BETAMETHASONE DIPROPIONATE GEL FOR TREATMENT OF LOCALIZED PLAQUE PSORIASIS

Objective: The main aim of this study was to design and characterise betamethasone di-propionate loaded transfersomes (BD-T); as a topical formulation for the treatment of localized plaque psoriasis.Methods: A full factorial design (23) was applied to study the effects of three independent variables: drug content, type of surfactants and surfactant contents on particle size (PS), entrapment efficiency (EE %), zeta potential (ZP), polydispersity index (PI) and drug release profiles. The optimized BD-T was formulated as a hydrogel using 5% sodium carboxymethyl cellulose. The gel was characterized for viscosity, drug content, in vitro drug release and stability. A comparative clinical study was performed on 20 patients with psoriasis to investigate the effect of BD-T gel and the marketed betamethasone dipropionate (BD) cream.Results: The optimized BD-T formulation containing 50 mg betamethasone dipropionate (BD) and 5 mg tween 80 showed spherical unilamellar vesicles with an average particle size of 242.80, % EE of 90.19%, ZP of-15.00 mV, PI of 0.407 and K0 of 4.290 mg/hr. The formulation showed good stability at 4 °C and 25 °C for 6 mo. The results revealed significant clinical improvement and a significant increase in safety and tolerability with BD-T gel compared with BD cream.Conclusion: As a conclusion, BD-T was found to be more effective, safe and tolerable for the treatment of psoriasis compared with the marketed product

Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature

<p>Abstract</p> <p>Background</p> <p>Extragonadal localization of germ cell tumors (GCTs) is rare; to the best of our knowledge, a location in the soft tissue of the arm has never been previously reported in the literature.</p> <p>Case presentation</p> <p>We report the case of a 37-year-old man who presented with a primary malignant mixed non-seminomatous GCT (teratocarcinoma variety) in the right arm, treated by a combination of cisplatin-based chemotherapy and surgery. After 18 months of close follow-up, no locoregional recurrence or distant metastases have been detected.</p> <p>Conclusions</p> <p>A combination of chemotherapy and surgery is the most appropriate treatment strategy for extragonadal GCTs, to ensure both local and systemic control.</p

Leydig Cell Tumor Associated with Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia due to 11β-Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) describes a group of inherited autosomal recessive disorders characterized by enzyme defects in the steroidogenic pathways that lead to the biosynthesis of cortisol, aldosterone, and androgens. Chronic excessive adrenocorticotropic hormone (ACTH) stimulation may result in hyperplasia of ACTH-sensitive tissues in adrenal glands and other sites such as the testes, causing testicular masses known as testicular adrenal rest tumors (TARTs). Leydig cell tumors (LCTs) are make up a very small number of all testicular tumors and can be difficult to distinguish from TARTs. This distinction is interesting because LCTs and TARTs require different therapeutic approaches. Hereby, we present an unusual case of a 19-year-old patient with CAH due to 11β-hydroxylase deficiency, who presented with TARTs and an epididymal Leydig cell tumor

Multiplication sexuée et asexuée d'Artemisia herba-alba Asso ; une espèce pastorale autochtone appréciée et surexploitée

Artemisia herba-alba is among the most important pastoral species, characterized by a high fodder value, especially for ruminants. However, Artemisia herba-alba steppes in Morocco are undergoing continuous degradation. Therefore, understanding the multiplication of this highly appreciated species is essential for its preservation and the rehabilitation of degraded pastures. The present study’s objective is to understand techniques of sexual and asexual multiplication of Artemisia herba-alba: germination and cutting. For sexual multiplication, three factors were considered: age of seeds, their origins and pre-treatments. For asexual multiplication, two factors were tested, i) the effect of Indole Acetic Acid IAA and ii) the cuttings type effect on the rooting of Artemisia herba-alba cuttings. The obtained results showed a high germination rate for freshly harvested seeds (88%), a decrease in the germination rate of seeds over the years, and those of the same year but lately collected (19.78%). Also, there is an increase is observed in the germination rate of seeds soaked for 48 h (21%) compared to the control (17%). In addition, an inhibitory effect of some IAA concentrations on the cuttings rooting was noted. The best rooting rate was observed in herbaceous cuttings control, collected in March (50%). Therefore, it can be concluded that cuttings represent the most efficient and promising technique for the propagation of Artemisia herba-alba.Artemisia herba-alba est l'une des espèces pastorales les plus importantes, caractérisée par une valeur fourragère élevée, en particulier pour les ruminants. Cependant. Les steppes à Artemisia herba-alba subissent une dégradation continue. La maitrise de la multiplication de cette espèce est indispensable, pour sa préservation et la réhabilitation des pâturages dégradés. La présente étude a pour objectif de maitriser les techniques de multiplication sexuée et asexuée d’Artemisia herba-alba: germination et bouturage. Pour étudier la multiplication sexuée, trois facteurs sont considérés: l’âge des graines, leurs provenances et leurs pré-traitements. Pour la multiplication asexuée, deux essais de bouturage sont menés, dans le but de tester l’effet i) du trempage dans une solution d’auxine AIA, et ii) de la nature des boutures (herbacées, semi-ligneuses et ligneuses) sur l’enracinement de ces boutures. Les résultats obtenus ont montré un taux de germination important pour les graines fraichement récoltées (88%), une diminution du taux de germination des graines au fil des années, et celles de l’année en cours, mais provenant du pastoretum et récoltées tardivement (19,78%). Aussi, une augmentation du taux de germination des graines imbibées pendant 48h (21%), par rapport au témoin (17%). Par ailleurs, nous avons noté un effet inhibiteur de certaines concentrations de l’AIA sur l’enracinement des boutures. Le meilleur taux d’enracinement a été observé chez les boutures herbacées témoins, collectées en mars (50%)

Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia

Background: Management of alopecia areata (AA) and androgenetic alopecia (AGA) is often challenging as patients may be resistant to currently available modalities of treatment. The use of stem cells may be a novel option for resistant cases. Objective: To evaluate the safety and efficacy of the use of autologous bone marrow derived mononuclear cells (including stem cells) as compared to follicular stems cells for the management of resistant cases of AA and AGA. Methods: This study included 40 patients (20 AA patients and 20 AGA patients), all patients were treated with a single session of intradermal injection of autologous stem cells (SCs) therapy. They were divided into four groups according to the applied modality [either autologous bone marrow derived mononuclear cells (bone marrow mononuclear cells [BMMCs] or autologous follicular stem cells [FSC]). Results: Six months after stem cell therapy (SCT) injection, there was a significant improvement, confirmed by immunostaining and digital dermoscopy. The mean improvement in all groups was “very good”. There was no significant difference between both methods in either type of alopecia. No serious adverse events were reported. Conclusion: Autologous BMMCs and FSC seem to be a safe tolerable and effective treatment for the management of both resistant AA and AGA

The Natural History of Incidental Colonic Diverticulosis on Screening Colonoscopy

Background. The natural history of colonic diverticulosis is unclear. Methods. Patients with incidental diverticulosis identified in a previous prospective cross-sectional screening colonoscopy study were evaluated retrospectively for clinic or hospital visit(s) for diverticular disease (DD= acute diverticulitis or diverticular bleeding) using review of electronic health records and patient phone interview. Results. 826 patients were included in the screening colonoscopy study. Three were excluded for prior DD. In all, 224 patients (27.2%; mean age 62.3 ± 8.2) had incidental diverticulosis distributed in the left colon (67.4%), right colon (5.8%), or both (22.8%). Up-to-date information was available on 194 patients. Of those, 144 (74.2%) could be reached for detailed interview and constituted the study population. Over a mean follow-up of 7.0 ± 1.7 years, DD developed in 6 out of 144 patients (4.2%) (4 acute cases of diverticulitis, 1 probable case of diverticular bleeding, and 1 acute case of diverticulitis and diverticular bleeding). Two patients were hospitalized, and none required surgery. The time to event was 5.1 ± 1.6 years and the incidence rate was 5.9 per 1000 patient-years. On multivariate analysis, none of the variables collected at baseline colonoscopy including age, gender, obesity, exercise, fiber intake, alcohol use, constipation, or use of NSAIDs were associated with DD. Conclusion. The natural history of incidental diverticulosis on screening colonoscopy was highly favorable in this well-defined prospectively identified cohort. The common scenario of incidental diverticulosis at screening colonoscopy makes this information clinically relevant and valuable to physicians and patients alike

Shattered worlds: political trauma amongst young activists in post-revolutionary Egypt

Based on qualitative testimonial research with Egyptian youth activists, this article argues that Egypt’s post-revolutionary aftermath has been profoundly traumatic. Trauma shatters one’s assumptive world as it confronts one with the fragility of existence and the possibility of immediate death. Activists experienced automatic psychological coping mechanisms of intrusion (e.g. dreams and nightmares) and numbing, but Egypt’s post-revolutionary social and political context inhibited the operationalisation of non-automatic, socially embedded, coping mechanisms of reintegration and reinterpretation. The former entails the reintegration of one’s experiences into an adjusted assumptive world through a shared holding space and the latter the reinterpretation of the suffered traumas through a positive outcome. In the absence of socially embedded coping mechanisms, due to political polarisation and a lack of positive revolutionary outcomes, Egypt’s social trauma deepened as is illustrated by the depoliticisation of activists as they tried to mend their shattered assumptive worlds