Methotrexate in the Treatment of Non-Melanoma Skin Cancers

Background: There are three types of non-melanoma skin cancer (NMSC): basal (BCC), keratoacanathoma (KA), and cutaneous squamous cell carcinoma (cSCC). These three malignancies account for 99 percent of all tumors in this category. Because it slows DNA synthesis in quickly proliferating cells, methotrexate (MTX) is an effective treatment for tumors that are fast developing. To prevent the production of the purine nucleotide thymidine, it inhibits the development of tetrahydrofolate by binding to the dihydrofolate reductase. Objective: To assess the efficacy and safety of MTX in the treatment of NMSCs.Conclusion: When used as a less intrusive and less expensive treatment for NMSCs, MTX has the potential to be a very effective and safe alternative treatment, especially in patients who are elderly or have other medical conditions

Spektrofluorimetrijsko određivanje ciklopiroks olamina prevođenjem u ternarni kompleks s Tb(III) i EDTA

A highly sensitive and selective spectrofluorimetric method was developed for the determination of ciclopirox olamine in raw material and in dosage forms. The proposed method is based on the formation of a ternary complex with Tb(III) in the presence of ethylenediaminetetraacetic acid. It was found that this complex manifests intense fluorescence at λem 489 and 545 nm with excitation at 295 nm. Different experimental parameters affecting the fluorescence intensity of the complex were carefully studied and incorporated into the procedure. Under the described conditions, the method is applicable over the concentration range of 30150 and 1070 ng mL-1 with minimum detectability of 6.7 and 0.9 ng mL-1 at λem 489 and 545 nm, respectively. The mean percentage recovery at λem 489 and λem 545 nm ranged between 98.7 and 100.2 for the pure substance, solution, and cream. Relative error of 0.10.4% and RSD up to 0.9% were estimated at λem 489 and 545 nm. A proposal of the reaction pathway is given.Razvijena je vrlo osjetljiva i selektivna spektrofluorimetrijska metoda za određivanje antimikotika ciklopiroks olamina, kao čiste supstancije i u ljekovitim oblicima. Metoda se temelji na stvaranju kompleksa s Tb(III) u prisutnosti etilendiamintetraoctene kiseline. Nakon ekscitacije pri 295 nm taj kompleks intenzivno fluorescira pri λem 489 i 545 nm. Proučavani su različiti eksperimentalni parametri koji utječu na intenzitet fluorescencije kompleksa. Za opisane uvjete metoda se može primijeniti u koncentracijskom području 30150 i 10 70 ng mL-1. Minimalna koncentracija koja se može odrediti je 6,7, odnosno 0,9 ng mL-1 na λem 489, odnosno 545 nm. Analitički povrat pri λem 489 i λem 545 nm iznosio je 98,7100,2% za čistu supstanciju, otopinu i kremu. Relativna pogreška metode je 0,10,4%, a relativna standardna devijacija 0,9%. Predložena je jednažba kemijske reakcije

Spektrofluorimetrijsko određivanje ciklopiroks olamina prevođenjem u ternarni kompleks s Tb(III) i EDTA

A highly sensitive and selective spectrofluorimetric method was developed for the determination of ciclopirox olamine in raw material and in dosage forms. The proposed method is based on the formation of a ternary complex with Tb(III) in the presence of ethylenediaminetetraacetic acid. It was found that this complex manifests intense fluorescence at λem 489 and 545 nm with excitation at 295 nm. Different experimental parameters affecting the fluorescence intensity of the complex were carefully studied and incorporated into the procedure. Under the described conditions, the method is applicable over the concentration range of 30150 and 1070 ng mL-1 with minimum detectability of 6.7 and 0.9 ng mL-1 at λem 489 and 545 nm, respectively. The mean percentage recovery at λem 489 and λem 545 nm ranged between 98.7 and 100.2 for the pure substance, solution, and cream. Relative error of 0.10.4% and RSD up to 0.9% were estimated at λem 489 and 545 nm. A proposal of the reaction pathway is given.Razvijena je vrlo osjetljiva i selektivna spektrofluorimetrijska metoda za određivanje antimikotika ciklopiroks olamina, kao čiste supstancije i u ljekovitim oblicima. Metoda se temelji na stvaranju kompleksa s Tb(III) u prisutnosti etilendiamintetraoctene kiseline. Nakon ekscitacije pri 295 nm taj kompleks intenzivno fluorescira pri λem 489 i 545 nm. Proučavani su različiti eksperimentalni parametri koji utječu na intenzitet fluorescencije kompleksa. Za opisane uvjete metoda se može primijeniti u koncentracijskom području 30150 i 10 70 ng mL-1. Minimalna koncentracija koja se može odrediti je 6,7, odnosno 0,9 ng mL-1 na λem 489, odnosno 545 nm. Analitički povrat pri λem 489 i λem 545 nm iznosio je 98,7100,2% za čistu supstanciju, otopinu i kremu. Relativna pogreška metode je 0,10,4%, a relativna standardna devijacija 0,9%. Predložena je jednažba kemijske reakcije

Impact of copeptin on diagnosis of acute coronary syndrome

AbstractBackgroundAcute coronary syndrome remains the principal cause of death, so the early diagnosis is of great importance. Cardiac troponin is the preferred biomarker for acute myocardial infarction. Cardiac chest pain immediately increased copeptin secretion. The combination of copeptin and cardiac troponin I is being suggested for early diagnosis of acute coronary syndrome.SubjectIt was done to emphasize the importance of association of copeptin, cardiac troponin I and high sensitive C reactive protein to confirm the diagnosis of acute myocardial infarction or unstable angina pectoris in patients with a cardiac chest pain.MethodThe current study enrolled 22 patients with acute myocardial infarction as group i and 33 patients with unstable angina pectoris as group ii. The third group consisted of 23 apparently healthy persons. Patients and controls were subjecting to laboratory investigations, which include the levels of copeptin, high-sensitivity cardiac troponin high sensitive C reactive protein creatine kinase MB fraction, lipid and I profile.ResultsWe found a significant increase of copeptin in group i when compared to group iii (30.01±12.92) (9.54±3.55), respectively, p value=0.000 and group ii (30.01±12.92) (11.16±4.58) respectively, p value 0.000, but a non-significant difference in group ii when compared to group iii (11.16±4.58) (9.54±3.55) respectively, p value=0.160. Also cardiac troponin I showed a significant increase in group i when compared to group ii (136.73±26.07) (11.18±3.79), p value=0.000, and group iii (136.73±26.07) (9.61±3.70) respectively, p value=0.000, but a non-significant difference between group ii (11.18±3.79), and group iii (9.61±3.70), p value=0.129. There was a positive correlation between copeptin and cardiac troponin I within group i, r=0.718, p value=0.000.ConclusionIn suspected acute coronary syndrome, determination of copeptin and cardiac troponin I provides a remarkable negative predictive value, which aids in early and safe ruling out of myocardial infarction

Impact of a Designed Nursing Intervention Protocol about Preoperative Liver transplantation Care on Patients’ Outcomes at A University Hospital in Egypt

Background: Literature review cited that, Liver transplantation is now considered as the gold standard for treatment of patients with end-stage liver diseases and early liver tumors in cirrhotic livers. Patient education is vital to the safety and success of a transplant. Aim: the aim is to assess the impact of a designed nursing intervention protocol about preoperative liver transplantation care on patient’s outcomes as indicated by: patients` knowledge & practice mean scores, and complications developed. To fulfill the aim of this study, the following hypothesis was formulated: patients undergoing liver transplantation who will be exposed to the designed nursing intervention protocol about preoperative liver transplantation care will show better outcomes. Material and Methods: A convenient sample of 14 adult male and female patients admitted to Liver Transplant Unit at El Manial University Hospital were included, three of them were died with an attrition rate of 21.4%. Four tools were formulated to collect data pertinent to the study. 1- Sociodemographic and medical data sheet; 2- Pre/Post knowledge assessment questionnaire sheet, 3- Observational checklists, & 4- Complications assessment sheet. Structured interview, reviewing medical records, direct observation and physical examination were utilized for data collection. Results: a  significant statistical difference was found in relation to the total and subtotal mean knowledge and practice scores during different assessment periods  with P values (0.00 for both); as well, 45.5 %  of patients developed respiratory complications (pleural effusion) compared to 53.8 % of their correspondence who developed respiratory complications (pleural effusion, chest infection, and others), in addition, 9.1% of the studied subjects developed  rejection, and ascites as compared to (1.9 %, 5.7%) of their correspondence over the last consecutive three years respectively. Conclusion: Liver transplantation patients showed a positive improvement in their knowledge and practice in relation to breathing, coughing, & using respirometer exercises and range of motion. Replication of this study on a larger sample selected from different geographical areas is highly recommended. Key wards: liver transplantation, designed nursing intervention protocol, preoperative liver transplantation care, knowledge, complications, and patient`s outcome

GENETIC PARAMETERS FOR GROWTH PERFORMANCE TRAITS OF EGYPTIAN BARKI LAMBS USING RANDOM REGRESSION MODEL

Variance components and genetic parameters for growth traits were estimated for Barki lambs using the average information REMLF90 (AIREMLF90). A total of 3205 Barki lambs’ records over the period from 1984 to 2017 from experimental Borg Al-Arab station belonging to Animal Production Research Institute (APRI) were analyzed by fitting Random Regression Model (RRM) with Legendre polynomials (LPs) for body weight traits from birth up to 480 days. Gender, type of birth, year, season and age of dam were considered as fixed effects in addition to the fixed regression on Legendre polynomials, while random regression of additive genetic and permanent environmental effects were considered as random factors in the model. The results showed that all fixed factors and some interactions were significant for all studied traits (P<0.05). Quadratic equation was the best description for growth curve. Additive genetic and permanent environment variances ranged from 0.88 to 6.08 and from 0.88 to 15.33 for birth and thirteen months weights, respectively. Additive genetic and permanent environment covariances ranged from 0.05 to 16.06 and from 0.08 to 9.20 for birth with six months weights and for weaning with ten months weights, respectively. Direct and total heritabilities ranged from 0.05 to 0.41 and from 0.08 to 0.74 for four months and birth weights, respectively. Additive, genetic and phenotypic correlation coefficients were the lowest between birth weight with other studied traits and  the highest between ten months weight with other studied traits. Phenotypic variances were oscillated between 2.27 for birth weight to 22.56 for seven months weight, while, residual variances were oscillated between 0.06 for birth weight to 14.05 for four months weight. Therefore, ten months of age recommended to be the best criterion for selecting Egyptian Barki lambs for meat production

Hepatitis B virus (HBV) genotypes in Egyptian pediatric cancer patients with acute and chronic active HBV infection

<p>Abstract</p> <p>Background</p> <p>There are eight genotypes of hepatitis B virus (A-H) and subgenotypes are recognized. Genotyping can be accomplished based on a partial sequence of HBV genome such as the pre-S or S gene. Several methods have been developed and used for HBV genotyping. This study was undertaken to determine the HBV genotypes in Egyptian pediatric cancer patients with acute and chronic liver disease.</p> <p>Methods</p> <p>HBV genotypes were determined in 22 patients who had acute forms of liver disease (AH) and in 48 patients with chronic active hepatitis (CAH). A type-specific primer based the nested-PCR method was employed in the HBV genotyping.</p> <p>Results</p> <p>This study showed that HBV infections in pediatric cancer patients are attributed predominantly to viral genotypes D and B that constituted 37.1% and 25.7%, respectively of the total infections. In addition, there was a relatively high prevalence of mixed infections of 15.7% among the studied group especially mixed A/D genotype infections. Genotype D was found significantly more often in patients with CAH than in patients with AH [23/48(47.9%) <it>v </it>3/22 (13.6%)].</p> <p>Conclusion</p> <p>These findings show the distribution of HBV A-D genotypes in pediatric cancer Egyptian patients. Furthermore, our results indicate a markedly high prevalence of mixed A/D genotype infections in subjects with CAH and a possible association of mixed infections with the severity of liver diseases.</p

The Micro-Elimination Approach to Eliminating Hepatitis C:Strategic and Operational Considerations

The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV, and it can build momentum by producing small victories that inspire more ambitious efforts. The micro-elimination approach encourages stakeholders who are most knowledgeable about specific populations to engage with each other and also promotes the uptake of new models of care. Examples of micro-elimination target populations include medical patients, people who inject drugs, migrants, and prisoners, although candidate populations can be expected to vary greatly in different countries and subnational areas

Modelling the potential effectiveness of hepatitis C screening and treatment strategies during pregnancy in Egypt and Ukraine

BACKGROUND & AIMS: Hepatitis C (HCV) test and treat campaigns currently excludes pregnant women. Pregnancy offers a unique opportunity for HCV screening and to potentially initiate direct-acting-antiviral treatment. We explored HCV screening and treatment strategies in two lower middle-income countries with high HCV prevalence, Egypt and Ukraine. METHODS: Country-specific probabilistic decision models were developed to simulate a cohort of pregnant women. We compared five strategies: S0, targeted risk-based screening and deferred treatment (DT) to after pregnancy/breastfeeding; S1, WHO risk-based screening and DT; S2, WHO risk-based screening and targeted treatment (treat women with risk factors for HCV vertical transmission (VT)); S3, universal screening and targeted treatment during pregnancy; S4, universal screening and treatment. Maternal and infant HCV outcomes were projected. RESULTS: S0 resulted in the highest proportion of women undiagnosed:59% and 20% in Egypt and Ukraine, respectively, with 0% maternal cure by delivery and VT estimated at 6.5% and 7.9%, respectively. WHO risk-based screening and DT (S1) increased the proportion of women diagnosed with no change in maternal cure or VT. Universal screening and treatment during pregnancy (S4) resulted in the highest proportion of women diagnosed and cured by delivery (65% and 70% respectively), and lower levels of VT (3.4% and 3.6% respectively). CONCLUSIONS: This is one of the first models to explore HCV screening and treatment strategies in pregnancy, which will be critical in informing future care and policy as more safety/efficacy data emerge. Universal screening and treatment in pregnancy could potentially improve both maternal and infant outcomes. IMPACT AND IMPLICATIONS: In the context of two lower middle-income countries with high HCV burden (Egypt and Ukraine), we designed a decision analytic model to explore five different HCV testing and treatment strategies for pregnant women, with the assumption that treatment was safe and efficacious for use in pregnancy. Assuming DAAs in pregnancy reduced vertical transmission, model findings indicate optimal maternal and infant benefits with provision of universal (rather than risk-based targeted) screening and treatment during pregnancy: the proportion of women diagnosed and cured by delivery would be 65% in Egypt and 70% in Ukraine (versus 0% with standard of care), and the proportion of infants that would be infected at the age of 6 months would decrease from 6.5% to 3.4% in Egypt, and from 7.9% to 3.6% in Ukraine, compared to standard of care. While future trials are needed to assess safety and efficacy of DAA treatment in pregnancy and impact on VT, there is increasing recognition that the elimination of HCV cannot leave entire subpopulations of pregnant women and young children behind. Our findings will be critical in informing policymakers in improving screening and treatment recommendations for pregnant women

Enhancing interventions for prevention-of-mother-to-child- transmission (PMTCT) of hepatitis B virus (HBV)

Prevention of mother to child transmission (PMTCT) of hepatitis B virus (HBV) infection is a cornerstone of interventions to support progress towards elimination goals for viral hepatitis. Current guidelines recommend maternal screening, antiviral therapy during the third trimester of high-risk pregnancies, universal and timely HBV birth-dose vaccine, and post-exposure prophylaxis with hepatitis B immunoglobulin (HBIG) for selected neonates. However, serological and molecular diagnostic testing, treatment and HBV vaccination are not consistently deployed, particularly in many high endemicity settings, and models predict that global targets for reduction in paediatric incidence will not be met by 2030. In this article, we briefly summarise the evidence for current practice and use this as a basis to discuss areas in which PMTCT implementation can potentially be enhanced. By reducing health inequities, enhancing pragmatic use of resources, filling data gaps, developing advocacy and education, and seeking consistent investment from multilateral agencies, significant advances can be made to further reduce vertical transmission events, with wide health, societal and economic benefits