التحديد المتزامن للمشاركة الدوائية بين الميتفورمين والسيتاغلبتين باستخدام تقنية الاشتقاق الطيفي

يواجه التحديد المتزامن للأدوية المركبة دون فصل مسبق لمكوناتها باستخدام الطرق الطيفية التقليدية صعوبة كبيرة بسبب التداخل بين أطياف الامتصاص العادية (انتقائية منخفضة)، لذا تم تطوير العديد من التقنيات لحل هذه المشكلة نذكر منها تقنية الاشتقاق الطيفي، والتي تعد تقنية صديقة للبيئة، اقتصادية، سريعة، ودقيقة. هدفت هذه الدراسة إلى التحديد المتزامن للمشاركة الدوائية بين الميتفورمين والسيتاغلبتين باستخدام تقنية الاشتقاق الطيفي. بدايةً تم تحضير سلاسل عيارية ومزائج مخبرية لكلتا المادتين وتسجيل أطياف الامتصاص لها ثم اشتقاق هذه الأطياف لثلاث رتب (الأول، الثاني، الثالث)، ثم تم تحسين معاملات الاشتقاق (Scale Factor, ) واختيار القيم المناسبة لكل مشتق، بعدها تم استنتاج تقنيات القياس (Zero-Crossings, AS, MAS, PF) وتطبيق هذه التقنيات على العينات التجارية (A,B,C) للعيار 850/50 ملغ، تمّ التحقّق من مصدوقية الطرق المختارة وفقاً لإرشادات ICH. كانت قيمة    = 20للميتفورمين والسيتاغلبتين وقيم scale factor للميتفورمين (50,35,10) وللسيتاغلبتين (700,500,100) للمشتقات الأول، الثاني، والثالث على التوالي. تم اختيار تقنيات القياس الأفضل تبعاً لقيم الاسترداد والخطأ النسبي للميتفورمين والسيتاغلبتين في المزائج المخبرية والعينات التجارية، حيث تبيّن إمكانية تطبيق التقنيات الثلاث (Zero-Crossings, AS, MAS) على المشتقين الأول والثاني، وتقنية P-Factor على المشتق الثاني فقط. أبدت جميع الطرق المختارة مصدوقية جيدة للمشتقين الأول والثاني، وبالتالي فإنه من الممكن الاعتماد على تقنية الاشتقاق الطيفي للتحديد المتزامن للميتفورمين والسيتاغلبتين

Efficacy of fractional co2 laser in the treatment of facial atrophic acne scars in Tishreen University Hospital outpatients in Lattakia 2017-2018

Background and objective: Facial scarring resulting from acne is a common cosmetic concern. Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application .Fractional co2 laser is one of the modern methods of skin resurfacing , and this study aimed to assess the efficacy of this method in treating facial atrophic acne scars. Patients and methods: Thirty participants with facial atrophic acne scars, 17 female and 13 male, underwent to three treatment sessions with fractional co2 laser , at 4-6 week intervals. Treatment energy parameters were  increased every session about 10 watt. Improvement of acne scarring was evaluated using ECCA Grading Scale before the first session and three months after the last session. We also evaluated resulting side effects after every session. Results: The mean ECCA score was 126.5 ± 30.6 before the first session and became 70.3 ± 27.5 three months after the last session  .  86.6% and 33.3% of patients have got  more than 25% and 50% improvement  respectively. The best result was seen in boxcar type. Post inflammatory hyper pigmentation was the most frequent side effect . Conclusion: Fractional co2 laser is an effective and safe therapy for facial atrophic acne scars especially boxcar type. المقدمة : تعتبر الندب العدية أشيع اختلاطات العد الشائع ، وعلى الرغم من كثرة الوسائل المتاحة لعلاجها إلا أنه لا يوجد حتى الآن وسيلة تحقق الحل الأمثل .  يعد ليزر co2  المجزأ من التقنيات الحديثة المستخدمة لتمليس الوجه وهدفنا في هذا البحث دراسة فعالية هذه التقنية في علاج الندبات العدية الضمورية التي تصيب الوجه . المواد وطرائق البحث: ضمت الدراسة 30 مريضاً (13ذكور – 17إناث) . خضعوا لثلاث جلسات علاجية بليزرco2 المجزأ بفاصل 4-6أسابيع بين الجلسات و باستخدام قيم طاقية متزايدة حوالي 10 واط  كل جلسة. تمت دراسة درجة التحسن لدى كل مريض باستخدام مقياس ECCA قبل البدء بالعلاج وبعد ثلاثة أشهر من الجلسة الاخيرة  . كما تم تقييم الآثار الجانبية الحاصلة بعد كل جلسة. النتائج: انخفضت قيمة متوسط مقياس ECCA بعد العلاج بمقدار 44.4% عن قيمته قبل العلاج .حقق 86,6% و 33,3% من المرضى درجات تحسن فوق 25% و 50% على التوالي . وُجدت أفضل النتائج في ندب صندوق السيارة . كان  فرط التصبغ أشيع الآثار الجانبية  وارتبط حدوثه بالتعرض للشمس . الخاتمة: ليزر co2 المجزأ وسيلة فعالة وآمنة لعلاج الندبات العدية الضمورية التي تصيب الوجه وبشكل خاص تلك المسماة ندب صندوق السيارة .

Learning cities and learning communities: analyzing contextual factors and their impacts on adult and lifelong learning in urban settings

This is the published version of an article published by Institute for Pedagogy and Andragogy, University of Belgrade in Andragogical Studies in June 2020, available online: http://www.as.edu.rs/search?l=enThis paper will elaborate upon the contextual aspects of community development in the scope of Learning City and Learning Community related practices of knowledge transfer and sharing in urban environments. Engaged colleagues will provide their critical approaches, reflections and proposals upon how we can understand and recognize adult and lifelong learning through communities trying to reach for peace, understanding, social inclusion and sensitive intercultural and intergenerational aspirations in times of difficulties and challenges affecting our vulnerable relationships. This paper will try to point out matters of equity, human discoveries of collection, sharing and saving values, tradition and dignities through Learning Communities in four different cultural environments from the British Isles, India, Palestine and Hungary. Their urban frames might not be necessarily called or considered as Learning Cities, but labels and notions are not the first priority. It is as simple as it sounds: No One Left Behind

Mental Health Burden and Resilience among Nigerians undergoing COVID-19 Isolation in Kaduna-Nigeria

Background: The coronavirus pandemic and Its “pandemic-fear,” is expected to come with lots of mental health challenges. Despites several global health vanguards sounding this alarm, there is paucity of systematic analysis of mental health distress and resilience being experienced by individuals undergoing treatments in isolation centres for coronavirus disease (COVID-19).Objectives: This study evaluated the pattern of mental distress and resilience in COVID-19 patients undergoing isolation-care in some treatment facility in Kaduna-Nigeria.Method: Data were collected cross-sectionally from 261 participants. These were sociodemographic and clinical variables, measures of mental distress (i.e. depression and anxiety), and well-being (i.e. resilience). Statistical analysis was carried out using SPSS version 21.Results: The mean age of participants was 35.6 years (SD = 11.1), with majority being males (73.6%) and without prior chronic medical condition (73.9%). Mental distress rates were 33.0% for depression and 19.2% for anxiety. Majority (97.1%) had good resilience characteristics. Significant variable associated with low mental distress and high resilience is belonging to age group 40 years and above. Also, resilience was moderately and significantly related to mental distress.Conclusion: Mental distress is relatively high among COVID-19 patients undergoing isolation-treatment. This rate is associated with age group of below 40 years and having low resilience characteristics. Efforts to boost resilience among COVID-19 might institute preventive measures against mental distress

Brushite: Synthesis, Properties, and Biomedical Applications

In this chapter, besides its biomedical applications, the synthesis and properties of brushite were investigated. Brushite consists of two types of crystals, platy and needle-like, and their formation depends on the pH of the medium during precipitation. Platy crystals are formed in a slightly acidic medium, pH = 5, and needle-like crystals at a higher pH = 6.5–7. In this study, the monoclinic brushite crystals were synthesized using dissolution-precipitation reactions. It is found that the brushite crystal growth occurs mainly along the (020) crystallographic plane. The thermogravimetric analysis confirms the presence of the two structural water molecules, which decompose at a temperature range between 80 and 220°C. Brushite was used in the preparation of tetracalcium phosphate mineral, which is the powder component for calcium phosphate cement (CPC). CPC was subsequently prepared from TTCP and phosphate-based hardening solution. In vitro evaluation of the resultant CPC using Hanks’ Balanced Salt Solution results in the growth of nanofibrous crystals of Calcium-deficient hydroxyapatite (CDHA) layers on the surfaces of the CPC. The cultured CPC exhibits new connective tissues and throughout the CaP matrix

Studying The Prevalence Of Achieving Therapeutic Goals Of Diabetes Treatment Among Diabetic Patients In Royal Medical Services

Diabetic complications are considered a public concern on global level and have their negative impacts on patients. The main objectives of the present study were to determine the prevalence of diabetic complications among a sample of diabetics in Royal Medical Services and to conclude the appropriate recommendations to reduce the effects of diabetic complications. The method of choice involved a retrospective design and 392 files of diabetic patients were reviewed. Study findings showed that the prevalence of diabetic neuropathy was 43%, hypertension 42%, diabetic foot ulcer 9%, glaucoma 48%, and heart disease 25%. Predictors for diabetic neuropathy were the level of HbA1C (p=0.015), and gender (p=0.018), while the predictors for hypertension were duration of DM (p=0.000) and age (p=0.000). The predictors of foot ulcer included the level of HbA1C (p=0.013), and the use of metformin (p=0.026). Glaucoma was predicted by duration of DM (p=0.002), and gender (p=0.017). Heart disease was predicted by duration of DM (p=0.003), gender (p=0.041), and age (p=0.000). Taken together, diabetic complications are prevalent on global level and in our settings which implies that the therapeutic options of DM are still far from their ultimate goals. we recommend adopting of more effective monitoring systems for screening diabetics, particularly those who are expected to develop diabetes. We also recommend to activate the roles of clinical pharmacist to raise the awareness level about diabetic complications among the public

Practice of non-pharmaceutical interventions against COVID-19 and reduction of the risk of influenza-like illness: a cross-sectional population-based study

INTRODUCTION: While the widespread implementation of the non-pharmaceutical interventions was intended to contain the COVID-19 pandemic, such measures could be also effective in limiting the spread of other respiratory infections. This study aimed to examine the association between the implementation of personal protective measures and the occurrence of influenza-like illnesses (ILI) in the general population. METHODS: An online retrospective cross-sectional observational study was conducted in April 2021 to assess cases of ILI among Lebanese adults aged 18 years and above, from all Lebanese governorates during the 2020-2021 flu season. Data were collected using a convenience sampling method. In addition to their socio-demographic information, participants were asked about their frequency of implementing personal protective measures and if they have experienced symptoms of ILI in the previous 6 months. The overall score of the personal protective measures was computed. Multivariable logistic regression was performed to examine the association between participants' level of adoption of personal protective measures against COVID-19 and the occurrence of ILI. RESULTS: Among the 1019 Lebanese adults participating in this study, 352 (34.54%) of them reported symptoms of ILI between October 2020 and March 2021. Lebanese adults who wore their facemasks frequently or always were less likely to suffer from symptoms of ILI than others who did not wear the mask (aOR = 0.452, 95% CI = 0.349-0.693, p < 0.001). Similarly, adults who adopt the following protective measures washing hands (aOR = 0.608, 95% CI = 0.524-0.922, p < 0.001), respecting cough etiquette (aOR = 0.763, 95% CI = 0.598-0.918, p < 0.001), disinfecting surface (aOR = 0.892, 95% CI = 0.632-0.911, p = 0.012), avoiding crowded places (aOR = 0.739, 95% CI = 0.688-0.903, p = 0.049), respecting physical distancing (aOR = 0.646, 95% CI = 0.482-0.833, p = 0.031) on a regular basis (frequently/always) were less likely to report symptoms of influenza-like illnesses when compared with those who did not adhere at all to these measures. CONCLUSION: Our study highlighted the potential of personal protective measures against COVID-19 in reducing the transmission of respiratory infections such as ILI. Such findings might be invested during influenza season, particularly among groups at high risk of developing severe complications. Exploring trends detected by the national severe acute respiratory infection surveillance system is recommended to confirm the utility of these measures

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely