Technetium-99m Sestamibi Scintigraphy Pattern in Patients with Secondary Hyperparathyroidism

complications of end stage renal disease (ESRD). We aimed in this investigation to explore the role of Technetium-99m sestamibi (99mTc MIBI) scintigraphy in the pre-operative assessment of refractory hyperparathyroidism in hemodialysis (HD) patients. Methods: Dual-phase 99mTc MIBI parathyroid scintigraphy was performed for 23 patients with ESRD who have persistent intact parathyroid hormone (iPTH) levels exceeding 300 pg/ml. Based on scintigraphy results, 13 patients underwent neck exploration during which only glands with positive scintigraphy findings were removed. Results: Among the six patients who had iPTH levels < 800 pg/ml, only one patient had positive scintigraphy findings (16.7%). Among the 17 patients who had iPTH levels ≥ 800 pg/ml, 16 patients had positive scintigraphy findings (94.1%). 99mTc MIBI scan detected 23 positive sites of focal trace uptake in those 17 patients. Partial parathyroidectomy was performed for 13 patients, removing in total 19 glands, while four patients declined surgery. On histological examination, 12 glands showed diffuse hyperplasia, four glands showed nodular hyperplasia and three glands revealed parathyroid adenoma. The three glands with parathyroid adenoma were correctly identified prior to surgery by 99mTc MIBI scintigraphy. The long-term outcomes of these patients are now being monitored. Conclusion: ESRD patients with iPTH level ≥ 800 pg/ml are more likely to have positive sites of focal tracer uptake on MIBI scan than patients with lower iPTH levels. Dual-phase 99mTc MIBI scintigraphy has the ability to correctly identify parathyroid adenoma prior to surgical exploration in these patients. Keywords: Hyperparathyroidism, parathyroid adenoma, parathyroid hyperplasia, scintigraphy, 99mTc sestamib

Hydration Characteristics of Limestone Filled Cement Pastes

The physico-mechanical properties of hardened limestone-filled cement pastes were studied. Five filled-cements were prepared from 0, 5, 10, 15 and 20 wt. % of limestone and OPC. The water of consistency of filled-cement pastes was 0.275, 0.275, 0.275, 0.272, and 0.270, respectively. The pastes are moulded into one inch cubic moulds and left within the moulds at 100% relative humidity for 24 h, then demoulded and cured under tap water for 3, 7, 28, and 90 days. At each hydration time, the combined water, bulk density, total porosity and compressive strength of the hardened filled-cement pastes were determined. Some selected filled-cement pastes were investigated using differential thermal analysis (DTA) and scanning electron microscope (SEM) Techniques. Addition of limestone to Portland cement causes an increase of hydration at early ages inducing a high early strength, but it can reduce the later strength due to the dilution effect. The results indicate that the addition of limestone up to 5 wt. % improves the physico-mechanical properties of ordinary Portland cement which acts as a nucleating agent and accelerates the hydration of filled cement pastes. The addition of 5 wt. % limestone can be used in the production of portland cement according to the international specifications. On the other side, the addition of 10-20 wt. % limestone can be used in the production of blended or mixed cements

Synthesis and Evaluation of Antioxidant Activity of Some New Heterocyclic Compounds Bearing the Benzo[B]Furan Moiety

New compounds were synthesized by the reaction of 3-acetyl-5- methoxy-2-methylbenzofuran (1) with cyanoacetylhydrazine which afforded the hydrazide hydrazone derivative 2. Compound 2 underwent a series of heterocyclization reactions to give the new pyrazole, isoxazole, cyclopentanothiophene, thiazole, triazole, 2H-chromene and pyridone derivatives (3-13). The elemental and spectral data (IR, 1H NMR and MS) characterized their structures. Screening for some selected compounds was carried for their potential antioxidant activities using ABTS. Among the tested samples compounds 9, 11, 5 and 10 exhibited promising activity

Pregnancy outcome in rheumatic mitral stenosis patients with and without surgical correction: a prospective cohort study

Background: The aim of the current study is to assess the maternal and fetal outcomes of pregnant females with and without surgically corrected mitral stenosis (MS).Methods: A cross sectional study was carried out at Assiut Women's Health Hospital, Egypt between February 2016 and December 2016. All pregnant women diagnosed with rheumatic heart disease attending the antenatal care clinic were enrolled in the study. They were divided into two groups according to previous surgical correction of MS or not. All women were followed up during pregnancy till the end of puerperium. The primary outcome of the study was the difference in the rate of maternal cardiac complications during pregnancy between both groups.Results: The study included 48 patients (39%) with surgically corrected MS and 75 patients (61%) with uncorrected MS. All cardiac complications were significantly higher in the uncorrected MS group (p <0.05). No difference between both groups in the mode of delivery (p=0.52). Postpartum hemorrhage is more common with the corrected MS group than the uncorrected group (25% vs. 9.3% respectively, p=0.003), while the need for postpartum admission to ICU was significantly higher in the uncorrected group (p=0.006). The mean birth weight was higher in the corrected MS group (p=0.000). The percentage of stillbirths and the rate of admission to PCU was higher in the uncorrected MS group (p=0.003).Conclusions: Surgical correction of MS significantly improves the maternal and fetal outcomes of rheumatic heart pregnant females with MS

Windbreak-Grown Casuarina and Eucalyptus Trees for Unbleached Kraft Pulp

A laboratory-scale evaluation was conducted of juvenile windbreak-grown Casuarina and Eucalyptus trees for kraft pulp production. Test results of unscreened pulp yields, pulp chemical analyses, and handsheet physical properties indicated that windbreak-grown materials are suitable for unbleached kraft pulp. Casuarina gave the best pulp yield and had higher tear strength than Eucalyptus, but both species were superior to kraft pulps from agricultural raw materials such as rice straw and Thymelia, which are currently used in Egypt. For both species, the best kraft pulping schedule tested was a 4:1 liquor-to-wood ratio with 20% active alkali with additional conditions constant. Scanning electron micrographs of handsheets helped explain the observed differences in physical properties between the two species. Mixing of Casuarina and Eucalyptus raw material prior to pulping shows promise for unbleached kraft pulp production

Comparison between two different regimens of anticoagulants for pregnant women with prosthetic heart valves

Background: The current study aims to assess the maternal and fetal outcomes of pregnant females with prosthetic heart valves receiving oral anticoagulants only versus the sequential regimen of heparin and OA throughout pregnancy.Methods: An observational was carried out at Assiut Women's Health Hospital, Egypt between February and December 2016. All pregnant women with prosthetic heart valves attending the emergency department during the study period were enrolled in the study. All included patients were classified into two groups; women who receive low molecular weight heparin (LMWH) during the first trimester then shift to warfarin till 36 weeks of gestation then continue on LMWH till delivery (Group I) and those who continue the all period of pregnancy on warfarin (Group II). The primary outcome of the study was the difference in the rate of maternal cardiac complications during labor between both groups.Results: The study included 72 patients have prosthetic valve replacement and on anticoagulants. Twenty-one were on oral anticoagulant; warfarin (Group II) and 51 pregnant women were on sequential regimen. Both groups were comparable in their basic and clinical data on admission. No difference between both groups in the mode of delivery (p=0.52), postpartum hemorrhage (0.09), sub rectal hematomas (p=0.08), the need for postpartum admission to ICU (p=0.93) and the duration of hospital stay (p=0.47). Additionally, no statistical significant difference between both groups as regard the mean birth weight (p=0.97), Apgar score (p=0.62), fetal sex (p=0.92) and congenital anomalies (p=0.08).Conclusions: The use of sequential LMWH and oral anticoagulants appears to be a safe option for those women although there is no difference in maternal and fetal outcomes with the use of continuous oral anticoagulants throughout the pregnancy

In vivo evaluation the efficiency of nitazoxanide with cationic Gemini surfactant on Cryptosporidiosis

تُعرض الإصابة بداء خفيات الأبواغ حياة العديد من الأشخاص للخطر وخصوصا المصابين بنقص المناعة، تحديدا مرضى فيروس نقص المناعة البشرية.  يُعد النيتازوكسانيد أحد الأدوية العلاجية الرئيسية المستخدمة في علاج داء الكريبتوسبوريديوسس. ومع ذلك، فهو ضعيف الذوبان في الماء ، مما يحد من فائدته وفعاليته في المرضى الذين يعانون من نقص المناعة. يحتوي الفاعل بالسطح على طابع برمائي وهذا يشير إلى قدرتها على تحسين قابلية الذوبان في الماء للعقار المضاد للماء. يتعلق بحثنا بتركيب مواد خافضة للتوتر السطحي من الجوزاء الموجبة الجديدة والتي لديها القدرة على تحسين قابلية ذوبان عقار نانازوكسيد. لذلك قمنا بتوليف مواد خافضة للتوتر السطحي توأمية موجبة.  N1,N1,N3,N3-tetramethyl-N1,N3-bis(2-octadecanamidoethyl)propane-1,3-diaminium bromide (CGSPS18) و  2,2‘-(ethane-1,2-diylbis(oxy))bis(N-(2-octadecanamidoethyl)-N,N-dimethyl-2-oxoethane-1-aminium) dichloride (CGSES18)   وتأكيد تركيبها الكيميائي بالطرق الطيفية المختلفة وكذلك دراسة خصائص السطح والسمية لها. بالإضافة إلى ذلك، تمت دراسة فعالية نيتازوكسانيد في الفئران المصابة بإضافة ثلاث جرعات مختلفة من المواد الخافضة للتوتر السطحي. لمعرفة تأثير النيتازوكسانيد والمواد الخافضة للتوتر السطحي معا، تم حساب العدوى بالطفيليات قبل العلاج وبعده ، كما تم فحص الأنسجة المعوية والكبدية والرئوية. في هذه الدراسة وجد أن الجمع بين عقار نيتازوكسانيد مع المواد الخافضة للتوتر السطحي وخاصة المركب (CGSPS18) بتركيز 25٪ زاد من الفعالية وأدى إلى انخفاض بنسبة 90.8٪. أظهر فحص الأنسجة المرضية أن المجموعة التي عولجت بعقار نيتازوكسانيد مع CGSPS18 أظهرت أفضل النتائج التي أظهرت نمطًا زغبيًا طبيعيًا تقريبًا. أظهرت هذه الدراسة زيادة في فعالية النيتازوكسانيد عند دمجه مع المواد الخافضة للتوتر السطحي ، وهذا يشير إلى مستقبل واعد لاستخدام المواد الخافضة للتوتر السطحي كعامل مساعد لتعزيز فعالية النيتازوكسانيد في علاج داء خفيات الأبواغ في المرضى الذين يعانون من نقص المناعة ، وخاصة مرضى فيروس نقص المناعة البشرية.Infection with cryptosporidiosis endangers the lives of many people with immunodeficiency, especially HIV patients. Nitazoxanide is one of the main therapeutic drugs used to treat cryptosporidiosis. However, it is poorly soluble in water, which restricts its usefulness and efficacy in immunocompromised patients. Surfactants have an amphiphilic character which indicates their ability to improve the water solubility of the hydrophobic drugs. Our research concerns the synthesis of new cationic Gemini surfactants that have the ability to improve the solubility of the drug Nanazoxide. So, we synthesized cationic Gemini surfactants. N1,N1,N3,N3-tetramethyl-N1,N3-bis(2-octadecanamidoethyl)propane-1,3-diaminium bromide (CGSPS18) and 2,2‘-(ethane-1,2-diylbis(oxy))bis(N-(2-octadecanamidoethyl)-N,N-dimethyl-2-oxoethane-1-aminium) dichloride (CGSES18) and the detection of their chemical composition by spectroscopic methods, as well as studying the properties of their surfaces and their toxicity. Furthermore, the efficacy of nitazoxanide in infected mice was studied in conjunction with three different doses of surfactants. To assess the effect of nitazoxanide and surfactants, the infection was parasitologically counted before and after treatment, and the intestinal, liver, and lung tissues were also examined histopathologically. In this study, it was found that the combination of the drug nitazoxanide with surfactants, especially the compound (CGSPS18) at a concentration of 25% increased the efficacy and resulted in a percentage reduction of 90.8%. Histopathological examination revealed that the group treated with the drug nitazoxanide in combination with CGSPS18 showed the best results exhibiting an almost normal villous pattern. This study demonstrated an increase in the effectiveness of nitazoxanide when combined with surfactants, and this suggests a promising future for the use of surfactants as an adjunct to enhance the effectiveness of nitazoxanide for the treatment of cryptosporidiosis in immunocompromised patients, particularly HIV patients

Mathematical Description of the Change in Properties of Casuarina Wood Upon Exposure to Gamma Radiation. 1. Changes in the Compressive and Tensile Strength

Casuarina cunninghamiana specimens were exposed to gamma-radiation doses ranging from 104 to 108 rad and tested in compression and tension parallel to grain. The percentage values of the irradiated specimens relative to that of the matched control (Y) were determined. The relationship between (Y) and log gamma radiation dose (X) was represented mathematically by the equation: Y = aXbcx. This equation described the change in compressive and tensile strength very well as was detected from the high correlation coefficients. Generally these properties increased slightly at low levels of radiation, reached a maximum, then decreased gradually thereafter. The reduction in tensile strength was more pronounced than in compressive strength.The threshold dose, i.e., the dose beyond which the properties began to decrease, was calculated. This dose ranged from 3.69 x 106 to 3.76 x 106 rad for compressive strength properties and from 1.51 x 106 to 1.70 x 106 rad for tensile strength properties. This indicated that irradiated casuarina wood had a greater resistance to compression than to tension

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Clinical audit of neonatal care in Assiut Women's Health Hospital, Egypt

Background: The current study aims to auditing the current care of healthy full term newborns in the delivery room and identify the gap between the current practice and ideal practice in Assiut Women's Health Hospital, Egypt.Methods: The current study was a clinical audit carried out in Assiut Woman Health Hospital, in the period from 1 September 2016 to 28 February 2017.The study included all newborns delivered in the delivery word of gestational age after 37 week. We excluded all Preterm babies, those with congenital anomalies, pregnant women with medical disorders and multiple pregnancies. In the present work all data was collected prospectively through direct personal patient contact, direct observation of care givers, patient interactions and attitudes, from the clinical records and then recording the data in special check sheet. All basic criteria of the study participants as age, parity, gestational age at delivery and type of delivery were obtained. The neonatal gender, weight, heart rate and respiratory rate were checked. Audit criteria were selected according to the WHO 2015 and AAP 2010-2015 guidelines.Results: The study included 800 women; the mean age of the women was 26.52±5.70 years. The mean parity was 1.78±1.85. The mean gestational age at delivery was 38.81±0.96 weeks. As regard the type of delivery, 54.1% of women were delivered by cesarean section. Calling neonatologists occurred in 67.9% of deliveries. The mean birth weight was 3.17±0.39 kilograms. Nearly half of them (52%) were males.Conclusions: Application of the guidelines of the neonatal handling is important for optimum care to the neonates. Re-audit the steps of the handling is important to discuss whether practice has improved or not in our tertiary hospital