Pilonidal Sinus Management Using 980 nm Diode Laser

Background: Pilonidal sinus is a chronic, debilitating disease of the natal cleft. It mainly involves the sacrococcygeal region and the presentation varies from asymptomatic pits to painful abscesses or sinuses. Treatment options vary from observation to wide excision. Unfortunately, surgical treatment may result in recurrence. Many conservative methods had being described for treatment of pilonidal sinus, photocoagulation using laser is one of them.The aim of study: To assess the efficacy of laser (diode) as a therapy to the pilonidal sinus.Design: A cohort of five patients with a provisional diagnosis of  pilonidal sinus (unbranched) were treated by photocoagulation of sinus tract by diode laser 980 nm, between 17 and 25 year old (20.6±2.58), were diagnosed clinically and by sinogram to know the exact length of the tract and to exclude branching tract. The average length of the tracts were (5 cm) ranging (3-7) cm. Only one patient had recurrent sinus after surgical excision.Result: The mean operative time was (10.10) min. (range of 6.10-14.10 min.). All patient were seen the day after the procedure and then weekly, only one patient had pus discharge at day nine and was treated with ciprofloxacin and metronidazole for ten days and tract closed after 21 days of the procedure. The average time for closure was (10.4) day ranging (6-21).conclusion: Diode laser as a surgical tools in the treatment of pilonidal sinus offers the following benefits: Reducing hospital stay, minimizing tissue assault by avoiding unduly extensive procedures with the attendant complications, early resumption of work by the patient and preventing recurrence of the disease. Keywords: pilonidal, diode 980nm, diode lase

KATEGORI KEPEMIMPINAN DALAM ISLAM

“Kepemimpinan adalah proses mempengaruhi atau membebaskan pemimpin melalui pengikut mereka dalam upaya mencapai tujuan organisasi. Peran kepemimpinan dalam pendapat Islam adalah suatu keharusan dalam kehidupan sosial. Selain itu, katanya, kehadiran pemimpin dalam kepemimpinannya sangat penting. Kriteria Kepemimpinan Islami Menurut Didin Hafidudin dalam buku Manajemen Syariah Dalam Praktik Mengatakan Ada beberapa kriteria pemimpin sukses dalam sebuah organisasi. Pertama, ketika seorang pemimpin dicintai oleh bawahannya. Organisasi yang dipimpinnya akan berjalan dengan baik jika kepemimpinannya dinakhodai oleh pemimpin yang dicintai oleh bawahannya. Dalam artikel ini juga dibahas mengenai faktor-faktor yang menentukan gaya atau tipe kepemimpinan.”   &nbsp

Novel Insights in the Modern Medical Management of Acromegaly

The main aim of this thesis was to assess the efficacy and safety of pasireotide LAR treatment in patients with acromegaly controlled with first-generation somatostatin analogues and pegvisomant. In chapters 3 and 4 we report the results of the PAsireotide LAR and PEgvisomant study (PAPE) study. Chapter 5 we assessed whether somatostatin receptor subtype 2 and 5 protein expression correlates and predicts response to pasireotide LAR treatment in the PAPE study. In chapter 6 we assessed plasma acylated and unacylated ghrelin levels in acromegaly patients using first-generation somatostatin analogues and pegvisomant combination treatment. Finally in chapter 7 we report the results of a pilot study evaluating whether pegvisomant is expressed in the liver and wheter kupffer cells are involved in the clearance of pegvisomant in two patients with acromegaly

Numerical Simulation Model of Multijunction Solar Cell

Multi-junction solar cells play an important and significant role in the Concentrated Photovoltaic (CPV) Systems. Recent developments in Concentrated Photovoltaic concerning high power production and cost effective- ness along with better efficiency are due to the advancements in multi-junction cells. Boeing SpectroLab Inc. has introduced a Multi-junction solar cell employing tunnel junctions which improves efficiency up to 40%. This paper presents a simulation model of the generalized Multi-junction solar cell. The model adopts a mathematical approach in order to simulate and investigate the cell characterization curves including current density and power curves with respect to the applied voltage for different concentration levels and number of junctions and by varying the material properties of the multi-junctions and the tunneling layer. The proposed simulation model simulates the performance characteristics of two different natures of multi-junction solar cells including InGaP/GaAs Dual-junction Solar Cell (DJSC) with tunneling layer of InGaP and InGaP /GaAs/Ge Triple-Junction Solar Cell (TJSC) with tunneling layer of GaAs. Simulation results are presented in this paper which is in agreement with experimental results. Key–Words: Modeling, Multi-junction Solar Cell, Simulation, Tunnel Junctio

Corneal endothelium, retinal nerve fiber layer, ganglion cell complex, and perimetry measurements in normal eyes and those with primary open-angle glaucoma

Background: Corneal endothelial cell (CEC) loss in glaucoma can be attributed to the direct compressive effect of elevated intraocular pressure. Herein, we aimed to evaluate specular microscopic changes in CEC count and morphology in correlation to retinal nerve fiber layer (RNFL) changes detected by spectral-domain optical coherence tomography (SD-OCT) in early and advanced primary open-angle glaucoma (POAG). Methods: This descriptive-analytical study involved patients with medically controlled POAG versus non-glaucomatous patients of the same age group. Specular microscopy, visual field testing, and SD-OCT of the RNFL and macular ganglion cell complex (GCC) were performed. Eyes with POAG were further subcategorized into early and advanced stages. Results: The study included 130 eyes of 130 participants; 70 were eyes with POAG (40 eyes with early-stage POAG, 30 eyes with advanced-stage POAG), and 60 were healthy eyes. The groups were comparable regarding mean age and sex. No significant difference was found in corneal parameters between healthy eyes, eyes with early POAG, and eyes with advanced POAG (all P > 0.05). In eyes with early-stage POAG, a significant negative correlation was found between the coefficient of variation (CV) and superior RNFL thickness (r = - 0.5; P = 0.018), and between the percentage of hexagonal cells (hexagonality) and vertical cup-to-disc ratio (r = - 0.43; P = 0.035). A significant positive correlation was found between hexagonality and superior as well as inferior RNFL thickness (r = + 0.53; P = 0.008 and r = + 0.50; P = 0.015, respectively). However, in the advanced glaucomatous eyes, no significant correlation was found between RNFL thickness and CEC parameters. Conclusions: CEC parameters were not affected in eyes with early or advanced POAG compared with healthy eyes, despite a significant thinning of RNFL and macular GCC. In eyes with early-stage POAG, a significant correlation was found between morphological characteristics of CECs, such as CV and hexagonality, with superior and inferior RNFL thickness in the optic nerve head on SD-OCT images. Future longitudinal studies with larger sample sizes are needed to verify our results

Pregnancy and acromegaly

Introduction: Acromegaly is a rare disorder in which, due to the high incidence of secondary hypogonadism, pregnancies are relatively rare. However, some women with acromegaly do get pregnant, which brings along questions about medication, complications and follow-up. This review tries to address these issues and provide the reader with practical information. Methods: This review summarizes published data. Conclusions: Acromegaly is a disorder that is characterized by changes in growth hormone (GH), insulin-like growth factor-1 (IGF-1) and insulin concentrations and actions. All these hormones are important in pregnancy as well. In principle, the fetal-placental collaboration between mother and child more-or-less takes over the control over GH and IGF-1, not only in normal physiology but also to a certain extend in acromegaly. When medication for the high GH levels or actions is continued during pregnancy, both dopamine agonists, somatostatin analogs and GH receptor antagonists have been used and the available data suggest that there are no adverse consequences on mother or fetus to date. However, it is strongly advised to stop any medical intervention during pregnancy until more data are available on the safety of these compounds. Also, medical treatment is not needed as tumor size and disease activity are not reported to escape

Small Molecule Catalysts with Therapeutic Potential

Catalysts are employed in many areas of research and development where they combine high efficiency with often astonishing selectivity for their respective substrates. In biology, biocatalysts are omnipresent. Enzymes facilitate highly controlled, sophisticated cellular processes, such as metabolic conversions, sensing and signalling, and are prominent targets in drug development. In contrast, the therapeutic use of catalysts per se is still rather limited. Recent research has shown that small molecule catalytic agents able to modulate the redox state of the target cell bear considerable promise, particularly in the context of inflammatory and infectious diseases, stroke, ageing and even cancer. Rather than being “active” on their own in a more traditional sense, such agents develop their activity by initiating, promoting, enhancing or redirecting reactions between biomolecules already present in the cell, and their activity therefore depends critically on the predisposition of the target cell itself. Redox catalysts, for instance, preferably target cells with a distinct sensitivity towards changes in an already disturbed redox balance and/or increased levels of reactive oxygen species. Indeed, certain transition metal, chalcogen and quinone agents may activate an antioxidant response in normal cells whilst at the same time triggering apoptosis in cancer cells with a different pre-existing “biochemical redox signature” and closer to the internal redox threshold. In pharmacy, catalysts therefore stand out as promising lead structures, as sensor/effector agents which are highly effective, fairly selective, active in catalytic, i.e., often nanomolar concentrations and also very flexible in their structural design

Combined treatment of somatostatin analogues with pegvisomant in acromegaly

Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can be observed in a vast majority of patients. The main side effects of the combination treatment are gastrointestinal symptoms, lipohypertrophy and transient elevated liver transaminases. In this review we provide an overview of the efficacy and safety of the combined treatment of LA-SSAs with PEGV

THE COMPARISONS AND CONTRASTS BETWEEN ENGLISH AND MALAY LANGUAGES

English and Malay languages are categorized as popular languages in the world.  However, both languages underwent different history and composition. This study investigates the languages in terms of history, phonology, loanwords, grammar, morphology and semantics. The purposes of studying the comparisons and contrasts of both languages are not only to analyze the uniqueness of the languages but also to identify the process of understanding the languages especially the view of second language learners. It is found that two languages come from different background; somehow they share similar characteristics such as the vowels sounds, loanwords and semantics. However, the learners face difficulty in learning both languages especially in pronunciations and spelling.Keywords: English language, Malay language, history of languag

Public satisfaction with COVID-19 vaccination program in Saudi Arabia

The challenges posed by the ongoing COVID-19 pandemic have required the introduction of new care delivery models and procedures. For the foreseeable future, vaccine administration will be a key part of the patient experience journey. It is important therefore to understand and evaluate experiences of individuals taking the vaccination, an area which requires considerable attention. To address this, the COVID-19 Vaccination Satisfaction survey was developed and administered at several healthcare facilities across Saudi Arabia. Between January 2021 and end of December 2021, a total of 1,699,177 completed surveys were collected. The survey results suggest high satisfaction among participants taking the vaccine; however, satisfaction with information and communication about the vaccine was relatively low. Results from this survey are updated daily and provide unique insights into the key strengths of the vaccination process, as well as aspects within the process that require improvement. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens