CT angiographic determination of most frequent anatomic variations of coronary arteries in Erbil population

Background and objective: Computed tomography angiography is one of the best methods for knowing the detailed anatomy of coronary arteries and can successfully detect any variation of coronary arteries. Anatomic variations of coronary arteries have not been studied among Erbil population which is mostly inhabited by Kurds. This study was conducted to compare the incidence of the anatomic variations of coronary arteries in Erbil population with international standards. Methods: Variations of coronary arteries were retrospectively studied by using computed tomography angiography of 412 cases (214 males 198 females) with mean age 51.5 ± 13.5 years (mean ± SD) who underwent this procedure on suspicion of coronary artery disease. The main indication was chest pain in patients with low to intermediate probability of ischemic heart disease. The present study was carried out in the Department of Radiology, Surgical Specialty Hospital/Cardiac Center in Erbil city. Results: The right coronary artery was dominant in 86.4% of cases, while the left main coronary artery was dominant in 10.92% of cases. Co-dominance was observed in 2.67% of cases, and Double Ostia of right aortic sinus was observed in 25% of cases. Long left main coronary artery was observed in 10.68 % of cases. Myocardial bridging was observed in 7.04% of cases. Other variations were also observed, and their prevalence was recorded. Conclusion: Variations of coronary arteries among Erbil population were recorded and were near to the international standards

Effect of Aspartame on the Rat’s Thyroid Gland: A histological and Morphometrical Study

Background: The aspartame is a synthetic sweetener has been used for many purposes as an anti-inflammatory agent, antioxidants and hepato protective, its metabolites can be toxic to many organs and several studies on laboratory animals have been made to verify aspartames toxicity which can cause harmful effect after administration for long duration at a dose of 150 mg/kg body weight. Objective: To evaluate the effect of aspartame on morphometric and histopathological changes of the rat’s thyroid gland, since the aspartame sweetener is widely used worldwide.      Patients and Methods: Fifty adult Wister albino rats were used and divided randomly into two groups. The treated group received 150 mg/kg aspartame orally daily after dissolving it in 2cc distilled water and the control group received 2cc distilled water daily orally for eight weeks. Results: Histological examination of aspartame-treated group showed loss of normal architecture of the thyroid gland. morphometrical measurement showed many follicles were small in size and others had disrupted wall and detached cells in their lumens, there was significant increase in the height of cells and number of follicles with decrease inwidth of the cells. Conclusion: Administration of aspartame at a dose 150 mg/kg had a significant effect on both histologic and morphometrical structure of the adult rat’sthyroid gland

Impact of the SARS-CoV-2 pandemic on routine immunization of the population in the Republic of North Macedonia

Immunization is one of the most powerful and cost-effective public health interventions, preventing about 2 to 3 million deaths each year. The SARS-COV-2 pandemic has spread all over the world and as a direct result of the virus, millions of lives were lost. The indirect effects of the pandemic are equally important. Routine childhood immunization systems were heavily influenced globally and in May 2020 the WHO announced that at least 80 million children under the age of one were put at risk of missing the important and scheduled life-saving vaccines. Data in this paper are from the submitted annual reports on conducted and completed mandatory immunization against infectious diseases in the Republic of North Macedonia, delivered by the Centres for Public Health and their regional units and/or health institutions that implement immunization in the country, as well as the processing and analysis of data obtained from the Institute of Public Health in Skopje, North Macedonia. Decrease in coverage with all types of vaccinations and revaccinations was present in 2020 and 2021, mainly due to current COVID-19 pandemic. There is no doubt that the pandemic had also a huge impact on other health services which are not related to the control and prevention of COVID-19, including mandatory routine immunization. Although the vaccination process was continuous and uninterrupted, the pandemic restriction measures and limitations had a strong impact on reducing the coverage percentage. The impact of restrictive measures in 2020 that included frequent restrictions on population movement and delays in vaccination due to fears of COVID-19 infection played a major role in reducing the coverage, while in 2021 there was an additional factor such as engagement of vaccination teams in COVID-19 vaccination, which resulted in a further reduction of mandatory routine vaccination coverage. Campaigns for public health awareness and educational interventions for healthcare workers and parents are more than necessary to ensure adequate catch-up of delayed or missed immunizations to prevent potential outbreaks of vaccine-preventable diseases

The influence of Covid-19 pandemic on the vaccination of the population with the influenza vaccine in the Republic of North Macedonia

The implemented actions to minimize the spread of the COVID-19 pandemic had a powerful effect on the transmission of other respiratory viruses, particularly influenza viruses. Influenza is a disease of viral aetiology that causes epidemics and occasionally pandemics during the wintertime almost every year. Generally, it is a mild and self-limiting disease, but it can represent high morbidity and even mortality when affecting the elderly population or people with latent chronic diseases. The existing circumstances of a persistent and ongoing epidemic caused by the SARS-CoV-2 virus, increase the probability of having active coincidence with the anticipated annual epidemic of influenza. Thus, the key is a logistic strategy for clinical and viral diagnosis of the SARS-CoV-2 virus that will determine the importance of understanding the role of influenza vaccines in virus-induced COVID-19 disease. This paper aims to compare the potential impact of the COVID-19 pandemic on the vaccination coverage of the population with the influenza vaccine. The official data for seasonal influenza vaccination were used, obtained from the weekly reports on the influenza situation in the Republic of North Macedonia from the Institute of Public Health as well as the data from the national system “MojTermin” for total vaccinated individuals with influenza vaccine for the season 2020/2021 and 2021/2022 including the 5th week. The analyzed data for the season 2021/2022 show an increase of applied doses by 8.3% compared to the season 2020/2021 and an increase of 11.5% compared to the season 2019/2020. Regarding the target groups in the season 2021/2022, including the 5th week, the coverage of influenza vaccination in children aged 6 months to 5 years has a significant decrease of 87.9% compared to the season 2020/2021. There is an increase in coverage in health professionals by 24.3% compared to last season, in the chronically ill the decrease of the applied doses is by 11.4% compared to last season, and in the elderly, over 65 it is noticeable an increase in coverage by 100% compared to the 2020/2021 season. Furthermore, there is a significant decrease of 95.7% in the vaccines administered to pregnant women compared to last season. The reduced coverage of influenza vaccination is partly due to the ambiguities arising from the influenza immunization campaign, which emphasized the importance of receiving a vaccine to minimize the spread of the influenza virus as an additional threat to the presence of COVID-19. Although the influenza vaccine does not protect against COVID-19, influenza vaccination has been part of the public health strategy to flatten the disease curve caused by respiratory viruses that attack the respiratory system, to protect and preserve the health of healthcare professionals providing care to patients with COVID-19. Influenza vaccination is still the most efficient preventive measure against influenza infections at our disposal and it is recommended by the most expert bodies including CDC, WHO, ECDC, and the National Committee for Immunization of the Republic of North Macedonia

Evaluation of chromatographic conditions for simultaneously determination of Emtricitabine and Tenofovir

A fixed-dose combination of two antiretroviral drugs (tenofovir and emtricitabine) used for the treatment of HIV is already present on the European market. However, monographs of emtricitabine and tenofovir are not included in the actual European Pharmacopoeia. There is no official method for quality control of pharmaceutical dosage forms containing both emtricitabine and tenofovir. Therefore, the aim of this study was to optimize and to propose chromatography conditions for simultaneous identification and determination of emtricitabine and tenofovir active compounds in pharmaceutical dosage forms suitable for routine analysis in the quality control laboratories. In this study we used seven different ODS columns and we evaluate their efficiency in emtricitabine and tenofovir analysis. Testing for identification, specificity, selectivity, resolution and suitability was according to requirements in the ICH Q2(R1) Guideline (ICH, 2019). The emtricitabine and tenofovir can be successively separated with RP–HPLC octadecylsylil columns. Our experimental results showed that the optimal chromatographic conditions for simultaneous HPLC analysis of emtricitabine and tenofovir are achieved with mobile phase composed of 30% acetonitrile and 70%, water acidified with o-phosphoric acid at pH 2.6, at flowrate 1 mL/min, column oven set at 30ºC, with specific UV detection at 260 nm for tenofovir and at 284 nm for emtricitabine. Optimal results were obtained with Lichrospher 100 C18 (250 mm x 4 mm) and Purospher C18 end capped (150 mm x 4.6 mm) columns

A validated isocratic RP-HPLC method for determination of linezolid in pharmaceutical dosage forms

Linezolid is an oral and parenteral antibiotic that belongs to a new group of synthetic antibiotics known as fluorinated oxazolidinones. Linezolid has been assayed in dosage forms by spectrophotometry, liquid chromatography, high–performance thin–layer chromatography and micellar electrokinetic chromatography (Mohapatra et al., 2011). However, there is yet no monograph on linezolid in the current European Pharmacopoeia. Therefore, we aimed to develop simple, fast and reliable RP-HPLC method for determination of linezolid in dosage forms in the presence of its degradation products. The method performance was further fully validated according to requirements in the ICH Q2(R1) Guideline (ICH, 2019). Chromatographic separation was performed on a reversed-phase column Agilent ZORBAX SB C18 (250 x 4.6 mm I.D., particle size 5 μm), in an isocratic mode. The mobile phase consisted of a mixture of methanol and water acidified with o-phosphoric acid, pH 2.6, 50:50 (V/V). The flow rate was kept at 1.0 mL/min. Wavelength was selected by scanning a standard solution of linezolid over 200–400 nm using Model Lambda 12 (Perkin Elmer) UV-visible spectrophotometer and the wavelength of 254 nm was chosen for detection of linezolid. The injection volume was 20 μL. All separations were performed at a temperature of 30°C ± 2°C. The proposed RP–HPLC method allows simple, accurate and precise determination of linezolid in pharmaceutical dosage forms, in the presence of its degradation products and related compounds. The advantages of the method include short run time, simple sample and mobile phase preparation, isocratic mode of elution, and excellent peak symmetry. Therefore, the developed method can be applied for the routine analysis for determination of linezolid in pharmaceutical dosage forms in quality control laboratories

A Cross-sectional Study of Clinical Characteristics and Outcomes among Adults with Laboratory-confirmed SARS-CoV-2 Infection with Omicron Variant

The emergence of the SARS-CoV-2 Omicron variant has raised concerns due to its increased transmissibility and potential implications on clinical characteristics and outcomes in infected individuals. The aims of this report were to study the profile of SARS-CoV-2 infection with omicron variant, investigate the infection outcome, reinfection rates with associated factors, antibody levels, and explore the associations between biochemical markers and disease severity. This prospective cohort study was conducted in Duhok city in the Northern of Iraq. All volunteers with confirmed SARS-CoV-2 RT–PCR and confirmed Omicron infection who were older than 18 years old and agreed to participate were recruited for this study. The study was carried out from January to April 2022. There were 234 cases of confirmed SARS-CoV-2 RT–PCR Omicron infection. The mean age was 48.12±17.3 years, 43.2% were vaccinated, and 40.2% were male. Among the recruited patients, 99.1% recovered and did not need hospitalization. In this study, (38.9%) had a history of previously confirmed COVID-19 infection. Reinfection was significantly higher in females than males (p=0.04; OR= 0.56). It was found that the IgG antibody levels were higher in patients who received Pfizer-BioNTech than in those who received other vaccines (p=0.001). The levels of IgG were also significantly higher in patients with mild infection (p=0.046), whereas the levels of D-dimer were significantly higher in patients with severe cases of the infection compared to those with mild or moderate cases (p=0.001). Additionally, the levels of C-reactive protein (CRP) were observed to be higher in individuals with moderate cases of infection than in mild and severe cases (0.001). Individuals who contracted the Omicron strain generally had positive outcomes. Reinfection with the Omicron variant was relatively high. IgG levels were higher in patients with mild disease, implying that they were associated with decreased disease severity. We found significant associations between D-dimer levels and the severity of the disease. Additional research is required to investigate the long-term effects of Omicron infection

Managing inclusion at a diverse workplace : from a managerial and employee perspective

Background: Globalization has changed the market in ways of creating new opportunities as well as new challenges for organizations and has given rise to a global phenomenon called workforce diversity. The phenomenon appeared as a result from the constantly changing marketplace where people as part of a worldwide economy, live and work in foreign countries. Thus, as global markets emerge, and workforce demographics shift, workforce diversity inches closer to becoming a necessity instead of a banner that businesses wave to show their commitment to embracing differences and change.  Purpose: The purpose of this thesis is to examine and to provide a better understanding of how diversity is managed through inclusive practices and policies, and how employees perceive these practices.  Method: The research is based on a qualitative case study. The primary data was collected through semi-structured interviews. The respondents of the interviews were both managers and employees in order to get the two different perspectives. Two managers and six employees were interviewed.  Findings: The empirical findings showed that managers’ perspective of inclusion practices differs much from how the employees perceive inclusion practices of a diverse workforce. The main findings were that the stated inclusion practices at The University are not perceived among the employees. One example was that some of the employees feel like they were excluded at The University. Moreover, some of the employees stated that people that are not ethical Swedes are not treated the same nor get the same opportunities. Another observable issue was that The University rarely speak English and all documented information is in Swedish, which mean that not all employees receive the information needed.

A Simple Isocratic RP-HPLC Method for Determination of Nitisinone in Pharmaceuticals

Nitisinone is a reversible inhibitor of 4-hydroxyphenylpyruvate dioxygenase and an active substance in the orphan drug used for the treatment of hereditary tyrosinemia type I, a rare genetic disease caused by mutations in the gene for the enzyme fumarylacetoacetase. The aim of our study was to develop a simple and accurate RP–HPLC method with UV detection for routine determination of nitisinone in commercially available pharmaceutical forms. The chromatographic separation was achieved on a reversed-phase column Purospher STAR® RP–8 end–capped (150 x 4.6 mm i.d., particle size 5 μm), with a mobile phase consisted of a mixture of acetonitrile and water acidified with o-phosphoric acid with pH adjusted to 3.0, 65:35 (V/V), filtered through 0.45μm nylon filter. The flow rate was kept at 1 mL/min. A diode array detector measured the UV absorbance at 272 nm. The injection volume was 10 μl. The method was validated by a determination of system suitability, specificity, linearity, range, accuracy, precision, detection limit and quantitation limit. Then, the method was applied for determination of nitisinon in commercially available capsules. The proposed RP-HPLC method allows a simple, accurate, precise and rapid determination of nitisinone in pharmaceuticals. The advantages of the method include simple sample treatment, good precision (RSD less than 2%) and high recovery (greater than 99%). The method could be recommended for routine analysis in quality control laboratories, in stability studies as well as for the evaluation of potentially counterfeit capsules containing nitisinone

Performance evaluation of different HPLC columns in sildenafil and tadanafil analysis

Sildenafil and tadalafil are oral drugs used to treat male sexual function problems (impotence or erectile dysfunction) by blocking an enzyme 5-phosphodiesterase in the body. The aim of this study was to evaluate performance of the various HPLC columns in sildenafil and tadalafil analysis using validated HPLC method. The following columns were compared: LiChrospher 100 RP-18 (250 x 4 mm i.d., 5 m); Hypersil BDS-C18 (125 x 4 mm i.d., 5 m) and Chromolith Performance RP-18e (100 x 4.6 mm i.d., monolithic rod). The performance evaluation was done by comparison of the following parameters: resolution (Rs), back-pressure (ΔP, bar), and theoretical plate height (ΔH, m) in correlation with flow-rate (u, mL/min). Chromatographic peak resolution data (Rs) obtained are acceptable for all three tested columns with values higher than the limit given in Ph. Eur. (>1.5). There is a significant difference between column back-pressure using different flow-rate. The efficiency of the columns is presented by the van Deemter plots. According to the results, the most efficient column is the longest column packed with particles, but the flow-rate which might be used is limited at maximum 2 ml/min. With increasing flow-rate its efficiency dramatically decreases. The van Deemter plot of the monolithic rod column demonstrates clearly that separation efficiency does not decrease significantly when the flow-rate is increased, as it is the case with particulate columns. According to all experimental results obtained, the monolithic rod column is a column of choice for tadalafil and sildenafil analysis. Using this column means shorter analysis time (for factor 3.6) in comparison with the longest column