Environmental Damages from Minefields

Desert Storm brought Iraqi Forces to Kuwait and, with them, mines. Aerial diagrams illustrate the areas of Kuwait still littered with landmines. Landmines are causing significant short- and long-term damage to the environment, resulting in soil erosion, destruction of vegetation and topsoil, and negatively impacting wildlife

Acute pain management in children

The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain is constantly being refined; with newer drugs being used alone or in combination with other drugs continues to be explored. Several advances in developmental neurobiology and pharmacology, knowledge of new analgesics and newer applications of old analgesics in the last two decades have helped the pediatric anesthesiologist in managing pain in children more efficiently. The latter include administering opioids via the skin and nasal mucosa and their addition into the neuraxial local anesthetics. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The development of receptor specific drugs that can produce pain relief without the untoward side effects of respiratory depression will hasten the recovery and discharge of children after surgery. This review focuses on the overview of acute pain management in children, with an emphasis on pharmacological and regional anesthesia in achieving this goal

Hepcidin and iron status in chronic kidney disease

Hepcidin is a critical inhibitor of iron export frommacrophages, enterocytes, and hepatocytes. Given that itis filtered and degraded by the kidney, its elevated levelsin renal failure have been suggested to play a role in thedisordered iron metabolism of uremia. It is a smalldefensin-like peptide whose production by hepatocytes ismodulated in response to anemia, hypoxia, orinflammation. Hepcidin could also act as an indicator offunctional iron deficiency (FID) in chronic kidneydisease (CKD) patients. This study was performed toassess hepcidin and its correlations with renal function,iron status parameters {serum iron, serum ferritin,transferrin saturation (TSAT) and soluble transferrinreceptor (sTfR)}, inflammatory cytokines (IL-6&IFN-?)and inflammatory markers (CRP) in patients with CKDeither on conservative treatment or on maintenancehemodialysis (HD). Serum prohepcidin was higher inHD patients compared to controls and CKD patients. Inthe whole patient group, serum hepcidin correlatedsignificantly with hemoglobin (Hb), IL-6, creatinine,CRP, sTfR and urinary hepcidin. In HD groupprohepcidin correlated significantly with creatinine.Multiple regression analysis showed that prohepcidinwas most predicted by serum creatinine and CRP.Elevated prohepcidin levels in HD patients studied couldmainly be due to its accumulation in impaired renalfunction in addition to low-grade inflammation,frequently encountered in this population

Care management for persistent pain: An introduction

Persistent pain is a frequently occurring condition with significant economic, clinical, and humanistic implications, for both individuals and society. Current literature, however, points to unresolved issues with regard to its identification, assessment, diagnosis, and treatment, and a number of suggestions have been made for improving the quality of care for pain sufferers. Because persistent pain shares many of the salient features of other chronic conditions such as diabetes and congestive heart failure, it is reasonable to believe that the adoption of a coordinated approach to care management could substantially improve the quality of care. Several strategiesincluding identification, appropriate referral, education, and planning can and should be implemented to offer comprehensive, individualized treatment alternatives that are not currently available and that improve patient outcomes, including quality of life

Organic Matter Assessment And Paleoenvironmental Changes Of The Middle Jurassic Main Source Rocks (Khatatba Formation) In The North Western Desert, Egypt: Palynofacies And Palynomorph Perspectives

The Middle Jurassic in the north Western Desert, Egypt, was a time of complex tectonics and increased environmental perturbations attributed to the predominant sedimentation of organic carbon-rich fine siliciclastic and carbonate deposits of the Khatatba Formation. Although some studies have addressed the hydrocarbon potential and source rock characteristics of the Khatatba Formation, a regional-scale investigation of the prevalent paleoenvironmental conditions and organic matter characteristics is still necessary. In this study, the Khatatba Formation is investigated for detailed palynofacies analysis and palynomorph composition to assess organic matter kerogen types and reconstruct the depositional paleoenvironmental patterns on a regional scale. For this purpose, 116 drill cuttings were collected from five wells in the Matruh, Shushan, and Dahab-Mireir Basins. Moderately diverse assemblages of spores, pollen, and dinoflagellate cysts are reported. Age-diagnostic dinoflagellate cysts, including Adnatosphaeridium caulleryi, Dichadogonyaulax sellwoodii, Korystocysta gochtii, Wanaea acollaris, and Pareodinia ceratophora, along with occasional records of Systematophora areolate and Systematophora penicillate, defined a Bajocian–Callovian age. Based on particulate organic matter (POM) composition, four palynofacies assemblages (PFAs) are identified. PFA-1 is the most common within the Khatatba Formation in the five studied wells. It contains high proportions of phytoclast fragments versus low contents of amorphous organic matter (AOM) and palynomorphs and is defined by a gas-prone kerogen Type III. PFA-2 is comprised of moderate abundances of AOM and phytoclast characteristics of oil-prone kerogen Type II. PFA-3 is dominated by phytoclasts and moderate to low proportions of AOM and palynomorphs of kerogen Type III, whereas PFA-4 consists of AOM and palynomorphs defining kerogen Type II. PFA-1 indicates predominant deposition in proximal active fluvio-deltaic sources to marginal marine conditions with enhanced contributions of terrestrial/riverine influx. PFA-2 and PFA-3 reveal deposition under an enhanced dysoxic to anoxic proximal inner neritic shelf due to the abundant occurrences of spores and coastal to shallow marine dinoflagellate cysts. PFA-4 suggests deposition under enhanced suboxic to anoxic distal inner neritic conditions because of enhanced AOM and abundant proximate and some chorate dinoflagellate cysts. Thus, the Middle Jurassic experienced a predominantly marginal to shallow water column in this part of the southern margin of the Tethyan Ocean where the Matruh, Shushan, and Dahab-Mireir Basins were located

Phase I Study Assessing the Pharmacokinetic Profile, Safety, and Tolerability of a Single Dose of Ceftazidime-Avibactam in Hospitalized Pediatric Patients.

This study aimed to investigate the pharmacokinetics (PK), safety, and tolerability of a single dose of ceftazidime-avibactam in pediatric patients. A phase I, multicenter, open-label PK study was conducted in pediatric patients hospitalized with an infection and receiving systemic antibiotic therapy. Patients were enrolled into four age cohorts (cohort 1, ≥12 to <18 years; cohort 2, ≥6 to <12 years; cohort 3, ≥2 to <6 years; cohort 4, ≥3 months to <2 years). Patients received a single 2-h intravenous infusion of ceftazidime-avibactam (cohort 1, 2,000 to 500 mg; cohort 2, 2,000 to 500 mg [≥40 kg] or 50 to 12.5 mg/kg [<40 kg]; cohorts 3 and 4, 50 to 12.5 mg/kg). Blood samples were collected to describe individual PK characteristics for ceftazidime and avibactam. Population PK modeling was used to describe characteristics of ceftazidime and avibactam PK across all age groups. Safety and tolerability were assessed. Thirty-two patients received study drug. Mean plasma concentration-time curves, geometric mean maximum concentration (Cmax), and area under the concentration-time curve from time zero to infinity (AUC0-∞) were similar across all cohorts for both drugs. Six patients (18.8%) reported an adverse event, all mild or moderate in intensity. No deaths or serious adverse events occurred. The single-dose PK of ceftazidime and avibactam were comparable between each of the 4 age cohorts investigated and were broadly similar to those previously observed in adults. No new safety concerns were identified. (This study has been registered at ClinicalTrials.gov under registration no. NCT01893346.)

Shock waves in two-dimensional granular flow: effects of rough walls and polydispersity

We have studied the two-dimensional flow of balls in a small angle funnel, when either the side walls are rough or the balls are polydisperse. As in earlier work on monodisperse flows in smooth funnels, we observe the formation of kinematic shock waves/density waves. We find that for rough walls the flows are more disordered than for smooth walls and that shock waves generally propagate more slowly. For rough wall funnel flow, we show that the shock velocity and frequency obey simple scaling laws. These scaling laws are consistent with those found for smooth wall flow, but here they are cleaner since there are fewer packing-site effects and we study a wider range of parameters. For pipe flow (parallel side walls), rough walls support many shock waves, while smooth walls exhibit fewer or no shock waves. For funnel flows of balls with varying sizes, we find that flows with weak polydispersity behave qualitatively similar to monodisperse flows. For strong polydispersity, scaling breaks down and the shock waves consist of extended areas where the funnel is blocked completely.Comment: 11 pages, 15 figures; accepted for PR

PROTECTIVE ROLE OF POMEGRANATE JUICE BLENDED WITH WHEATGRASS AND LEMON EXTRACTS FOR RELIEVE CARBOHYDRATE INTOLERANCE

Characteristics and protective effect of pomegranate juice (PJ), lemon juice (LJ), wheatgrass juice (WGJ) and their functional blends were evaluated. Total phenolics (TP), flavonoids (TF) content as well as free radical scavenging activity were determined. Meanwhile, total acidity, pH values were determined and the organoleptic attributes were evaluated. Also, the protective effect of functional blending juice against carbohydrate intolerance in patients was investigated by hydrogen breath test.  The results revealed that the WGJ are low acidic in nature. While, the PJ and LJ showed high acidity which raised the total acidity in the functional blending juice. PJ had high content of total phenolics 17.45 mg/ml followed by 5.85 mg/ml for functional blending juice. While, the LJ showed high acidity which raised the total acidity in the in the functional blending juice. PJ had high content of total phenolics 17.45 mg/ml followed by 13.25 mg/ml for functional blending juice. While, significant increase in the TF 22.15 mg/ml in the wheatgrass juice followed by functional blending juice 5.70 mg/ml significant increase in the TF 25.25 mg /ml in the functional blending juice followed by 22.15 mg/ml for wheatgrass juice. Whereas, the results showed that functional blending juice recorded the highest antioxidant activity, which revealed great free radical scavenging activity 98.16%. Depending on sensory evaluation, the proportions of fourth blend WGJ: PJ: LJ in ratio 20:70:10 was most preferred for consumption by the panelists compared to other blending ratios.  After one month for patients group treated by functional blending juice at blinds ratio (WGJ 20: PJ 70: LJ 10), showed a significant decrease in the concentration of the hydrogen level in the exhalation air to reach a significant level of the control patients group, indicating the ability of the active compounds in functional blending juice to relieve the problems of carbohydrate intolerance. Accordingly, healthy promoting beverages can be produced by addition blending of pomegranate juice, lemon juice and wheatgrass juice

Spectral-Domain Optical Coherence Tomography of Preclinical Chloroquine Maculopathy in Egyptian Rheumatoid Arthritis Patients

Purpose. To evaluate the role of spectral-domain optical coherence tomography (SD-OCT) in early detection of Chloroquine maculopathy in rheumatoid arthritis (RA) patients. Methods. 40 left eyes of 40 female rheumatoid arthritis patients who received treatment chloroquine for more than one year were recruited in the study. All patients had no symptoms or signs of Chloroquine retinopathy. They were evaluated using SD-OCT, where the Central Foveal Thickness (CFT), parafoveal thickness and perifoveal thickness, average Retinal Nerve Fiber Layer (RNFL) thickness, and Ganglion Cell Complex (GCC) measurements were measured and compared to 40 left eyes of 40 normal females. Results. The mean CFT was found to be thinner in the Chloroquine group (238.15 µm ± 22.49) than the normal controls (248.2 µm ± 19.04), which was statistically significant (p value = 0.034). The mean parafoveal thickness was lesser in the Chloroquine group than the control group in all quadrants (p value 0.05) in all quadrants. No significant difference was detected between the two groups regarding RNFL, GCC, or IS/OS junction. Conclusions. Preclinical Chloroquine toxicity can lead to early thinning in the central fovea as well as the parafoveal regions that is detected by SD-OCT