Oral manifestations of inflammatory bowel disease

Inflammatory bowel diseases (IBD), including Crohn\u2019s disease and ulcerative colitis, have important extraintestinal manifestations, notably in the oral cavity. These oral manifestations can constitute important clinical clues in the diagnosis and management of IBD, and include changes at the immune and bacterial levels. Aphthous ulcers, pyostomatitis vegetans, cobblestoning and gingivitis are important oral findings frequently observed in IBD patients. Their presentations vary considerably and might be well diagnosed and distinguished from other oral lesions. Infections, drug side effects, deficiencies in some nutrients and many other diseases involved with oral manifestations should also be taken into account. This article discusses the most recent findings on the oral manifestations of IBD with a focus on bacterial modulations and immune changes. It also includes an overview on options for management of the oral lesions of IBD

SURGICAL TREATMENT OF SACROCOCCYGEAL PILONIDAL SINUS WITH THE LIMBERG FLAP: REVIEW OF 81 CASES

Pilonidal sinus disease is a complex condition that causes both discomfort and embarassment to suffers. Direct cost through absence from work is high. Controversy still exists regarding the best surgical technique for its treatment in terms of minimizing disease recurrence and patient discomfort. Thus, we conducted this study to evaluate the results of rhomboid excision and Limberg flap reconstruction in the surgical treatment of pilonidal sinus disease. This prospective study included 81 patients who had pilonidal sinus and were treated by the rhomboid excision and Limberg flap. The mean follow-up was 18 months and all patients were satisfied with the procedure. There were lower complication rates, minimal discomfort, patients disharged in 2-3 days and only two recurrences. The Authors recommend the Limberg flap procedure for pilonidal sinus disease. It is effective, with short hospitalization, low recurrence rate and shorter time off work

The Effect of Symptoms on the Survival Time of Coronavirus Patients in the Sudanese Population

The COVID-19 pandemic has rapidly spread worldwide, resulting in substantial rates of illness and death. Gaining insight into the various factors that impact the duration of survival among individuals diagnosed with COVID-19 is of utmost importance to inform clinical practices and public health strategies This study aims to evaluate the relationship between the acuteness of symptoms and the survival time of coronavirus patients in Sudan. The Kaplan-Meier curves and log-rank test were used to determine the symptom pattern. The results of COVID-19 and Cox regression were utilized to determine the most critical symptoms affecting coronavirus patients. The log-rank test revealed that there are differences in the pattern of age and symptoms among coronavirus patients. Cox regression revealed that symptoms affect on the survival time of coronavirus patients. The Cox proportional Hazard Model shows that the hazard of age at any time increases by 116.5%, diarrhea increases by 9%, headache increases by 62.0%, fatigability increases by 13.3%, and other symptoms increase by 47.3%. This study differs from prior studies in several ways. No current study in Sudan has used survival analysis to discover the most relevant symptoms affecting survival time

MONTELUKAST SPRAY DRIED MICROPARTICLES: PREPARATION, EXCIPIENTS SELECTION AND IN VITRO PULMONARY DEPOSITION

Objective: This study focused on the preparation of montelukast sodium (MTK) fast release pulmonary targeted microparticles using the spray drying technique.Methods: The effect of addition of different excipients namely: mannitol, leucine and ovalbumin on the physico-chemical characteristics of MTK spray dried powders were investigated. Powder flow properties, drug association efficiency as well as microparticle size and mass median aerodynamic diameter were determined. The prepared microparticles were characterized using FT-IR and TGA. The powder crystallographic and thermal properties were studied using DSC and X-ray powder diffraction. A twin stage impinger was used to evaluate in vitro pulmonary deposition from which the inhalation indices were derived.Results: The tested excipients showed no adverse chemical interactions with the drug based on FT-IR. The best inhalation indices were obtained with powders spray dried with leucine followed by leucine/mannitol mixtures with MMAD of 1.73±0.08 and 1.36±0.16 and fine particle fraction of 60.55±1.63 and 52.31±3.52, respectively. The dried powders showed good physico-chemical stability for up to 6 mo storage.Conclusion: The developed MTK spray dried particles may offer a good platform for the targeted pulmonary delivery of MTK overcoming the major biological barriers

Multi-dimensional simulation of underground subway spaces coupled with geoenergy systems

Old and deep subway lines suffer from overheating problems, particularly during summer, which is detrimental for passenger comfort and health. Geothermal systems could serve as one of the potential energy efficient cooling solutions, compared to energy intensive conventional cooling. The waste heat of the subway tunnel can be harnessed, to provide heating to residential and commercial blocks above the tunnels. This paper presents a multi-scale co-simulation framework for quantifying the amount of useful heat that can be extracted from overheated underground subway tunnels using geothermal heat exchangers. The co-simulation is applied and tested on a representative section of the London Underground's Central Line. The Central Line is modelled using a 1D heat and mass transfer model. The geothermal system, on the other hand, is represented using a 3D finite element model. The 1D and 3D models are co-simulated, using the subway tunnel's outer wall temperatures as boundary conditions. The model is run parametrically to identify the best arrangement and depth of geothermal heat exchangers for extracting excess heat from subway tunnels. Results show that the depth of 15 m. below the tunnel is sufficient for vertical closed loop heat exchangers to yield temperature drop of 4C in the subway tunnel and platforms. Partially insulated boreholes, alternating between extracting and injecting heat into the soil, are also assessed for their potential to provide heating and cooling demand simultaneously and improve the overall geothermal system efficiency. The heat extracted along a representative section of the tunnels is compared to the heating demand of the buildings above ground

Low platelet to lymphocyte ratio and high platelet distribution width have an inferior outcome in chronic lymphocytic leukaemia patients

Introduction.  Chronic lymphocytic leukaemia (CLL) is an incurable disease of the elderly, characterised by gradual accu­mulation of small mature B lymphocytes which escape apoptosis through inflammatory signals from the microenviron­ment. Elevated inflammatory markers are associated with very poor prognosis in different types of cancer. Therefore, we examined retrospectively the impact of platelet lymphocyte ratio (PLR) and platelet distribution width (PDW) on 180 CLL patients’ outcome. Materials and methods.  This retrospective study included 180 patients with CLL who were diagnosed and selected among cases referred to the Oncology Center Mansoura University between January 1st, 2008 and June 30th, 2016. All the relevant information was collected from the electronic medical records of the selected patients. Results.  Our results revealed that low PLR (<2.5) was more frequently observed in patients with stage C (p < 0.001), with 17p deletion (p = 0.017), and CD38 expression (p = 0.08), but not with seropositive HCV patients (p = 0.2). High PDW (≥18.5 fl) was more frequently associated with intention to treat population (p = 0.038), and CD38 expression (p = 0.068), but not with 17p deletion (p = 0.25) and seropositive HCV patients (p = 0.4). Multivariate analysis for overall survival showed that stage A and low PDW were independent factors for overall survival (p = 0.014 and 0.04 respectively), while high PLR (p = 0.05), and seronegative HCV patients (p = 0.1) lost their significance. Conclusion.  Our data showed that low PLR and high PDW were associated with poor prognostic markers. Stage C-CLL and high PDW were independent predictors of survival

COMPARATIVE TOXICITY STUDY OF CHLOROQUINE AND HYDROXYCHLOROQUINE ON ADULT ALBINO RATS

Expanded use of Chloroquine and hydroxychloroquine drugs for non-malarial disease entities has resulted in prolonged duration of therapy and higher daily dosages leading to cumulative doses greater than those used in antimalarial therapy. The aim of the study is to evaluate and compare the toxic effects of chloroquine and hydroxychloroquine on different organs of albino rats. The study was conducted on 60 normal albino rats divided into 3 groups, the 1st group is the control group that received only distilled water, the 2nd and the 3rd group were given a single daily oral doses equivalent to 1/10th of LD50 chloroquine and hydroxychloroquine respectively. Assessment of liver and kidney functions, and histopathological changes in liver, kidney, and heart in different groups was done. The chloroquine treated group showed significant elevation of serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), total bilirubin (TB), serum creatinine-urea (Cr-U), Creatine Kinase-MB, C-reactive protein and Malonic dialdehyde levels as compared to control and hydroxychloroquine treated group. The histopathological evaluation showed marked hydropic degeneragtion, vascular congestion, interstitial hemorrhage, and necrosis in the liver, kidney and heart of chloroquine treated group, while hydroxychloroquine treated group showed mild congestion and slight cellular degeneration. Thus, hydroxychloroquine is less toxic and physicians should prescribe it better than chloroquine. Chloroquine if prescribed for therapeutic uses should be taken for short periods

COMPARATIVE TOXICITY STUDY OF CHLOROQUINE AND HYDROXYCHLOROQUINE ON ADULT ALBINO RATS

Expanded use of Chloroquine and hydroxychloroquine drugs for non-malarial disease entities has resulted in prolonged duration of therapy and higher daily dosages leading to cumulative doses greater than those used in antimalarial therapy. The aim of the study is to evaluate and compare the toxic effects of chloroquine and hydroxychloroquine on different organs of albino rats. The study was conducted on 60 normal albino rats divided into 3 groups, the 1st group is the control group that received only distilled water, the 2nd and the 3rd group were given a single daily oral doses equivalent to 1/10th of LD50 chloroquine and hydroxychloroquine respectively. Assessment of liver and kidney functions, and histopathological changes in liver, kidney, and heart in different groups was done. The chloroquine treated group showed significant elevation of serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), total bilirubin (TB), serum creatinine-urea (Cr-U), Creatine Kinase-MB, C-reactive protein and Malonic dialdehyde levels as compared to control and hydroxychloroquine treated group. The histopathological evaluation showed marked hydropic degeneragtion, vascular congestion, interstitial hemorrhage, and necrosis in the liver, kidney and heart of chloroquine treated group, while hydroxychloroquine treated group showed mild congestion and slight cellular degeneration. Thus, hydroxychloroquine is less toxic and physicians should prescribe it better than chloroquine. Chloroquine if prescribed for therapeutic uses should be taken for short periods

The Mechanism Analysis of Underactuated Robotic Finger for Optimum Grasping Using Gradient Descent Method

This study was devoted in investigating the optimum geometric parameters for underactuated linkage three phalanges robotic finger. New kinematic and kinetic equations of grasping were derived in this research taking into account the angle for the ternary solid links of the four-bar linkages. To obtain the target of optimization, a gradient descent method was used which consists of three stages to find the optimal geometric parameters with high accuracy. Five criteria were selected to find the optimal solution by using multi objectives function algorithm, these are percentage of the grasping stability, the grasp forces, squeezing force, Mimic function for grasping task, and transmission angle for grasping operation. Gradient descent method starts by detecting the optimal geometric parameters for each criterion and choosing the best geometric parameters from the five criteria functions. At the optimum solution, the underactuated robotic finger prototype was built from hard Polylactic acid (PLA) plastic using rapid prototyping and was tested performance by grasping objects. Finally, the results have been shown that the robotic finger adapts to the wanted configurations