with IDD. Future studies using these tools in clinical settings are warranted

Effect of Modifying Mechanical Ventilator Trigger Sensitivity on Arterial Blood Gases in ICU Patients

Background: Despite the fact that mechanical ventilation is an essential part in management of critically ill patients, mechanically ventilated patients have a higher risk of complications, which can lead to increased morbidity and mortality. Objective: This study aimed to study the effect of training inspiratory muscle through modifying mechanical ventilator (MV) trigger sensitivity on arterial blood gases in mechanically ventilated patients. Patients and Methods: Sixty adult patients diagnosed with acute respiratory failure, needed to be intubated and connected to mechanical ventilated. They were from both gender and their ages ranged from 50 to 70 years. The patient were chosen from Intensive Care Unit (ICU), Department of Chest Diseases, Cairo University Hospitals. They were randomly assigned into two equal groups. Group (A): included thirty patients who received training for inspiratory muscle through modifying MV trigger sensitivity plus usual physical therapy. Group (B): included thirty patients who received usual physical therapy only. Results: The results showed a significant increase in partial arterial pressure (PaO2) in both groups, this increasing was significantly higher in&nbsp; patients who received training for the inspiratory muscle plus the usual chest physical therapy than patients who only received usual chest physical therapy (P-value &lt; 0.001). The results showed no significant change in neither power of hydrogen (pH) nor partial pressure of carbon dioxide (PaCO2). Conclusion: Training to inspiratory muscles in mechanically ventilated patient through modifying mechanical ventilator trigger sensitivity can produce a significant increase in partial arterial pressure (PaO2). Although it has no effect in pH nor PaCO2

The Ishraq Program for out-of-school girls: From pilot to scale-up

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities of local facilitators and partners to implement the program. This report identifies ways to continue expanding Ishraq, for which community demand remains high, including a new generation of girls’ programs to support graduates in exercising their rights and becoming active members of the community; and notes many important lessons on recruitment strategy, program structure and implementation, capacity-building, and partnerships

SERS enhancement of silver nanoparticles prepared by a template-directed triazole ligand strategy

Two advances in the development of a one-pot method to prepare silver nanoparticles (AgNPs) using the Tollens’ reagent are described. First, a template-directed process of AgNP synthesis using resorcinol triazole ligands bearing two pendent galactose sugars is shown. Second, the conversion of these AgNPs into SERS nanotags is demonstrated using malachite green isothiocyanate as the Raman reporter molecule