The use of mitomycin C with autologous limbal-conjunctival autograft transplantation for management of recurrent pterygium

Mohamed A FakhryDepartment of Ophthalmology, Kasr El Aini Hospital, Cairo University, Cairo, EgyptPurpose: The purpose of this study is to evaluate and compare recurrence rates upon using mitomycin C (MMC) with limbal-conjunctival autograft for treating recurrent pterygia.Methodology: An interventional, prospective, comparative clinical study was performed in 30 eyes (26 patients) with recurrent pterygia, allocated into two groups: Group A (19 eyes) operated by pterygium excision and limbal-conjunctival autograft transplantation (L-CAT) without MMC and Group B (20 eyes) operated with injection of 0.1 mL of MMC 0.15 mg/mL 1 month before L-CAT surgery. Exclusion criteria included patients with symblepharon, cicatricial conjunctival diseases, limbal stem cell deficiency, and other intraocular diseases.Results: A total of four cases of recurrences for Group A (P = 0.012) and one case of recurrence for Group B (P < 0.001) were recorded.Conclusions: Preoperative injection of MMC in low dose and concentration improves the results of L-CAT in recurrent pterygium.Keywords: recurrent pterygium, limbal autograft, conjunctival autograft, mitomycin

Evaluation of intralesional propranolol for periocular capillary hemangioma

Ahmed Awadein, Mohamed A FakhryCairo University Faculty of Medicine, Cairo, EgyptBackground: The purpose of this study was to evaluate the use of intralesional propranolol injection in the management of periocular capillary hemangioma.Methods: A prospective study was performed in 22 consecutive patients with periocular hemangioma. Twelve patients underwent intralesional propranolol injection and ten patients underwent intralesional triamcinolone injection. The size of the lesion was measured serially every week during the first month, every 2 weeks for the second month, and then monthly for another 2 months. The refractive error and degree of ptosis if present were measured before injection and at the end of the study.Results: There was reduction in the size of hemangioma, astigmatic error, and degree of ptosis in both groups. The difference in outcome between both groups was not statistically significant. Rebound growth occurred in 25% of the propranolol group and 30% of the steroid group but responded to reinjection. No adverse effects were reported during or after intralesional propranolol injection.Conclusion: Intralesional propranolol injection is an alternative and effective method for treatment of infantile periocular hemangioma.Keywords: propranolol, intralesional, periocular capillary hemangiom

A dramatic decline in university hospital admissions of acute rheumatic fever in the eastern region of Saudi Arabia

AbstractBackgroundsAcute rheumatic fever (ARF) and its sequel, chronic valvular heart disease are the most important causes for cardiovascular morbidity and mortality worldwide and mainly in developing countries. However, the incidence of ARF has declined in developed countries during the second half of 20th century.Material and methodsThe case files of all patients admitted as new cases of ARF over ∼11 years and 8 months, both in pediatric and medical departments of a university hospital located in the eastern region of Saudi Arabia were reviewed. The demographic and clinical data and the frequency of the new cases were compared with the data that have been published by us 10 years ago from the same hospital during a similar period of time (11 years and 8 months).ResultsIn the current study there was a significant decline in the frequency of admission of cases of ARF as compared to our previous study during a similar period of time, with a frequency rate of 12 cases per 100.000 hospitalizations versus 45 cases per 100.000 hospitalizations, respectively, P<0.001. Dyspnea and chest pain as clinical features of acute rheumatic carditis (ARC) were less frequent in the current study as compared to the previous study (35% versus 44%, P=0.02 and 10% versus 28.6%, P=0.031). The subgroup analysis revealed also a decreased frequency of the clinical features of ARC in pediatric age group in the current study as compared to our previous study.ConclusionThere is a significant decline in the frequency of new hospital admissions due to ARF. This decline was associated with similar decline in the frequency of the manifestations of ARC especially in pediatric age group (1–12 years)

Die Entwicklung des deutschen Pluralsystems im 20. Jahrhundert

Die vorliegende Arbeit behandelt in fünf Kapiteln die Entwicklung des deutschen Pluralsystems im 20. Jahrhundert. Es wird die Frage verfolgt, ob es innerhalb des deutschen Pluralsystems zu einer Ab- und Zunahme der verschiedenen Klassen von Pluralformen (-e, -e, (e)n, -er, -0) kommt, ob sich vielleicht bestimmte Tendenzen durch den Vergleich zwischen den Pluralklassen im untersuchten Zeitraum erkennen lassen, und ob sich Veränderungen im Pluralsystem zeigen. Es geht aber nicht nur um die Pluralbildung der nativen Wörter, sondern auch um die aus fremden Sprachen übernommenen Substantive, bei denen sich besondere Schwierigkeiten innerhalb des deutschen Pluralsystems ergeben. Ich habe bei der Unterscheidung zwischen produktiven und unproduktiven Pluralformen die Hypothese bestätigt, dass die Klassen der Nomen mit produktiven Pluralformen neue Mitglieder bekommen und wenige alte verlieren. Im Gegenteil dazu verringert sich die Anzahl der Wörter mit unproduktiven Pluralformen im untersuchten Zeitraum von 1904 bis 2000 zusehends. Diese Entwicklungen und andere Ergebnisse konnte ich anhand der erstellten Datenbank und der Untersuchung der relevanten Literatur feststellen

Torsional ultrasound mode versus combined torsional and conventional ultrasound mode phacoemulsification for eyes with hard cataract

Mohamed A Fakhry1,2, Malak I El Shazly11Department of Ophthalmology, Kasr El Aini Hospital, Cairo University, Cairo, Egypt; 2Cataract and Refractive Consultant, International Eye Hospital, Cairo, EgyptPurpose: To compare torsional versus combined torsional and conventional ultrasound modes in hard cataract surgery regarding ultrasound energy and time and effect on corneal endothelium.Settings: Kasr El Aini hospital, Cairo University, and International Eye Hospital, Cairo, Egypt.Methodology: Ninety-eight eyes of 63 patients were enrolled in this prospective comparative randomized masked clinical study. All eyes had nuclear cataracts of grades III and IV using the Lens Opacities Classification System III (LOCS III). Two groups were included, each having an equal number of eyes (49). The treatment for group A was combined torsional and conventional US mode phacoemulsification, and for group B torsional US mode phacoemulsification only. Pre- and post-operative assessments included best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp evaluation, and fundoscopic evaluation. Endothelial cell density (ECD) and central corneal thickness (CCT) were measured preoperatively, 1 day, 7 days, and 1 month postoperatively. All eyes were operated on using the Alcon Infiniti System (Alcon, Fort Worth, TX) with the quick chop technique. All eyes were implanted with AcrySof SA60AT (Alcon) intraocular lens (IOL). The main phaco outcome parameters included the mean ultrasound time (UST), the mean cumulative dissipated energy (CDE), and the percent of average torsional amplitude in position 3 (%TUSiP3).Results: Improvement in BCVA was statistically significant in both groups (P &amp;lt; 0.001). Comparing UST and CDE for both groups revealed results favoring the pure torsional group (P = 0.002 and P &amp;lt; 0.001 for UST; P = 0.058 and P = 0.009 for CDE). As for %TUSiP3, readings were higher for the pure torsional group (P = 0.03 and P = 0.01). All changes of CCT, and ECD over time were found statistically significant using one-way ANOVA testing (P &amp;lt; 0.001).Conclusion: Both modes are safe in hard cataract surgery, however the pure torsional mode showed less US energy used.Keywords: torsional, cumulative dissipated energy, cataract&amp;nbsp

Smoking counseling practices of physicians in the United Arab Emirates

Background. Despite the cost effectiveness of physician smoking cessation counseling, many physicians do not adhere to current clinical practice guidelines. Methods. A cross-sectional mail survey was conducted in a sample of general practitioners in the United Arab Emirates (UAE), emirates of Sharjah, Dubai and Abu Dhabi, to document cessation-counseling practices and identify correlates of these activities. Results. Of 391 eligible GPs, 218 (56%) completed the questionnaire. Despite favorable beliefs/attitudes about cessation counseling, less than half of GPs (47%) indicated that they have the skills to help their patients quit smoking and only 24% knew of community resources to refer patients to. GPs who perceived physician barriers in offering smoking counseling as very important were significantly less likely to ascertain smoking status of most of their patients (OR: 0.28, 95% CI: 0.09,0.88). Moreover, high self-efficacy and favorable beliefs/attitudes were significantly associated with high level of counseling completeness (OR: 4.44, 95% CI: 1.21, 16.37; OR: 3.78, 95% CI: 1.25, 11.35; respectively). Conclusion. Support, training and intervention programs to overcome lack of awareness and knowledge, unfavorable beliefs/attitudes, and low self-efficacy could increase and enhance cessation-counseling practices among general practitioners in the UAE. © 2010, SAGE Publications. All rights reserved

Die Entwicklung des deutschen Pluralsystems im 20. Jahrhundert

Die vorliegende Arbeit behandelt in fünf Kapiteln die Entwicklung des deutschen Pluralsystems im 20. Jahrhundert. Es wird die Frage verfolgt, ob es innerhalb des deutschen Pluralsystems zu einer Ab- und Zunahme der verschiedenen Klassen von Pluralformen (-e, -e, (e)n, -er, -0) kommt, ob sich vielleicht bestimmte Tendenzen durch den Vergleich zwischen den Pluralklassen im untersuchten Zeitraum erkennen lassen, und ob sich Veränderungen im Pluralsystem zeigen. Es geht aber nicht nur um die Pluralbildung der nativen Wörter, sondern auch um die aus fremden Sprachen übernommenen Substantive, bei denen sich besondere Schwierigkeiten innerhalb des deutschen Pluralsystems ergeben. Ich habe bei der Unterscheidung zwischen produktiven und unproduktiven Pluralformen die Hypothese bestätigt, dass die Klassen der Nomen mit produktiven Pluralformen neue Mitglieder bekommen und wenige alte verlieren. Im Gegenteil dazu verringert sich die Anzahl der Wörter mit unproduktiven Pluralformen im untersuchten Zeitraum von 1904 bis 2000 zusehends. Diese Entwicklungen und andere Ergebnisse konnte ich anhand der erstellten Datenbank und der Untersuchung der relevanten Literatur feststellen

Developing and Validating of a Managerial Procedures Manual for Head Nurses

The managerial skills are a set of behaviors based on knowledge that can be learned through procedure. Procedures are descriptions of how to carry out an activity. Procedures manual is essential to ensure consistency and quality in products and services. The aim of this study was to develop and validate a managerial procedure manual for head nurses at Ain-shams University Hospital. The study was conducted in Ain Shams University Hospital using operational design. It included a group of 78 head nurses for assessment and a jury group consisting of 16 faculty members of Nursing Administration and 8 nursing directors and assistants. Data were collected using a head nurses' self-administered questionnaire and opinionnaire form for the jury group. The researchers discussed the idea of the study with representatives of the hospital administration to reach to an agreement regarding the importance of the proposed manual and its content, then assessed head nurses’ view of the importance of a managerial manual. The results showed that 25.6% of the head nurses did not know about the presence of a manual for managerial nursing procedures, 96.2% expressed the need for such manual, and 70.7% reported having faced problems due to lack of such manual. Based on analysis of the data the researchers developed the manual that was validated by the jury group, and distributed to head nurses after approval of the hospital administration. The hospital administration participated in all steps of the development of the manual, and adopted its use in the setting. The effectiveness of the manual in reducing head nurses' stress related to managerial problems needs to be assessed after a few months of implementation. Key words: Head nurse, Manual, Managerial skills and Managerial procedure

Use of 2-{[5-(2-Amino-4-oxoquinazolin-3(4H)-yl)-1,3,4-thiadiazol-2-yl]methyl}-1H-isoindole-1,3(2H)-dione in the Synthesis of Novel Quinazolinone Derivatives

The 2-{[5-(2-Amino-4-oxoquinazolin-3(4H)-yl)-1,3,4-thiadiazol-2-yl]methyl}-1H-isoindole-1,3(2H)-dione 1 was synthesized and allowed to react with each of  p-methoxybenzaldehyde,  p-methoxyacetophenone and chloroacetyl chloride to produce the Schiff bases 2 and 3 and 2-chloro-N-(3-{5-[(1,3-dioxo-1,3-dihydro-2H-isoindol-2-yl)methyl]-1,3,4-thiadiazol-2-yl}-4-oxo-3,4-dihydroquinazolin-2-yl)acetamide 6, respectively. The products 2 and 3 were reacted with phenyl isothiocyanate to afford 4 and 5. Derivative 6 was reacted with various nucleophiles, namely: thioglycolic acid, ethyl glycinate and 2-aminoethanol giving 7-9 respectively. In turn, the derivative 8 was reacted with α-bromoglucose tetraacetate affording product 8a whereas 9 was reacted with p-acetylaminobenzenesulfonyl chloride affording derivative 9a. Moreover, the reactions of the derivative 6 with potassium thiocyanate, potassium cyanate, malonitrile, ethyl cyanoacetate and ammonium acetate gave derivatives 10-15, respectively. All the synthesized derivatives were confirmed by the IR, mass, 1H-NMR and elemental analysis. Key words: Quinazolinyl thiazolidine, thioxodiazetidinyl quinazoline, piperazinyl quinazolinone, thiomorpholine and  triazinoquinazoline

Use of 2-Ethoxy(4H)-3,1-benzoxazin-4-one as a Precursor for Synthesis of Quinazoline and Quinazolinone Starting Materials

The interactions of 2-ethoxy(4H)-3,1-benzoxazin-4-one (1) with various nitrogen nucleophiles such as ammonium acetate,  hydrazine hydrate, ethanolamine, p-phenylenediamine, o-phenylenediamine, o-tolidine, dapsone, 2-aminophenol, 4-aminophenol, 4-aminobenzoic acid and 2-aminonicotinic acid have been discussed. The reactions of 2-thoxy-(3H)-quinazolin-4-one with ethyl chloroformate, phosphorus pentasulfide, chloroacetyl chloride and phosphorus oxychloride have also been investigated. Similar reactions of 2-ethoxy-4-chloroquinazoline with hydrazine hydrate and thiosemicarbazide have been introduced. Aminolysis of the 2-ethoxy group in some of the thiadiazoloquinazolinone derivatives has been attempted. The interactions of these aminolized derivatives and the 3-aminoquinazolinone with chloroacetyl chloride have been studied. All of the synthesized derivatives have been used in a wide range as starting materials for the synthesis of novel quinazoline and/or quinazolinones which have biological activity. The structures of all these products, obtained by heterocyclic ring opening and ring closure, were inferred by the IR, MS, 1H NMR spectral as well as elemental analyses. Keywords: Aminothiadiazole, Benzoxazin-4-one, N-nucleophile, quinazoline, quinazolin-4-one, thiosemicarbazide